Your total white blood cell count is the sum of five different types of white blood cells, all with different roles in battling foreign invaders in the body: neutrophils, eosinophils, basophils, lymphocytes, and monocytes.
Neutrophils make up the largest share of your white blood cell count, contributing 60-70% of the total. It's for this reason that a low white blood cell count is most likely due to a low neutrophil count, also called neutropenia. Neutrophils are the immune system’s first responders—within minutes of an injury, trauma, or inflammation to tissue in the body, neutrophils are drawn to the scene. They essentially control traffic to and from an infection site by recruiting additional white blood cells specialized to the type of invader. Neutrophils function by engulfing the pathogen and breaking it down. And even though they are microscopic, you’ve seen probably seen neutrophils, as they are the basis of pus! The lifespan of a neutrophil is very short, ranging from 5 hours to a few days.
Because your white blood cells play a vital role in immune function, low levels can leave you more susceptible to infection, increase the duration of illness, and increase the severity of it. It’s important to note that white blood cell levels can fluctuate daily and even hourly, so it’s important not to jump to conclusions about your levels from a single blood test.What’s a normal range for white blood cell count? The definition of “normal” depends on the lab that processed your blood results. Generally, though, a normal white blood cell count is 4,000-11,000 per microliter of blood. This is usually reported as 4.0-11.0 thousands/μL. And if you get neutrophil counts measured as well, this corresponds to a count of1500-7800 cells/μL. You may also see this value represented as a percent of your total white blood cell count.
The many causes of low white blood cellsFirst, before trying to pinpoint the cause behind a low WBC measure, it is important to note that a single data point really can't provide a comprehensive answer. Ideally, you should be able to compare recent blood results with past ones to identify a pattern or a deviation from your “normal.” The good news is that WBC count is frequently tested as part of a complete blood count (CBC) panel, a routine test you might've had at your doctor's office or if you’ve ever been hospitalized. So track down past blood work and use it as a comparison point for your new results—using multiple data points can help you determine whether you fall into one of the below categories.
If you have a history WBC levels just below the 4.0 thousands/μL normal cutoff and you haven’t experienced a high incidence of illness throughout your life, you likely just have a lower “resting state.” It is still important to discuss your findings with your physician to rule out the need for any additional testing.
If your white blood cell levels were once normal, but have been consistently low as of lateIf you do not have a history of low WBC but have experienced a pattern of low results over recent months, you may be experiencing an issue with the production of white blood cells. Of course, it is important to have historical data of your WBC to determine the pattern is new—levels right below the 4.0 thousands/μL cutoff likely aren’t clinically significant, but consistent values less than 3.5 thousands/μL—and definitely below 3.0 thousands/μL—should be discussed with your health care provider to determine the cause and assess follow-up testing. Causes range from relatively benign to more serious. Here a few: Vitamin and mineral deficienciesSome vitamins and minerals like vitamin B12 and folate play a crucial role in WBC formation. Low levels of vitamin B6, copper, and zinc may also play a role in low WBC production. A blood test can identify whether these nutrients are low, as you should not take supplements of these nutrients if your levels are normal. Chronic malnutrition and alcoholism can also result in these deficiencies, and can therefore also be a cause of low WBC.
Viral infectionsViral infections that last for several months (or indefinitely) can cause white blood cell levels to be chronically low. These include hepatitis B & C, HIV, and tuberculosis, among others. But you likely won’t identify such an infection from a single blood test, so it is important not to jump to conclusions from a single WBC measurement.
Autoimmune diseasesLow white blood cell counts can results from some autoimmune conditions (like rheumatoid arthritis), as autoimmune diseases attack the immune system.
Bone marrow cancersCancers that impact the bone marrow can cause low WBC counts, as most most white blood cells are produced in the bone marrow. WBC counts would be extremely low in these situations, not just mildly below the normal range.
Treatment and medicationSome people develop low white blood cell counts due to medical treatments or medications, most prominently chemotherapy.
InfectionIndividuals with chronically low white blood cell counts should be particularly cautious about infections. Hand washing is a critical step in preventing pathogens on the hands from entering the body through eating or contact with the face. Wearing a facemask is also a good idea to prevent inhalation of pathogens. Cuts and wounds should also be avoided as much as possible, and when a cut or wound is present, great care should be taken to keep the wound clean. Depending on the severity of low WBC, special consideration should also be given to the source and preparation of foods.
You usually have normal white blood cells but your last test result was lowA short-term low white blood cell count is usually due to acute neutropenia, a short period of time in which absolute number of neutrophils in the blood are low. Acute neutropenia is usually due to high neutrophil use in the body or low neutrophil production, which are common when your body is fighting off an infection. It's a relatively common occurrence and is tolerated well in the body.
When an immune response is mounted, neutrophils leave the circulation to defend the body at the location of the damage. Since white blood cells engulf invading pathogens to destroy them, they tend to have a very short lifespan—most neutrophils can only effectively remove a few pathogens before they themselves die. This high usage of neutrophils results in a low level of them in the blood. And since neutrophils are the most common type of white blood cell, lower neutrophil levels bring down your overall WBC count.
So don't be too stressed about a one-time low WBC measurement. If you are not feeling ill by the time you get your blood test results (they usually take several days to be processed), it is likely that your WBC count and neutrophil levels have retuned to normal since your blood draw. A single low WBC result means that your immune system is working as it should, especially if you never felt sick.
Can low white blood cells cause fatigue? Low white bloods cells likely aren’t the cause of fatigue. If you have low WBC and are increasingly feeling fatigued, both are likely symptoms of an underlying issue. This could be a range of issues, from over-exercise or overtraining, low folate or B12 levels, autoimmune diseases, viral infections, and certainly cancers.
6 ways to improve your white blood cell countIf your “resting state” white blood cell count is low, it’s unlikely that lifestyle changes will have an impact on your levels. For other causes of unoptimized white blood cell levels, there are some things you can do to help to reduce the demand on your immune system and increase its ability to protect you from foreign pathogens:
1. Manage your stress
Mental, emotional, and physical stressors all contribute to your body’s ability to defend itself from infection. The term allostatic load refers to the wear and tear on the body and brain as a result of stress. It is regulated by adrenalin and cortisol, among other compounds. As your body works to adapt to and deal with the biological causes of stress, its ability to manage resources for the immune defense response may be compromised.
2. Get adequate sleep
The impact of inadequate sleep on white blood cells is well documented. Sleeping 6-8 hours per night can help you maintain normal levels of white blood cells, especially neutrophils.
The impact of exercise on white blood cell count and immune function is a U-shaped curve. That is, too little exercise and too much exercise can both increase your risk of infection. Routine, moderate-intensity exercise (e.g. 30 minutes of moderate intensity activity 5 days per week) has been demonstrated to support optimal white blood cell levels.[8,9] If you engage in high intensity training regularly without a rest day between activities, reducing the frequency of high intensity exercise can also be helpful in restoring your normal WBC level.
4. Eat a variety of fruits and vegetables
Fruits and vegetables contain vitamins, minerals, antioxidants, and phytochemicals. These compounds can help to support the normal functioning of white blood cells and the immune system overall. In particular, focus on the antioxidants vitamin A, C, E and selenium. Vitamin A can be found in red, orange, and yellow-hued fruits and vegetables, as well as dark leafy greens. It is best absorbed when eaten with some source of fat and a mixture of fresh and cooked sources. Vitamin C is found in citrus, berries, broccoli, bell peppers, kiwis, and Brussels sprouts. Limited cooking is best to preserve vitamin C content. Vitamin E is mostly found in nuts and seeds. Wheat germ, wheat germ oil, sunflower seeds, and sunflower seed butter at the best sources. Selenium is found in the highest concentration in Brazil nuts. Two Brazil nuts per day provide the daily recommended amount.[10,11]
5. Maintain a healthy body weight
Excess body weight is associated with elevated levels of white blood cells, as it can cause an increase in inflammation and result in a WBC imbalance.
The best way to understand your white blood cell count
Utilizing a history of blood data is the best way to understand a low white blood cell count. A single low WBC measure is not enough information for diagnosis. Speak with your physician about the need for follow-up testing. For most people, a low white blood cell level does not indicate illness or disease, but rather that your immune system is functioning properly. To maintain a properly functioning immune system, take action on improving lifestyle factors related to your white blood cell count. To learn what actions you can take to impact your white blood cell count, upload your results and develop your action plan with InsideTracker.
Ashley Reaver, MS, RD, CSSDAshley is the Lead Nutrition Scientist at InsideTracker. As a registered dietitian and educator, Ashley enjoys cooking and teaching individuals the power that food has on their health. You’ll find Ashley hiking, eating, and spending time with her family. Follow her on Instagram @lower.cholesterol.nutrition.
 Crosslin DR, McDavid A, Weston N, et al. Genetic variants associated with the white blood cell count in 13,923 subjects in the eMERGE Network.
What is the most common reason for low white blood cell count?
ANSWER: A low white blood cell count almost always is related to a decrease in a type of infection-fighting white blood cell called neutrophils. When you have a low level of neutrophils, the condition is known as neutropenia. There are many causes of neutropenia, and some medications can lead to this problem.
Is low white blood count serious?
A low white blood cell count is a consequence of serious diseases, and it can lead to harmful health problems—including infections, slow healing, and cancer. A low white blood cell count doesn't cause symptoms, but the complications of a low white blood cell count can cause many different symptoms.
Should I be worried about low white blood cell count?
The main risk of an abnormally low white blood cell count is how vulnerable it may make a person to infection. Without an adequate white blood cell response available to fight infection, the body is at greater risk that any infection (including those usually regarded as minor) may cause serious illness or death.
What are the symptoms of low white blood cell count?
If you have a low white blood cell count, you may:.
Have repeated fevers and infections..
Get bladder infections that may make it painful to pass urine, or make you urinate more often..
Get lung infections that cause coughing and difficulty breathing..
Get mouth sores..
Get sinus infections and a stuffy nose..