How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Anthony Bray, MD Your Own Question

Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6187
Experience:  14 years as clinician in the field of Family Practice
Type Your Health Question Here...
Anthony Bray, MD is online now
A new question is answered every 9 seconds

I need help reading my blood work.Neutrophils 33 (low)Lymphs

Resolved Question:

I need help reading my blood work.
Neutrophils 33 (low)
Lymphs 58 (high)
Neutrophils Absolute 1.6 (low)
Submitted: 11 months ago.
Category: Health
Expert:  Dr. Sohaib replied 11 months ago.

Hello and Welcome to Just Answer.
Thank you for the question. Answers given are for informational purposes only and are not meant to replace an exam by an in-person.
I am Dr. Sohaib, a Medical Internist (who deals with diseases of all the organ systems of body) and I will do my best to find an answer for you.
You need to answer a few questions first which will help me assist you in a better way.

Can you write down the Total Leucocyte Count (white cell count) for me?

Why was the test done? What were your symptoms?

Customer: replied 11 months ago.

Hello Dr.Sohalib
My WBC is 4.9
I am experiencing a wide rang of symptoms such as fatigue, headaches, my stomach is bloated, I am constantly thirsty and tired. I also occasionally have UTI symptoms that would resolve it self within a few hours; I have taken a at-home UTI test that came out negative fir nitrite and positive for leukocytes. I also have a receding hairline, which I feel it might be unrelated and simply due to stress.

Expert:  Dr. Sohaib replied 11 months ago.

Thank you very much.

Regarding the Absolute Neutrophils count (1.6) can you give me the normal reference range on your report?

Customer: replied 11 months ago.

Neutrophils Absolute range: 1.8 - 7.8

Additional information
Neutrophils range: 40 - 70
Lymphs range: 14- 46

Test order : CBC With Differential/Platelet; Comp. Metabolic Panel
The only ones flagged where Neutrophils Absolute range, Neutrophils, and Lymphs.

Expert:  Dr. Sohaib replied 11 months ago.

Thank you very much for the useful information.

Well, your report suggests that the total number of Neutrophils are reduced. The neutrophils are the type of white blood cells which combat any acute infection.

They are acutely reduced in number due to many reasons, most commonly viral infections, drugs, HIV and certain other disorders of bone marrow.

A rise in the number of Lymphocytes means few important possibilities including viral infections, tuberculosis, chronic lymphocytic leukaemia and whooping cough.

Your symptoms are suggestive of a viral illness, which can give you fatigue, lethargy, and weakness.

However, in an acute viral infection, the symptoms are usually short lived and settle down in few days or a week.

If your symptoms have been persistant, then we need to investigate this further in detail.

A bone marrow biopsy will be of great help to ascertain the exact cause for this fall in neutrophils and rise in lymphocyte numbers.

Right now, your UTI need to be treated and this will probably require a round of antibiotics.

You should see an Internist, discuss all the details i have mentioned and get a management plan chalked out that suits best to your needs.

I hope this clarifies and answers your question.

I would have been worried too if I were at your place, but let me reassure you that this is a treatable condition and carries a good prognosis with appropriate management.

It was a pleasure assisting you and thank you very much for visiting us.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service. If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Customer: replied 11 months ago.

I am sorry but are the numbers really far off or are the neutrophils temporarily depressed? Is it alarming enough to go see a doctor? I have a normal white count and I am not sure if the aberration in the values are just a temporary thing.
Also, I had blood work done March 15, 2013 which reads
Neutro 58.2
Lymph 33.3
WBC 5.8
(the range is the same as in my pervious lab work)

What could be the drastic change in my blood and/or may have there been an error in interpreting my results?

Customer: replied 11 months ago.

I need help reading my blood work.
Neutrophils 33 (low)
Lymphs 58 (high)
Neutrophils Absolute 1.6 (low)

My WBC is 4.9

Neutrophils Absolute range: 1.8 - 7.8

Additional information
Neutrophils range: 40 - 70
Lymphs range: 14- 46

Test order : CBC With Differential/Platelet; Comp. Metabolic Panel
The only ones flagged where Neutrophils Absolute range, Neutrophils, and Lymphs.


I am experiencing a wide rang of symptoms such as fatigue, headaches, my stomach is bloated, I am constantly thirsty and tired. I also occasionally have UTI symptoms that would resolve it self within a few hours; I have taken a at-home UTI test that came out negative fir nitrite and positive for leukocytes. I also have a receding hairline, which I feel it might be unrelated and simply due to stress.

Are the numbers really far off or are the neutrophils temporarily depressed? Is it alarming enough to go see a doctor? I have a normal white count and I am not sure if the aberration in the values are just a temporary thing.
Also, I had blood work done March 15, 2013 which reads
Neutro 58.2
Lymph 33.3
WBC 5.8
(the range is the same as in my pervious lab work)

What could be the drastic change in my blood and/or may have there been an error in interpreting my results?

 

Optional Information:
Person's Gender: Female
Person's Age: 21
Have you seen a Doctor about this?: No

Expert:  Anthony Bray, MD replied 11 months ago.
Hello !!I think that with regard to your low neutrophil count that this simply needs a period of several weeks and recheck. The drop in count is most typically just a transient thing. This is a common finding to see a mildly low neutrophil count and most cases would show improvement back to normal range on recheck in one to two months time. On this don' t panic. I think at this point that it is VERY UNLIKELY that you would need to pursue an invasive test such as a bone marrow biopsy!!! If you have ongoing recurrent symptoms of a UTI then you may well need treatment for this... It sounds suspicious to me that you probably have a mild UTI. It is not normal for the leukocyte esterase to test positive. This suggests the presence of white blood cells being present due to infection. I would advise a follow up with your doctor on this. I agree with you that your other symptoms may be completely unrelated. The fatigue for example is a very broad type symptom that may be part of normal experience to possibly being due to a wide range if possible causes. The time course and quality if your fatigue would hold clues as to possible causes. ( everyone gets tired so the first question would be if this is pathological ---disease related or not. One type of fatigue is related to feeling abnormally drowsy during the day. This type may be caused by sleep disorders ( ex sleep apnea) or insomnia or hypothyroidism or mononucleosis as common possible causes. Another type is feeling poor tolerance of exercise or easily short of breath---- this type may be caused by anemia, iron deficient, pulmonary problems( ex asthma) heart related problems ( less likely at your age ) or other such as diabetes or B-12 deficiency. The general problem of fatigue often calls for careful review of details of the quality and time course. This is followed by physical exam and finally tests directed at the most common possibilities.With you feeling frequently thirsty I would advise that you ask your doctor to check you to rule out diabetes as a possible cause. This is best checked with a combination of a fasting blood glucose plus a hemoglobin A1C( this test reflects what your blood sugar has been on average over the past three months)The headaches are yet another issue. The most common types are tension headaches. These are usually a constant type ache. They tend to come on during the day. These are frequently related to stress. You would usually benefit with these from Tylenol or Advil plus rest for example. If you had throbbing quality, aches more to one side, associated nausea, bright lights make it worse and also loud noise--- then this pattern would be more characteristic if migraine type headaches... These would typically benefit from migraine specific type treatments such as Triptan class medications---( Immitrex, Zomig, Maxalt as common examples)I hope this helps. Let me know if you have further questions. I know that I have not yet addressed each potential issue that you have mentioned but I simply ask for your direction for what are the most important questions that you have at this point!!! Let me know and I will be happy to get back with you !!If my answers are helpful and to your satisfaction then please remember to leave positive feedback. Thank you and best regards,Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6187
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 6 other Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
< Last | Next >
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • Armed with your answer I was able to talk with my son and daughter-in-law about their child who wasn't growing and who wasn't speaking. Since then she has grown about 1/4 of an inch and picked up 4 lbs. Her appetite and awareness have both improved. Sydney Galveston, Texas
  • You are absolutely the best team of health professionals on the WEB! MB Rosedale, NY
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4013
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4013
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5575
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    16265
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12090
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    8726
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery