Re: Q: critical lab value (low) for WBC

[Guest guest]

assuming she is not on chemo for ca, or on any drugs that can do this, I think you have to rule out an occult malignancycannot afford to miss thiscan be low WBC in chronic infections, but cannot assume this until find out what if anymeanwhile advise stay on astragalus and other bone marrow protectivesrun ANA, CRP and other regular testsWith D, people have genetic polymorphisms so it can rise that hi on D but as long as level is not higher than 120 it is not a worry.R Zieve MD

Hi! I don't know what the panic level is for WBC, low critial value... Please, share your knowledge and experience!

Background:

41 yo female who presented to me Nov 2011 with CC:\\ lack of stress managment, past high chol (240's --> eats oatmeal to keep it low), and interrupted sleep. Overall, she says she's 'healthy': vaginal birth 2005, no smoking/ alcohol drinking/ caffeine, training to be a yoga teacher. 5'8" andd 126#.

We started blood-type diet, BTGs (castor oil packs, dry skin brushing, lifestyle, etc.), probiotics. Spouse has been a 'closet' alcoholic for years, apparently, and she just found out. Marriage is shaky.

I have three sets of labs from Nov 2010, Dec 2011 and May 2012...

WBC (ref range 4.0-11.0) has decreased from 6.1 to 4.1 to the NOW CRITICAL VALUE OF 2.8 thou/ul

RBC: (ref range 4.00-5.40) 4.03 to 4.11 to low value of 3.97mil/ul

MCH (27.0-31.0): 31.5 to low 31.4 to high 31.7

Platelets (150-450): 225 to 192 to 176 (IN RANGE, BUT DECREASING TOWARDS LOW)

Absolute Neutrophils (2.00-7.50 thou/ul): 4.1 to 2.4 to low 1.54

Absolute Lymphs (1.2-4.0 thou/ul): 1.6 to 1.27 to low 1.01

Other pertinents: hypothyroid. Vit D went from 34 in Dec 2011 to 81 in March 2012 with 10,000 IU qd x 30d, then 5,000IU qd x 30days then 2,000 IU qd until re-test. I've NEVER seen a Vit D level increase so quickly.

She isn't acutely ill. I'm thinking bone marrow or autoimmune issues. What next tests do I run? Am I obligated to call the patient ASAP with a critical value? And say what?

Thank you for your timely reponses!!

Leigh

Dr. Leigh H. White

Naturopathic Physician

Natural Family Health, LLC

East/ West Healing Arts Center

410 State Street

North Haven, CT 06473

www.naturalfamilyhealth.net

[Guest guest]

" run ANA, CRP and other regular tests " Other regular tests?

>

> >

> > Hi! I don't know what the panic level is for WBC, low critial value...

Please, share your knowledge and experience!

> >

> > Background:

> > 41 yo female who presented to me Nov 2011 with CC:\\ lack of stress

managment, past high chol (240's --> eats oatmeal to keep it low), and

interrupted sleep. Overall, she says she's 'healthy': vaginal birth 2005, no

smoking/ alcohol drinking/ caffeine, training to be a yoga teacher. 5'8 " andd

126#.

> >

> > We started blood-type diet, BTGs (castor oil packs, dry skin brushing,

lifestyle, etc.), probiotics. Spouse has been a 'closet' alcoholic for years,

apparently, and she just found out. Marriage is shaky.

> >

> > I have three sets of labs from Nov 2010, Dec 2011 and May 2012...

> > WBC (ref range 4.0-11.0) has decreased from 6.1 to 4.1 to the NOW CRITICAL

VALUE OF 2.8 thou/ul

> > RBC: (ref range 4.00-5.40) 4.03 to 4.11 to low value of 3.97mil/ul

> > MCH (27.0-31.0): 31.5 to low 31.4 to high 31.7

> > Platelets (150-450): 225 to 192 to 176 (IN RANGE, BUT DECREASING TOWARDS

LOW)

> > Absolute Neutrophils (2.00-7.50 thou/ul): 4.1 to 2.4 to low 1.54

> > Absolute Lymphs (1.2-4.0 thou/ul): 1.6 to 1.27 to low 1.01

> >

> > Other pertinents: hypothyroid. Vit D went from 34 in Dec 2011 to 81 in

March 2012 with 10,000 IU qd x 30d, then 5,000IU qd x 30days then 2,000 IU qd

until re-test. I've NEVER seen a Vit D level increase so quickly.

> >

> > She isn't acutely ill. I'm thinking bone marrow or autoimmune issues. What

next tests do I run? Am I obligated to call the patient ASAP with a critical

value? And say what?

> >

> > Thank you for your timely reponses!!

> > Leigh

> >

> >

> > Dr. Leigh H. White

> > Naturopathic Physician

> > Natural Family Health, LLC

> > East/ West Healing Arts Center

> > 410 State Street

> > North Haven, CT 06473

> >

> > www.naturalfamilyhealth.net

> >

> >

>