What It Means When Your White Blood Cell Count Is Low

A low white blood cell count can be serious because these cells help your body fight infection. Low white blood cells can also lead to problems with wound healing and can make you more susceptible to cancer and other diseases. Certain medical conditions, like bone marrow disease, can cause low white blood cells.

Neutropenia describes a condition in which you have a low number of neutrophils, a type of white blood cell.

This article will discuss low white blood cell count, its symptoms, risk factors, and treatment. It will also let you know when to contact your healthcare provider.

Symptoms of Low White Blood Cells 

When white blood cells are low, the immune system is weak. A weakened immune system can cause medical problems.

Infections are the most common problem caused by low white blood cells. These infections can be more frequent and more severe than what you would experience if you had a healthy immune system. Low white blood cells can also make it difficult for you to heal from injuries or recover from illnesses.

Symptoms you may experience from complications of having a low white count include: 

• Fatigue 
• Fevers, chills 
• Sore throat, coughing, difficulty breathing 
• Nausea, vomiting, diarrhea 
• Painful urination, blood in the urine, urinary frequency 
• Skin sores that don’t heal 
• Mouth sores, mouth pain 

The symptoms that accompany a low white blood cell count can vary and will depend on what’s causing the low count. For example, a bladder infection can cause urinary symptoms, and a stomach infection can cause nausea and vomiting.

Sometimes a lack of white blood cells leads to opportunistic infections, which are infections that wouldn’t normally develop in a person with a healthy immune system. 

Causes of a Low White Blood Cell Count

The most common reason for low white blood cell count is an infection. Other common causes include:

White blood cells are made in the bone marrow and circulate throughout the body. Diseases, toxins, medications, or medical treatments that harm the bone marrow can prevent white blood cells from being produced. Some medical conditions can also cause the destruction of white blood cells.

A low white blood cell count is often a sign of chronic disease. But sometimes medications or infections can temporarily cause this problem due to the destruction of white blood cells. This should resolve once the infection clears up or the medication is discontinued.

Benign ethnic neutropenia is a cause of inherited chronic neutropenia. It is seen mostly in people of African, Middle Eastern, and West Indian descent worldwide. It does not increase a person’s risk of infection.

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 divide rapidly, chemotherapy treatments can prevent their 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.

When to See a Healthcare Provider 

If you have been diagnosed with low white blood cells, it’s helpful for you to know the signs of complications and to get medical attention if you start to develop problems. You won’t be able to feel any direct effects of a low white blood cell count, so you may need periodic testing to monitor your count.

Call your healthcare provider or make an appointment if you get a fever or chills, feel run down, develop sores or a wound that won’t heal, vomit, have diarrhea, or lose your appetite.

Get prompt medical attention for any of the following:

• Severe vomiting or diarrhea
• Signs of dehydration such as sunken eyes, dry skin, and decreased urination
• Confusion, lethargy
• Severe pain or swelling
• Painful, red, or pus-filled wound
• Shortness of breath

If you have a medical condition that causes low white blood cells, it’s important that you maintain consistent medical care. This can include getting regular blood tests to monitor your white blood cell count and surveillance for complications.

You may need symptomatic treatment, as well as treatment of the underlying cause. Some medical conditions that cause low white blood cells are serious chronic illnesses, like HIV or blood cancers.

Coping with these health problems can be overwhelming. Make sure you find ways to reach out for support from your family, friends, healthcare team, or support groups to help manage the stress.

How Is a Low White Blood Cell Count Diagnosed?

Diagnostic tests can identify the white blood cell count, as well as the cause of low white blood cells. A complete blood count (CBC) is a blood test that measures the number of white blood cells, as well as the number and proportion of each type of white blood cell.

A normal white blood cell count is 4,500 to 11,000 white blood cells per microliter.

The cause of a low white blood cell count can be identified with other diagnostic tests as well. The specific testing depends on the signs, symptoms, and risk factors. For example, an HIV test can identify HIV as the cause, while a bone marrow biopsy can often identify blood cancer.

Preventing Infection

When you have a low white blood cell count, you are more susceptible to developing infections. Some ways to lower your risk of getting sick or developing an infection include:

• Practice good hygiene, such a frequent hand-washing
• Clean and cover wounds and treat them with an antibacterial ointment
• Avoid crowds or wear a mask in crowded places
• Stay up to date on vaccines such as influenza and COVID-19
• Avoid sharing personal items such as utensils, towels, and razors
• Don’t swim in public pools, rivers, or lakes

Treatment

Symptoms that may develop as a result of having low white blood cells often require treatment in addition to the treatment that’s needed for managing the underlying issues.

Treating an Infection

This may include:

• Tylenol (acetaminophen) or nonsteroidal anti-inflammatories (NSAIDs), such as Advil (ibuprofen) and Aleve (naproxen sodium) for treatment of pain or fever
• Fluid intake to prevent dehydration from vomiting or diarrhea
• Dietary supplements to prevent or treat malnutrition
• Antibiotics or antivirals to treat infections

Increasing White Blood Cell Count

Sometimes a low white blood cell count can be treated directly, depending on the cause. Examples of treatments may include antiretroviral therapy for treating HIV or a bone marrow transplant for cancer.

Neulasta (pegfilgrastim), a granulocyte colony-stimulating factor (G-CSF), is a medication that can be used in certain circumstances to prevent low white blood cells from occurring as a side effect of chemotherapy.

These treatments require ongoing and close medical care.

There are also lifestyle changes you can make that may help improve your white blood cell count. These include:

• Eating high-quality proteins such as fish and poultry 
• Taking a vitamin supplement containing B12 and folate, which can help your body make white blood cells

Summary 

A low white blood cell count is a consequence of serious diseases, and it can lead to harmful health problems including infections, slow healing, and cancer.

A low white blood cell count doesn’t cause symptoms, but the complications can. These often need to be treated, and management of low white blood cells is important to prevent serious complications from occurring.