Concerned about CBC results

[AusConn]

I am a 39 yr old male and I've had mild fatigue over the last year but nothing substantial. I recently received bloodwork and was a little concerned at the low range for rbc and wbc along with the other results. I was wondering if this is something I should seek out additional opinions or testing? Of course, worse case scenario of cancer comes to mind:
WBC 10e3/uL = 5
RBC 10e6/uL = 4.54
HGB g/dL = 14.4
HCT % = 40.9
plt 10e3/uL = 191
neutrophil % = 38.8%
lymphocyte% = 46.3%
mono% = 13.7%
neutrophil # 10e3/uL = 2
lymph # 10e3/uL = 2.3
mono # 10e3/uL = .7

[Ken_PA]

I've sent you a PM. Please check that ASAP. Yes, to immune/inflammation and marrow.

[Ken_PA]

You could ask for the two common tests for inflammation: CRP and ESR. Not very expensive. Maybe might possibly provide some useful data. More possibly relevant tests would be for IL-1, IL-6 and TNF.

[Ken_PA]

"my primary care physician and she seemed to think that since the absolute counts were within range that I shouldn't be concerned."
Yep, that's the standard answer that she is more or less obliged to give. But I wouldn't be satisfied with that, unless you knew that your white and red cells had been lowish for years - then you could say that's normal for you.

"I am very anxious and tend to be prone to stress, not sure if that matters."
Yes, it does. I've seen lots of cases where people with overactive immune systems also have anxiety - especially health anxiety. So that tends somewhat to your problem being immune related. I'd become very deliberately aware if any foods cause any increase in anxiety or other symptoms. Maybe keep a log. What happens in the gut can influence overall inflammation.

"As a next step, would you suggest following up to get additional testing?"
Well, one thing is you'd want regular CBCs. You can even do that yourself in most states without a doctor's order. Shop the online sites like walkinlab.

Otherwise, there aren't enough clues yet to justify any other tests. You can make ultra sure to get enough sleep.

Then we can sort of grasp at some straws and hope for benefit. Do meditation or whatever. Take magnesium (the 'calming mineral'), which most people mare deficient in. Become expert in nutrition possibilities. I'm assuming you have no extreme type of diet. And not over exercising.

I don't see any reason to suspect cancer.


Thanks for the detailed reply, most people don't reply at all these days. So I'll add more detail:

The reason that a blood cancer makes CBCs go low is that the cancer cells get into the marrow and suppress production. But you have no signs of cancer. Low CBC would not be the *first* sign of cancer.

But you might have some non-cancer problem (some inflammation) in the marrow, that's one possibility.

Fatigue is very general and could be from the same cause as your CBC numbers being low. Or the mild anemia can be causing the fatigue.

[Ken_PA]

Hi, there is not much reason for alarm at this point. But there is reason to investigate what is going on. There is a wide range of possibilities, from a virus to an inflammatory disorder, or severe stress or starting a new med. Cancer is among the least likely possibilities.

Usually, neutrophils are more numerous than lymphocytes; yours are not so that's a clue. If you have any previous CBCs from the previous year, that is important info. Also, consider if anything big happened before the start of the fatigue. Also, any family history of immune system dysfunction. Also any personal history of health oddities. I imagine you've already checked yourself thoroughly for bumps.

Your CBC is not typical of leukemia.

[AusConn]

Thank you for the response! I followed up with my primary care physician and she seemed to think that since the absolute counts were within range that I shouldn't be concerned. However, I don't have access to previous CBCs. I have no family history of immune system dysfunction or other cancers aside from prostate cancer in my father. My PSA was checked and is normal. I don't have any lumps or additional symptoms. I am very anxious and tend to be prone to stress, not sure if that matters. Certainly, doesn't help with this situation.

As a next step, would you suggest following up to get additional testing? Obviously, I don't want to let something linger and potentially get worse.