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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18663
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hi Dr David I just got a message from another Dr on just

Customer Question

Hi Dr David
I just got a message from another Dr on just answer saying that my wbc isn't normal ! I didn't ask her a question she sent a reply to me ?
Now I'm confused ?
Can you help ?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.
The expert that you requested has not responded, probably because he is not online, so the question has been opened to other experts to get a more timely answer.
However, it is up to you whether you would like to wait.
Do you want to wait for your requested expert to return online?
Or can I be of assistance?
Customer: replied 2 years ago.
Hi Dr love.
You know me so I will be happy to get your help.
Dr David and yourself have reassured me that my wbc of 3.69 to 4.2 is ok to live with but another Dr on just answer replied to me. , I didn't ask her a question !! And scared me saying bone marrow biopsy ??????
Expert:  Dr. D. Love replied 2 years ago.
Hello again.
If I recall correctly, the WBC has been in the range of 3.69 - 4.2 on multiple occasions, correct?
What is the differential for the WBC of 3.69?
Customer: replied 2 years ago.
Sorry what does that mean please ?
Expert:  Dr. D. Love replied 2 years ago.
The differential is the count of the various different white blood cells that total to 3.69, such as neutrophils, lymphocytes, etc. Do you have the differential?
Customer: replied 2 years ago.
Yes sir
Neutrophils 2.08 lymphosites 1.13 mono sites 0.3 eosophils0.16 monosites 0.34 basophils 0.03
Expert:  Dr. D. Love replied 2 years ago.
Very good.

These numbers are OK.

A WBC of 3.69 that is remaining at about that level is frequently normal, although the differential is also important to review. For someone that normally runs a WBC in the middle of the normal range that then suddenly develops a WBC of 3.69, it may be a significant change that requires further consideration, but since you are consistently running 3.69 - 4.2, it would be less of a problem, if the differential is OK.

The reason that the differential is important is that the WBC is actually a total of the counts of each of the different types of WBC. There is a normal range for the total WBC, but there is also a normal range for each of the individual types of WBC. In someone that has a level for each of the individual WBC types that are each in the lower portion of the normal range are still normal, but the total will be low. This is true in your case. Each of the individual types of WBC are OK, so the fact that the total is low is not a concern.

Interpretation of any lab value also has to be done in the context of normal statistical variation. If you took any classes in statistics, you may recall the concept of the standard deviation. The normal range for most labs is defined as the values encompassed by two standard deviations above and below the average value for a normal population, and by standard statistics, this will include 95% of that normal population. So, by definition, 5% of normal people will have a lab result that is outside the normal range. So we frequently deal with people that have a value that is slightly outside the normal range, and this is not an issue.

In your case, there is no reason to be concerned about the WBC level of 3.69 with the differential that you note above.

If I can provide any further information, please let me know. If I can assist you in the future, you can post a question through my profile at www.justanswer.com/medical/expert-DrDLove/.
Customer: replied 2 years ago.
Are you saying that a cancer for example would drop the variants In a different way ie drop one part of the count dramatically or move all my other numbers around. They were normal on my cbc. FYI. C relative protein 0.6 platelets 158 red cells 5.0 iron 29.9 esr 1. I've also been told that cancer can show high wbc?
Expert:  Dr. D. Love replied 2 years ago.
Yes, if the low WBC is because of cancer, for exam le, then one of the individual types of WBC would be abnormal relative to the normal range for that type of WBC. Cancer can cause either a high or a low WBC, depending upon the type of cancer and the presentation. For exam le, cancer that is causing a low WBC by affecting bone marrow production will typically present with a low neutrophil count, which is the type of WBC that is most sensitive to changes in the bone marrow.

So, there is more of a potential issue if someone presents with a WBC of 3.69, and has a lymphocyte count that is in the middle or upper portion of the normal range for lymphocytes, but a neutrophil count that is significantly below the lower limit of the normal range for neutrophils. But in your case, with each type of WBC within the respective normal ranges, there is not a similar concern, even though the total is the same.
Customer: replied 2 years ago.
Looking back over a year the neutrophils have been 1.67 to 2.10 Lymphosites 1.03 to 1.3 and the others stay the same. But they do rise and fall slightly. In January for example the wbc was 3.1 by July it was 4.1 then sept 3.43 October 3.69. I'm guessing it would go up with something serious ???????
Expert:  Dr. D. Love replied 2 years ago.
It may go up with certain serious conditions, but it also may get progressively lower with other serious conditions. Using the above example, a cancer that is affecting the bone marrow will cause a progressive lowering of the neutrophil count.
Customer: replied 2 years ago.
But mine going back up from last time is ok and that I should put that out of my mind ?
Expert:  Dr. D. Love replied 2 years ago.
Yes, your levels are fine.
Dr. D. Love and other Medical Specialists are ready to help you
Customer: replied 2 years ago.
My doctor has reviewd the last 3 years blood work it sits between 3.3 and 4.7 the whole time. Neutroohil between 1.78 and 4.01 up and down.
He agrees completely with you he examined me and said I am fine.
Sent me on my way.
Do you agree with him ?
Expert:  Dr. D. Love replied 2 years ago.
Yes, I agree with him, which is also in agreement with what I noted above.
Customer: replied 2 years ago.
Thank you again Dr love I will leave a bonus for you as you were there when my anxiety needed help it's also worth mentioning that I had a large molar extracted surgically a week ago and the socket healed in 5 days !!!
My doctor said that adds to my reassurance do you agree ?
Expert:  Dr. D. Love replied 2 years ago.
Yes, that is also a good sign of overall excellent health.
Customer: replied 2 years ago.
So if the bloods keep coming back at 3.3 and above it will stay that way and is ok as long as the neutrophils don't drop below 1 and the lymphosites don't fly up ?
Esr1 ck 100 c relative protein 0.6. Red cell 5.0 iron 28.2 hct .45 and platelets 155 are also good signs ?
Bonus on its way. Last question for today
Expert:  Dr. D. Love replied 2 years ago.
Yes, it is fine if the WBC and differential continue in these ranges indefinitely. If the neutrophils drop significantly, then that would warrant further evaluation.

These other labs are all fine.