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Q. My blood report shows low WBC count. Is this an serious issue?

Answered by
Dr. Parth R Goswami
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Oct 14, 2020 and last reviewed on: Oct 23, 2020

Hello doctor,

I recently had my complete blood test and said my WBC is low at 3.6, just below the reference range of 3.8. However all the other values of the WBC were in normal range. The RBC showed normal ranges too. Could this be due to increased exercise intensity everyday for the last two months or is this a serious issue such as leukemia, myeloma, or lymphoma? I am a 31-year-old male, 151 lbs. No smoking or drinking, and I do daily exercise for 30 minutes. Interestingly enough, my WBC was 5 ealier, but now it was 3.7. When my blood was tested this time, my ALT, AST, and CK was high, but we are well below the normal range to quarantine. I have been working out extra hard during quarantine and wondering if that has played an affect. Online research says strenuous exercise increases those items. Please advise if you think I should see an oncologist or hematologist? I am quite concerned about my WBC.

Glucose (mg/dL) 89.00.

Calcium (mg/dL) 9.70.

Magnesium (mg/dL) 2.20.

Creatininekinase (U/L) 1 767.00.

Vitamin B12 (pg/mL) 355.00.

Folate (ng/mL) 20.70.

Vitamin D (ng/mL) 64.00.

Ferritin (ng/mL) 27.00.

Total cholesterol (mg/dL) 152.00.

Hemoglobin (g/dL) 14.90.

HDL (mg/dL) 56.00.

LDL (mg/dL) 82.00.

Triglycerides (mg/dL) 61.00.

Testosterone (ng/dL) 816.00.

Sodium (mmol/L) 143.00.

White blood cells (thousands/uL) 3.60.

HbA1c (%) 4.90.

ALT (U/L) 44.00.

Cortisol (µg/dL) 14.00.

Iron (ug/dL) 153.00.

TIBC (ug/dL) 287.00.

Albumin (g/dL) 4.90.

Free testosterone (ng/dL) 9.78.

AST (U/L) 79.00.

GGT (U/L) 13.00.

TS (%) 53.00.

SHBG (nmol/L) 64.00.

hsCRP (mg/L) 0.30.

Red blood cells (x10E6/µL) 4.97.

Neutrophils (cells/µL) 1 778.00.

Basophils (cells/µL) 29.00.

Eosinophils (cells/µL) 112.00.

Lymphocytes (cells/µL) 1 429.00.

Monocytes (cells/µL) 252.00.

Hematocrit (%) 44.10.

MCV (fL) 88.70.

MCH (pg) 30.00.

MCHC (g/dL) 33.80.

RDW (%) 12.10.

Platelets (thousands/uL) 160.00.

MPV (fL) 12.10.

Neutrophils (percent) (%) 49.40.

Eosinophils (percent) (%) 3.10.

Basophils (percent) (%) 0.80.

Lymphocytes (percent) (%) 39.70.

Monocytes (percent) (%) 7.00.

RBC Magnesium (mg/dL) 4.90.

Dr. Parth R Goswami

Hematology Pathology


Welcome to

I have read all three reports (attachment removed to protect patient identity).

The total WBC (white blood cells) count is low only in the latest attached report. There are many causes for low WBC count, including viral infection to blood cancer.

Your main fear is the possibility of leukemia like blood cancer. However, if you have blood cancer like leukemia, then in differential count, premature cells should be present like myelocytes, metamyelocytes, blast cells, etc. All these cells are not present in the attached report. So the possibility of leukemia is very unlikely.

Exercise increases count usually, but it is not in your case. However, do not worry about that. I suggest you drink more water and repeat your CBC after a few days. Revert with repeat CBC report.

If the total WBC count is still low after few days, then peripheral smear examination and USG (ultrasound) abdomen to check liver and spleen should be done.

I hope this helps.

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Thank you doctor,

I also forgot to add that I finished 4.5 months of Accutane (Isotretinoin). Is this any residual effect?

Dr. Parth R Goswami

Hematology Pathology


Welcome back to

Isotretinoin could also cause low count. However, the drug-induced low count is temporary. Unnoticed viral infection also can be the cause for the low count, which is also temporary.

So, considering these two causes as a possibility, kindly repeat CBC with a peripheral smear examination report of the blood after a few days. Mostly after a few days to the week, your count will be normal. You can revert with that repeat report.

I hope this helps.

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