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Low RBC/WBC counts...cause for concern?

 

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MuelFuel

Jan 27, 05 17:12

Post #1 of 29 (23018 views)
Low RBC/WBC counts...cause for concern? Quote | Reply

I just had my annual physical and it was discovered that I had low RBC/WBC counts...am under the assumption that this is related to an immunodeficiency?? I haven't gotten sick that often over the past years but did have a severe asthma attack which lead me to be pulled off the bike course at mile 100 at Kona this year. My oxygen saturation dropped pretty low and I was hypertensive when taken off the course...could have this affected my bloodwork? Anyways, I was wondering if this is something I should be concerned about or need further check up on? Any doc's able to help me with this?

Thanks,

Kim Brown, MS, RD
Sports Nutritionist
http://www.kbnutrition.com

Kim Mueller, MS, RD
Sports Nutritionist
http://www.kbnutrition.com


Sojourner

Jan 27, 05 18:12

Post #2 of 29 (23005 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

How about some actual numbers.


MuelFuel

Jan 27, 05 18:17

Post #3 of 29 (23001 views)
Re: Low RBC/WBC counts...cause for concern? [Sojourner] [In reply to] Quote | Reply

WBC 3.7 K/ul RBC 4.1 M/ul Thanks!

Kim Mueller, MS, RD
Sports Nutritionist
http://www.kbnutrition.com


miss_ocr3

Jan 27, 05 18:20

Post #4 of 29 (23000 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

Kim, I know that having low RBC would be a concern, what is your Hgb? As for WBC if that is low not sure, but what does your doctor say? I have a rare bleeding disorder, so when my RBC is low my Hgb is usually low as well. I would talk to your doctor and do some research on your own. Doing research on your own is always good. Did you get a copy of your labs?


MuelFuel

Jan 27, 05 18:38

Post #5 of 29 (22987 views)
Re: Low RBC/WBC counts...cause for concern? [runnergirl] [In reply to] Quote | Reply

My iron levels (hemoglobin/hematocrit) are normal. I haven't found any thing definite in my research of the issue. A low WBC count is indicative of a depressed immunity although I haven't been sick for a long time. This is all fascinating to me since I am interested in physiology...just thought I'd try to get some feedback from any athletic docs on this forum. Healthy trails, Kim Brown, MS, RD Sports Nutritionist http://www.kbnutrition.com

Kim Mueller, MS, RD
Sports Nutritionist
http://www.kbnutrition.com


rroof

Jan 27, 05 18:46

Post #6 of 29 (22978 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

Kim: need more info, sorry.

Your hematocrit (% of red blood cells in serum) is usally about 3 times your hemoglobin level. If you are anemic, there are a lot of different types and reasons why. Need to know your RBC morphology - my first guess would be iron deficiency anemia (based on most common). However, most endurance women athletes (if you were at Kona, that certianly counts) have little to no menstration anymore.

A single lab test with a low white blood cell count means very little in the abscence of other symptoms/lab findings. Repeat the bloodwork in a few weeks. Also, there should have been a breakdown here as well (%neutrophils, etc.)

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD


Sojourner

Jan 27, 05 18:48

Post #7 of 29 (22977 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

I'm not a doctor, but I believe your WBC is only to be elevated when you ARE sick. Isn't that what they are for, to fight (actually eat I believe) off things that aren't supposed to be in you? Your iron levels and your hematocrit and hemoglobin levels are not the same. Did you get any paperwork for you to look at? If your hematocrit is around the 37% mark it's kind of low for a female, as with readings under 13 for your hemoglobin. Any hard numbers for those two indicators?


MuelFuel

Jan 27, 05 19:13

Post #8 of 29 (22967 views)
Re: Low RBC/WBC counts...cause for concern? [Sojourner] [In reply to] Quote | Reply

Here is the full blood workup:

WBC: 3.7 k/ul

LYM 1.3, 34%L

MID 0.3, 7.4%M

GRAN 2.2, 58.6%G

RBC 4.1 M/ul

HGB 13.2 g/dl

HCT 38.7%

MCV 92.6 fL

MCH 31.6 pg

MCHC 34.1 g/dL

RDW 12.2%

PLT 263 k/ul

MPV 8.8 fL

Another flag was BUN/CREAT ratio being elevated (31.4) and creatinine being low (0.5 mg/DL)

Lower-than-normal levels of creatinine may indicate:
  • Muscular dystrophy (late stage)
  • Myasthenia gravis


Elevated levels of BUN/CREAT ratio may indicate

Considered together, the BUN, blood creatinine and their ratio give very good evidence of the filtering function of the kidneys and also, a measure of the degree of bodily hydration. The ratio of BUN: creatinine is normally 10:1. With dehydration, the ratio can increase to 20:1 or even higher. This makes sense because I came from a very intense workout that morning and most likely was a dehydrated...spent the rest of that day rehydrating.

Kim Brown, MS, RD

Sports Nutritionist

http://www.kbnutrition.com

Kim Mueller, MS, RD
Sports Nutritionist
http://www.kbnutrition.com


Sojourner

Jan 27, 05 19:51

Post #9 of 29 (22954 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

I'll defer to rroof, but it seems like your 'crit and hemoglobin are within the normal range for a female.


jhc

Jan 28, 05 8:50

Post #10 of 29 (22927 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

Didn't you have a physician give the physical and interpret the labs for you? What did he/she say?



_______________________________________________
I love sushi, but I'd rather not have it served next to a "fish taco". - KEJ


smartasscoach

Jan 28, 05 9:10

Post #11 of 29 (22913 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

I would be a little worried if my nutricionist couldn't either read bloodwork that or didn't have handy a source to look it up. But that's just me.

-
"Yeah, no one likes a smartass, but we all like stars" - Thom Yorke


smartasscoach.tri-oeiras.com


mwbyrd

Jan 28, 05 9:29

Post #12 of 29 (22895 views)
Re: Low RBC/WBC counts...cause for concern? [smartasscoach] [In reply to] Quote | Reply

Why would a nutritionist need to know how to read a blood test besides chloesterol (sp?)?



Unless nutrition affect RBC/WBCs...maybe the pros are eating something to raise their hemocrit levels??


TheBikeRacer.com


MuelFuel

Jan 28, 05 9:34

Post #13 of 29 (22886 views)
Re: Low RBC/WBC counts...cause for concern? [smartasscoach] [In reply to] Quote | Reply

Smartasscoach...

I do have books/access to information as everyone else does but thought I may gather some better input from specialists, doctors who may give me something a little more valuable than textbook knowledge. I am always looking to expand and by outreaching to other professionals in forums like Slowtwitch, I find myself learning more valuable information than what can be found in books.

I guess my outreach for help is very much like a coaches/doctors asking me for my expert knowledge on nutrition even though I am sure they have at least a textbook knowledge on the subject.

Healthy regards,

Kim Brown, MS, RD
Sports Nutritionist

www.kbnutrition.com

www.kbnutrition.com

Kim Mueller, MS, RD
Sports Nutritionist
http://www.kbnutrition.com


smartasscoach

Jan 28, 05 9:39

Post #14 of 29 (22880 views)
Re: Low RBC/WBC counts...cause for concern? [mwbyrd] [In reply to] Quote | Reply

Mine does... I guess I'm spoiled. But like I said, it's a personal opinion.

-
"Yeah, no one likes a smartass, but we all like stars" - Thom Yorke


smartasscoach.tri-oeiras.com


jhc

Jan 28, 05 9:48

Post #15 of 29 (22869 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

FWIW your RBC count is normal,

Your WBC is lower but you don't seem to have a specific population affected (lymph/PMN/mono percentages are all normal).It's pretty nonsepcific - did you just have the flu?



_______________________________________________
I love sushi, but I'd rather not have it served next to a "fish taco". - KEJ


el fuser

Jan 28, 05 9:50

Post #16 of 29 (22867 views)
Re: Low RBC/WBC counts...cause for concern? [smartasscoach] [In reply to] Quote | Reply

Don't trust your nutritionist to interpret your blood chemistry. I'm suprised s/he would even attempt to do that. There's many things that can be going on with your blood chem that a nutritionist wouldn't know about or pick up on.


docfuel

Jan 28, 05 10:02

Post #17 of 29 (22851 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

Your creatinine is also related to your muscle mass (as well as your kidney function.) More muscle, more creatinine. The BUN is related to protein intake as well as kidney function. The elevated BUN/creatinine may be related to relative dehydration, as well. If you consume a lot of protein and have a small muscle mass, this could effect the relative ratios.

Your total granulocyte count is normal, so the lowish WBC count probably is OK. Your red cells are borderline large, so your RBC count will be lower for the same Hemoglobin level. Large RBC may be related to reduced B12 absorption or decreased folate intake. Hemolysis can give you largish RBC'c as well. A reticulocyte count, folate and B12 levels might be instructive. But, most likely these are normal variants. I'm not an adult doc, so you might want to confirm this with an internist or hematologist.

_________________
Dick

Take everything I say with a grain of salt. I know nothing.


jhc

Jan 28, 05 10:07

Post #18 of 29 (22846 views)
Re: Low RBC/WBC counts...cause for concern? [docfuel] [In reply to] Quote | Reply

I'm not sure you can call an MCV of 92 increased when the average normal values are ~80-100


edit: also, sorry for the nitpicky nature of this, but her total neutrophil count is low too, in proportion to the other WBC subsets.



_______________________________________________
I love sushi, but I'd rather not have it served next to a "fish taco". - KEJ

(This post was edited by jhc on Jan 28, 05 10:10)


MuelFuel

Jan 28, 05 10:10

Post #19 of 29 (22844 views)
Re: Low RBC/WBC counts...cause for concern? [jhc] [In reply to] Quote | Reply

Don't think I have the flu although it is funny that you mention that cuz when I went to go see the doc, I hadn't been able to keep anything in my system and was running a slight fever...I related to something new I ate but suppose I could have had a bought of the flu. And the combination of my intese workout I did that morning and not being able to hold anything in my system explains the dehydration and BUN/CREAT abnormality. Smartasscoach...hearing such input from experts, people who draw blood and look at blood chemistry values every day, is why I am on this forum cuz the info is far more valuable than regurgitated information from a textbook.

Healthy regards,

Kim Brown, MS, RD

Sports Nutritionist

www.kbnutrition.com

Kim Mueller, MS, RD
Sports Nutritionist
http://www.kbnutrition.com


ironclm

Jan 28, 05 10:24

Post #20 of 29 (22834 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

>>...hearing such input from experts, people who draw blood and look at blood chemistry values every day, is why I am on this forum<<

Interesting, considering about 95% of the people on this forum post anonymously so do you really know if they are who/what they say they are???

clm


clm
Nashville, TN
https://twitter.com/ironclm | http://ironclm.typepad.com
http://tnwomenscycling.com


MuelFuel

Jan 28, 05 10:32

Post #21 of 29 (22825 views)
Re: Low RBC/WBC counts...cause for concern? [ironclm] [In reply to] Quote | Reply

Yes, you are correct in that you always have to be careful as to who you take information from. When reading responses from others, I do my own homework too to make sure the information meshes with what I know to be true. I also seek out personal help from professionals I network with in the area.

Kim Mueller, MS, RD
Sports Nutritionist
http://www.kbnutrition.com


docfuel

Jan 28, 05 10:42

Post #22 of 29 (22816 views)
Re: Low RBC/WBC counts...cause for concern? [jhc] [In reply to] Quote | Reply

The lymphocyte counts are relatively less important. Lots of people have lowish WBC's, but ia total granulocyte count to 2000k is fine. The normal tables I use list adult nomrals from 80-92, this does vary from lab to lab. MCV is a ratio of RBC count to hematocrit, so for the same hematocrit the RBC numbers will vary by cell size.

_________________
Dick

Take everything I say with a grain of salt. I know nothing.


jhc

Jan 28, 05 11:18

Post #23 of 29 (22807 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

I'm curious as to what your actual doc said.

(PS - I'm not an expert, I'm a med student)



_______________________________________________
I love sushi, but I'd rather not have it served next to a "fish taco". - KEJ


jhc

Jan 28, 05 11:39

Post #24 of 29 (22800 views)
Re: Low RBC/WBC counts...cause for concern? [docfuel] [In reply to] Quote | Reply

There seems to be a lot of variation in normal values, I've now seen "normal" values for total neutrophils as 1800-(I forget the upper value) [a hematology book], 2500-7500 [some page on the internet], and 3000-5800 [Conn's Current Thereapy] And MCV ranges 80-100, 70-100, 80-96. Probably the source of confusion.

Interesting that you said that the lymphs were less important. Maybe that's true when you think about opportunistic infections, but if I had a patient with low WBC, normal total neutrophils, and pretty low lymphs, I'd be concerned about the underlying cause of that.



_______________________________________________
I love sushi, but I'd rather not have it served next to a "fish taco". - KEJ


IronRed

Jan 28, 05 12:16

Post #25 of 29 (22781 views)
Re: Low RBC/WBC counts...cause for concern? [KimBrown] [In reply to] Quote | Reply

3.7 WBC is not a problem. I'm at 2.7 and the hemotolgist told me that the range isn't exact. He said 2.7 does not concern him. Different ethnic groups fall in different ranges.


Olen

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