What is up with my CBC???

[charlenec]

My CBC counts were great in December 07. Everything normal. One month later, January 08 I had a rash and was tested for Lyme which was negative but they discovered Parvo Virus. My WBC were at 3.0 at that time. Now I am still having CBC issues and am finally being referred to a Hematologist. I did have an HIV test about a month ago that was negative and have had no exposures. I am not on any medications except for Metoprolol ( for Atrial Fibrillation ) and an aspirin a day. My counts are as follows:

WBC 3.3 (low)
RBC 3.42 (low)
Hemoglobin 12.1 (normal)
Hematocrit 34.4 (low)
MCV 100.6 (high)
MCH 35.3 (high)
MCHC 35.1 (normal)
Platelet Count 343 (normal)
Neutrophil % 57.3 (normal)
Lymphocyte % 27.0 (normal)
Monocyte % 7.9 (normal)
Eosinophil % 5.1 (high)
Basophil % 2.5 (high)
Neutrophil # (ANC) 1.9 (normal)
Lymphocyte # 0.9 (low)
Monocyte # 0.3 (normal)
Eosinophil # 0.17 (normal)
Basophil 0.1 (high)

Iron 114
TIBC 314
TSH 4.97
Free T4 0.62
Ferritin, Serum 28

What is up? This is driving me crazy and my hematology appt. is in 3 weeks!

Thanks.

[Jules77733]

By the way--your thyroid values might be in the "normal" range according to your labs, but the new standard for normal TSH range is 0.3 - 3.0, and most people (from what I've read on the forums here, and elsewhere) feel most comfortable with a TSH of around 1.0 - 2.0. Your TSH of 4.97 is definitely causing you problems. Depending on when your blood was drawn, also, might mean your TSH has been higher and you just don't know it yet. Bloodwork should generally be done around 7:30am - 8:00am and this is when TSH will be at its highest--in the morning, when you wake up. It decreases throughout the day until it reaches it's lowest point, at about 2pm in the afternoon.

Your free T4 is also on the low end, from what I understand. I thought the normal range for this was about 0.8 - 1.8, so you definitely don't have enough thyroid hormones circulating in your body...which makes sense when you couple this level with your TSH level.

Glad to hear you've already got an endo appointment--that's smart of you! Don't listen to the doctors who tell you you don't have a problem if you know something is wrong...keep plugging away until you get better.

[Jules77733]

With chest and back pain, I'd consider Hodgkin's lymphoma, but you'd have to have swollen lymph nodes (for more than 1 - 2 months) and you'd likely be losing weight, not gaining it. The hypothyroidism is definitely causing you to gain weight, and the tongue symptoms can be from the hypothyroidism, too, if I recall correctly (I was having some weird tongue issues so I did some reading about all sorts of tongue problems).

Dr. Noopur--could the low WBC and RBC counts be a result of autoimmune thyroid disease just kicking in?

The skin rashes are hormonal issues, unless it looks like you've been "slapped" on either side of your face--this would be the Parvovirus rearing its ugly head. Usually, when the rash breaks out (intermittently), it's accompanied by a low-grade fever, or at least a general feeling of heat intolerance...I'm not sure if you're experiencing this, too?

I definitely think if you get your thyroid problems solved, most of your other issues will begin to go away, unless you have autoimmune thyroid disease and you're now becoming more susceptible to other autoimmune diseases.

Thanks for the good luck, I could sure use it right about now!

[charlenec]

Hi,

I have been tested for anemia and was found to be okay.
I am very tired most of the time however I am on Metoprolol and I know that causes me to be tired. I have had skin rashes on my face and seem to be breaking out. ( I have never had acne even as a teenager ) My tongue is whitish for about a month. I went to my GP and it is not thrush. I have had chest and back pain and recently have undergone all tests from my cardiologist except cardio catheter because he thought it was not necessary. I have gained about 20 lbs in the last 5-6 months and I am not eating terribly more that before. I usually consume about 1500-2000 calories a day. I would say that I don't feel awful but I don't feel good either. I lack total energy for sure.

Thanks,
Charlene

[DrNoopurMD]

Hi,

How are you?
Low WBC and RBC count indicates myelosuppression which can be due to myelodysoplastic syndrome or due to cancer.
These findings need to be correlated with your symptoms. What symptoms do you have as of now?
Low RBC counts are seen in anemia and low WBC counts are seen after severe viral infections.
Anemia needs to be ruled out in your case.

[charlenec]

Thanks, I have an endocrinology appointment on the 16th to address my thyroid. I have long thought that my thyroid was an issue  ( hair thinned, gained weight, super tired, dry skin ) but because my levels are within the lab "normal" I have not been able to get a referral. Finally I just made the appointment myself. It would be great to know what is going on! All my vitamins were tested and were fine. I think I will ask the hematologist ( on the 18th ) about the other tests you have suggested to to rule things out (hopefully). My cholesterol was fine but one test should high triglycerides.

Thanks, for the 'good luck' and I wish the same to you.

[Jules77733]

Your TSH is high and your free T4 is low--it looks like you might have hypothyroidism, and may want to have a full thyroid panel done the next time you have bloodwork done (soon, I would hope!). If you have the autoimmune form of hypothyroidism, which just means "underactive thyroid", called Hashimoto's thyroiditis, this opens the door for a lot of other autoimmune diseases to crop up, as they typically travel in multiples (aka if you have one autoimmune disease, the chances of you having another one are high).

You may want to have a GP run a full metabolic panel on you to look at lipids, cholesterol, glucose, and other chemicals in your blood, like CO2, potassium, sodium, etc. You may even want to have some of your vitamin levels assessed, like Vitamin B12, Vitamin B1, and Vitamin D. The high basophil count might mean you have allergies--which are autoimmune. Have you ever been to an allergist or been tested for allergies? This is a seasonal thing for a lot of people, which could explain your sudden disturbance in blood levels. Eosinophils also fight infections--allergies and asthma, but elevated numbers of these granulocytes can be found in patients with Addison's disease, Rheumatoid arthritis, parasitic infection of the intestines, Hodgkin's lymphoma, and reflux esophagitis.

Your best best might be to get a GP and have them start analyzing your results and ordering more bloodwork to begin ruling things out (like Rheumatoid arthritis) to get to the bottom of this. I'm currently infected with the Parvovirus, too, but I've got a lot of symptoms that were around before I caught the Parvovirus. Typically, the people who actually experience symptoms from the Parvovirus are ones who have a compromised immune system--namely, an immune system that's already trying to fight against something. I haven't been able to shake the Parvovirus yet, and it's been almost 3 months now...I'm still on a quest to figure out the underlying problem so I no longer become infected by every little virus and bacteria that I breathe in.

Good luck and I hope you find out what's going on! Get your thyroid tested, for sure... :)

[PlateletGal]

A low WBC could be due to infections, AMI, inflammation disorders, leukemia, cancer, stress, DKA, collagen vascular disorders, uremia, tissue necrosis and other conditions.