HomeAnswersRheumatologyneutropeniaIs neutropenia associated with pain and fatigue?

How can we increase the neutrophil count?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Sneha Kannan

Published At April 27, 2021
Reviewed AtJuly 20, 2023

Patient's Query

Hi doctor,

I am a 37-year-old female with intermittent low-grade fever, chronic fatigue, and generalized pain. My CBC shows neutropenia for the past three to five years. My pain and fatigue are getting worse. Can you help me with this?

Hello,

Welcome to icliniq.com.

I would like to know if there are any localizing symptoms like cough, diarrhea or constipation, or burning sensation while passing urine. Are your periods regular? Are your stress levels normal? Do you have a loss of appetite or noticed weight loss in recent years? How is your overall digestion? Have you taken any other blood tests like thyroid profile (blood test done to measure the level of thyroid hormone in the blood)? Also, please tell me the list of medications you have taken so far, including multivitamins.

Patient's Query

Hello doctor,

There is no cough, diarrhea or constipation, or burning sensation. Also, there is no weight loss or loss of appetite, and my digestion seems to be normal. Thyroid levels have been tested till last year, and it is normal. The stress level is also fair. I have not taken any medications so far except Vitamin C tablets.

Hi,

Welcome back to icliniq.com.

As you do not have any other symptoms and also since your appetite and weight are stable, I do not want to investigate you further at this point. It looks more like chronic fatigue syndrome (CFS) or fibromyalgia. I would suggest you with the following lifestyle regimen for three to four weeks, and after seeing the results, if needed, we can investigate it further.

1. Food:

  • Avoid all bad carbohydrates, junk foods, carbonated drinks.
  • Eat fruits in the day, preferably before 3 PM.
  • Take vegetables daily.
  • Consume low-fat dairy if you take 100 grams of animal protein.
  • Drink 2.5 liters of water daily.
  • Do not take coffee more than twice a day.
  • Do not consume alcohol after 5 PM.
  • Try to practice intermittent fasting 16:8 (Eat for 8 hours during the day and fast for the rest of the day).
  • Have your dinner early.
  • Take nuts only after overnight soaking.
  • Fast at least once a week.

2. Physical exercises:

  • Daily walk for 2 miles and do stretching exercises for 20 minutes, or you can alter it with HIIT (high-intensity interval training) or tai chi (internal Chinese martial art).

3. Get a body massage once a week or do it on your own.

4. Take Probiotics twice daily for two weeks.

5. Multivitamin:

  • Vitamin D 2000 IU daily for three weeks.
  • Magnesium 250 mg daily for two weeks.
  • B-complex, Iodine 100 mg, and Levocarnitine 500 mg once daily, all for two weeks.

6. Paracetamol 1 g if needed for pain relief.

7. Green tea once a day and rosemary seasoning.

8. Do daily meditation.

9. Maintain a daily diary for pain score, moods, aggravating and relieving factors.

10. Practice giving and gratitude in a family or get involved in community service. Try to build positive emotions.

11. Get good 7 to 8 hours sleep daily. If needed, use St. John's wort 500 mg at bedtime.

Follow-up after two weeks.

Patient's Query

Thank you doctor,

I have a high ESR of 33 mm/hr and positive ANA on the mitotic spindle. All the other test results are normal such as rheumatoid factor and CBC.

Hi,

Welcome back to icliniq.com.

Your laboratory reports look fine. Kindly mention your condition now with your symptoms.

Patient's Query

Thank you doctor,

Does positive anti-nuclear AB look normal?

Hi,

Welcome back to icliniq.com.

Keep a follow-up on it. Repeat CRP (C-reactive protein), ESR (erythrocyte sedimentation rate), CBC (complete blood count), urine analysis, KFT (kidney function test), LFT (live function test) and ANA (anti-nuclear antibody) after six months. If you are clinically fine and all other parameters are normal, then just have a follow-up. Maintain a good lifestyle and take measures to decrease inflammation.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Rahul Ramji Kackar
Dr. Rahul Ramji Kackar

Endocrinology

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