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Why might I have and high wbc

I had two surgeries in 2016 and have yet to be the same. Emergency gall bladder and complete hysterectomy at two different times. Ever since gall bladder surgery, i have been so swollen in my arms, hands, face, fingers, stomach.. i am most swollen when I wake, but stay swollen through out the day even with taking a diuretic. My vitamin D stays low even though I’ve been taking 51,000 iu 2X a week for almost a year. It’s only 38. Without the huge doses, it goes way low.. so obviously my body is not retaining it. I have not been able to lose weight and I’m one of the most discipline dieters.. i eat healthy anyway, but I don’t cheat when I’m dieting. My cholesterol is high too. The good cholesterol is low(which should be high) and the bad cholesterol is high... my blood pressure is great. My wbc is 13.2 and my red blood cells are high normal.. i had high absolute lymphocytes and high immature granulocytes. Please help me figure this out....
35 Responses
1081992 tn?1389903637
COMMUNITY LEADER
Hi, first off: was your gall bladder empty of stones ("acalculous") ?  If so, that would point to an immune system gone awry.

2nd: are you taking any medications, e.g. steroids?

1 Comments
I did have a few stones in my gall bladder.

I’m taking hormones: progesterone, estrogen, was taking testosterone but now my testosterone is too high...
I’m taking adderall, vit D, diuretic, acid reducer, Effexor
1081992 tn?1389903637
COMMUNITY LEADER
Okay, I just took a *quick* look and Effexor doesn't seem to cause any of your symptoms. It's best to check more than one source, though.

I believe that testosterone can make your cholesterol go bad.

Leukocytosis (high WBC) can be caused by stress and/or stimulants (Adderall). But your WBC is not near high enough to think of leukemia, btw.


It's a good idea to first identify which symptoms can be caused my meds, then focus on what remains. Have you been able to sort through all that procedure yet?

Have you had your cortisol level tested?





1 Comments
My cortisol levels were normal last time they were checked, but it may have been 6 months ago. I have tried to research my meds and see if that could be cause.. is it weird that my wbc is high and my red blood count is “almost” high?
Wonder why I can’t retain Vitamin D?
Do you think lymphoma is something not to worry about either? I have had an enlarged lymph node in my left arm pit for years. My dr has had 2 ultrasounds on it. All they tell me is lymph nodes enlarged... can they be enlarged for no good reason?
1081992 tn?1389903637
COMMUNITY LEADER
Lymph nodes normally get enlarged to fight some infection. When they don't go down afterwards as they should, it would usually be from internal buildup of scar tissue (fibrosis). Or it could be from a chronic infection, like EB virus. Or 'granulomas' inside. That could very well be related to elevated WBCs.

I'd have to think about how the low vit D fits in, it could be a cause or an effect. The same for elevated RBCs.


Can you get the sonogram reports? If they say
"fatty hilum" or "normal architecture" is present, you can stop worrying about lymphoma. (I wouldn't worry about lymphoma anyway at this  point.

I'll be back later...

1 Comments
Yes, I’ll look for report! Thank you so much for helping me. I’m not sure if I mentioned how tired I’ve been since having gall bladder surgery in ‘16. I teach part time and get off by 2:00. When I get home, I’m resting . On weekends, it’s hard to do anything for my lack of energy as well. So the swelling and lack of energy are causing me not to be able to enjoy life with family and friends..
1081992 tn?1389903637
COMMUNITY LEADER
I think we can make some progress on Dx'ing this :)

Do you have any CBC that breaks down your granulocytes as to which one is high? Eosinophils, basophils, and also what are your neutrophils?

I think that you are correct that the gallbladder surgery triggered this, possibly a runaway immune reaction. That can certainly cause chronic tiredness, too.

Would you say that your sleep in unrefreshing?

Do you have blood relatives with odd immune conditions? Lupus, bad allergies, Raynaud's?

Do you get spontaneous flushing of the skin?

Do you get lightheaded when standing?

Did you have any bad reaction to the surgery anesthesia?


(It's very good that your answers are so thorough.)
2 Comments




CBC WITH DIFF PLUS ABSOLUTE COUNTS 05/27/2018 (#1966748, Final, 05/23/2018 2:39pm)
Report Result Ref. Range Units Status Lab
WBC 13.2 3.8-11.5 K/uL High Final
RED BLOOD CELL COUNT (RBC) 5.24 3.60-5.30 M/mm3 Final
HEMOGLOBIN (HGB) 15.0 12.0-16.0 gm/dL Final
HEMATOCRIT (HCT) 45.6 37.4-48.3 % Final
MCV 87.0 81.0-102.0 fL Final
MCH 28.6 26.9-35.0 pg Final
MCHC 32.9 30.4-34.8 g/dL Final
RDW 43.4 38.6-53.8 fL Final
PLATELET COUNT 379 137-397 K/cumm Final
NEUTROPHILS AUTOMATED 59.4 41.0-77.0 % Final
LYMPHOCYTES AUTOMATED 32.8 14.0-48.0 % Final
MONOCYTES AUTOMATED 5.6 4.0-13.0 % Final
EOSINOPHILS AUTOMATED 1.3 1.0-8.0 % Final
BASOPHILS AUTOMATED 0.5 0.0-1.5 % Final
IMMATURE GRANULOCYTE AUTOMATED 0.4 0.0-1.0 % Final
ABSOLUTE NEUTROPHIL COUNT 7.9 2.0-8.2 K/uL Final
ABSOLUTE LYMPHOCYTE COUNT 4.3 0.9-3.6 K/uL High Final
ABSOLUTE MONOCYTE COUNT 0.7 0.3-1.0 K/uL Final
ABSOLUTE EOSINOPHIL COUNT 0.2 0.0-0.6 K/uL Final
ABSOLUTE BASOPHIL COUNT 0.1 0.0-0.1 K/uL Final
ABSOLUTE IMMATURE GRANULOCYTE 0.05 0.00-0.03 K/uL High Final
RESULT NOTE Test perform
My sleep is not usually refreshing. I toss and turn.  I don’t have blood relatives with lupus or anything you mentioned, but my mom has autoimmune hepatitis along with arthritis.

My grandmother died from adrenal gland cancer which is very rare..
i only have flushing if I’m having a hot flash. I do have lots of allergies to grass and trees and pollens, etc. when I go outside and especially in the heat, my skin literally gets tight from swelling.

I’ve never had bad reaction from anesthesia. I do throw up hours later. I don’t really get light headed when standing but I do sometimes when I use the bathroom... I hope this isn’t TMI!!  I can’t thank you enough for your help. I’m so desperate.
1081992 tn?1389903637
COMMUNITY LEADER
Not TMI at all, it takes lots of info to understand a case like this.

And bingo, here is what I was looking for, re the granulocyte breakdown:
"ABSOLUTE BASOPHIL COUNT 0.1 0.0-0.1 K/uL"

That's at the very upper edge of normal, almost in the high zone. Basophils are similar to the very important MAST CELLS, which cause swelling. This is very likely at the center of your problems.

The term "granulocyte" means that they are cells (cytes) that contain granules, and the granules contain powerful biochemicals. One such chemical is the famous HISTAMINE, which causes fluid to leak from the blood vessels out into the tissues. That's your swelling from water (not from calories of course). That's also runny nose from allergies. Mast cells also put out many other powerful biochemicals that have a large variety of effects.


Do you get very bad reactions from bee stings?

"my skin literally gets tight from swelling"
Likely your mast cells again. And that is a valuable clue because it's rare.

Do you feel dehydrated a lot? Drink a lot of water? Have you had a creatinine/BUN blood test?
2 Comments
Report Result Ref. Range Units Status Lab
SODIUM 141 134-145 mEq/L Final
POTASSIUM 4.1 3.4-5.4 mEq/L Final
CHLORIDE 101 97-109 mEq/L Final
CO2 27 22-32 mEq/L Final
GLUCOSE 84 65-99 mg/dL Final
BUN 10 5-26 mg/dL Final
CREATININE 0.9 0.5-1.5 mg/dL Final
CALCIUM 10.1 8.5-10.3 mg/dL Final
PROTEIN 7.7 6.1-8.3 g/dL Final
ALBUMIN 4.3 3.7-5.2 g/dL Final
ALKALINE PHOSPHATASE 87 38-126 IU/L Final
ALT (SGPT) 22 7-52 IU/L Final
AST (SGOT) 29 13-39 IU/L Final
BILIRUBIN, TOTAL 0.4 0.2-1.5 mg/dL Final
A/G RATIO 1.3 1.1-2.5 mg/dL Final


I haven’t been stung by a bee in years and years... but I had terrible reactions as far as skin swelling and red and hot.. my throat didn’t swell or anything.

I am probably dehydrated. I drink when I feel thirsty, but I should probably drink more but when I do I feel super bloated. I take a diuretic, but I don’t go to bathroom often. Is that weird?

What can I do about all of this???
1081992 tn?1389903637
COMMUNITY LEADER
The bee sting reaction is a classic sign of excess mast cell reactions. No anaphylaxis yet, but you must be wary of things getting worse. A mast cell doc named Theoharides gave all his Pts an epi pen.

What you need is to become very versed in all this so that you can convince a doc to do whatever testing you might want.

"when I do I feel super bloated"
Mast cells line the GI tract, so you can have lots of GI symptoms from them. Also they line the respiratory tract. Also the skin, of course.

What to do? It's complicated. Determine why your MCs are over reactive. Rule out any bad causes. Then take "mast cell stabilizers" probably. Also avoid things that might make your MCs more volatile. You'll have to do research and become expert. There is probably no cure per se, but you can do management and improve your quality of life a lot.

Which diuretic? A thiazide or a lasix/bumex type?

1 Comments
Also what do woikd i see for mast cell diagnosis?
1081992 tn?1389903637
COMMUNITY LEADER
Can you write on your sternum with your fingernail? (dermographia)
1081992 tn?1389903637
COMMUNITY LEADER
Do you have cystitis?
1081992 tn?1389903637
COMMUNITY LEADER
here's an MC degranulating, 29 sec video
https://www.youtube.com/watch?v=VT7knZ6_8rk

Also please find some vids showing "niacin flush". You might flush a *lot* more than normal, so be very careful if you experiment.

Also, have you had homocysteine tested?

Let's see what else... your potassium is okay so you maybe/probably are on a loop diuretic, and you'd have to be wary of loop diuretics producing more prostaglandins which cause reddening. Then there's possibly avoiding arachidonic acid in foods.

Got to go for now...

1 Comments
I’m going to watch the videos and do some research too. I appreciate all of your help. If you think of anything else, please let me know. I don’t know if i have a UTI, I wasn’t checked for that before given the antibiotic that I’m taking now for two weeks. If my wbc is elevated do to the mast cells, will antibiotic decrease my wbc?
1081992 tn?1389903637
COMMUNITY LEADER
here's an MC degranulating, 29 sec video
https://www.youtube.com/watch?v=VT7knZ6_8rk

Also please find some vids showing "niacin flush". You might flush a *lot* more than normal, so be very careful if you experiment.

Also, have you had homocysteine tested?

Let's see what else... your potassium is okay so you maybe/probably are on a loop diuretic, and you'd have to be wary of loop diuretics producing more prostaglandins which cause reddening. Then there's possibly avoiding arachidonic acid in foods.

Got to go for now...

1081992 tn?1389903637
COMMUNITY LEADER
I ran across this very recent article. It pretty much says what we've been talking about.  https://www.medscape.com/viewarticle/893858

Mast Cell Activation May Underlie 'Chronic Fatigue Syndrome'

Also, you hadn't replied as to which kind of diuretic you've been taking, but from a very quick look I don't anyway see that being used to treat angioedema. Angioedema is localized and temporary, while what you have seems to be similar but generalized and chronic - quite possibly because your MCs are constantly releasing. Antihistamines might be a good avenue for you. There are many types. Or/and maybe corticosteroids.

Quercetin is a plant-derived option to try and stabilize MCs.

1 Comments
Thank you so much for this information. The diuretic I’m on is furosemide. I will have repeat blood work tomorrow. I’m hoping my wbc will go down after two weeks of being on antibiotic. While taking the antibiotic I have been even more lethargic. There were days I literally slept until 1:00 in the afternoon. When I would finally wake, I felt drugged... i just want to feel normal again.
1081992 tn?1389903637
COMMUNITY LEADER
It seems to be known that an abx can cause tiredness. The possible cause could be somehow from killing off the beneficial gut bacteria. If ever I was taking an abx, I'd take yogurt as a minimum to help restore the beneficial bacteria. Or you can go further and buy capsules with mixtures that also include bifido etc. It's a complicated subject, like most things are.

Let's hope that stopping the abx helps end the awful tiredness. Let me know how it goes.
1 Comments
I sure will! I bought 3 books on the mast cell activation. I’m looking forward to gaining lots of knowledge. I’ll keep you posted on blood work results next week.
1081992 tn?1389903637
COMMUNITY LEADER
Wow, you're very determined. That is great.

Btw, if you can't concentrate (aka "brain fog"), that's likely from immune system chemicals. When you feel tired and bad from the flu, that's all from immune chemicals, not from the virus itself.

Insomnia? Sominex is diphenhydramine, which is the anti-histamine Benadryl.

Consider that the "antacid" Tagamet is a histamine blocker.

Maybe you'd like a vid from this top doc/researcher, Theoharides: https://www.youtube.com/watch?v=Owtt8NO7ahU

or Carnahan: https://www.youtube.com/watch?v=ISV2EUcBP1Q



1 Comments
I do have insomnia! Sometimes I can’t go to sleep until 5:00 am.. so Tagamet would be good for me and so would benedryl? I wish it would let me click on the links you send, but it doesn’t. I guess I just need to copy and paste it. Do you have a personal Fb account? I was wondering if you sent the links through messenger if I would be able to click on them?
1081992 tn?1389903637
COMMUNITY LEADER
It's worth trying the diphenhydramine for insomnia, but cautiously. I think you said you feel full easily, so Tagamet might help that part.

If you cautiously take niacin and flush much much more than usual, that's evidence to give to a doc.

Btw I've seen reports of people with MC disorders who've had problems with surgery.

I sent to you a PM with link, maybe that will work. I don't use FB at all.
1 Comments
You have given me more information than all the drs I have ever been too! That says a lot. I can’t thank you enough!!!
1081992 tn?1389903637
COMMUNITY LEADER
What you seem to have is an immune dysfunction which is, or is similar to, Chronic Fatigue Syndrome in many ways. People with CFS often go years before a diagnosis. So yes, it's lucky that you came here and I am glad to be of help :)

But people with CFS have a variety of symptoms. The all over angioedema is something very unusual. Improvement there would be dramatic and easily visible, right? We can try to logic our way through that.

I don't think there is one particular type of doc that handles these things. It depends more on their experience with themselves or their patients.
1 Comments
Yes, that would be a big dramatic improvement. I know the swelling sets me back as far as quality of life.  I am a school teacher and have been teaching elementary school for 13 years. My doctor took me out of work due to my symptoms and hormones and my physical and mental state at the time... I’m so afraid I won’t be able to work full time soon? Do most people recover enough to be able to work? I was a work aholic and worked no matter what, but after the two surgeries, it knocked me into another realm of swelling and fatigue... it’s been over a year and I am still feeling the same physical. I’m a lot better mentally because I’m on hormones as mine were absolutely and completely depleted.
1081992 tn?1389903637
COMMUNITY LEADER
I've never heard of the swelling like that, so I don't know the prognosis. But the standard treatment  with the "loop diuretic" has done nothing. That's a clue.

It is prudent to do any experimenting with a doc's approval.

So for now there is the generic benadryl, or the quercetin capsules. I doubt there's anything topical that would get deep enough into where the problem is.


Were you an avid exerciser?
1 Comments
I was not an avid exerciser and one reason is because when I would exercise I would swell like crazy too. When I did crossfit for a 3 month span, I worked hard at it, but my whole body felt so swollen. I could not do push ups on the ground because my hands, wrists, and fingers would swell so much it was too uncomfortable. Anytime my body is exposed to heat internally and or externally, I feel miserable!
1081992 tn?1389903637
COMMUNITY LEADER
Okay, so your MCs go off (almost like a land mine) from physical triggers like heat and maybe pressure. That is probably genetic and would be your predisposition.

(CrossFit is pretty heavy duty, so you must have been fairly fit to even start it.)

Then the operations *triggered* a period of chronic immune dysfunction. That's the working theory. I know somebody who had a gallbladder removal and went through a period of sickness for months. Then it just stopped, but don't count on that.

Is there any drug you started right after the 1st operation? A med can be a trigger.



Have you ever had homocysteine tested?
1 Comments
I really wasn’t fit at all! I just pushed myself. My fit daughter went with me so I tried to keep up!  Lol i had to modify a lot the first month, but built a tolerance to pain and gained more strength..

I have not been tested for that as far as I know. What would it read on lab results? Is there an abbreviation for it?

I didn’t even take pain meds after gall bladder surgery.. except for ibuprofen.
1081992 tn?1389903637
COMMUNITY LEADER
homocysteine = Hcy

Is your pulse rate high? If you get dizzy because the water in your blood stream is leaving and going into tissue, that makes the heart beat faster to compensate.


Please research to find any association of your meds with angioedema.

Got to go for now...

1 Comments
I will research! My pulse gets higher than usual at times. I can feel it raising and yes, it usually makes me dizzy..
1081992 tn?1389903637
COMMUNITY LEADER
Keep your chin up, we're making progress in Dxing :)

"I didn’t even take pain meds after gall bladder surgery.. except for ibuprofen."  Why was that?
1 Comments
Because I always get too constipated with pain meds. Like I can go week plus days without Bm if I take pain pills... miserable!
1081992 tn?1389903637
COMMUNITY LEADER
...and angioedema is usually associated with rashes (urticaria). But you don't mention having rashes, so that's a clue. Of something.
1 Comments
No rashes, but very sensitive skin! Very dry skin too!!
1081992 tn?1389903637
COMMUNITY LEADER
"Because I always get too constipated with pain meds. Like I can go week plus days without Bm if I take pain pills... " Okay, that's because opioid type painkillers stop movement in the gut (peristalsis). But if you're more sever than average, why? Maybe lack of good gut bacteria. Maybe. Some people get horrible health because of that, especially after many bouts of Abx.
2 Comments
I have always been prone to constipation. First week home from hospital as a newborn I did not have a BM.. mom called pediatrician and he said it was normal.. I disagree!! I had problems with that until after y’all bladder surgery and I literally go often... however I do take a natural colon cleanse or I don’t go everyday and I do still get constipated.
In 6th grade, I literally didn’t go for two weeks and finally told my mom and after 2 or 3 enemas I finally went.. during pregnancy was terrible!!!!
Also, what brand niacin and mg should I start with?
1081992 tn?1389903637
COMMUNITY LEADER
"In 6th grade, I literally didn’t go for two weeks and finally told my mom and after 2 or 3 enemas I finally went.. during pregnancy was terrible!!!!"

Problems with gut bacteria, which you have, can lead to heightened inflammation bodywide. That worsens the mast cell problem. Did you have a CRP blood test?

How old are you?
1 Comments
I’m not sure what CRP stands for! I’m 46 years old.
1081992 tn?1389903637
COMMUNITY LEADER
"Also, what brand niacin and mg should I start with?"

Watch some vids first. It's a test, not a treatment. It will even make your BP go down temporarily and possibly dramatically, so you should be wary. Or maybe don't do it at all.
1081992 tn?1389903637
COMMUNITY LEADER
CRP (C-Reactive Protein) is a measure of overall inflammation. Another is ESR. There are others.

If your whole system has higher inflammation, the MCs are more likely to go off.
1 Comments
I sent lab results to your pm. Some of the results were a year ago..
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