What exatly happens to you when your blood count gets too low?

[Jane_s]

At week 44 now and have to go and have an extra blood test next week because my blood count(?) levels are too low, this is about the third time this has happened during treatment and each time I pick up again by the next blood test but I never did ask what happens if they fall below the lowest 'safe' level. Can anyone tell me what happens please?

[sofarsogood]

Jane, red blood cells carry a molecule called hemoglobin. Hemoglobin latches onto inspired oxygen via the lungs and delivers it to the cellular level where processes occur promoting life. Too low of hemoglobin and you don't have enough oxygen carrying capacity. Depending on other co-morbid conditions one may have (cardiovascular disease, emphysema, chronic obstructive pulmonary disease, cancers, several other respiratory diseases) adding an insult of low oxygen carrying capacity may compound things. One may tolerate a low blood count where another (different age, co-morbid conditions) may run into problems. Shortness of breath is a big issue. Increased chest pain in a person with coronary artery disease may occur.

As an ER nurse I've seen people come in with hemoglobins as low as 4 and be alive. This is almost always a process that occurs over weeks and the body has a chance to compensate. They are by no means doing well though and in fact are in trouble.

While on combo therapy my hemoglobin dropped to 8.5. Combo therapy causes the red cells to destruct. It is call a hemolytic anemia. I felt like ****. Poor exercise tolerance and shortness of breath were the main symtoms.

Believe me when I say this. There are many, many things/conditions that can cause a low blood count. Again with combo therapy it is hemolysis or bursting of the cells that cause the issue.

Hope that isn't too complicated for you. It is nice to be in the normal range when having a blood count done. IMHO one cannot really appreciate it until they have acutally taken care of people with anemia or experienced it themself.

Dale

[cuteus]

which blood count? red or white?

[sofarsogood]

red

[cuteus]

lol, I mean jane's count, she did not state which one had lowered in her case, maybe we should post the wbc info also just in case.

[sofarsogood]

lol, I think she is referring to red cells. But the whites take a hit on the meds as we all know. I believe the reason white blood cells decline is secondary to immunosuppression, or the meds working on the bone marrow to not kick out as many white cells as normal. There is a lot more to the body's ability to fight off infection than just bone marrow suppression. It is a bit too detailed to tell about here.

The simple answer is too low of a count of white blood cells (WBC) increases the chances of contracting an infection. While on tx my whites hovered in the 1.5 to 1.8 range (in thousands), it was a decrease from the normal of 5-10K. That is OK because another value the physician looks at when checking a complete blood count is called the absolute neutrophil count (ANC). I believe neutrophils are precorsors to white cells. In the face of a low white count I had a barely adequate ANC. I did OK without needing a drug like neupogen.

Dale

[help1564]

I have been advised that my blood count is low. I have heavy blood lose every month during my period after having my tubes cut and burnt. My blood count now is 8, I was given a chart on foods to eat, and I have started. Though I have no other medical conditions. And on top of that I have been lately consuming a lot of alcohol, nine beers wvery other day along with a two glasses of wine, and eating tons of ice. Please help.

[nygirl7]

"Though I have no other medical conditions. And on top of that I have been lately consuming a lot of alcohol, nine beers wvery other day along with a two glasses of wine, and eating tons of ice."

That in itself sounds like a medical condition to me.  Thinning your blood with alcohol certainly won't help anything. I advise you to get some help to find out what additional circumstances are causing you to have such problems.  If you aren't on treatment and don't have hepC the most likely you will need to go to a forum that discusses blood matters. We don't know too much about that here as this is a HCV forum and most people are or have been patients of that disease.

AA is a great program and there are many many meetings in every town in the country.

Good luck.

[Mplsgirl57]

My husband started the combination therapy for hep c in December and his blood count and platelets are very low.  I think his hemoglobin is around 9 and they want to start him on Procrit.  Is this for his hemoglobin?  He seems to cough constantly, esp. when we go walking.  Is this from low homoglobin too?  I'm hoping the coughing will stop when he starts on Wed. with procrit.  Also I read here that there is a diet he should be following.  His drs. have not said anything about a diet.  Can you share this with me?  Thanks!

[jdwithhcv]

Yes, procrit will help the low hemoglobin.  The shortness of breath and coughing during exertion are related to the anemia (low hemoglobin).  The procrit should help but it does take a couple of weeks to see any improvement.

As for diet, I don't know of a particular recommended diet.  He should eat healthy food but during treatment many people have problems eating.  He should eat whatever he can tolerate.  Good luck to you both.  This treatment is hard but if he can clear the virus it will be worth it.

jd

[Mplsgirl57]

Thanks for the info!  Good to know.  It's hard to get answers from the drs. sometimes.  

After 12 weeks his counts are still not negative.  They were concerned that he still had a trace in his blood and said it may not go away at this point.  He is continuing his treatment for a while longer with 1 shot a week and if still no negative results he may have to take a shot everyday.  Have you ever heard of anyone getting rid of hcv past the 12 week mark?  We are so worried about this.  It has ruined his liver to the point that he now has cirrohsis.  Can someone live a long life like this?  I'm hoping for some good news for him!

[jdwithhcv]

Yes, there are people who do not clear by week 12 but go on to acheive SVR.  Many of them extend treatment to 72 weeks.  I am not too knowledgable about extended tx, but there are quite a few on this forum who are and I hope they will chime in.

The daily shot your doctor discussed is probably consensus interferon, which is called Infergen.  A couple of people on the forum are taking Infergen.  It is a particularly difficult course of treatment, but if it helps him clear the virus that will be a good thing.

Keep posting and reading.  This is a great place to get information, or just to vent when you need to.

[portann]

Hi Mpls,

Welcome to the forum. I'm glad to hear your husband will be starting Procrit this Wednsday.

Do you know his platelet count? Mine has gone as low as 50, and my doctor was not concerned.

The thanks are mine for your having found and brought up this very old and valuable thread from 2005. It cheered me up to read some of the comments.

As it turns out, as of last week my own hgb tanked and can I ever feel it. How the heck is your husband walking around with a HGB of 9? I can barely talk (a good thing) and feel shaky. I asked my phlebotomist at the lab this afternoon to carry me home and she was half-tempted, seeing me so wilted. So your husband is amazing.


My hgb stayed at ten or above without procrit for 43 weeks of treatment but now that it's below ten, it's another world. A walk to the bathroom feels like the early days when my HGB dropped suddenly from 16 to 11. I functioned decently for months at my new low number but it's altogether different down here in the 9's.

I have no hesitation in recommending that your husband start procrit this Wednesday but it can take two or four weeks to kick in.

As for diet, that's a hefty topic around here. And I don't know anything about why he'd be coughing due to treatment.

[Mplsgirl57]

Thanks for the info.  This is a great website that I just literally stumbled on today.  I will have to check back frequently.  Yes, my husband sleeps most of the day away.  He is not working now and frankly I do not see how anyone can hold a job with all the dr. appts and fatique that goes with it.  He was diagnosed about 8 years ago and was not responsive to the other interferon, but last summer I got him to go back in and he is taking good care of himself now.  He has progressed to cirrhosis now and his symptoms are the itchy skin (just aweful - to the point that he starts bleeding from scratching) and  fatigue.  His platelet count is down to about 34 or 36.  Last week he had his 12 week follow up and there was still a trace of hep c (about 2040) and they wanted him to be negative at this point.  They told us that he is non-responsive at this point and his alternatives were to stop everything, keep going with 1 shot/week and 6 riba pills/day or he can start taking the shots every single day and try to get rid of it that way.  They are also going to see if there are any clinical trials for him.  So he wanted to go one more month with 1 shot/week and see if the numbers go down a little, if not he will have to start daily shots along with blood pressure meds and procrit shots weekly.  He is staying very positive, but of course has his bad days.  There are so many questions.  This website is very helpful.  Thanks to all of you for responding!

[portann]

It's truly amazing how having support can lift people's morale and make a hard road ahead seem easier.

Maybe ask him to join the forum, too. He may be surprised at how many helpful people have been, or are, in his boat.

[thegypsy9164]

Hello Jane,

My RBC went to 7.1.  You've had good information provided here from others and I'll not remake the wheel.  At 7.1 I felt like death.  Everything hurt, I had a hard time breathing, I passed out and was on the border to repeat that every minute and other not real fun stuff.  They did a transfusion on me, gave me a couple bags of blood and my treatment was temporarily interrupted.  That was a week ago.  My RBC is now in the 10's and I actually have some energy again.  Had enough to get out in the yard and get dirt under my fingernails (yeehaa!) this past weekend.  I almost went to the dropzone and did a couple of skydives but I'm not strong enough yet to resume my passion quite yet.  Work closely with your doc on the RBC. I understand how sick you can get with it being too low.  Good luck and make responsible, informed decisions.
Joey

[Mplsgirl57]

Can someone tell me what these abbreviations mean?

SVR
Tx

Also, does anyone else suffering from coughing during treatment?  

[Bill1954]

There is a list of acronyms used here listed on this page under “commonly used HCV acronyms”; you can find it in the box “most viewed health pages’ or click on this link:

http://www.medhelp.org/health_pages/Hepatitis/Common-Hepatitis-C-Acronyms/show/3?cid=64

Welcome to the forum—

Bill

[Bill1954]

Unfortunately, a lot of patients undergoing HCV treatment develop a mean cough; usually a dry hack. This can be attributed to either the ribavirin or low hemoglobin; hopefully, the Procrit will help him get some relief. Make sure he mentions this to his doc; they might have other ides to help as well.

Take care—

Bill