Patient's Query
Hello doctor,
I get a complete blood count every two months, and it has been noticed that levels of B12 and neutrophils are low, and lymphocytes are high. I feel tired all the time and have been diagnosed with chronic sinus infections and muscle tension. I am taking cyclobenzaprine for muscle cramps in my back, and I have been seeing a chiropractor every week for the past three years. It seems that my neutrophils are dropping every time.
They are currently at 23, and my lymphocytes are increasing and are at 64. I am currently being treated for B12 Deficiency with shots every month, along with pills. For the past three months, I have been very tired and even missed a period. Should I be concerned about the varying blood counts?
Kindly suggest.
Thank you.
Hello,
Welcome to the icliniq.com
I can understand your concern.
Three issues are present in your case.
Abnormal neutrophil and lymphocyte count.
Vitamin B12 deficiency.
Chronic fatigue.
Your lymphocyte count is high, but absolute lymphocytosis should be ruled out by calculating it in comparison to the total WBC (white blood cells) count. High lymphocytes can be seen in viral infections like infectious mononucleosis, mumps, infectious lymphocytosis, tuberculosis, syphilis, and HIV (Human immunodeficiency virus), which can also lead to high lymphocytosis. Lymphoid malignancy (malignancy suspected when the liver and spleen are palpable) can also be the cause. Neutrophils are low because of lymphocytosis.
If vitamin B12 deficiency is not improving with completing a course of injections, then vitamin B12 malabsorption should be suspected, and endoscopy may be needed. Bacterial overgrowth and tropical sprue can affect vitamin B12 absorption. If needed, a suitable antibiotic course can be given for that.
Examination of the liver, spleen, and lymph node should be done with a detailed history. If fatigue continues after correction of vitamin B12 anemia,then causes for chronic fatigue should be ruled out, like stress, lack of sleep, overexertion, thyroid issues, and electrolyte disturbance.
I hope this information will help you.
Kindly revert in case of further queries.
Thank you.
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Answered byDr. Goswami Parth Rajendragiri
Medically reviewed byiCliniq medical review team
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