Dr. Hive - should I be concerned about white blood cell count?

[Kassia]

My white blood cell count was always in the normal range until I went for my last physical in September.  It's been checked a few times and it's always in the low 3s now.  I had blood drawn on Monday and my level was 3.1 (the normal range starts at 4.5).  I'm also mildly anemic, but that isn't really anything new - it's the wbc count that is new.  

Should I be concerned?  I don't have any faith in my doctor - she wants me to either recheck in 6-8 weeks or see a hematologist.  Since September, she's referred me to a kidney doctor, GI, vascular doctor, and neurologist.  IMO, I only needed to see the vascular doctor.  She also had me have other unnecessary expensive tests even though I have told her I need to be very careful with medical expenses.  

 

 

[TCB]

1 hour ago, Kassia said:

My white blood cell count was always in the normal range until I went for my last physical in September.  It's been checked a few times and it's always in the low 3s now.  I had blood drawn on Monday and my level was 3.1 (the normal range starts at 4.5).  I'm also mildly anemic, but that isn't really anything new - it's the wbc count that is new.  

Should I be concerned?  I don't have any faith in my doctor - she wants me to either recheck in 6-8 weeks or see a hematologist.  Since September, she's referred me to a kidney doctor, GI, vascular doctor, and neurologist.  IMO, I only needed to see the vascular doctor.  She also had me have other unnecessary expensive tests even though I have told her I need to be very careful with medical expenses.  

 

 

Are you taking any meds regularly? Some can affect WBC.

[Kassia]

20 minutes ago, TCB said:

Are you taking any meds regularly? Some can affect WBC.

No meds at all other than supplements/vitamins.

[TCB]

23 minutes ago, Kassia said:

No meds at all other than supplements/vitamins.

I was taking a PPI for a year or so and my WBC was slightly low when checked. I decided to wean myself off and it was back to normal after I got off that particular one. I’ve now been able to stop PPIs completely, thankfully. They do a wonderful job treating heartburn etc but do worry me about other effects. I would probably check into the supplements just to see if they do anything weird like that.

[TravelingChris]

Are all those referrals just for the white blood cell problem or are you having other issues than anemia and the low white blood cells?

Did you come to her w any complaints?

As to the blood issues, why see a vascular doctor versus vs hemotologist?   As a person who has seen almost all the specialist except a neohrologist (kidney issues) and saw my first vascular specialist last week, vascular doctors only deal with veins and arteries but not the blood.  Hematolog8st would be the specialist about blood disorders.

Because w all the referrals she us giving you plus all the blood tests she wants you to have, I suspect ghat she either thinks you have some very serious issues or is s complete idiot,and I think it is the former. unfortunately.

[TravelingChris]

And yes, people like me have consistently lower parts of my wbc but I have a number of autoimmune illnesses.  

Having both low rbc and low wbc is what is very troubling.  Again, people with RA and lupus get this (I have both) but so do people w even more serious issues- life threatening issues..

What blood tests did she order that you didn't have done?  You can pm me if you don't want to discuss here.

 

[Kassia]

30 minutes ago, TravelingChris said:

Are all those referrals just for the white blood cell problem or are you having other issues than anemia and the low white blood cells?

Did you come to her w any complaints?

As to the blood issues, why see a vascular doctor versus vs hemotologist?   As a person who has seen almost all the specialist except a neohrologist (kidney issues) and saw my first vascular specialist last week, vascular doctors only deal with veins and arteries but not the blood.  Hematolog8st would be the specialist about blood disorders.

Because w all the referrals she us giving you plus all the blood tests she wants you to have, I suspect ghat she either thinks you have some very serious issues or is s complete idiot,and I think it is the former. unfortunately.

The referrals were for some other issues.  

The vascular doctor was referred because I have raynaud's w/poor circulation to my fingers, which causes awful chilblains.  The vascular doctor was fantastic and I really liked her.

I saw the nephrologist (total quack) because my sodium levels have been very low.  That is my fault because I drink way too many fluids.  

The GI doctor was referred because my liver enzymes have been elevated, but only mildly and I don't think there are any problems there so I'm not going.  The neurologist was referred because she suspected postprandial syndrome, but I'm not going for that.  Oh, and she also referred me to an endocrinologist for possible blood sugar issues (I think that could be valid).  

I do wonder if I have autoimmune issues, but she tested me for some things related to that and the results were normal.  

I went to her for a physical in September complaining of fatigue and feeling fuzzy/weak/shaky that seemed to be related to eating, but could also be caused by the low sodium levels.  She's a terrible doctor and I really need to find someone better, but we've had terrible luck with doctors and I'm just tired of investing time and money for bad medical care/advice.  

Thank you for your response!  I'm sorry about your health issues.  Do you think 3.1 white blood cell count is something I should be concerned about?  I didn't realize sodium was a big deal until my doctor completely freaked out about it and said she would have to hospitalize me if it dropped any lower.  

 

 

 

 

 

 

 

[melmichigan]

If you have always been in the normal range, and you are now consistently testing around 3.1, there is an issue somewhere that is worth having checked. I would consider checking with the vascular doctor when choosing whom to be referred to since your faith in your own doctor is limited.

Edited December 31, 2020 by melmichigan

[TravelingChris]

1 hour ago, Kassia said:

The referrals were for some other issues.  

The vascular doctor was referred because I have raynaud's w/poor circulation to my fingers, which causes awful chilblains.  The vascular doctor was fantastic and I really liked her.

I saw the nephrologist (total quack) because my sodium levels have been very low.  That is my fault because I drink way too many fluids.  

The GI doctor was referred because my liver enzymes have been elevated, but only mildly and I don't think there are any problems there so I'm not going.  The neurologist was referred because she suspected postprandial syndrome, but I'm not going for that.  Oh, and she also referred me to an endocrinologist for possible blood sugar issues (I think that could be valid).  

I do wonder if I have autoimmune issues, but she tested me for some things related to that and the results were normal.  

I went to her for a physical in September complaining of fatigue and feeling fuzzy/weak/shaky that seemed to be related to eating, but could also be caused by the low sodium levels.  She's a terrible doctor and I really need to find someone better, but we've had terrible luck with doctors and I'm just tired of investing time and money for bad medical care/advice.  

Thank you for your response!  I'm sorry about your health issues.  Do you think 3.1 white blood cell count is something I should be concerned about?  I didn't realize sodium was a big deal until my doctor completely freaked out about it and said she would have to hospitalize me if it dropped any lower.  

 

 

 

 

 

 

 

Raynaud\s is autoimmune.

[Kassia]

8 hours ago, melmichigan said:

If you have always been in the normal range, and you are now consistently testing around 3.1, there is an issue somewhere that is worth having checked. I would consider checking with the vascular doctor when choosing whom to be referred to since your faith in your own doctor is limited.

Thanks.  That is a good idea.  

 

7 hours ago, TravelingChris said:

Raynaud\s is autoimmune.

 It can be, but I don't think it always is.  My DH and dd have it, but neither of them have any other issues.  

ETA - I did have blood tests done a few months ago to check for autoimmune issues, but everything seemed ok.  I've always suspected autoimmune because of my symptoms.  Could I have normal blood test results and still have some kind of autoimmune disease?  

 

 

Edited December 31, 2020 by Kassia

[ktgrok]

19 hours ago, TravelingChris said:

And yes, people like me have consistently lower parts of my wbc but I have a number of autoimmune illnesses.  

Having both low rbc and low wbc is what is very troubling.  Again, people with RA and lupus get this (I have both) but so do people w even more serious issues- life threatening issues..

What blood tests did she order that you didn't have done?  You can pm me if you don't want to discuss here.

 

This. If it was one or the other...maybe wait and see. Both is concerning, and yes, I'd see a hematologist ASAP. And bring all your other lab tests and a list of symptoms. 

[Kassia]

9 minutes ago, ktgrok said:

This. If it was one or the other...maybe wait and see. Both is concerning, and yes, I'd see a hematologist ASAP. And bring all your other lab tests and a list of symptoms. 

Thank you.  Do you feel this way even if RBC/Hemoglobin/Hematocrit were just a little low (but consistently dropping).  I was really hoping to just wait six weeks and retest.  I hate going to doctors - I've had such bad experiences and they are so expensive.  😞  

[Martha in GA]

My wbc (generally about 3.4, but has been as low as 2.3) has been low for many years, but my doctor doesn't seem too concerned about it. He just said I had leukopenia and that some people normally have low wbc. I don't know if it has always been low, or if I just developed that as I got older. I do have Hashimoto's, but I don't know if that plays into it or not. My rbc is normal, though.

[Kassia]

10 minutes ago, Martha in GA said:

My wbc (generally about 3.4, but has been as low as 2.3) has been low for many years, but my doctor doesn't seem too concerned about it. He just said I had leukopenia and that some people normally have low wbc. I don't know if it has always been low, or if I just developed that as I got older. I do have Hashimoto's, but I don't know if that plays into it or not. My rbc is normal, though.

 

Thank you!  My wbc was always in the middle of the normal range until I had my physical in September and it has stayed low since then.  I don't know if this is my "new normal" or if it's something to be concerned about.  Do you know if your low wbc means you are more susceptible to infection? 

[Martha in GA]

I have never had a problem with being more susceptible to infection -- I've never had the flu, and I very rarely get a cold (maybe every two or three years?). I'm hoping I don't get COVID, lol.

[Kassia]

15 minutes ago, Martha in GA said:

I have never had a problem with being more susceptible to infection -- I've never had the flu, and I very rarely get a cold (maybe every two or three years?). I'm hoping I don't get COVID, lol.

I never get sick either.  But I haven't been out at all since this change in my CBC (due to Covid) and was wondering if I'm at higher risk now.

[ktgrok]

2 hours ago, Kassia said:

Thank you.  Do you feel this way even if RBC/Hemoglobin/Hematocrit were just a little low (but consistently dropping).  I was really hoping to just wait six weeks and retest.  I hate going to doctors - I've had such bad experiences and they are so expensive.  😞  

Consistently dropping is definitely concerning. Here is the thing that no one s wanting to say. This could be nothing...but it could be bone marrow related, including possibly cancer. And if it is cancer, you need to know sooner rather than later. So not like say, blood sugar or thyroid or whatever where it is ok to wait and see....this is a "probably not the worst case, but it could be, so you need to find out ASAP so you can treat it on the off chance it is". 

Again, not saying it is cancer, or even probably or even likely cancer. But it's a red flag, and needs to be checked. 

 

[Ditto]

2 minutes ago, ktgrok said:

Consistently dropping is definitely concerning. Here is the thing that no one s wanting to say. This could be nothing...but it could be bone marrow related, including possibly cancer. And if it is cancer, you need to know sooner rather than later. So not like say, blood sugar or thyroid or whatever where it is ok to wait and see....this is a "probably not the worst case, but it could be, so you need to find out ASAP so you can treat it on the off chance it is". 

Again, not saying it is cancer, or even probably or even likely cancer. But it's a red flag, and needs to be checked. 

 

This.

As smart as the hive is, this is beyond what we are capable of.  The bottom line is that only  a hematologist can assess accurately what is going on.  The answers can't be found on the internet or on WTM.    I agree with all those that said that you need to take all of your lab records to a hematologist and it needs to be done now.

[Kassia]

4 minutes ago, ktgrok said:

Consistently dropping is definitely concerning. Here is the thing that no one s wanting to say. This could be nothing...but it could be bone marrow related, including possibly cancer. And if it is cancer, you need to know sooner rather than later. So not like say, blood sugar or thyroid or whatever where it is ok to wait and see....this is a "probably not the worst case, but it could be, so you need to find out ASAP so you can treat it on the off chance it is". 

Again, not saying it is cancer, or even probably or even likely cancer. But it's a red flag, and needs to be checked. 

 

Thank you.  I am not worried that it's cancer, but I would definitely want to rule it out if a specialist thinks it's a possibility.  I appreciate your honesty because I am really ignorant about all of this and don't trust my family doctor at all.  

[ktgrok]

28 minutes ago, Kassia said:

Thank you.  I am not worried that it's cancer, but I would definitely want to rule it out if a specialist thinks it's a possibility.  I appreciate your honesty because I am really ignorant about all of this and don't trust my family doctor at all.  

Well, keep in mind that although I come from a long line of nurses, my own background and degree are in animal medicine, not human, lol. But...bone marrow is bone marrow and a lot overlaps 🙂

[Kassia]

19 minutes ago, ktgrok said:

Well, keep in mind that although I come from a long line of nurses, my own background and degree are in animal medicine, not human, lol. But...bone marrow is bone marrow and a lot overlaps 🙂

I appreciate you taking the time to share your honest thoughts with me!  

[Pen]

https://www.lifeextension.com/protocols/heart-circulatory/raynauds-phenomenon

fwiw

I think a good haematologist does sound like a good idea to be safe as to some severe things that could potentially have low wbc as a sign as others have mentioned.  
 

Although  for the low wbc plus fatigue etc symptoms, I also have impression / experience that things like Lyme/Tick borne illnesses can cause those and probably would not be what a hematologist would be looking for. 

[Pen]

I guess if I were trying to save money I might prioritize who to start with according to my own sense of likelihood of the problem , so for example, where I live a tick borne illness would be very likely compared to some other possibilities. But that might be quite different analysis depending on ones personal environment and activities.   If in South America maybe something completely different like Chagas would be more likely. 
 

A completely different approach could be to seek a more “generalist” toward restoring health like in “Functional Medicine” rather than specialists. 

Edited January 1, 2021 by Pen

[Kassia]

1 minute ago, Pen said:

I guess if I were trying to save money I might prioritize who to start with according to my own sense of likelihood of the problem , so for example, where I live a tick borne illness would be very likely compared to some other possibilities. But that might be quite different analysis depending on ones personal environment and activities.   If in South America maybe something completely different like Chagas would be more likely. 

Thank you!  We do have ticks here, but I am rarely outside where they would be (I run, but only on the road).  I doubt Lyme would be an issue.  I am thinking of going to the hematologist to rule out anything serious, but I hate to spend any more money.  I've spent so much on medical expenses in the past three years and I hate to start the year with more expenses just to rule things out.  😞  

[BeachGal]

Any chance you could have had Covid? The fuzzy headedness is a symptom. Have you tested for it or for antibodies? Elevated liver enzymes are also one of the symptoms in some people. Leukopenia usually appears in more severe cases, though. Have you had a ferritin test recently?

Have you had any kind of GI surgery?

Edited January 1, 2021 by BeachGal

[Pen]

7 minutes ago, Kassia said:

Thank you!  We do have ticks here, but I am rarely outside where they would be (I run, but only on the road).  I doubt Lyme would be an issue.  I am thinking of going to the hematologist to rule out anything serious, but I hate to spend any more money.  I've spent so much on medical expenses in the past three years and I hate to start the year with more expenses just to rule things out.  😞  

I think what you need more than specific specialty is a superb diagnostician — especially someone who can perhaps figure things out even if not in her his specialty— but that that tends to be hard to find.  Without it though one can end up chasing from specialty to specialty .

[Kassia]

45 minutes ago, BeachGal said:

Any chance you could have had Covid? The fuzzy headedness is a symptom. Have you tested for it or for antibodies? Elevated liver enzymes are also one of the symptoms in some people. Leukopenia usually appears in more severe cases, though. Have you had a ferritin test recently?

Have you had any kind of GI surgery?

I've had two colon resections - 2018 and 2019.  My bloodwork was fine after those surgeries.  Do you think the surgeries could be connected to what's going on now?  

I doubt I've had Covid.  We are very careful and I haven't been in contact with anyone who has tested positive that I know of.  I've had the fuzzy head feeling for a while so it isn't anything new, but the elevated liver enzymes just started this year like the low wbc.  

No ferritin tests.

 

 

42 minutes ago, Pen said:

I think what you need more than specific specialty is a superb diagnostician — especially someone who can perhaps figure things out even if not in her his specialty— but that that tends to be hard to find.  Without it though one can end up chasing from specialty to specialty .

Exactly!  I need someone to look at all the pieces and figure this out.  Something is wrong, but I have no idea how it all fits together for a diagnosis.  

 

Edited January 1, 2021 by Kassia

[BeachGal]

2 hours ago, Kassia said:

I've had two colon resections - 2018 and 2019.  My bloodwork was fine after those surgeries.  Do you think the surgeries could be connected to what's going on now?  

I doubt I've had Covid.  We are very careful and I haven't been in contact with anyone who has tested positive that I know of.  I've had the fuzzy head feeling for a while so it isn't anything new, but the elevated liver enzymes just started this year like the low wbc.  

No ferritin tests.

 

 

Exactly!  I need someone to look at all the pieces and figure this out.  Something is wrong, but I have no idea how it all fits together for a diagnosis.  

 

Okay. No, I thought it was you who had those surgeries and was just verifying. My thinking is whether your microbiome could be playing a role in your white blood cell count but I don't think so.

Any chance you could give blood at a site that’ll test for Covid antibodies? The drawback is you’d be sitting in an enclosed space while they take your blood so you might not want to do that, either. I just wonder if you might have been asymptomatic. Even people who’ve been very careful have caught it and were completely asymptomatic. My youngest is an example of this. He was living with us for quite awhile and none of us were going out and took extreme measures to stay safe. I’m going to give blood to see if I have antibodies as well.

Anyway, this is just a preprint that looked at cases under age 18 but it mentions they did see leukopenia in mostly the asymptomatic cases. So, leukopenia plus your elevated liver enzymes, which they’re also seeing in some of the Covid cases, plus your fuzzy headedness — it’s possible you could have a wonky, lingering, low-grade case of Covid or the residual effects of it. Many long-haulers wax and wane with different symptoms for months. Just throwing this out as a possibility.

https://www.medrxiv.org/content/10.1101/2020.05.21.20074682v2

The number of asymptomatic COVID-19 infections with leukopenia were significantly more than confirmed cases (p=0.04). Conclusions: Leukopenia mostly occurred in asymptomatic COVID-19 infections under 18 years old compared with the confirmed patients.

 

Regardless, it is probably a good idea to find out what’s causing those low numbers. I hope you can get some helpful answers soon.

Edited January 1, 2021 by BeachGal

[Kassia]

6 minutes ago, BeachGal said:

Okay. No, I thought it was you who had those surgeries and was just verifying. My thinking is whether your microbiome could be playing a role in your white blood cell count but I don't think so.

Any chance you could give blood at a site that’ll test for Covid antibodies? The drawback is you’d be sitting in an enclosed space while they take your blood so you might not want to do that, either. I just wonder if you might have been asymptomatic. Even people who’ve been very careful have caught it and were completely asymptomatic. My youngest is an example of this. He was living with us for quite awhile and none of us were going out and took extreme measures to stay safe. I’m going to give blood to see if I have antibodies as well.

Anyway, this is just a preprint that looked at cases under age 18 but it mentions they did see leukopenia in mostly the asymptomatic cases. So, leukopenia plus your elevated liver enzymes, which they’re also seeing in some of the Covid cases, plus your fuzzy headedness — it’s possible you could have a wonky, lingering, low-grade case of Covid or the residual effects of it. Many long-haulers wax and wane with different symptoms for months. Just throwing this out as a possibility.

https://www.medrxiv.org/content/10.1101/2020.05.21.20074682v2

The number of asymptomatic COVID-19 infections with leukopenia were significantly more than confirmed cases (p=0.04). Conclusions: Leukopenia mostly occurred in asymptomatic COVID-19 infections under 18 years old compared with the confirmed patients.

 

Regardless, it is probably a good idea to find out what’s causing those low numbers. I hope you can get some helpful answers soon.

Thank you.  I can't give blood now if I'm anemic, but I could probably boost up my numbers if I take iron.  One of my sons is a frequent donor and we suspect he had covid in March (he wasn't living with us then and we hadn't seen him in months), but for some reason he never gets an antibody report.  

DH and I did have very mild cold symptoms for a couple of weeks early in the pandemic and I'm never sick so I do often wonder if we could have had very light cases.

[footballmom]

My recent health has a lot of parallels to yours - white blood count dropping, anemic, fatigue, dizziness.  I went to see a hematologist last month and he’s started me on iron infusions and vitamin b 12 shots.  I asked him about wbc and he wasn’t concerned based on my numbers, but go see a hematologist! He suspects my cycles are one cause of my severe anemia and may refer me to a GI doctor to look for gut issues.  The iron infusions and b12 injections have made a world of difference! I have energy! I don’t have sudden bursts of dizziness where I think I’m going to drop right there.  Based on your frustrations with general doc, I can’t recommend hematologist highly enough!

[Kassia]

10 minutes ago, footballmom said:

My recent health has a lot of parallels to yours - white blood count dropping, anemic, fatigue, dizziness.  I went to see a hematologist last month and he’s started me on iron infusions and vitamin b 12 shots.  I asked him about wbc and he wasn’t concerned based on my numbers, but go see a hematologist! He suspects my cycles are one cause of my severe anemia and may refer me to a GI doctor to look for gut issues.  The iron infusions and b12 injections have made a world of difference! I have energy! I don’t have sudden bursts of dizziness where I think I’m going to drop right there.  Based on your frustrations with general doc, I can’t recommend hematologist highly enough!

Thank you!  I did find a really good hematologist that is covered by our insurance - he actually treated my MIL and FIL.  

Glad you are feeling so much better!  That is wonderful!  🙂  I'm in menopause so don't have cycles, but I really want to feel better - I have days where I'm so weak and shaky.  

 

[TravelingChris]

On 12/31/2020 at 4:31 AM, Kassia said:

Thanks.  That is a good idea.  

 

 It can be, but I don't think it always is.  My DH and dd have it, but neither of them have any other issues.  

ETA - I did have blood tests done a few months ago to check for autoimmune issues, but everything seemed ok.  I've always suspected autoimmune because of my symptoms.  Could I have normal blood test results and still have some kind of autoimmune disease?  

 

 

Who did the blood tests is the first question.   If Labquest, they are a notoriously unreliable lab so yes.  Because another lab would havd positive results.

Secondly, yes in early stages of autoimmune disease.  And then in later stages, when you are taking lots of medications to improve your autoimmune diseases too.