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Do I Need To See A Hematologist For White Blood Cell Count On My CBC W/differential Was Low. 3.76 On A 4-13 Scale?

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Posted on Wed, 15 May 2024
Question: Hello, My white blood cell count on my CBC w/differential was low. 3.76 on a 4-13 scale. All other numbers were fine including normal CMP, c-reactive protien, b12, sed rate. My TSH was 3.93 on a scale of 0.27-4.2 which had gone up from July 2023 reading at 2.64. I am not ill but have been having extreme burning and pins and needles throughout my body, including burning mouth syndrome. My neurologist wants to do a skin biopsy for small fiber neuropathy. I am concerned about the low white blood cell count as i have never had an abnormal reading Do i need to see a hematologist and is the jump in thyroid normal and of any significance.
doctor
Answered by Dr. Sunny Madar (11 hours later)
Brief Answer:
Skin biopsy is safe, low counts can be due to viral infection.tsh normal

Detailed Answer:
Hi dear
Do you also have fever ? As viral infection can present with this .please send report of your heamoglobin and ferritin and iron levels too. Biopsy is safe and can make diagnosis and tell exact cause of your pains I.e needles and pins as you mentioned. What are your other levels like t3,t4, and free levels of thyroid hormones too especially free thyroxine T4 levels. Are you taking any meds related to thyroid? As with age tsh increases normally also . But you can retest if any unusual symptom or after 2 months .take multivitamins for 1 week at least. Avoid spicy,hot, tob,alcholic drinks,high acid products too and do breathing exercises like sky and antioxidants in diet like amla,aloevera etc are helpful too. You can visit haematologist he definitely can tell better too. Please send all reports as mentioned above
Hope this helps , thanks for asking
Above answer was peer-reviewed by : Dr. Dr. Prasad J
doctor
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Follow up: Dr. Sunny Madar (2 days later)
No fever. Test results below
Vitamin B12 (549) scale 221-946
Ferritin. (145.3) on scale of 13.0-150.0
Iron. (112) 37-145
TOTAL IRON BINDING (288) scale 298-536 LOW
Saturation percent (39) scale 13-45
UIBC (176) scale 45-160

TSH (3.930) scale 0.27-4.2
SED Rate (7) scale 0-20mm
C-reactive protein value <0.30 Normal range <=0.50mg/dl
All other numbers normal on CBC CMP

Burning pain and twitching throughout all muscles in body. Fatigue upon any exertion
I am on 100mg gabapentin twice a day
Estradiol patch 0.05
Cyclobenzaprine 5 mg a few times a week
Lansoprazole 15 mg for Barrett’s disease
Propranolol 10 mg as needed for inappropriate sinus tachycardia.
Thank you for any additional input. Could the low iron cause drop in white blood cell count? Should I see a hematologist?
doctor
Answered by Dr. Sunny Madar (35 minutes later)
Brief Answer:
Your iron levels are normal within range, gabapentin can cause low cell

Detailed Answer:
Hi dear
Your blood tests results shows all normal and your iron levels are normal unless Mistaken in typing. Gabapentin can cause leucopenia in 1 to 5 % of cases .once eeg should be done to rule out seizures as gabapentin also used in partial seizures also.if you have inappropriate tachycardia then alone estrogen should not be taken but plus progestin should be used once consult for that to your physician.tests like pbf ,eeg and ecg should be done.and with these tests results go to haematologist if you want to because he can rule out 100% other possible risk factors.and also follow what things are suggested in last answer.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Dr.Raju.A.T
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Answered by
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Dr. Sunny Madar

General & Family Physician

Practicing since :2017

Answered : 1190 Questions

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Do I Need To See A Hematologist For White Blood Cell Count On My CBC W/differential Was Low. 3.76 On A 4-13 Scale?

Brief Answer: Skin biopsy is safe, low counts can be due to viral infection.tsh normal Detailed Answer: Hi dear Do you also have fever ? As viral infection can present with this .please send report of your heamoglobin and ferritin and iron levels too. Biopsy is safe and can make diagnosis and tell exact cause of your pains I.e needles and pins as you mentioned. What are your other levels like t3,t4, and free levels of thyroid hormones too especially free thyroxine T4 levels. Are you taking any meds related to thyroid? As with age tsh increases normally also . But you can retest if any unusual symptom or after 2 months .take multivitamins for 1 week at least. Avoid spicy,hot, tob,alcholic drinks,high acid products too and do breathing exercises like sky and antioxidants in diet like amla,aloevera etc are helpful too. You can visit haematologist he definitely can tell better too. Please send all reports as mentioned above Hope this helps , thanks for asking