Been lurking here for months.
Took the physical and lab for a drug study (geno2b) but they said my neutrophil count was too low. I searched/google and to those of you knowledgable, what does that mean.
I was going to start a 24 week tx on Thursday. I was retested yesterday but my neutrophils are always low and my GP or hepatologist never said a word (last four labs).
Neutrophils are a type of white blood cell (there are several types of white blood cells, not just one). Neutrophils are also called "ANC's" on some labwork. They're responsible for fighting off bacterial and fungal infections, so if they fall to very low levels you can be vulnerable to potentially dangerous infections. Taking interferon is what causes neutrophils to drop in your bloodtstream, so that's why low neutrophils (i.e. "neutropenia") are a common problem/side effect with HCV treatment. Low neutrophils during treatment are usually dealt with by either lowering the IFN dose and/or by giving the patient neupogen (a white blood cell booster drug). Unfortunately lowering IFN dose below optimal levels can adversely affect the odds of going on to SVR later. So if there is any (safe) way to avoid a dose reduction (by taking neupogen for instance), a patient would be well advised to strive for that goal.
So you have low/marginal neutrophils to start out with before even taking the treatment drugs?? If so that's too bad, not sure what might be done to correct for that (other than taking neupogen, which would probably be ill advised for someone not yet on treatment). I do know that exercising vigorously can at least temporarily boost your neutrophil count. There are a lot of neutrophils in your body that are trapped in your tissues and are not always being circulated within your bloodstream. Vigorous exercise mobilizes many of these trapped neutrophils and returns them to the bloodstream, thereby increasing your measured neutrophil count (as long as the blood was sampled shortly after exercising).
I don't know if a regular intensive exercise program actually helps to increase actual total neutrophil count within the body, but it wouldn't surprise me if it did. Exercise has long been known to stimulate and improve the effectiveness of our immune systems (neutrophils being a part of that immune system). Considering those observations, if I were looking to start treatment and had marginal starting ANC's, I'd seriously look into starting a vigorous regular exercise program. And I would do so well prior to enrolling in any drug trial or SOC alone. Exercise also has the added benefit of increasing hemoglobin which is commonly depressed by ribavirin. This could give you some headroom which may prove very useful in preventing riba dose reductions and also in alleviating fatigue (which can be crushing, I can assure you). All in all, starting a regular vigorous exercise program is a good idea for a whole host of factors especially prior to enrolling in any HCV treatment program.
I have to laugh to keep from crying. I fx my fibula Easter w/e, had ankle surgery so treatment was delayed due to that. I would have been well into this treatment by now. Sucked up all my sicktime I had saved for this illness.
So no, I have not been exercising other than arm weights and abdominal work.
Before Easter, I was a regular gym member, spinning classes, weights, aerobic classes. At 54 y/o, very active person. I have a very strenous job which I get to return to on Monday.
Everything happens for a reason.....so one day I will look back and see why.
Other than hep c, I don't have a single medical problem. Low neutrophils??? Nobody ever said a word.
Thanks so much for responding. I get my lab tomorrow. Either I start treatment on Thursday or I'm waiting. Geno 2b and the doctor said I could easily wait. I just jumped on the drug study when it was offered to me three weeks ago.
I remember feeling really worried and stressed about starting treatment. All in all it hasn't been that bad. The first injection was the scariest but it was so easy to do and the effects of the first injection were minimal and thought this is going to be a breeze. After 17 weeks things are manageable with support, support, support and lots of water. I can't believe how fast the time has gone by.
Tonight I am in limbo. Guess I will just wait and see. I have alot of faith in my hepatologist and the research group he is associated with. I live in a large city and several GI doctors said "he is the one". After a 2nd and 3rd opinion. lol
I stopped worrying about the treatment and side effects (the dozens of what if's) since I've known about this since last year. You can only have nightmares and ruin so many days of your life stressing over it, which is exactly what I did. I finally just had to put it in God's hands after the emotional pain was more than I could bear.
I see an heptologist who is part of a surgical and research group. They treat aggressively and are flexible. They see many patients and give second opinions to other doctors. If you are in Northern California or Vegas, I can give you contact info.
I think my doc would quite likely put you on higher dosing of neupogen and monitor you with weekly CBCs. Having said that, I found neupogen harder than tx. If your liver is healthy, you may be better off taking care of yourself and waiting.
Good luck with your decisions.
I also have 2b and had low blood white blood cell counts and low hemoglobin before starting treatment. I thought I was starting in a weakened condition but the nurse told me that it is just the way my body is, everyone is different. My white blood cell count and hemoglobin did go down more from the treatment but they keep track of my test results and so far I haven't needed any new medications or a reduction in my treatment dose. I also had an operation and used sick time at work a few months before starting treatment so I can relate to your comments about postponed treatment and using up sick time at work. I chose to take 6 months off work to complete the treatment because that option was available to me and my family was insistent that I take time off to take care of myself. All the best to you as you start treatment. I am in my 17th week of 24 week treatment so the countdown in on.
mremeet - You make an interesting point about exercise boosting the WBC and hemoglobin. I haven't heard that before and it makes sense according to my body as I don't exercise regularly and haven't for the past couple of years. Mostly due to lack of motivation not for any physical reasons.
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