Introduction

White blood cells (WBCs), which are a type of blood cells are an essential part of our immune system and play a critical role in protecting the body against infection, illness, and disease. However, an abnormally high number of white blood cells in the bloodstream can indicate an underlying medical condition that requires urgent attention. So, whether you’re a medical professional or just eager to learn more, join us for an in-depth look at WBCs, their importance, normal range, dangerous levels, low WBC count and medical treatment for low WBC.

Did you know?

• For every increase of 1,000 cells/mm3 in white blood cell count, the risk for diabetes increases by 7.6%. source: PMC3554323
• Low-normal white blood cell count (<5,400 cells/mm3) may protect against diabetes even in the presence of risk factors like overweight, family history, or elevated triglyceride levels. source: PMC3554323
• Age and white blood cell count also contribute to the variation in diabetes risk prediction models. source: PMC3554323

What is a Dangerous White Blood Cell Count?

The WBCs value includes the sum total of the subtypes of white blood cells which include eosinophils, neutrophils, lymphocytes, atypical leucocytes and monocytes. The normal range for WBCs for different age groups is as follows:

• Newborn: 13-38 x10⁹/L
• Birth-2 weeks: 5-20 x10⁹/L
• Adult: 4.5-11 x10⁹/L

A WBC count lower than the given range is leukopenia and higher than the range is called leukocytosis. Either is dangerous and requires an immediate medical opinion.    

After ordering a complete blood test profile, your doctor will diagnose leukocytosis or leukopenia and determine the need for further evaluation and tests.

In case of an abnormal laboratory value, your doctor will do a physical examination and take a detailed history to ascertain/identify the possible cause of an abnormal WBC count. Depending on the signs and symptoms, the need for hematology/oncology consultation, genetic testing will be evaluated.^1,2

In my experience, your body’s ability to produce WBCs may be impacted by poor nutrition or insufficient amounts of certain vitamins, such as folic acid and B12. Abusing alcohol might affect both your WBC levels and the nutrients in your body.

Dr. Siddharth Gupta, MD

Dangers and Risks Associated With a Low White Blood Cell Count

A dangerous WBC count may vary depending on the individual’s health condition and medical history. However, a general guideline is that white blood cell count above 11 x10⁹/L (leukocytosis) can be fatal.

A low level of WBCs in your body commonly called as leukopenia may increase the risk of infections in all age groups and developmental defects in children. Leukopenia is asymptomatic, i.e. it may present without any symptoms but it can cause infections which may have the following symptoms: ^2,3

• Fever and chills
• Redness and swelling
• Mouth sores
• Sore throat
• Skin rashes
• Tiredness 
• Toothache 
• Flu-like symptoms which may include headache, runny nose, cough, body ache etc.

If you have any of the above complaints, you should seek medical guidance at the earliest for a proper management and do not rely on any home-remedies or self-medication.

WBCs are produced by the spleen. It may enlarge and cease to function properly as a result of infections, blood clots, and other issues. From my perspective, the result will be a decrease in WBC.

Dr. Rajeev Singh, BAMS

Causes of a Low WBC Count

Following are the conditions/causes associated with a low WBC count in the body: ^2,3

• Cancer and cancer treatment like radiotherapy
• Antipsychotic medications or medications used to treat psychotic disorder
• Medicines used to treat hyperthyroidism
• Autoimmune diseases like rheumatoid arthritis
• HIV/Hepatitis 
• Megaloblastic anaemia (anaemia due to folic-acid deficiency)

White blood cells (WBCs) are crucial for maintaining your body’s health. They guard it against outside contaminants and stop infection. But did you know that even the excess WBCs might also cause a big problem? Leukocytosis refers to a condition in which there are more white blood cells than usual. Studies have revealed that while WBCs counts often rise as they perform their duties, there are certain additional circumstances in which they could do so, such as women who are pregnant may have somewhat higher number of WBCs.

Dr. Smita barode, BAMS

How to Increase WBC Count? ^4,5

Following are the ways by which the levels of WBCs can be restored:

• Diet: Including a good quality diet which is rich in proteins is important as they would help in making new WBCs. If possible you can consult a dietician for a proper dietary regimen.

• Supplements: if you have trouble eating or have a poor diet, you may benefit from a supplement or multivitamin.

• Exercises: a study conducted by Sand et al. in 2013 stated that mild-moderate intensity exercises like cycling may help improve WBC count. 

Dietary Changes That Can Boost WBC Production

• A study conducted by Lassale et al. in 2021 stated that Mediterranean diets which are rich in healthy foods like fruits, vegetables, beans, seafood and nuts have the potential to increase WBC levels.⁶
• Montagnana et al. in 2017 conducted a review in 2017 which stated that dark chocolate consumption may increase the level of WBCs in the body.⁷

However, you should refrain from the following foods if you have low WBC count: ⁸

• Raw meat 
• Fish and other seafoods
• Eggs 

Supplements and Natural Remedies to Increase WBCs

• Supplements containing Vitamins B6 and B12 may help in restoring the WBCs.^8,9
• A study conducted by Varughese et al. in 2020 stated that the consumption of raw jackfruit may help in elevating WBCs.¹⁰ 
• Indian milkvetch or astragalus, also known as Katira or Huang which is a flowering plant was found to improve WBC counts.¹¹

Medical Treatments to Increase WBCs

• There is no drug or medicine approved to increase the WBC count, the management includes withdrawing or holding the drugs which may cause white blood cells to decrease. The course of treatment also involves providing prophylactic treatment for the risks like infections, which may include antibiotics. 
• Chang et al. in 1989 stated that leukopenia caused due to cancer can be effectively managed using medications. However, more studies are needed to assess the effectiveness of these medicines to treat leukopenia.¹²

Also Read: Astragalus Benefits: Exploring Research-Backed Health Improvements

Conclusion

The white blood cells value includes the sum total of the subtypes of white blood cells which include eosinophils, neutrophils, lymphocytes, atypical leucocytes and monocytes. The normal range for white blood cells for adults is 4.5-11 x10⁹/L. A dangerous white blood cell count may vary depending on the individual’s health condition and medical history. White blood cell count above 11 x10⁹/L (leukocytosis) can indicate a sign of danger. On the other hand, leukopenia or the abnormal reduction of the white blood cells can be dangerous too.  It’s important to consult with your healthcare professional if you have concerns about your white blood cell count. There are no medicines approved to improve the levels of white blood cells, however dietary changes and supplements may improve the level of white blood cells.

Frequently Asked Questions (FAQs)

References

1. Riley LK, Rupert J. Evaluation of patients with leukocytosis. American family physician. 2015 Dec 1; 92(11):1004-11. Available at: https://www.aafp.org/pubs/afp/issues/2015/1201/p1004.html
2. Ing VW. The etiology and management of leukopenia. Canadian Family Physician. 1984 Sep; 30:1835. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2154209/pdf/canfamphys00223-0129.pdf 
3. Low white blood cell count [Internet]. Health A to Z. NHS; 2023 [cited 2023 May 11]. Available from: https://www.nhs.uk/conditions/low-white-blood-cell-count/
4. White blood cell count and diet [Internet]. Oncology Nutrition. Academy of Nutrition and Dietetics. Available from: https://www.oncologynutrition.org/erfc/eating-well-when-unwell/white-blood-count-diet
5. Sand KL, Flatebo T, Andersen MB, Maghazachi AA. Effects of exercise on leukocytosis and blood hemostasis in 800 healthy young females and males. World journal of experimental medicine. 2013 Feb 2; 3(1):11. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905589/
6. Hernáez Á, Lassale C, Castro-Barquero S, Babio N, Ros E, Castañer O, Tresserra-Rimbau A, Pintó X, Martínez-González MÁ, Corella D, Salas-Salvadó J. Mediterranean diet and white blood cell count—A randomized controlled trial. Foods. 2021 Jun 2; 10(6):1268. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227102/
7. Montagnana M, Danese E, Lima-Oliveira G, Salvagno GL, Lippi G. Dark chocolate intake acutely enhances neutrophil count in peripheral venous blood. Iranian Journal of Pathology. 2017 Jul 1; 12(3):311-2. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835384/
8. Hawkins WW, Evans MK. White blood cells and lymphoid tissue in vitamin B6 insufficiency. American Journal of Physiology-Legacy Content. 1952 Jul 1; 170(1):160-7. Available at: https://pubmed.ncbi.nlm.nih.gov/12985879/
9. Lewicki S, Lewicka A, Kalicki B, Kłos A, Bertrandt J, Zdanowski R. The influence of vitamin B12 supplementation on the level of white blood cells and lymphocytes phenotype in rats fed a low-protein diet. Central-European journal of immunology. 2014; 39(4):419. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439950/
10. Varughese T, Joseph J, Menon R. Efficacy of Jackfruit365™ Green Jackfruit Flour Fortified Diet on Pegfilgrastim to Prevent Chemotherapy-Induced Leukopenia, Irrespective of Tumor Type or Drugs Used—A Retrospective Study. Biomolecules. 2020 Feb 2; 10(2):218. Available at: https://pubmed.ncbi.nlm.nih.gov/32024271/ 
11. Weng XS. Treatment of leucopenia with pure Astragalus preparation–an analysis of 115 leucopenic cases. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi Jiehe Zazhi= Chinese Journal of Integrated Traditional and Western Medicine. 1995 Aug 1; 15(8):462-4. Available at: https://pubmed.ncbi.nlm.nih.gov/8580691/
12. Chang KH, Tan R, Chung CH. The use of lithium carbonate to correct leukopenia during cancer treatment. Zhonghua yi xue za zhi= Chinese Medical Journal; Free China ed. 1989 Mar 1; 43(3):165-70. Available at: https://pubmed.ncbi.nlm.nih.gov/2507118/

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