My blood report shows a low WBC count. Is this a serious issue?

Question

Hello doctor,

I recently had my complete blood test and said my WBC is low at 3.6, just below the reference range of 3.8. However, all the other values of the WBC were in the normal range. The RBC showed normal ranges, too.

Could this be due to increased exercise intensity every day for the last two months, or is this a serious issue, such as leukemia, myeloma, or lymphoma?

I am a 31-year-old male, 151 lbs. No smoking or drinking, and I do daily exercise for 30 minutes. Interestingly enough, my WBC was 5 earlier, but now it is 3.7. When my blood was tested this time, my ALT, AST, and CK were high, but we are well below the normal range for quarantine.

I have been working out extra hard during quarantine, and I'm wondering if that has had an effect. Online research says strenuous exercise increases those items.

Please advise if you think I should see an oncologist or hematologist? I am quite concerned about my WBC. My test values are mentioned below:

Glucose (mg/dL) 89.00.
Calcium (mg/dL) 9.70.
Magnesium (mg/dL) 2.20.
Creatininekinase (U/L) 1 767.00.
Vitamin B12 (pg/mL) 355.00.
Folate (ng/mL) 20.70.
Vitamin D (ng/mL) 64.00.
Ferritin (ng/mL) 27.00.
Total cholesterol (mg/dL) 152.00.
Hemoglobin (g/dL) 14.90.
HDL (mg/dL) 56.00.
LDL (mg/dL) 82.00.
Triglycerides (mg/dL) 61.00.
Testosterone (ng/dL) 816.00.
Sodium (mmol/L) 143.00.
White blood cells (thousands/uL) 3.60.
HbA1c (%) 4.90.
ALT (U/L) 44.00.
Cortisol (µg/dL) 14.00.
Iron (ug/dL) 153.00.
TIBC (ug/dL) 287.00.
Albumin (g/dL) 4.90.
Free testosterone (ng/dL) 9.78.
AST (U/L) 79.00.
GGT (U/L) 13.00.
TS (%) 53.00.
SHBG (nmol/L) 64.00.
hsCRP (mg/L) 0.30.
Red blood cells (x10E6/µL) 4.97.
Neutrophils (cells/µL) 1 778.00.
Basophils (cells/µL) 29.00.
Eosinophils (cells/µL) 112.00.
Lymphocytes (cells/µL) 1 429.00.
Monocytes (cells/µL) 252.00.
Hematocrit (%) 44.10.
MCV (fL) 88.70.
MCH (pg) 30.00.
MCHC (g/dL) 33.80.
RDW (%) 12.10.
Platelets (thousands/uL) 160.00.
MPV (fL) 12.10.
Neutrophils (percent) (%) 49.40.
Eosinophils (percent) (%) 3.10.
Basophils (percent) (%) 0.80.
Lymphocytes (percent) (%) 39.70.
Monocytes (percent) (%) 7.00.
RBC Magnesium (mg/dL) 4.90.

Kindly guide.

Answer 1

Hi,

Welcome to icliniq.com.

I have read all three reports (attachment removed to protect patient identity).

The total WBC (white blood cells) count is low only in the latest attached report. There are many causes for low WBC count, including viral infection to blood cancer.

Your main fear is the possibility of leukemia, a blood cancer. However, if you have blood cancer like leukemia, then in a differential count, premature cells should be present, like myelocytes, metamyelocytes, blast cells, etc. All these cells are not present in the attached report. So the possibility of leukemia is very unlikely.

Exercise increases count usually, but it is not in your case. However, do not worry about that. I suggest you drink more water and repeat your CBC after a few days. Revert with repeat CBC report.

If the total WBC count is still low after a few days, then peripheral smear examination and USG (ultrasound) of the abdomen to check the liver and spleen should be done.

I hope this helps.

Revert if you have any other questions.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Isotretinoin could also cause a low count. However, the drug-induced low count is temporary. An unnoticed viral infection can also be the cause of the low count, which is also temporary.

So, considering these two causes as a possibility, kindly repeat CBC with a peripheral smear examination report of the blood after a few days. Mostly after a few days to a week, your count will be normal. You can revert with that repeat report.

I hope this helps.

Please let me know if you have any other doubts.

Thank you.