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Fatigue And Low White Blood Cell Count

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Conditions That Affect The Bone Marrow

Low white blood cell count, fatigue and flu-like symptoms, battling cancer

Anything that interferes with the production of white blood cells in the bone marrow may potentially lead to leukopenia, including:

  • Infiltration of the bone marrow: Infiltration of the bone marrow can disrupt the process of blood cell formation. Metastases to the bone marrow can similarly lead to leukopenia. Cancers that tend to spread to the bone marrow include breast cancer, prostate cancer, colon cancer, melanoma, and stomach cancer.
  • Bone marrow disorders, including aplastic anemia, myelodysplastic syndromes, multiple myeloma, myelofibrosis

Ways To Prevent Covid

There may not be many ways to prevent having a low blood count. Typically, a low WBC count is the result of an infection or a condition, or of a medication that you need.

You can, however, take steps to protect yourself against COVID-19, and you should be extra vigilant with these steps if you know you have a low WBC count. Usually, people with low WBC counts are educated on how to prevent an infection, and much of that guidance mirrors the strategies to avoid COVID-19, such as:

  • Wear a mask.
  • Avoid large crowds, especially indoors.
  • Avoid people who are sick.
  • Clean and disinfect the areas around you frequently.

Unlike with some other infections like HIV, you can also be vaccinated against COVID-19. Recent spikes in infection have proven the effectiveness of the vaccine, with far more unvaccinated people being hospitalized with the virus than vaccinated people.

What Medications Cause Low White Blood Cells

Some medications can cause low white blood cells as a side effect.

Chemotherapy treatments are the medications most commonly associated with low white blood cells. These medications target rapidly dividing cancer cells, as well as rapidly dividing healthy cells. Radiation therapy, also used as a cancer treatment, can have the same effect.

Because white blood cells rapidly divide as the body frequently replaces them, chemotherapy treatments can prevent their healthy production.

Other medications known to cause low white blood cells include antibiotics, antihypertensives, antipsychotics, immunosuppressants, and anti-epilepsy drugs. These medications do not cause a low white blood cell count in everyone, and there may be a genetic predisposition to this side effect.

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Symptoms Of Acute Myeloid Leukemia

If the AML cancer cells, called blasts, become very high in number, they can cause a serious condition known as leukostasis, which literally means slowing of the normal blood flow due to congestion. This can lead to symptoms such as:

Some people with AML may have bone or joint pain if the leukemia builds up in the bone marrow in these areas.

If AML spreads to the skin, it can cause spots that look like a rash. Certain types of AML may affect the gums, causing pain, swelling, and bleeding. Enlarged lumps under the skin of the neck, groin, underarms, or collarbone are a sign that the cancer has spread to your lymph nodes.

When cancer cells collect in the liver or spleen, the organs may enlarge and cause swelling of the abdomen or a feeling of fullness.

People with a certain type of AML, known as acute promyelocytic leukemia , may have bleeding and clotting problems.

If AML spreads to your brain or spinal cord, it could cause:

  • Weakness

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Eat A Variety Of Fruits And Vegetables

Fatigue and an Elevated White Blood Cell Count

Fruits and vegetables contain vitamins, minerals, antioxidants, and phytochemicals. These compounds can help to support the normal functioning of white blood cells and the immune system overall. In particular, focus on the antioxidants vitamin A, C, E and selenium. Vitamin A can be found in red, orange, and yellow-hued fruits and vegetables, as well as dark leafy greens. It is best absorbed when eaten with some source of fat and a mixture of fresh and cooked sources. Vitamin C is found in citrus, berries, broccoli, bell peppers, kiwis, and Brussels sprouts. Limited cooking is best to preserve vitamin C content. Vitamin E is mostly found in nuts and seeds. Wheat germ, wheat germ oil, sunflower seeds, and sunflower seed butter at the best sources. Selenium is found in the highest concentration in Brazil nuts. Two Brazil nuts per day provide the daily recommended amount.

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How Is A Low White Blood Cell Count Diagnosed

To determine if a person has a low white blood cell count, the doctor will order a blood test known as a complete blood count. The doctor may order a complete blood count test on a regular basis to check on a patient who has certain conditions, such as an infection or immune system disorder. Other information from the complete blood count will help your doctor come up with a list of possible diagnoses. Your doctor may recommend a referral to a hematology specialist.

The Connection Between White Blood Cell Count And Covid

A high WBC count, also called leukocytosis, is usually a sign that the body is fighting an infection, and the same is true in COVID-19. Research has shown that people who test positive for COVID-19 but have no symptoms typically have a high WBC count, particularly lymphocytes.

Lymphocytes circulate throughout your body, and create antibodies, proteins released to fight pathogens, to help your immune system fight infections. B cells focus on attacking invading viruses and bacteria, while T-cells destroy the body’s own cells that have been damaged by things like viruses or cancer.

The high level of lymphocytes observed in asymptomatic people with COVID-19 makes sense. It means that their immune systems are doing a good job of keeping the coronavirus in check by creating antibodies and destroying damaged cells.

Studies have shown more severe illness and death in people with COVID-19 who had a high WBC count. A number of other studies have found that lower WBC counts or elevated WBC counts with decreased levels of lymphocytes in particular were associated with more severe illness and death in COVID-19.

This can be because the levels of some types of WBCs like neutrophils are higher as the body fights off the virus, while levels of lymphocytes remain low.

  • Loss of taste or smell
  • Sore throat

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If Your Normal Is Lower Than The Defined Normal Range

percentage of the population that has a lower resting state level of white blood cellsdo not necessarily predispose you for an increased risk of infection

If you have a history WBC levels just below the 4.0 thousands/L normal cutoff and you havent experienced a high incidence of illness throughout your life, you likely just have a lower resting state. It is still important to discuss your findings with your physician to rule out the need for any additional testing.

Complications Can Cause Many Symptoms

Managing the Side Effects of Chemotherapy

Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.

Some medical conditions, like bone marrow disease, can cause low white blood cells. These cells are a vital part of the immune system, and having low white blood cells can cause medical problems, especially infections. Low white blood cells can also lead to problems with healing from wounds and make you more susceptible to cancer and other diseases.

This article will discuss the symptoms experienced with a low white blood cell count, what causes the symptoms, risk factors, treatment, and when to contact your healthcare provider.

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Causes Of Low Levels Specific Types Of White Blood Cells

Some medical conditions lead to a disproportionally low number of one specific type of white blood cells, and other white blood cell counts may be normal. An isolated low level of some types of white blood cells may also be important in predicting the presence of or severity of a disease.

Neutropenia: A low level of neutrophils is often the most concerning of the leukopenia due to the risk of infection. Neutropenia without general leukopenia suggests causes such as autoimmune diseases or vitamin deficiencies whereas conditions involving the bone marrow usually affect all types of white blood cells.

Eosinopenia: A low level of eosinophils is commonly seen with physical or emotional stress , with Cushingâs syndrome, and with acute inflammation. Eosinopenia also appears to be an important marker for sepsis.

Basopenia: A low levels of basophils may be seen with:

  • Allergic conditions, such as hives , severe allergies, angioedema, and anaphylaxis
  • With high doses or long term use of corticosteroids
  • With stress
  • During the acute phase of infections or inflammation
  • With hyperthyroidism or thyrotoxicosis

Lymphopenia: Lymphopenia without a correspondingly low level of other white blood cells is not very common but can be very important in some cases or provide helpful information. Causes may include:

Lymphocyte counts tend to drop with normal aging, although lymphopenia appears to correlate with the overall risk of death in adults in the U.S.

What Are White Blood Cells


Your total white blood cell count is the sum of five different types of white blood cells, all with different roles in battling foreign invaders in the body: neutrophils, eosinophils, basophils, lymphocytes, and monocytes.

Neutrophils make up the largest share of your white blood cell count, contributing 60-70% of the total. It’s for this reason that a low white blood cell count is most likely due to a low neutrophil count, also called neutropenia. Neutrophils are the immune systems first responderswithin minutes of an injury, trauma, or inflammation to tissue in the body, neutrophils are drawn to the scene. They essentially control traffic to and from an infection site by recruiting additional white blood cells specialized to the type of invader. Neutrophils function by engulfing the pathogen and breaking it down. And even though they are microscopic, youve seen probably seen neutrophils, as they are the basis of pus! The lifespan of a neutrophil is very short, ranging from 5 hours to a few days.

Because your white blood cells play a vital role in immune function, low levels can leave you more susceptible to infection, increase the duration of illness, and increase the severity of it. Its important to note that white blood cell levels can fluctuate daily and even hourly, so its important not to jump to conclusions about your levels from a single blood test.

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When Should I See A Doctor About A Possible Low White Blood Cell Count

Ask your doctor if he or she is concerned about your white blood cell count and if you will need additional tests. If your white blood cell count is low, and you feel like you have an infection, contact your healthcare provider right away.

Last reviewed by a Cleveland Clinic medical professional on 01/12/2018.


What Does A Low White Blood Cell Count Mean The Answer Isnt Simple

Weakness, Fatigue, and an Abnormal White Blood Cell Count

While blood cells are the driving force behind a healthy immune system. But a low white blood cell count doesnt necessarily mean theres anything to worry about. In fact, white blood cell measurements from blood tests are best considered in context of your historic data and whether recent tests deviate from your normal. Heres a comprehensive overview of white blood cells, the reasons they might be low, and how to support their production.

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Why Do Doctors Check Your Wbc Count

The WBC count is usually included in a test that measures your complete blood count . A low white blood cell count or a high blood cell count may indicate an infection or an undiagnosed condition such as a blood disorder, an autoimmune diseases or an immune deficiency. The WBC count can help doctors detect and provide treatment for these potential conditions as well as help monitor the effectiveness of radiation treatment or chemotherapy for cancer patients.

What Are The Symptoms Of Low Blood Counts

The symptoms of bone marrow failure diseases like aplastic anemia, MDS and PNH are caused by low blood counts. The specific symptoms depend on which type of blood cell is affected. Read the section below to see the symptoms for each type of cell.

You may have many of these symptoms or just one or two of them. And you may get a new symptom at any point in the course of your illness.

A low red blood cell count is called anemia. If you have a low red blood cell count, you may:

  • Feel a little tired or very tired.
  • Feel less alert or have trouble concentrating.
  • Have a loss of appetite or lose weight.
  • Have paler-than-normal skin.

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Absolute Vs Relative Leukopenia

When looking at the number of white blood cells on a complete blood count, itâs important to note that only a minority of the white blood cells present in the body circulate in the bloodstream. For this reason, the number can sometimes shift quite rapidly.

Only around 2% to 3% of mature leukocytes are circulating freely in the blood. Roughly 80% to 90% remain in the bone marrow, stored in case they might be needed quickly. The remainder of white blood cells line blood vessels so that they do not freely circulate . Once in the bloodstream, white blood cells live on average from two to 16 days.

A number of conditions can cause the white blood cells lining the blood vessels to enter the circulation , such as shock, heavy exercise, or great stress. This may cause a white count that is actually low to appear normal. In contrast, dilution of the blood, such as when a person receives a plasma transfusion, may artificially lower the white blood cell count.

When To See A Doctor

Common Signs and Symptoms of Polycythemia Vera

Many of the symptoms of leukemia may be caused by other, more common conditions. However, if youre experiencing any symptoms that could potentially be related to leukemia, its best to see a doctor who can figure out the cause. Its particularly important to seek a doctors guidance if symptoms persist or worsen.

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Definition Of Low White Blood Cell Count

The correct term for a blood test or exam is called complete blood count or CBC. Doctors often order a CBC because it analyzes the numbers of cell components, including white blood cells. The normal threshold for white blood cell count may differ. Mayo Clinic states that the normal range is 3.5 billion to 10.5 billion cells per liter of blood. Meanwhile, MEDLINE Plus states that the normal 4,500 to 11,000 white blood cells per microliter .

A CBC is the only way to determine the numbers of white blood cells in the body. Your doctor may order several CBC tests to monitor your blood cell counts.

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Chronic Conditions That Cause Anemia Of Inflammation

Many different chronic conditions can cause inflammation that leads to anemia, including

  • other chronic diseases that involve inflammation, such as diabetes and heart failure

In people with certain chronic conditions, anemia may have more than one cause. For example

  • Causes of anemia in CKD may include inflammation, low levels of EPO due to kidney damage, or low levels of the nutrients needed to make red blood cells. Hemodialysis to treat CKD may also lead to iron-deficiency anemia.
  • People with IBD may have both iron-deficiency anemia due to blood loss and anemia of inflammation.
  • In people who have cancer, anemia may be caused by inflammation, blood loss, and cancers that affect or spread to the bone marrow. Cancer treatments such as chemotherapy and radiation therapy may also cause or worsen anemia.

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What Can I Do To Avoid/prevent A Low White Blood Cell Count

To minimize the chances of certain diseases and a low white blood cell count:

  • Practice good hygiene. For instance, wash your hands after using the bathroom and before cooking.
  • Be careful around pets and other animals that might transmit infections.
  • Make sure foods are thoroughly cooked before eating them.
  • Stay away from people who have infections.
  • Practice safe sex avoid drugs and sharing needles.

What Are Neutropenic Precautions

What Causes Low Platelet Count or Thrombocytopenia?

If your white blood cell count drops to 1,000 per mm3 or below, you are considered to be neutropenic. Until your count rises, it will be necessary for you to take additional measures to further decrease your risk for infection.

These are referred to as “neutropenic precautions” and include:

  • Take your temperature by mouth four times each day. Call your oncologist if your oral temperature is above 100.5o F.
  • Eliminate uncooked foods, which may contain germs, including:
  • raw meats or fish salads
  • natural cheeses
  • You may eat fresh fruits and vegetables if they are thoroughly washed and peeled.
  • Avoid fresh flowers and plants, which may have germs in the soil.
  • Avoid enemas, rectal suppositories and rectal temperatures.
  • Unless an emergency, do not have any dental work performed. If you have an emergency that requires dental work, inform your dentist when you schedule your appointment that you are receiving chemotherapy. You may want to suggest that your dentist contact your oncologist prior to your scheduled dental work.
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    Stopping Treatments Or Medications That Cause Leukopenia

    Sometimes you may need to stop a treatment to give your body time to make more WBCs. Your blood cell counts may naturally rise when treatment like radiation is over or between chemotherapy sessions. The amount of time it takes for WBCs to replenish varies from person to person.

    If youre taking a medication that causes leukopenia, your doctor may adjust the dose that youre taking. They may also recommend switching to a different medication, if possible.

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