qestion about low white blood count

[Liselotte]

She is a also vegetarian, and eats ONLY tofu, broccoli and
oatmeal and does not take vitamins. (she drinks diet coke)

She tells me that she is getting all she needs in her diet,
plus she has suffered from a eating disorder (anorexia)
before. She is 5´6 and weighs 114 with clothes now. Does that
kind of diet really supply enough vitamins and protein?? I
suppose that it has the mineral, with the broccoli??

She has just been sick with a virus. the doctor did a lot of
blood work and found everything normal, except for a low white
count and a borderline globulin count.

Can anybody recommend some kind of food or supplement to up
her white count.

thanks Lise

[Jedilworth]

Is the doctor worried about her white count? How low? What
types of cells? You've gotta give more information than this.

Viral infections tend to give low white counts with a
tendency towards a high lymphocyte count. Does the doc want a
repeat of the count later? White counts don't stay the same
every day. They fluctuate depending on what's going on in her
body. Does she have a white count that was done when she was
well to compare it to? Chances are her WBC was in the normal
range then.

If nature take it's course and the viral infection goes
away, her white count will probably go back to normal. WBC
counts aren't diet related per se. White cells respond to
infectious agents.

Judy Dilworth, M.T. (ASCP) Microbiology

"Liselotte S." wrote:
>
> Can anybody recommend some kind of food or supplement to up
> her white count.
>
> thanks Lise

[Jorge]

"Liselotte S." wrote:

> She is a also vegetarian, and eats ONLY tofu, broccoli and
> oatmeal and does not take vitamins. (she drinks diet coke)
>
> She tells me that she is getting all she needs in her diet,
> plus she has suffered from a eating disorder (anorexia)
> before. She is 5´6 and weighs 114 with clothes now. Does
> that kind of diet really supply enough vitamins and
> protein?? I suppose that it has the mineral, with the
> broccoli??
>
> She has just been sick with a virus. the doctor did a lot of
> blood work and found everything normal, except for a low
> white count and a borderline globulin count.
>
> Can anybody recommend some kind of food or supplement to up
> her white count.
>
> thanks Lise

I see the concern you have for your friend and it can get
pretty frustrating dealing with anothers health. You don't
really treat a laboratory value per say as you first get a
diagnosis and depending on that diagnosis a treatment plan
is followed. A certain type of white cell number can be used
to assess malnutrition. It's one reason why the malnourished
are susceptible to TB. Certain vitamin deficiencies such as
folate B12 can cause this as well as viral infections can
also. In short there is a long list of causes for a low WBC
and if the clinical correlation (that which the doctor
thinks she has) doesn't match then further workup may be
necessary. The intuitive approach of it is low then we need
to add some is not always right in dealing with some lab
values. I am not saying at all that she has leukemia but it
may present with a low blood WBC count in which case trying
to raise it would be inappropriate. It would appear to be
counterintuitive in that case.

[Liselotte]

Well here is a copy of her blood count. I dont know what the
numbers mean.

neutrophils, absolute 1472 ref range 1500-7800 L lymphocytes,
783 850-3900 L monocytes , 343 200-950 eosinophils, 89 50-550
basophils, 16 0-200

wbc 2.9 3.8-10.8 rbc 4.57 3.80-5.10 hgb 14.1 11.7-15.5 hct
41.1 35.0-45.0 mcv 89.9 80.0-100.0 mch 30.8 27.0-33.0 mchc
34.2 32.0-36.0 pow 13.1 11.0-15.0 platelets 140.000 140-400
mpv 10.9 7.5-11.5

t.neu % 54.5
u.lymph 29.0
v.mono 12.7 eosn 3.3 baso 0.6

plus there is ofcourse all the other results, where I saw the
globulin being borderline low. Her doctor has not spoken to me
yet, I got these results from the nurse.

Thanks for your time

Lise

JEDilworth wrote:
>
> Is the doctor worried about her white count? How low?
> What types of cells? You've gotta give more information
> than this.
>
> Viral infections tend to give low white counts with a
> tendency towards a high lymphocyte count. Does the doc want
> a repeat of the count later? White counts don't stay the
> same every day. They fluctuate depending on what's going on
> in her body. Does she have a white count that was done when
> she was well to compare it to? Chances are her WBC was in
> the normal range then.
>
> If nature take it's course and the viral infection goes
> away, her white count will probably go back to normal. WBC
> counts aren't diet related per se. White cells respond to
> infectious agents.
>
> Judy Dilworth, M.T. (ASCP) Microbiology
>
> "Liselotte S." wrote:
> >
> > Can anybody recommend some kind of food or supplement to
> > up her white count.
> >
> > thanks Lise

[Jedilworth]

I didn't know the information about white count vs.
tuberculosis. It would make sense, though, as many throughout
the world are exposed to TB but only some of those go on to
have full blown fulminant TB. The others wall off the
organism, probably because they're in better shape.

I would further question the doctor about this low WBC and get
his or her thinking about it. If you can get them to commit to
a repeat CBC in a month or so, that might ease your mind. If
she's fully over this viral illness, and her white count is
STILL low, then you probably need more investigation. Don't
let the doc off the hook on this one. Bottom line is she just
doesn't have the white cells needed to fight off infection,
and there's some reason for this.

Good luck.

Judy Dilworth, M.T. (ASCP) Microbiology

Jorge wrote:

> I see the concern you have for your friend and it can get
> pretty frustrating dealing with anothers health. You don't
> really treat a laboratory value per say as you first get a
> diagnosis and depending on that diagnosis a treatment plan
> is followed. A certain type of white cell number can be used
> to assess malnutrition. It's one reason why the malnourished
> are susceptible to TB. Certain vitamin deficiencies such as
> folate B12 can cause this as well as viral infections can
> also. In short there is a long list of causes for a low WBC
> and if the clinical correlation (that which the doctor
> thinks she has) doesn't match then further workup may be
> necessary. The intuitive approach of it is low then we need
> to add some is not always right in dealing with some lab
> values. I am not saying at all that she has leukemia but it
> may present with a low blood WBC count in which case trying
> to raise it would be inappropriate. It would appear to be
> counterintuitive in that case.

[Jedilworth]

Just off the top of my head (I haven't done hematology in
years, but did work with it for two years and went through
training in hematology) her differential (the percentages)
look normal. Her absolute neutrophils and lymphocytes are
a tad low but that's probably because her total count is
low. Her hemoglobin is really good for someone that
doesn't eat meat,
i.e. she's not anemic. Her MCV also indicates she's not
chronically anemic. MCV is Mean Corpuscular Volume, and
is an indicator of cell size. Patients with chronic
anemia end up with low MCV's and little cells, as the
body tries to conserve hemoglobin.

Does the doc think this is worth repeating?

Jorge's information is good and much more informative than
mine on this score (see elsewhere in this thread).

How did you obtain a "friend's" CBC result? Doctor's offices
don't hand over results to anyone but the adult patient,
usually. Is this work on you, or a relative under your care?

Judy Dilworth, M.T. (ASCP) Microbiology

"Liselotte S." wrote:
>
> Well here is a copy of her blood count. I dont know what the
> numbers mean.
>
> neutrophils, absolute 1472 ref range 1500-7800 L
> lymphocytes, 783 850-3900 L monocytes , 343 200-950
> eosinophils, 89 50-550 basophils, 16 0-200
>
> wbc 2.9 3.8-10.8 rbc 4.57 3.80-5.10 hgb 14.1 11.7-15.5 hct
> 41.1 35.0-45.0 mcv 89.9 80.0-100.0 mch 30.8 27.0-33.0 mchc
> 34.2 32.0-36.0 pow 13.1 11.0-15.0 platelets 140.000 140-400
> mpv 10.9 7.5-11.5
>
> t.neu % 54.5
> t.lymph 29.0
> t.mono 12.7 eosn 3.3 baso 0.6

[Jorge]

JEDilworth wrote:

> I didn't know the information about white count vs.
> tuberculosis. It would make sense, though, as many
> throughout the world are exposed to TB but only some of
> those go on to have full blown fulminant TB.

There is a battery of tests that can be done for malnutrition
including prealbumin and total lymphocyte count which
correlates with the degree of general malnutrition from
mild,mod to severe but I do not recall the ranges just now.

[Liselotte]

It is not my friend but my daugther. :-)

I (we) travel a lot, so when ever we have lab work done, we
always get copies. We have property in India and Europe, and
it is handy to have results og the last problems along. I have
found the doctors appriciate the additional help.

The doctor will repeat the test, but I dont know when to make
an appointment, I am not sure how long one should give this to
change back?

Thanks again Lise

[Jedilworth]

Thanks for the information. I don't think prealbumin was a
test offered when I was in training in 1973-4. I've been doing
micro exclusively since 1988, so I would have a lot to catch
up on if I were to go back to the "other side."

Judy Dilworth, M.t. (ASCP) Microbiology

Jorge wrote:
>
> There is a battery of tests that can be done for
> malnutrition including prealbumin and total lymphocyte
> count which correlates with the degree of general
> malnutrition from mild,mod to severe but I do not recall
> the ranges just now.