Chronic low WBC

[Twinny]

I’ve had low wbc for years and lowest being 2.4 this week. Monocytes high at 17. Abs neutrophil low at 1.2 and abs leukocytes low at .7. Been to hematologist 7 years ago and he monitored me and said I was good. Now dr sending me back and I’m terrified. Please help

[Ken_PA]

Hi, Shanon. I don't see any reason to suspect a blood cancer. A leukemia would have resulted in some type of white cell going very high. Or if you had a lymphoma for years, something would have shown up such as swollen lymph nodes.

There are benign causes for what you have.

In a week or so, I can answer in detail about what the REAL cause of your signs and symptoms might be - such as high cortisol (the 'stress hormone'). I didn't want to just leave you unanswered for now, with your fear of cancer.

(Easy bruising from a blood cancer is caused by very low levels of platelets, which you don't have. But excess cortisol can do that - and hair loss, too.)

[ShanonB77]

Hello I too have low wbc 2.8 and neutrophils 1.3, on latest blood tests.  Like original poster, I’ve had low wbc’s for years. I’m 45 F and still get periods (although believe I’ve been going through peri menopause.) Symptoms have been fatigue, hair loss, bruising on legs. But I also have iron deficiency anemia. So I attributed my symptoms to that. So I started on iron pills, magnesium and Vit S which were low and have been feeling better, not as fatigued as before. RX I take are Lexapro, Xanax and a beta blocker MT. But now wonder if it could possibly be a blood cancer? I’m quite anxious. Thoughts? Thanks.

[ShanonB77]

I meant Vit D

[Ken_PA]

I'm glad to hear it, Twinny. Thanks for letting me know.

[Ken_PA]

Well, Twinny, it's my understanding of smoldering Multiple Myeloma that if it were present, it would also cause low red blood cells. But you don't have that.

The reason is that the SMM cells would be in the marrow and interfere with normal production of WBCs and also RBCs.

You could always ask the hema to run a blood test for the proteins that SMM cells produce. My guess is that the hema would say the test isn't justified; but then, you never know until you ask :)

Btw, if you press on your spleen area (beneath the stomach), there is no tenderness or swelling, right?

[Twinny]

All went well with hematologist. Nothing further needs to be done. Just have blood test every 6 months. Thank you for your help!

[Ken_PA]

Well, I have more than once suggested to people that it might help their anxiety if they research non-cancer causes for their condition. Sort of to distract the mind away from the worst possible thoughts.

For instance, I just did a quick webseach for --> flecainide pancytopenia

and I saw that flecainide can indeed lower blood cell counts, even though that's rare. But somebody's got to be the rare case, right?

You can check the other drugs also, and correlate with when you started taking them. ("pancytopenia" means all the blood cells are low. "pan" means across the board, "cyto" means cells, and "penia" means low. It's just a convenient term to use in this case, even though your RBCs aren't low. It leads to papers where flecainide influences cell numbers in general.)

[Twinny]

Thank you. That’s a good idea. I just went for a walk and I just want my mind to rest and stop thinking the worst. You have given me your opinion and my dr not concerned. I seem to be the only one worried!!

[Twinny]

I am back to researching again and noticed how multiple myeloma can linger for years without symptoms. My low wbc dates back to 2009 so not sure if it would be that long to produce no symptoms. I’m trying to be ok but then something like this pops up. Please advise. Thanks.

[Ken_PA]

Low-normal platelets are still normal and I don't think any doc would be concerned.

You would have mentioned if you are taking any meds that could cause low blood cells. Another possibility is heavy metals in food or water, just a thought. In probably most cases of low blood cells, there is never a cause known.

I've seen more than a few people come through with "health anxiety". I realize it's not something you can control, it's not your fault and it's not as if it's some defect or flaw in you. It just is. Hopefully though, you can realize that it's not reality based in this case, as all the medical facts are in your favor.  

Write again anytime at all, Twinny.

P.S. Would it make you feel better to get a new CBC as soon as possible, to see that the monocytes are normal? Then by all means call one of your docs tomorrow and ask for the order. It's cheap and they shouldn't mind.

[Twinny]

You’re so understanding with the health anxiety. I take Lopressor, Fleacanide, Lipitor and Ativan. Been taking for years also. I asked my Dr if I should do another test and she said to wait since I see hematologist on March 11. My mind just can’t relax. I need to get a grip. All weekend I’ve done nothing but cry and search internet. Hubby doesn’t understand the fear I have. My teens, well they’re teens! Lol! I appreciate your responses

[Ken_PA]

Hi, there's no reason to suspect a cancer. Some people just have naturally low-ish WBCs. Are you very thin and lean?

When blood cells go low from a cancer, it's because the cancer has invaded the bone marrow, which is where the blood cells are made. That's not you. Especially since you've been okay for years, which is very important. But if this were a sudden new development, it would be more worrisome.

Also, since you don't get frequent colds or other infections, your immune system seems to be doing its job quite well even though the WBC is technically low. People with a genetically caused malady of low immune cells tend to get sick a LOT.

If you think of a "bell curve", somebody has to be on the left and still be normal.

Having a low WBC tends to say you have low general inflammation, and that should be good in that you are less inclined to diseases of chronic inflammation such as heart disease. So that's the plus side :)


"Dr sending me back to hematologist for another evaluation."

I would look at that as "we have to be a little bit on guard, just as a matter of standard procedure".

[Twinny]

I was also noticing platelets are in normal range but low side of normal: been consistent like that through the years. I’m trying to de-stress but failing. Still so nervous but I’m going to try to calm down. Thank you.