In this second part of the series, I’ll explain how to interpret the white blood cell (WBC) markers on a blood test. See Part I of this series to understand red blood cell markers.
Measuring WBC are used to assess how the body’s immune system is functioning. And WBC are mainly used to determine an active or chronic infection, in addition to the type of infection. It can also point to an allergic response or inflammatory state in the body. In addition to the total amount of WBC, there are five individual types of WBC that can and should be examined.
First I’ll discuss the WBC count as a whole.
The “WBC” value that is listed on your lab test measures the absolute or total number of WBC in a given sample. When WBC are decreased, it typically indicates a “weak” or “taxed” immune system, usually because of a chronic infection. This can be also be due to nutrient deficiencies, which may have first led to an infection… Many different nutrients are important for proper immune function. In fact, it can be argued that every nutrient is necessary for a properly functioning immune system. This is in contrast to the basics of red blood cell health which primarily depend on adequate supplies of folic acid, vitamin B12, and iron (although more can and certainly do play a role).
When WBC are increased, it typically indicates an immune system on “high alert” which is actively fighting an acute infection. Keep in mind that the infection can be of any nature such as: bacterial, viral, protozoal, and/or fungal. Also, realize that not everything goes according to the “textbook” and there may be variations among people where the tests aren’t as cut and dry. Sometimes a person can have an active infection with low total WBC and vice versa. But then again, a person can have both a chronic and active infection of different origin at the same time.
When a CBC is ordered “w/ differential” you’ll be able to see the percentage and absolute number of the five different types of WBC that will be helpful in indicating the type of infection or immune system process that is taking place. Keep reading to learn about the individual WBC.
1) Neutrophils – These are the most abundant and important type of WBC. And they are the most involved in responding to inflammation. When it comes to microbial infections, neutrophils generally respond to bacteria; so when they’re high one would expect an existing bacterial infection. Again, checking the absolute number of WBC can help point to whether the infection is chronic or acute.
2) Lymphocytes – Lymphocytes are the second most abundant immune system cell, and typically respond to viral infections. As a result, if they are increased, one would suspect a viral infection. And if there is a viral infection, remember to check the total number of WBC to determine if it’s chronic or acute. Another thing to consider is that if lymphocytes are high, neutrophils are usually low, because the immune system preferentially produces more of the cells that are necessary to fight the infection. And the same goes for a bacterial infection; typically neutrophils will be high and lymphocytes will be low with a bacterial infection.
3) Monocytes – These cells are the largest in size, although third in total number. Monocytes are responsible for removing dead cells and other “particles/debris” from the blood, in addition to producing the anti-viral agent interferon. Typically these cells will be high when there is a significant inflammatory response present. Something like a sprained ankle can cause enough inflammation for this marker to be high. That said, they would typically be high just following an acute injury and not necessarily with a chronic sprain/strain injury. Aside from an acute injury though; it may be prudent to search for sources of chronic cell damage and inflammation. I’d start by considering the following based on the patient’s history and symptoms :toxic metal exposure – e.g.: lead, mercury, aluminum, etc.; synthetic chemicals of any sort; and microbial imbalances.
4) Eosinophils – These cells become especially active during a parasitic infection or allergic response, and are responsible for releasing histamine. Although, there are many other diseases that can cause a spike in eosinophils. The patient’s history and symptoms should be able to help point the clinician in the right direction to begin looking.
5) Basophils – Fluctuations in basophils outside of the normal reference range may point to a parasitic or allergic response, but I find that they are very often within the normal range; and typically look to eosinophils when I suspect a parasitic or allergic response. Also, pathological processes can cause a spike in basophils and may need to be investigated.
Although what I’ve written is generally textbook knowledge. I’ve never had a textbook walk into my office and have everything fit together into an easy-to-read puzzle. Interpreting blood work is as much an art as it is a science… Hopefully you’ve found this helpful and can be a bit more aware of how your body functions and understand how “good” you look on paper.
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology