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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56240
Experience:  GP in the United States
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What might be the reason I have had a lowish white cell count

Resolved Question:

What might be the reason I have had a lowish white cell count for over a year?
Should I see a haematologist? It has been about 3.4-3.7
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Phil, MD replied 3 years ago.

Dr. Phil, MD :

Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.

Dr. Phil, MD :

please enter chat mode

Dr. Phil, MD :

Hi I'm Dr. Phil. Can I ask your first name?

Customer: Wendy
Dr. Phil, MD :

Hi Wendy. Nice to meet you

Dr. Phil, MD :

Do you have any health problems?

Dr. Phil, MD :

Are the counts normal otherwise?

Customer: Hi, yes, except MCHC WHICH IS 351 just slightly above upper limit!
Dr. Phil, MD :

ok good.

Customer: I am on Zoladex implants for fibroids and Livial for menopause symtoms
Customer: this is the only medication I take
Dr. Phil, MD :

let me look that up for a minute

Customer: have always been fit and healthy until the last year where I get one virus after another
Dr. Phil, MD :

I see.

Customer: was so bad in Palma last year ended up in hospital for 3 days, with heart attack symptoms but after ruling that out they said I had avirus
Dr. Phil, MD :

Could it be the medicines?

Dr. Phil, MD :

I suspect it could be

Customer: how would they compromise my immune system like that?
Dr. Phil, MD :

these drugs have a lot of side effects

Dr. Phil, MD :

these are very potent drugs

Customer: i continually feel tired, headaches, painful teeth gums, jaw, metallic taste in my mouth and itch all over
Dr. Phil, MD :

I think you need to get off these drugs Wendy

Customer: my sister & father have pernicious anaemia but if anything my B12 is high
Dr. Phil, MD :

ok good

Customer: my son was diagnosed with systemic lupus last year ?
Customer: would there be any connection
Dr. Phil, MD :

I see. I'm sorry about that.

Dr. Phil, MD :

Yes, there could be for sure!

Dr. Phil, MD :

lupus is well known to cause low white counts

Dr. Phil, MD :

you should get tested

Customer: how do you get lupus?
Dr. Phil, MD :

it is your own immune system going whacky

Customer: what test can they do
Dr. Phil, MD :

blood tests for it

Customer: which tests ? What are they looking for?
Dr. Phil, MD :

blood tests---ANA, dsDNA for two

Dr. Phil, MD :

They are looking for inflammation mostly

Customer: I feel bloated all the time and have put on a stone since last year, having never had a weight problem
Dr. Phil, MD :

That could be thyroid related.

Dr. Phil, MD :

Thyroid can also explain some other symptoms. That should be tested as well Wendy

Customer: why would my GP not do these tests? She has suggested I see a haematologist??
Dr. Phil, MD :

Maybe she doesn't feel comfortable working up lupus. Many doctors don't

Customer: Why?
Dr. Phil, MD :

It is a very complex and mysterious disease

Dr. Phil, MD :

That is hard to diagnose

Customer: i really can't believe that is what I have, as my son had blisters all over his body which were horrendous!
Dr. Phil, MD :

I have seen dozens of lupus patients and never seen blisters

Dr. Phil, MD :

There are a wide variety of presentations of lupus Wendy.

Customer: Should I not see an immunologist then?
Dr. Phil, MD :

Not many have blisters

Dr. Phil, MD :

No, you should see a rheumatologist

Customer: I saw my gynaecologist on Sat and he has told me to stop the implants for the time being to see how my ovaries react, so hopefully the menopause symptoms will not be so severe but the constant viruses are getting me down, and I'm normally very upbeat
Dr. Phil, MD :

I think this will help a lot to stop the implants

Customer: should I go back to GP or to haematologist, which is hard to find privately
Dr. Phil, MD :

I would go back to your GP

Customer: and say what?
Dr. Phil, MD :

say your low white count is a result of something else. Not a primary problem

Dr. Phil, MD :

You have a family history of lupus and other symptoms of autoimmune disease

Dr. Phil, MD :

you request a rheumatologist

Dr. Phil, MD :

or a further workup by your GP

Customer: is lupus hereditary?
Dr. Phil, MD :

yes, it can be

Customer: what is ME? Would the symptoms be similar?
Dr. Phil, MD :

I'm not familiar with it

Customer: another symptom is my mouth feels swollen at time inside
Dr. Phil, MD :

Interesting. That can be stomatitis

Dr. Phil, MD :

Another sign of lupus

Customer: ok well I don't really feel any the wiser but thank you.
Dr. Phil, MD :

You don't Wendy???

Dr. Phil, MD :

I thought I provided you with a ton of info!

Dr. Phil, MD :

Lupus is when your immune system goes wacky

Dr. Phil, MD :

It can cause a variety of symptoms including low white count, sore mouth, fatigue, etc

Dr. Phil, MD :

It could also be your meds

Dr. Phil, MD :

I would look to diagnose lupus first and get off your meds

Dr. Phil, MD :

start there

Dr. Phil, MD :

does that help?

Customer: I can try my GP again but why would she not have suggested testing for lupus?
Dr. Phil, MD :

Maybe she didn't think of it Wendy

Dr. Phil, MD :

Your GP is only human.

Dr. Phil, MD :

Many doctors are good in some areas and not so good in others

Customer: yes, well was in nursing for 26 years and feel that it shouldn't be the patient who does the ground work and investigations ,
Dr. Phil, MD :

Correct.

Dr. Phil, MD :

But you have to be your own advocate sometimes Wendy

Dr. Phil, MD :

Which is what you are doing

Customer: nevertheless I will go back down the GP route, albeit they don't like it when you make the suggestions
Dr. Phil, MD :

That is a plan :)

Dr. Phil, MD :

Did I do excellent work Wendy?

Customer: Excellent would be to say you have suggested something I hadn't already thought of but I was able to bounce my thoughts and discuss my concerns . Thank you :)
Dr. Phil, MD :

thanks :)

Dr. Phil, MD :

would you be so kind as to rate me positive and follow up with me to let me know how it goes?

Dr. Phil, MD :

hello?

Dr. Phil, MD :

wendy?

Dr. Phil, MD and 3 other Medical Specialists are ready to help you
Expert:  Dr. Phil, MD replied 3 years ago.
I noticed that our chat is not complete.

A positive rating is the only way I am credited for my work. However, my main goal is your 100% satisfaction. If you are satisfied, please rate positively. If not, just click reply and I will happily provide more information.