When someone has low white blood cells present in their blood, this makes them very vulnerable to developing infections, viruses and other illnesses. Leukopenia, or a low white blood cell count, can be the result of a wide range of health problems — for example, aplastic anemia, radiation or chemotherapy, leukemia, Hodgkin’s lymphoma, influenza, tuberculosis or lupus.
What can you do to defend yourself against potential health problems if you’re experiencing leukopenia? Your doctor will decide if you need treatment with antibiotics, steroids, vitamins, fluids, etc. depending on the underlying cause of your condition. But you can also help strengthen your immune system by eating a nutrient-dense diet and practicing good hygiene.
What Is Leukopenia?
Leukopenia (also called leukocytopenia) describes low white blood cell count, which can be caused by various diseases such as iron-deficiency anemia, an overactive spleen or cancers that damage bone marrow.
Why are white blood cells so important? As Health Encyclopedia puts it, “You can think of white blood cells as your immunity cells.” (1) White blood cells (also called leukocytes or leucocytes), which are a part of the immune system and have the important job of protecting the body against both infectious disease and foreign invaders, are made inside bone marrow. (2)
Bone marrow is the spongy tissue found inside larger bones. Once white blood cells are made, they are stored in your blood and lymphatic tissue. Having a low white blood cell count means that there is also a reduced amount of disease-fighting cells in your blood, which raises the risk for health problems like infections.
Leukopenia vs. Neutropenia
Many times when someone has leukopenia, they are experiencing a decrease in one type of white blood cell. For example: (3)
- Neutropenia is a reduction in the number of neutrophils. This is the most common form of leukopenia, which is almost always due to neutropenia or lymphopenia. Severe congenital neutropenia syndrome typically begins in infancy. Adults can also develop neutropenia for a variety of reasons. When your absolute neutrophil count (ANC) falls below 1,000 cells/mm3, the risk of bacterial infection increases significantly, especially if it’s less than 500 cells/mm3.
- Lymphopenia is a reduction in the number of lymphocytes.
- Granulocytopenia is decrease in the number of granulocytes, which includes neutrophils, monocytes, eosinophils and basophils. Granulocytopenia and neutropenia are often used interchangeably to describe the same condition.
- Agranulocytosis describes severe and dangerous leukopenia, usually the neutrophil type.
- On the opposite end of the spectrum from leukopenia is leukocytosis, which describes when white cells (the leukocyte count) are above the normal range in the blood.
Leukopenia Symptoms and Signs
If someone has mild leukopenia, they may not experience any noticeable symptoms at all. If this is the case, further evaluation or treatment usually isn’t needed. But severe or sudden-onset leukopenia, especially neutropenia, can cause alarming and serious symptoms that typically need to be treated right away. Usually, it’s not leukopenia itself that causes symptoms, but rather other illnesses or infections that result from low immune function.
When they do occur, the most common leukopenia symptoms include: (4)
- Fever symptoms, like having chills, nausea, headaches and loss of appetite (This can indicate the presence of an infection, which can either be a cause for leukopenia or a result from it.)
- Diaphoresis (excessive sweating)
- Weight loss
- Symptoms of a localized infection, such as skin rashes, swelling, pain, tenderness, heat, redness, etc.
- Lymphadenopathy, or inflammation of the lymph nodes which causes them to swell and increase in size
- Sepatomegaly or splenomegaly, or abnormal enlargement of the spleen
- Symptoms of anemia, such as fatigue, weakness, pallor and poor circulation
- Signs of thrombocytopenia (a decrease in the number of platelets present in the blood), such as mucosal bleeding, petechiae or purpura
- Inflamed joints
- Liver abscess
- Cough and sometimes pneumonia
- Urinary tract infections
- Oral ulcerations
Causes and Risk Factors
There are two main reasons someone will develop low white blood cell count: either their body is destroying the cells more quickly than they can be replenished or their bone marrow is not making enough white blood cells.
There are many different health conditions and illnesses that can cause leukopenia. Some of the most common leukopenia causes include: (5)
- Severe bacterial infections that cause the body to use up white blood cells at an accelerated pace, such as tuberculosis (TB)
- Viral infections that damage bone marrow, such as malaria or HIV/AIDS. HIV/AIDS weakens the immune system, lowers white blood cell count and can result in a variety of other illnesses
- Certain types of cancers that damage bone marrow, such as leukemia or Hodgkin’s lymphoma. Is leukopenia the same as cancer? No, but some types of blood cell and bone marrow cancers can lead to low white blood cell count
- Autoimmune diseases that destroy white blood cells or bone marrow, which can include lupus, or rheumatoid arthritis
- Congenial disorders (those that are present from birth) that result in diminished bone marrow function, such as Kostmann’s syndrome or myelokathexis
- Certain medications, such as antibiotics, immunosuppressive drugs, antipsychotic drugs, cardiac drugs, anti-rheumatic drugs, interferons and some antidepressants
- Sarcoidosis, which is when inflammatory cells collect in the body
- Iron-deficiency anemia or aplastic anemia (6)
- Having had chemotherapy or radiation therapy, which destroys white blood cells
- Hypersplenism, which is an abnormality of the spleen that causes blood cell destruction
- Cirrhosis of the liver
- Malnutrition and nutrient deficiencies, such as folate deficiency or protein loss
- To a lesser extent, other conditions such as extreme physical stress, injury or chronic emotional stress, which all take a toll on the immune system
Doctors diagnose leukopenia based on whether a patient’s white blood cell count is low on a blood test known as the complete blood count. What qualifies as “low white blood cell count?” Normally adults have a leukocyte count that ranges from approximately 4,000 to 10,000 cells/mm3. (7) There is some variability in the exact cut-off as to what’s considered leukopenia, but most medical practitioners consider anything less than 3,000 to 4,000 white blood cells per microliter of blood (or cells/mm3) in adults to be considered abnormally low. (8)
If you have another condition that commonly causes leukopenia, such as an autoimmune disease or leukemia, then your doctor will likely recommend testing your blood cell count. Those who are at risk for leukopenia should have a complete blood cell test done as part of any physical checkup on a regular/yearly basis.
Leukopenia can either develop acutely, meaning over several weeks or less, or be chronic and occur for many months or even years. Acute leukopenia is considered to be more serious and requires prompt evaluation in order to check for conditions like drug-induced leukopenia, infections or acute leukemia. Leukopenia that develops over the course of months calls for an evaluation for chronic infections and primary bone marrow disorders.
A “peripheral smear” is used to determine which type of white cell line is abnormally low and to evaluate if the form of cells are also immature or abnormal. Depending on the type of deficient or abnormal cells that are found, other tests may be recommended, including:
- Complete metabolic panel, including liver enzymes
- Blood cultures
- Human immunodeficiency virus (HIV) test
- Ultrasound to confirm the presence of splenomegaly
- Tests for Parvovirus, Epstein-Barr virus, cytomegalovirus, herpes simplex viruses and hepatitis viruses
- Tests for tick-borne illnesses, including rickettsia and anaplasma
- Tests for autoimmune diseases, such as those that look at antinuclear antibodies or rheumatoid factor
- Immunoglobulin test
- Bone marrow aspirate and biopsy
Leukopenia treatment depends on the underlying cause of the condition. Treatment options can include:
- Intravenous antibiotics if needed, if a severe infection is found (Examples include cephalosporins, anti-pseudomonal penicillins, carbapenems, aminoglycosides, aztreonam and fluoroquinolone.)
- If there is a decrease in the number of platelets present in the blood (thrombocytopenia), this may be treated with vitamins, immune-suppressants and steroids.
- Altering medications if leukopenia is drug-induced
- Treatment of anemia
- Management of autoimmune diseases
- Leukopenia patients can sometimes become “immunocompromised,” and when this happens, precautions need to be taken so the patient does not become sick very quickly. Hospitalization, intravenous fluids and other protocols may be recommended to lower the risk for infections and complications.
4 Natural Ways To Support Leukopenia Recovery
It’s not always possible to prevent leukopenia — even if you live a healthy lifestyle and eat a nutrient-dense diet. That being said, there are ways to reduce your risk for some health conditions that can trigger leukopenia and to support your immune system while you recover.
1. Immune-Boosting Diet
Which leukopenia foods can help with treatment? First, make sure you are consuming enough calories, fluids and nutrients to support recovery. Your diet can be tailored depending on factors like your serum iron level, total iron-binding capacity, ferritin level (protein in cells that store iron), folate level and vitamin B12 level.
If you’re experiencing deficiencies and/or weight loss due to malnutrition, loss of appetite, nausea or vomiting, it’s best to be monitored by a doctor and to consider visiting a dietician. If you’re currently battling a condition like cancer, cancer treatment or an autoimmune disease, this may change your dietary needs, so always make sure to address this. Foods that are generally beneficial for boosting immunity and reducing inflammation include:
- Whole foods, especially brightly-colored fruits and vegetables (A balanced diet that provides sufficient fluids, calories, protein, vitamins and minerals and iron will also help decrease symptoms associated with leukopenia, such as fatigue.)
- High-antioxidant foods, such as: all types of leafy green veggies, cruciferous vegetables, berries (blueberries, raspberries, cherries, strawberries, goji berries, camu camu and blackberries), kiwi, citrus fruits and orange and yellow-colored plant foods (like sweet potatoes, berries, pumpkin, squashes and other plant foods)
- Quality protein, such as from: organic/grass-fed meats, wild-caught fish, eggs and raw/fermented dairy products, nuts and seeds
- Healthy fats like coconut oil, olive oil, ghee, grass-fed butter and avocados
- Other foods that are also supportive of your immune system and help to fight lymphadenitis, including manuka honey, garlic, herbs, spices and apple cider vinegar.
- Probiotics are good bacteria that support gut health and immunity. I recommend probiotic foods and supplements for people with food sensitivities, autoimmune disease and a weakened immune system.
- Eating iron-rich, zinc-rich and selenium-rich foods on a daily basis is important for keeping your energy up and immune system strong. Examples of foods high in these nutrients include: grass-fed meats and poultry, eggs, nutritional yeast, brazil nuts, spirulina, organ meats like liver, salmon and sardines, lentils and other beans, dark chocolate, spinach and sunflower seeds.
If you don’t have much of an appetite or you’re nauseated, eat smaller meals spread throughout the day. Sit up for about an hour after eating to relieve any pressure on the stomach. Try to eat at least three hours before bed to help you digest.
Also be sure to stay hydrated. Aim to drink one to two liters of water per day. Have a glass of water at least every two to three hours, or whenever you feel thirsty. Other hydrating drinks that also support your immune system include herbal teas, tea with lemon juice and manuka honey, fresh squeezed vegetable juices, bone broth and coconut water.
2. Good Hygiene To Prevent Infections
Because having a very low white blood cell count makes you vulnerable to infections, you’ll need to take extra precautions to avoid catching contagious diseases. Early detection and treatment is the best bet for preventing serious infections and complications.
- Always wash your hands regularly and thoroughly. This is especially important after using public restrooms and touching surfaces in hospitals and other public places.
- Your doctor may recommend you wear a face mask and avoid anyone with a cold or other illness.
- Pay attention to how even tiny cuts and scrapes heal. It’s important to properly clean and care for all wounds to prevent infections. If you’re under hospital care, prompt removal of IV lines and urinary catheters when they are no longer necessary can help to prevent serious infections like sepsis.
- Echinacea may help stop recurring infections, such as common colds, coughs and respiratory infections.
- Astragalus is an adaptogen herb that is anti-inflammatory and has been demonstrated in certain studies to help reduce toxicity induced by drugs such as immunosuppressants and cancer chemotherapeutics. (9)
- Vitamin D can help modulate the immune responses. Ask your doctor if supplementing is a good idea for you. Also expose your skin to sunlight for about 15 minutes daily so your body can make its own vitamin D.
- Oregano essential oil is known for its immune-boosting properties and may help fight infections naturally due to its anti-fungal, antibacterial, antiviral and anti-parasitic compounds. Frankincense oil and myrrh oil also work to combat pathogens and have anti-infective properties.
- Ginseng may be able to support your immune system by regulating each type of immune cell, including macrophages, natural killer cells, dendritic cells, T cells and B cells.
- Ginger root and ginger essential oil have natural antimicrobial potential and may help fight infectious diseases. Ginger and turmeric together both have anti-inflammatory effects and can help build resilience against viruses, bacteria and parasites and stressors like chemical agents and cigarette smoke.
4. Other Lifestyle Habits to Boost Immunity and Manage Symptoms
- Talk to your doctor about any drugs you are taking that might be making symptoms worse. You may need to change your dosage or try another medication.
- Do what you can to get enough sleep and rest. Adjust your sleep habits to encourage a good night’s sleep. Try not to nap during the day for more than 30 minutes. Do something relaxing before bedtime, such as taking a warm bath or shower, reading, writing in a journal or meditating. Try to stick to a regular sleep-wake cycle by going to sleep at roughly the same time each night. Keep your bedroom cool, quiet and dark. Don’t do any activity before bed that involves blue light exposure, such as using a computer or your phone, playing video games or even watching television.
- If you’re struggling with headaches, apply a cool compress to your forehead, neck or any inflamed area to reduce pain and swelling. Do this for 10–15 minutes a few times daily until the swelling goes down. Adding 1–2 drops of tea tree oil and/or oregano oil to the compress will also help to fight infections. Additionally, you can inhale peppermint essential oil or rub it into your temples, neck or chest.
- Avoid caffeine, alcohol or high-sugar foods that can make headaches, fatigue and other symptoms worse.
- It’s important to find ways to incorporate physical activity/exercise into your daily and weekly regimen to strengthen your immune system, especially as you age. Studies suggest that high levels of physical activity and exercise improve the immunosenescence (gradual deterioration of the immune system) in older adults aged 55 through 79. (7) Start by going outside, getting some fresh air and taking daily walks.
- Quit smoking, drinking more than moderate amounts of alcohol and using tobacco or other drugs. For help with quitting smoking, talk to your doctor about useful interventions; speak with a therapist or start an online program that specializes in smoking cessation.
- Limit your exposure to toxins, chemicals and pollutants at work as much as possible. Talk to your doctor about your risk for developing illnesses in the future if you’ve been treated with chemotherapy or radiation in the past.
- If symptoms like fatigue/lethargy start causing mood-related symptoms such as depression, consider psychosocial support like cognitive behavioral therapy, stress management techniques and other coping strategies.
- Leukopenia (or leukocytopenia) describes a low white blood cell count.
- Causes of leukopenia include various diseases such as: anemia, viruses and infections, autoimmune diseases, an overactive spleen or cancers that damage bone marrow like lymphoma and leukemia.
- White blood cells (also called leukocytes or leucocytes) are a part of the immune system and have the important job of protecting the body against both infectious disease and foreign invaders.
- Leukopenia is usually asymptomatic (doesn’t cause symptoms), but it raises the risk for getting other infections and viruses.
- Symptoms associated with leukopenia can include: infections, fatigue, fever, enlarged spleen or liver, pneumonia, anemia, headaches and others.
- Conventional leukopenia treatments include: antibiotics, hospitalization if necessary, intravenous fluids and other interventions to treat underlying health conditions. Sometimes if leukopenia is mild, no treatment will be necessary.
4 Natural Ways to Support Leukopenia Recovery:
- Immune-boosting diet
- Hygiene to prevent infections
- Other lifestyle habits to boost immunity and lower symptoms