Patient's Query
Hello doctor,
I am 25 and a mom of three. For over four years, I have been dealing with extreme fatigue, low energy, and feeling cold all the time, even when others are comfortable. I honestly feel like I could sleep for days.
I am on Vilazodone and a Dextroamphetamine with Amphetamine combo (Adderall), prescribed for depression. But I do not feel sad or hopeless, just completely drained. Without Adderall, I struggle with even basic tasks like showering or brushing my teeth. Doctors previously thought it was due to low iron or depression, but my iron levels are now normal, and the fatigue has not improved.
My persistently high white blood cell counts, which have been noted repeatedly over the last 15 years, worry me the most. Each time I have been told it might be a mild illness, but that explanation no longer feels right.
Here are my recent lab results:
WBC is 15.8, 14.8, 14.3, 12.7, and 10.9 cells per microliter.
Absolute neutrophils ranged from 7500 to 12,740.
RBC is 4.5 to 5.5 million cells/mcL.
Platelets are 412 to 475 platelets/mcL.
I also have a family history of leukemia; my uncle was diagnosed (not sure which type). I am scared something more serious is being missed, like a chronic blood condition. I am not trying to overthink it. I just want to understand what is happening so I can feel better and be fully present for my kids.
I would truly appreciate your help.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
At your age, if we were to consider chronic leukemia, the most likely type would be chronic myeloid leukemia (CML). CML is a type of blood cancer where white blood cells, especially neutrophils (cells that help fight infections), are often found in very high numbers, usually between 100,000 and 200,000 cells per microliter.
Your highest recorded white blood cell count has been 15,800 cells/µL, which is only mildly elevated. This kind of increase is often seen with bacterial infections, stress, hormonal changes, or even after exercise. It does not fall within the range typically seen in CML.
Although your neutrophil percentage is elevated, your blood work and peripheral smear do not show any immature cells (called blasts), which are a key sign of leukemia. Their absence is very reassuring and strongly rules out leukemia, including CML.
Your platelet count is on the higher end of normal, which is still considered healthy. In more severe forms of leukemia, platelet counts often exceed 800,000/µL, which is not the case here.
Given your ongoing stress, fatigue, and history of depression, your blood counts may be fluctuating. I recommend repeating the tests after a calm, infection-free month. Also, focus on a nutritious diet and continue your medications as prescribed.
Please try not to worry. Based on your lab results and history, I am confident that there is no evidence of leukemia at this time.
I hope this helps.
Kindly revert so I can assist you further.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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