Multiple Sclerosis and White Blood Cell Count

Blood Test For MS

What Is Your White Blood Cell Count Tell You?

While many of the disease modifying drugs which treat Multiple Sclerosis causes a reduction in White Blood Cell count (CBC), not all of us do have low counts. Knowing this information though is important for a couple of reasons.  First you need to ask your physician or read the insert that comes with your med to see if you are actually on one of these medications; and if so really be alert to this potential problem.

Most of us who are on MS medication require monthly lab checks or at least once every 3 months. These are to check for potential problems or prevent a problem from getting worse. In general, these labs do include a check of our immune system, thyroid, liver, and even a urine test. If everything is running smoothly, you may never know what the results are, but for some of us, we will get a call telling us when something is abnormal and we need to get a recheck. Today, I just want to focus on what a “Low White Blood Cell” count means.

You have probably known someone who has been on a chemotherapy medication and knows that it does weaken the immune system; which means it lowers the WBC, Lymph’s, Neutrophils, and other immune lab work. This is usually ordered as a CBC with diff; (aka complete blood count) with differentials. This test includes white blood cells or leukocytes; which normal range is 4500-11,000. It also includes RBC,( red blood cells), hemoglobin, platelets, hematocrit, and a few other things. The differential count includes: neutrophils, lymphocytes, monocytes, eosinophils, basophils, and bands. These counts dive deeper into your immune system. Usually the concern comes when the WBC is low along with a few of these other counts. Running a low WBC can also be labeled Leukopenia.

If you have Leukopenia or low WBC, find out what that number is, what your normal count usually runs, and how long you have had the lower count. Depending on how low it is and if there are any other abnormally low counts associated with it can determine if you need to be around large groups of people or children, especially if any of them are sick. Your resistance to fighting infections is down which could cause a boat load of problems that neither you nor your MS really need. For me in this state, an infection means stronger antibiotics for a longer than normal period of time. Another reason for knowing your counts is so you can make your other health care providers aware if you require care for a problem. An example of this is: I had a WBC of 2 which is low but my neutrophil and lymph’s were also low. I came down with a bad case of sinusitis and bronchitis. Because I alerted my primary care physician of my low counts, I became ineligible for a treatment with steroids for the sinus infection. Steroids will weaken the immune system even more. The low count also alerted them to do further tests to rule out pneumonia or other issues along with treating me with a stronger antibiotic for an appropriate length of time.

In this day and time when so much information is on the web, you don’t have to remain in the dark to what your abnormal labs mean or even what the normal counts should be. I urge you to be invested in your health and know exactly what is going on with you; know what medication you are taking and what side effects are associated with it. It is funny that I know my body so well; I can usually tell when my WBC has taken a dip because of the increased fatigue that I experience. When I explained this to my physician, he just laughed and said there is no way, but I have found other people who have also been able to tell this same thing. At least I realize I am not crazy if others can do the same thing. Information is power and can prevent things from getting out of hand or being under- treated. Next time you have your labs done remember to ask your physician about the results.

MS Blogger and Multiple Sclerosis Activist shares her journey living with MS, tips for others living MS and her husband, Steve, offers his insight as a caregiver for MS.
  • Spencer Schaffner

    As someone with MS who has also had longterm Neutropenia (not caused by any medication), I read your post with great interest. The numbers certainly are interesting and tracking them over time can be pretty revealing. All best, Spencer (