Low lym­pho­cyte count is cause for con­cern

Cape Breton Post - - IN MEMORIAM/ADVICE/LIFESTYLES - Keith Roach To Your Good Health Dr. Roach re­grets that he is un­able to an­swer in­di­vid­ual letters, but will in­corpo rate them in the col­umn when­ever pos­si­ble. Read­ers may email ques­tions to ToYourGoodHealth@med.cor­nell.edu or re­quest an or­der form of avai

DEAR DR. ROACH: I am a 58year-old male. Sev­eral months ago, I lost 17 pounds, and even though I have gained back about 2 pounds in the past month, I can­not gain the weight back, even by in­creas­ing my food in­take. I feel tired all the time, and my energy level is not good. My doc­tor did a CBC, and my white blood cell count is low, at 3.1 (range is 4-11). He asked me if I re­cently had a cold, and I told him I had not. Since it was a new doc­tor, there are no pre­vi­ous re­sults for com­par­i­son. The doc­tor did not tell me any­thing or in­struct me to do any­thing else, which con­cerns me. There are two other re­sults with low read­ings: lym­pho­cytes are 0.1 (range is 1.2-3.4), and lym­pho­cyte per­cent is 3.4 (range is 20-45).

I would like to know what, if any­thing, I should do next, other than wait­ing a few months for another blood test. Do I have to be wor­ried about this? — V.B.

AN­SWER: I am sorry, but you do have to be wor­ried about this. Your lym­pho­cyte count is ex­tremely low.

There are many po­ten­tial causes, some of which are se­ri­ous. In­fec­tions are the most com­mon cause. Any se­ri­ous in­fec­tion can tem­po­rar­ily re­duce lym­pho­cyte count, but most of these are acute, to the point that peo­ple need hos­pi­tal­iza­tion.

One com­mon in­fec­tion to cause a low lym­pho­cyte count is HIV. In the early days of the epi­demic, a low lym­pho­cyte count was a clue to ei­ther acute or ad­vanced HIV. The Cen­ters for Dis­ease Con­trol and Preven­tion rec­om­mends, and I agree, that all adults should get an HIV test as a part of their rou­tine check­ups, and that peo­ple with on­go­ing risk should get a test an­nu­ally.

A par­tial list of other causes for low lym­pho­cyte count in­clude med­i­ca­tions (usu­ally pow­er­ful anti-im­mune-sys­tem medicines or chemo­ther­apy), au­toim­mune dis­eases such as lu­pus or rheuma­toid arthri­tis, lym­phoma and other can­cers, and pri­mary dis­eases of the im­mune sys­tem, such as aplas­tic ane­mia. Pre­vi­ous re­sults would help in­di­cate whether this is a new con­di­tion.

This can't wait a few months for a fol­low-up test. If your doc­tor isn't look­ing ag­gres­sively for the cause, you need a sec­ond opin­ion.

The arthri­tis book­let dis­cusses rheuma­toid arthri­tis, os­teoarthri­tis and lu­pus. Read­ers can or­der a copy by writ­ing: Dr. Roach — No. 301, Box 536475, Or­lando, FL 32853-6475. En­close a check or money or­der (no cash) for $4.75 U.S./$6 Can. with the re­cip­i­ent's printed name and ad­dress. Please al­low four weeks for de­liv­ery.

DEAR DR. ROACH: While read­ing your re­cent ar­ti­cle about sul­fites, a ques­tion came to mind: What are sul­fites? Are they min- eral, chem­i­cal, or­ganic? Do they grow on trees? How do they af­fect food? — M.C.

AN­SWER: Sul­fites are chem­i­cals found nat­u­rally at low lev­els in wine and some foods, and are used as preser­va­tives at sig­nif­i­cantly higher lev­els.

Most peo­ple are not sen­si­tive to sul­fites even at high lev­els, but some peo­ple have sig­nif­i­cant re­ac­tions even at fairly low lev­els. Peo­ple with se­vere al­ler­gies need to know that sul­fites are not al­ways in­di­cated on the la­bel and should ed­u­cate them­selves about all the foods con­tain­ing sul­fites. One re­source I found is at https://edis.ifas.ufl.edu/fy731.

Ev­ery­thing we eat, drink and breathe is com­posed of chem­i­cals. The dif­fer­ence be­tween a “bad” chem­i­cal and a “good” one is one of dosage: We can't live with­out oxy­gen, but too much oxy­gen is toxic. Most med­i­ca­tions are use­less at ex­tremely low doses, help­ful for some peo­ple with cer­tain con­di­tions at the proper dosage, and toxic if taken at too high a dose.

Sul­fites are no ex­cep­tion to this rule and, like any other chem­i­cal, some peo­ple are more sen­si­tive to toxic ef­fects at lower doses than oth­ers.

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