YANMD, White Blood Cell Count Question

May 2, 2019 6:14 PM

Looking for reasons why my white blood cell count is consistently low. You are not my doctor. Nobody here is giving me medical advice. I am seeing a doctor next week.

A few years ago I had bloodwork done and learned I had a low white blood cell count (below the recommended level but not severely low. Just enough to make the doctor raise her eyebrows.) I went to a hematologist. He told me that it was not cancer, and that it might be caused by drinking. Well, at the time, I was in college and drank a lot. So I quit drinking. A few months passed, we took another test, the number had risen into the low-but-normal range, great.

Last year (during the fall months) as I was looking for a job, I fell into the glass-of-wine-at-night habit. I quit when I got a job in January, both to lose weight and because I wanted a fresh start. I have not had a drink since. This week I had bloodwork done again, to find that my white blood cell count has dropped again. Why?

I am not a vegan. I eat fish, though very little of it, and no red meat or poultry. I eat eggs and cheese. However, lately I haven't eaten many animal products at all, just out of not having them around. As a child I was diagnosed with anemia. The nurse said this can be a cause of low white blood cell count. Is it possible I have anemia now and don't even know it? If I do, why doesn't this round of bloodwork clearly show that I have it?

Medications? I take Zyrtec, sometimes Zolpidem, and Sertraline. Could these cause it?

If this is a little disorganized I apologize. It wasn't a happy phone call.

Thanks for your thoughts.

posted by Crystal Fox to Health & Fitness (8 answers total)

My white cell count has always been right on the border or slightly below it. It's been this way for more than 20 years. After a few tests my doctor said that low is just normal for me. The "normal" ranges for most medical tests are two standard deviations, so some people like me are just at the end of the bell curve. Demographics: Male, 58, non-drinker (but drank when I was originally diagnosed), omnivore, moderate caffeine (equal to about 1 cup of coffee/day), coincidentally I take Zyrtec and Zolipidem and an anti-depressant too but started those many years after being diagnosed.
Get checked out, and if the tests are fine, don't worry about it. I get sick very infrequently despite four grandkids under 5, and don't seem to have any effects from a low white cell count.
posted by Grumpy old geek at 6:25 PM on May 2, 2019 [1 favorite]

Based on you mentioning your diet not including meat or poultry, it’s possible that your neutropenia could be caused by a slight vitamin B12 deficiency. It’s really hard to say anything definitive based on the limited information we have available. However, if you’re not experiencing any symptoms, and your doctor otherwise gives you a clean bill of health during your visit, I’d say that you’ve got nothing to worry about—although if it turns out you *are* deficient in B12, it’s worth considering supplementation.
posted by un petit cadeau at 6:32 PM on May 2, 2019 [1 favorite]

Have you been tested for B12? I was recently diagnosed with both low white blood cell and low b12, and my doctor said they were most probably related. You don't actually need to be anemic for low b12 to affect your white blood cell count (again, according to my doctor). After the first blood test results, I was asked to start b12 supplementation, and went back after a month, and it had improved. I have a similar diet to your, not a lot of animal products.

So....get a b12 done, if you haven't yet. I am a bit surprised your gp did not test you for that before sending you to a specialist just based on your diet alone.
posted by nanook at 6:33 PM on May 2, 2019 [1 favorite]

And don't worry about it. Low b12 is a major problem in this country and the cause of a lot of undiagnosed illness, especially later in life. I don't intend to start consuming more animal products, and I will be taking a daily b12 for the rest of my life.
posted by nanook at 6:36 PM on May 2, 2019

I don't think drinking one glass (5 ounces) of wine a night should have a major effect on your WBC count. People that abuse alcohol though are at risk for a low WBC count and Anemia. Source and another source . Hemoglobin and hematocrit are two tests that are usually run with the WBC count. If your hemoglobin and and hematocrit are within the normal range you shouldn't have to worry about anemia. Other tests for anemia are ferritin and serum iron level. You might want to ask your Doctor to order an Iron Blood Test Panel (should include the ferritin and serum iron level tests). I agree that you should ask to test for vitamin B12. I'm mostly vegan and I take daily multivitamin that includes vitamin B12.
posted by mundo at 7:15 PM on May 2, 2019 [1 favorite]

I’ve had a low white blood cell count for 25 years. Additional tests for many things turned up nothing. My Dr says it’s just my particular normal and he isn’t concerned about it at all anymore. By all means get some further testing done, but this is not necessarily bad news. Good luck!
posted by bookmammal at 7:36 PM on May 2, 2019 [1 favorite]

My white count is consistently low and my doctor chalks it up to genetics and race (I’m a person of color.) I noticed my white count was higher when I cut sugar out of my diet.
posted by Pretty Good Talker at 10:12 PM on May 2, 2019

Best answer: I'm a hematologist (and not your hematologist). It comes down to which type of white blood cell is low. The differential counts neutrophil, lymphocytes, monocytes, eosinophils, and basophils.

Sometimes, it's congenital (neutrophils - usually people of African-American ancestry). I look for vitamin deficiencies, viral infections (hepatitis and HIV, but can be others too), spleen size, possible autoimmune issues. Also some cases of chronic cyclic neutropenia which can require treatment. But most people it's just how they're made.
posted by honeybee413 at 4:33 AM on May 3, 2019 [2 favorites]