Nutrients can’t fix low blood cell count

Dear Dr. Roach: I am 90 years old and in good health. I recently saw my doctor and had abnormal blood test results.

My white cell count was 2.1, my hemoglobin 9.5 and my hematocrit was 29 percent. Is there a vitamin or food I can take to raise my levels? — M.A.

Both your white blood cells and red blood cells are abnormally low. Before prescribing a course of treatment, such as a vitamin or special diet, it’s critical to find out why these counts are low. I don’t have enough information to narrow down a long list of possibilities, but I can outline the approach doctors generally take when considering this condition.

I would first want to know the results of your platelet count. I expect that it will be low, in which case the condition goes by the general name of “pancytopenia,” which just means “all the blood cells are low.”

While it is true that some nutritional deficiencies can cause this (vitamins B-12 and folic acid, and the mineral copper are the most common), there are many other causes that are more common. Since all of these cells are produced in the bone marrow, a marrow biopsy sometimes is necessary. However, long before that point, a hematologist (blood specialist) will do a complete history and exam, and will look personally at your blood sample for signs of infection, immune system diseases, medication side effects and primary bone marrow diseases that can cause this problem.

Some of the causes are serious and benefit from early intervention, so I would recommend seeing a specialist about this soon. Age makes some conditions much more likely. In a 20-year-old with this, I would think about EpsteinBarr virus (the cause of infectious mononucleosis), but at age 90, I’d be concerned about the myelodysplastic syndromes. Please let me know what you find out.