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The Critical Blood Tests for Diabetes and Other Illnesses
Risk Factors for Diabetes

How to Get Healthy
Getting healthy is the combination of the right mindset and attitude and the right information. If you have the right attitude, all you need is the right information! And, to get the right information, start with the Death to Diabetes book, which supports diabetics and non-diabetics.

How to Slow Down the Aging Process
Diabetes causes our bodies to age much faster than normal. If you want to learn how to slow down the aging process:
Are You Dying Too Fast?
Well, we're all dying and we're all going to die. But, if you're diabetic, overweight, or suffering with high blood pressure or some other ailment, more than likely, you're dying at a faster rate than you have to die. Also, there is no need to suffer while you're dying!

Also, there's no need to "drop dead" like Tim Russert, Bernie Mac, Michael Jackson, Luther Vandross, and so many other people who are not as well-known. Heed their warning, and don't expect that it can't happen to you. Think of your loved ones ...

The good news is:
  • You can figure out if you're dying too fast
  • You can slow down how fast you're dying
How to Figure It Out: The Critical Blood Tests
The most important thing to do is to get a set of blood tests, urine tests, and hormone tests every 3 to 6 months to track your health progress.

Some of the critical blood tests and other tests include:
  • Blood pressure
  • Blood glucose
  • Hemoglobin A1C
  • Cholesterol
  • Electrolytes
  • Inflammation markers: homocysteine, CRP, lp(a), fibrin
  • Waist size (BMI)
  • Microalbumin
  • Bowel regularity
Note: Your doctor may resist giving you some of these blood tests, especially the inflammation markers. But, remember, it's your life! Don't give in -- push back and kindly request the blood tests. It's the first step in obtaining a proper diagnosis.

Warning: If your blood tests indicate high blood pressure, your doctor will recommend that you start taking a drug such as Lisinopril or hydrochlorothiazide (a water pill, abbreviated HCTZ, HCT, or HZT). These drugs may seem harmless, but these drugs will gradually cause damage to your kidneys and liver.

Similarly, if your blood tests indicate high cholesterol, your doctor will recommend that you start taking a statin drug such as Lipitor, Zocor, Caduet, Crestor, Mevacor, Pravachol, Simcor, or Vytorin.

These statin drugs will lower your cholesterol, but they will not prevent a heart attack or heart disease.  Why? Because cholesterol is not the cause of heart disease! (Read Chapter 15 for more information).

In fact, heart disease and heart attacks have continued to rise each year despite the fact that statin drugs are now one of the top prescription drugs in America. These drugs may seem harmless, but these drugs will gradually cause damage to your liver and maybe your heart muscle.

Go to the following web pages for more information about the danger of these prescription drugs and other drugs:

Key Point: During your doctor's appointment, after the nurse measures your blood pressure, ask her/him to tell you or write down the actual reading. Some nurses may tell you that "Your numbers are okay." or "You're a little high today." But, that's not specific enough -- you need to know the actual reading.

In addition, you should always ask for a copy of your blood test results -- especially if you need to share the data with another healthcare practitioner, a nutritionist, or a diabetes educator.

There are several lifestyle indicators that are just as important as the blood tests.

The lifestyle indicators include:
  • Nutritional profile (frequency, size, quality)
  • Activity level
  • Drug usage
  • Stress level
  • Spiritual health
  • Emotional support
  • Financial health
  • Relationship health
  • Passion/Personal Drive level
How to Slow It Down
The most important thing to do is to eat as healthy as possible; and, try not to rely on toxic drugs to keep you healthy.

Ironically, the drugs don't slow down your dying or fight your diabetes -- they cover up the symptoms, making you feel that everything is okay.

Now, don't get me wrong -- drugs are not all bad. After all, they saved my life. Drugs are important for trauma and life-threatening situations, but you shouldn't rely on drugs for the rest of your life.

Instead, use superior nutrition to fight your diabetes and eliminate the need for the drugs.

And, get the top-selling book, Death to Diabetes.
Risk Factors
The following is a list of risk factors that can accelerate the rate of dying, or, lead to one of the top killer diseases, i.e. heart disease, cancer, diabetes, obesity.

  • Abdominal (belly) fat: a waistline greater than 40 inches (for a man), or 35 inches for a woman
  • Overweight: Body Mass Index (BMI) greater than 25
  • Poor nutrition: too much processed white rice, potatoes, bread, pasta, and other refined flour products; too many cookies, cakes, pies, bottled juices, soda, ice cream, and other sweets; and, not enough fiber, water, plant oils, and nutrients from vegetables and fruits
  • Drug usage: including prescription drugs, OTC drugs, recreational drugs
  • Tobacco/alcohol consumption
  • Sedentary lifestyle: infrequent physical activity or exercise
  • Age: 45 years or older
  • High blood pressure: 130/80 or higher
  • High triglycerides: over 150; Low HDL cholesterol: under 40 for men, 50 for women)
  • High inflammation: High C-reactive protein, high homocysteine and/or small, dense LDL particles, indicators of 
  • Non-Caucasian ethnicity: Hispanic-American, African-American, Native-American, Asian- American (partially due to societal “isms”)
  • Family history: of Type 2 diabetes or cardiovascular disease
  • Gestational diabetes during pregnancy
  • Poor mental health, e.g. depression
  • Chronic fatigue: low energy, tired at the end of the day
  • Acanthosis nigricans: patches of thick, brownish, velvety skin on the neck, underarms, or groin; also, just below the breasts in women

Please Note: If you have 3 or more of these risk factors, you need to take action now -- before your health deteriorates to a point where drugs and surgery become your only options.

Do not fall for the "false illusion of good health" -- just because you feel fine doesn't mean you're really fine!

This is the false trap that the author fell into before his near-death coma episode.

How many times have you heard about someone having a stroke or heart attack and you just talked with that person just a few days ago and he/she looked completely healthy?

And, despite this type of health crisis occurring on a regular basis, we never translate that health crisis happening to us.

And, for those of us who are ill with a health problem such as diabetes, obesity, or high blood pressure, we ignore the signs and live with the false hope that "I'm fine."

Don't let this happen to you! Think about your loved ones ...

You may not think this is going to happen, but it will ...

The Critical Blood Tests    
The following is a list of the major types of blood tests that your doctor may perform to help determine your current state of health (diagnosis) and your future state of health (prognosis). These tests are very important in your overall health planning.

Fasting Blood Glucose measures the amount of glucose (sugar) in the blood.

Hemoglobin A1C measures the percentage of glucose in the blood during the past 2 to 3 months.

Glucose, formed by the digestion of carbohydrates and the conversion of glycogen by the liver is the primary source of energy for most cells. It is regulated by insulin, glucagon, thyroid hormone, liver enzymes and adrenal hormones.

Glucose is elevated by diabetes, liver disease, obesity, pancreatitis, steroids, stress, or diet. Low levels may be indicative of liver disease, overproduction of insulin, hypothyroidism, or alcoholism.

Range for Fasting Blood Glucose: 80 to 120 mg/dl; Optimum value: < 100 mg/dl
Range for Hemoglobin A1C: 4.2% to 5.5%; Optimum value: < 5.0%

Blood Pressure measures the pressure (force per unit area) exerted by the blood on the walls of the blood vessels.

The first number is the systolic pressure, which measures the force at which the heart contracts. The second number is the diastolic pressure, which measures the pressure when the heart is at rest (between beats).

High blood pressure is an indication that one or more of the body’s systems is not functioning properly, causing the heart muscle to work harder to push the blood throughout the body.
Systolic (first number): < 120 mm Hg
Diastolic (second number): < 80 mm Hg

In addition, measuring the blood pressure in other parts of the body such as the ankle, leg or toe can help to diagnose other problems that may go undetected. For example, according to recent research from Sweden, measuring toe blood pressure can be an effective screening method to identify diabetics with lower extremity arterial disease. Unlike the routine arm blood pressures where diastolic and systolic pressure are measured, extremity blood pressures measure only systolic pressure.

Blood Cholesterol measures the amount of lipids (fat) in the blood.

Cholesterol is a critical fat that is a structural component of cell membrane and plasma lipoproteins, and is important in the synthesis of steroid hormones, glucocorticoids, and bile acids. Mostly synthesized in the liver, some is absorbed through the diet, especially one high in saturated fats. High density lipoproteins (HDL), which indicates more (dense) protein and less cholesterol, is desired as opposed to the low density lipoproteins (LDL), which indicates less protein and room for more cholesterol within the molecule.

Elevated cholesterol levels have been seen in atherosclerosis, diabetes, hypothyroidism and pregnancy. Low levels are seen in depression, malnutrition, liver insufficiency, malignancies, anemia and infection.

Triglycerides, stored in adipose tissues as glycerol and fatty acids, are reconverted as triglycerides by the liver. Ninety percent of the dietary intake and ninety-five percent of the fat stored in tissues are triglycerides.

Increased levels may be present in atherosclerosis, diabetes, hypothyroidism, liver disease, pancreatitis, myocardial infarction, metabolic disorders, and toxemia. Decreased levels may be present in chronic obstructive pulmonary disease, brain infarction, hyperthyroidism, malnutrition, and malabsorption.

LDL or Low density lipoprotein is the cholesterol remnants of the lipid transport vehicle VLDL (very-low density lipoproteins).

A high level of LDL is an indication of a clogged liver, an unbalanced metabolic system, or possible arterial wall damage (atherosclerosis). Due to the expense of direct measurement of LDL, the Friedewald formula is used:
LDL = Total Cholesterol - HDL Cholesterol - Triglycerides/5.
When triglyceride levels are greater than 400, this method is not accurate.

HDL or High density lipoprotein is the cholesterol carried by the alpha lipoproteins.

A high level of HDL is an indication of a healthy metabolic system if there is no sign of liver disease or intoxication. HDL inhibits cellular uptake of LDL and serves as a carrier that removes cholesterol from the peripheral tissues and transports it back to the liver for catabolism and excretion.

The normal ranges for these cholesterol parameters are:
  • Total Cholesterol (TC): < 200 mg/dl
  • Low Density Lipoprotein (LDL): < 130 mg/dl
  • High Density Lipoprotein (HDL): > 40 mg/dl
  • Triglycerides: < 150 mg/dl
  • TC/HDL Ratio: < 4:1;  LDL/HDL Ratio: < 3:1
Note: Actually the ratios are better indicators of your cholesterol health than the absolute numbers, which can be misleading, especially if you have a high HDL, which is a good indicator.

Body Mass Index (BMI) provides a measure of weight relative to height to use as a guideline to determine whether your weight is at a normal, overweight, or obese level.
BMI Range: 20 to 25
BMI greater than 25 indicates an overweight level.
BMI greater than 30 indicates an obese level.

Waist Size: Actually the size of one’s waist may be a better measure and indicator of one’s health state. In general, if the waist size exceeds 40 inches (for a male), or 35 inches (for a female), this indicates a risk factor for developing diabetes and other weight-related health problems. Keep in mind that these are only guidelines for average-sized people.

Note: Refer to the Obesity web page for more information about obesity and excessive weight gain.

Cardiac Risk/Inflammation Factors include homocysteine, lipoprotein (a), C-reactive protein (CRP), and fibrin; and, are better indicators of cardiovascular disease and inflammation than your level of cholesterol.

They measure the amount of inflammation and amino acids in the blood. However, since your doctor may not order these tests until he/she has determined that you may be at risk for cardiovascular disease, you may need to request these tests, especially if you are not making any significant progress with your health.
  • Homocysteine is a sulfur-containing amino acid created by a normal metabolic breakdown of the amino acid methionine; and is an indicator of inflammation.
  • Lipoprotein (a) is produced by the liver to repair arterial injuries due to a lack of Vitamin C to produce collagen for tissue repair.
  • C-Reactive Protein (CRP) is a plasma protein produced by the liver in response to inflammation.
  • Fibrin is an insoluble protein that is deposited around a wound in the form of a mesh to dry and harden, so that bleeding stops. Platelets, a type of cell found in blood, release the enzyme thrombin when they come into contact with damaged tissue, triggering the formation of the soluble protein, fibrinogen. Fibrinogen is then converted to fibrin as the final stage in blood clotting, which helps to repair damaged arterial walls.
The normal ranges for these cardiac risk/inflammation parameters are:
  • Homocysteine: < 17 umol/L
  • C-Reactive Protein (CRP): < 10 mg/L
  • Lp (a): < 25 mg/dl    
  • Fibrin: 145-348 mg/dl
These numbers are only guidelines and may be slightly different depending on the test methods used by your doctor’s lab. Therefore, when you review your blood and urine test results with your doctor, you should always ensure that you understand the normal range for each blood or urine test and how far you are outside that range.

Waste Products include blood urea nitrogen (BUN), creatinine, and uric acid.

They indicate the health of the kidneys. Blood Urea Nitrogen (BUN) is the end product of protein metabolism and its concentration is influenced by the rate of excretion. Creatinine is the waste product of muscle metabolism. Its level is a reflection of the bodies muscle mass. Uric acid is the end product of purine metabolism and is normally excreted through the urine. Bun/Creatinine Ratio is a good measurement of kidney and liver function.

Electrolytes/Minerals indicate the health of the kidneys, adrenal glands, parathyroid glands, and the acid/alkaline status of the blood.

  • Potassium helps to regulate blood pressure and heart function; along with sodium, helps to maintain osmotic balance; is involved in acid-base balance; and, is needed for proper nerve and muscle action. It has an inverse relationship with sodium -- when potassium is increased, sodium decreases and vice versa.
  • Sodium functions in the body to maintain osmotic pressure, acid-base balance and to transmit nerve impulses. It functions with chloride and bicarbonate to maintain a balance of positive and negative ions (electrically charged particles) in our body fluids and tissues.
  • Calcium levels are highly sensitive to elements such as magnesium, iron and phosphorus as well as hormonal activity, Vitamin D levels, alkalinity and acidity, and many different drugs.
  • Carbon dioxide level is related to the respiratory exchange of carbon dioxide in the lungs and is part of the bodies buffering system.
  • Magnesium plays a major role in the metabolism of glucose. It is required for the formation of enzymes that release energy from food; and, is used in the production of cellular energy and to create protein.
  • Phosphorous is needed for its buffering action, calcium transport and osmotic pressure.
  • Chloride influences osmotic pressure, as it helps to keep the amount of fluid inside and outside of cells in balance.

Proteins measure the amount and type of protein in the blood.
  • Albumin is the major constituent of serum protein (usually over 50%). It is manufactured by the liver from the amino acids taken through the diet. It helps in osmotic pressure regulation, nutrient transport and waste removal.
  • Globulin is important for its immunologic responses, especially its gamma portion.
Liver Enzymes measure specific liver enzyme levels to assess how well the liver and the body’s systems are functioning and whether there has been any tissue damage; indicating injury to the cells of the muscles, liver, or heart.

Enzyme tests include Aspartate aminotransferase (AST), Alanine amino-transferase (ALT), Alkaline phosphatase (ALP), Gamma-Glutamyl Transpeptidase (GGT), Lactic acid dehydrogenase (LDH), and Bilirubin.

Thyroid tests measure the levels of the thyroid hormones in the blood, Thyroxine (T4) and Triiodothyronine (T3).

Note: If you are diagnosed with an underactive thyroid (hypothyroidism), you may have an iodine deficiency -- especially if you live in mountainous regions of the world where food is grown in soil poor in iodine or remote inland areas where no marine foods are eaten. Iodine food sources include: seafood, sea salt, kelp,  wakame, kombu, nori, other sea vegetables, iodized salt.

FYI: Iodine is a mineral that is essential for proper thyroid function. Iodine, when combined with the amino acid tyrosine, produces vital thyroid hormones that control our metabolism, insulin sensitivity, enzyme and protein synthesis, and are essential in the development of the skeletal and central nervous systems of developing fetuses.

Note: The combination of a low-salt diet, no sea food, and drinking tap water (with chlorine) can inhibit iodine absorption, and may cause a possible iodine deficiency, which, in turn, may decrease insulin-receptor sensitivity.

Complete Blood Count (CBC) measures the quantity of different cells in the blood.

Other blood count tests include White Blood Count (WBC), Red Blood Count (RBC), Platelet Count (PLT), Mean Corpuscular Volume (MCV), and Hemoglobin (Hgb or Hb).

Bone Density measures the density of the bones to identify potential bone loss -- osteopenia (the early stage of bone loss) or osteoporosis.

Blood pH measures the alkalinity/acidity of the blood, and may indicate acidosis if the pH level is less than 7.365.

Urine Tests can be performed to provide additional insight, especially concerning the health of the kidneys.

Microalbumin measures the amount of protein that is not removed by the kidneys and has leaked into the urine. When kidneys function properly, they filter out waste products from the blood, but when the kidneys become damaged, the waste products remain in the blood and protein leaks into the urine.

At first, when the damage is just beginning, only very small amounts of albumin escape into the urine, a condition known as microalbuminuria. In later stages of kidney disease, large amounts of protein leak into the urine (> 30g/dl), causing a condition called macroalbuminuria, also known as proteinuria.

Ketones measure the level of ketones, which are the by-product of the fat burning process that occurs in the absence of insulin. Other urine tests include pH (acidity for your urine), specific gravity (SG), glucose, protein, bilirubin, nitrate, leukocyte esterase, and sediment

Excretory Factors are usually overlooked, but they can tell your doctor a lot about what you’ve been eating and how your body has been processing what you eat on a daily basis. Infrequent bowel movements (constipation) or indigestion is usually the first sign of problems in the gastrointestinal tract.

Bowel movement frequency, texture, shape: 3-4 times per day (1 per meal), soft, peanut butter-like texture, slightly S-shaped

Urination frequency, color: 4-6 times per day, yellow-straw in color

Note: This is not a comprehensive list of tests.  Get the Blood Tests PDF for the comprehensive list. Depending on your health, there are many other blood tests and medical diagnostic tests that your doctor may perform to better understand your health state.

Other tests include hormone tests, vitamins/minerals tests, liver detoxification tests, amino acids tests, fatty acid analysis, intestinal permeability test, stool test, immune system tests, oxidative stress analysis, and hair analysis tests.

Although health insurance coverage may be a concern, do not hesitate to ask your doctor if there is an additional test that he/she could perform that would better define your health state.

If you and your doctor do not fully understand your health state, it may be difficult to devise an effective “get well” plan. As a result, two to three years later, you may find that you’re either not feeling better or you’re taking more medication. Both of these are signs that indicate that the original diagnosis may have been incorrect.

Low Blood Count

Thrombocytopenia is the medical term for a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that play an important role in blood clotting. Platelets stop blood loss by clumping and forming plugs in blood vessel holes.

Thrombocytopenia often occurs as a result of a separate disorder, such as leukemia or an immune system malfunction, or as a medication side effect. Thrombocytopenia may be mild and cause few signs or symptoms. In rare cases, the number of platelets may be so low that dangerous internal bleeding can occur.

Thrombocytopenia usually improves when the underlying cause is treated. Sometimes medications, surgery or a blood transfusion can help treat chronic thrombocytopenia.

Signs and symptoms of thrombocytopenia may include:

  • Easy or excessive bruising
  • Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs
  • Prolonged bleeding from cuts
  • Spontaneous bleeding from your gums or nose
  • Blood in urine or stools
  • Unusually heavy menstrual flows
  • Profuse bleeding during surgery or after dental work
Normally, you have anywhere from 150,000 to 450,000 platelets per microliter of circulating blood. Because each platelet lives only about 10 days, your body continually renews your platelet supply by producing new platelets in your bone marrow.


Thrombocytopenia has many possible causes.

Trapping of platelets in the spleen
The spleen is a small organ about the size of your fist located just below your rib cage on the left side of your abdomen. Normally, your spleen works to fight infection and filter unwanted material from your blood. An enlarged spleen — which can be caused by a number of disorders — may harbor too many platelets, causing a decrease in the number of platelets in circulation.

Reduced production of platelets
Platelets are produced in your bone marrow. A disease or condition that involves your bone marrow, such as leukemia and some types of anemia, could lead to a reduction in the number of new platelets produced. Viral infections, including HIV infection, may suppress your bone marrow's ability to make platelets. Toxic chemicals, chemotherapy drugs and heavy alcohol consumption also can impair platelet production.

Increased breakdown of platelets
A number of conditions can cause your body to use up or destroy platelets more rapidly than they are produced, leading to a shortage of platelets in your bloodstream. Examples include:

  • Pregnancy. Being pregnant may cause mild thrombocytopenia.
  • Idiopathic thrombocytopenic purpura (ITP). In ITP, your body's immune system mistakenly identifies platelets as a threat and forms antibodies that attack them.
  • Autoimmune diseases. Other diseases in which your body's immune system attacks healthy tissue may cause thrombocytopenia. Examples include lupus and rheumatoid arthritis.
  • Bacteria in the blood. Severe bacterial infections involving the blood (bacteremia) may lead to destruction of platelets.
  • Thrombotic thrombocytopenic purpura (TTP). TTP is a rare condition that occurs when small blood clots suddenly form throughout your body, using up large numbers of platelets.
  • Hemolytic uremic syndrome. This rare disorder causes a sharp drop in platelets, destruction of red blood cells and impairment of kidney function. Sometimes it can occur in association with a bacterial Escherichia coli (E. coli) infection, such as may be acquired from eating raw or undercooked meat.
  • Medications. Certain medications can cause a thrombocytopenic reaction by confusing the immune system and causing it to destroy platelets. Examples include heparin, quinidine, quinine, sulfa-containing antibiotics, anticonvulsants and gold salts.
Warning: Dangerous internal bleeding can occur when your platelet count falls below 10,000 platelets per microliter. Though rare, severe thrombocytopenia can cause bleeding into the brain or intestines, which can be fatal.

Tests to diagnose thrombocytopenia
Tests and procedures used to diagnose thrombocytopenia include:

  • Blood test. A complete blood count determines the number of blood cells, including platelets, in a sample of your blood. Normal blood contains 150,000 to 450,000 platelets per microliter. If the complete blood count finds you have fewer than 150,000 platelets, you have thrombocytopenia.
  • Physical exam. Your doctor may do a physical exam to look for signs of bleeding, such as excessive bruising or petechiae. Your doctor may also feel your abdomen to see if your spleen is enlarged.

Other tests to determine the cause of thrombocytopenia
Once your doctor diagnoses your thrombocytopenia, you may undergo other tests and procedures to determine the cause. The tests and procedures you undergo depend on your other signs and symptoms.

Other words you may hear:

  • Myelosuppression - a decrease in the production of blood cells, which may lead to low blood count.
  • Pancytopenia - a lowering of all three types of blood cells; red blood cells, platelets, and white blood cells, which may lead to low red blood cell count, low blood platlet count, and/or low white blood cell count.
  • Anemia - a decrease in the number of red blood cells (RBC), which may lead to low red blood count.
  • Thrombocytopenia - a decrease in the number of platelets (PLT), which may lead to low blood platlet count.
  • Leukopenia - a decrease in the total number of white blood cells (WBC), which may lead to low white blood cell count.
  • Neutropenia - a decrease in the number of neutrophils, one type of white blood cell, which may lead to low white blood cell count.
  • Granulocytopenia - a decrease in the number of granulocytes, the group of white blood cells that include neutrophils, basophils and eosinophils, which may lead to low white blood cell count.

What are low blood counts?

Many of the chemotherapy drugs temporarily stop cells from dividing, especially the cells that divide quickly.  Blood cells; red blood cells, white blood cells and platelets are made by the bone marrow.  These blood cells divide quickly.  Chemotherapy may lead to low blood counts, causing the possibility of a variety of symptoms.  The symptoms depend on the type of low blood cell count.

Low Red Blood Cell Count (Anemia, low hemoglobin, low hematocrit)

Red blood cells carry oxygen and nutrients throughout the body.  A complete blood count (CBC) is a blood test used to check your blood count.  The RBC, hemoglobin, and hematocrit are tests to see if you have low red blood count.  

Normal Adult Values Male Female
RBC 4.5 - 6.0 M/ul 4.2 - 5.4 M/ul
Hemoglobin (HgB) 14 - 18 g/dL 12 - 16 g/dL
Hematocrit (Hct) 40 - 52% 37 - 47%
Note:  Normal values will vary from lab to lab.

When you have low red blood cell count you may feel:

  • Fatigued
  • Weak
  • Short of breath
  • Increase in your heart rate
  • Dizzy or lightheaded when you change positions quickly

If you suffer from low red blood cell count, you may experience:

  • Headaches
  • Chest Pain
  • Pale skin

Things you can do to help manage your low red blood count:

  • Rest between activities.
  • Plan ahead and save your energy for the most important activities.
  • Avoid or stop activities that make you short of breath or make your heart beat faster.
  • Ask others for help.
  • Eat a diet with adequate protein and vitamins.
  • Drink plenty of non-caffeinated and non-alcoholic fluids.

When to call your doctor or health care provider about low blood counts:

  • Severe weakness.
  • You feel dizzy or lightheaded.
  • Your heart is beating faster.
  • You feel short of breath or are having difficulty breathing.
  • Call immediately if you are having chest pain.

Your doctor or health care provider may prescribe or suggest to treat your low red blood count:

  • Epoetin alfa (PROCRIT®).
  • Darbepoetin (Aranesp®).
  • Iron supplement.
  • Multivitamin.
  • A diet high in protein.
  • A red blood cell transfusion.


Leukopenia - A decrease in the total number of white blood cells, which may lead to low white blood cell count.
Neutropenia - A decrease in the number of neutrophils, which may lead to low white blood count.
Granulocytopenia -  Some people use this term in place of Neutropenia.

White blood cells fight infection.  The white blood count (WBC) is part of a complete blood count (CBC) that is used to check your blood counts.  There are several types of white blood cells.  A differential test will show more detail about your white blood cell count:

Normal Adult Values
White Blood Cell Total 4-11 k/ul
     Lymphocytes 22-44%
     Monocytes 0-7%
          Neutrophils 40-70%
          Eosinophils 0-4%
          Basophils 0-1%
Note:  Normal values will vary from laboratory to laboratory.

When you have a low white blood cell count there is an increased risk of infection.  The level of risk depends on several factors:

  • How low your white blood count falls
  • How long your white blood count is low
  • Which type of low white blood cell count you have 
  • Other medications you may be taking such as steroids or immunosuppressive agents (cyclosporin).

One measure of risk is the absolute neutrophil count (ANC).  The ANC is calculated by multiplying the total white blood count by the percent of neutrophils (also called segmented neutrophils, segs, polymorphoneucleated cells or PMNs, polys)

Total white blood count  x % neutrophils* = ANC

* Neutrophils may be reported as segs & bands (a band is slightly less mature form of a seg).  In this case add the % of segs to the % of bands then multiply by the total number of white blood cells. 

(% segs + % bands) x Total white blood count = ANC 

Risk of Infection based on Absolute Neutrophil Count (ANC)
ANC greater than 1500 No increased risk of infection
ANC 1000-1500 Slight increase in risk of infection
ANC 500-1000 Moderate increase in risk of infection
ANC 100-500 High risk of infection
ANC less than 100 Extremely high risk of infection

Things you can do to reduce your risk of infection when you have low white blood count:

  • Frequent hand washing of both you and those coming in contact with you.
  • Avoid contact with anyone who is sick.  If someone in the home is sick limit contact and consult your doctor or nurse.
  • Do not have dental work done while your white blood cell count is low.

When your white blood cell count is low you may NOT have the usual signs and symptoms when developing an infection such as:

  • Redness
  • Swelling
  • Pus formation  (at the site of an injury or incision)
  • Cough
  • Sputum
  • Nasal drainage (from a sinus or respiratory infection) 

Therefore, it is extremely important to be alert to any change in how you feel and report and discuss what you are feeling with your doctor or nurse.

When to call your doctor or health care provider about low blood count:

Call immediately if you have: 

  • A temperature greater than or equal to 100.5°F.  (Check with your health care provider, you may be instructed to call for temperature greater than or equal to 100°F)
  • Chills (rigors) or shakes
  • Sudden onset of a new unexplained pain.

Call within 24 hours if you experience the following:

  • Sore throat
  • Sores in your mouth
  • A white coating in your mouth, especially your tongue
  • Signs of a bladder infection
    • Burning with urination
    • Blood in your urine
    • Needing to urinate more frequently than normal
    • Having to urinate in hurry and possibly not making it to the bathroom in time. 

Your doctor or health care provider may prescribe or suggest to treat low white blood cell count:

  • The following medications may be given after each cycle of chemotherapy to prevent your white blood cells from falling too low and/or for too long.
    • Filgrastim (Neupogen®)
    • Peg - Filgrastim (Neulasta®)
    • Sargramostim (Leukine®)
  • The following are antimicrobial medications that may be prescribed to prevent specific infections that are common when the immune system is suppressed by chemotherapy and/or other medications.
    • Sulfamethoxazole - trimethoprim
    • Acycolovir
    • Flucanozole
    • Intraconazole
  • Other antiobiotics or antimicrobials are used to treat specific infections as needed.


LOW BLOOD PLATELET COUNT (Thrombocytopenia, low PLT) 

Platelets help blood to clot.  They are found in the blood flowing through the blood vessels.  Platelets also line the inside of the blood vessel.  When low blood platelet count is present, this layer thins and tiny drops of blood can leak through the spaces made when this layer thins, causing red dots on the skin called petechiae (pa-TEE-kee-eye). 

Normal Platelet Count 150,000 - 400,000 cells/mm3
Note:  Normal values will vary from laboratory to laboratory.

When low blood platelet count present a person is at an increased risk of bleeding.

Risk of Bleeding is based on the Platelet Count
100,000 - 149,000 cells/mm3 Little to no risk of bleeding
50,000 - 99,000 cells/mm3 Increased risk of bleeding with injury
20,000 - 49,000 cells/mm3 Risk of bleeding increased without injury
10,000 - 19,000 cells/mm3 Risk of bleeding greatly increased
Less than 10,000 Spontaneous bleeding likely

When you suffer from low blood platlet count you may notice:

  • Increased bruising
  • Petechiae (red dots on your skin described above)
  • Bleeding from nose, gums, rectum

Call your doctor immediately if you have sudden, severe unexplained pain.

Things you may do to decrease your risk of bleeding if you have low blood platlet count:

  • Do not take medications that interfere with the platelets being able to form a clot, i.e.  Aspirin, Ibuprofen (Advil®, Motrin®), Naproxen (Aleeve®
  • If you are not sure about taking any medication, check with your doctor, nurse or pharmacist.
  • Do not use rectal suppositories or take your temperature rectally.
  • Use caution or avoid flossing your teeth.
  • Use a very soft bristle toothbrush or oral swabs as recommended by your doctor or health care provider.
  • If your gums bleed, rinse with cold water.  If bleeding does not stop call your doctor or health care provider.
  • Avoid activities that increase your risk of bleeding when you have low blood platlet count:
    • Contact sports
    • Amusement park rides that involve fast or quick motion.
    • Strenuous exercise.
    • Avoid or limit the use of sharp objects such as knives, razors.
    • Hold pressure on any cut or scrape for at least 5 minutes. 

When to call your doctor or health care provider about low blood count:

  • Bleeding that will not stop after 5 minutes of pressure.
  • Bleeding that occurs spontaneously (by itself), without injury.
  • New or unexplained pain
  • Fall or experience trauma or injury
  • Feel dizzy or lightheaded
  • Have difficulty seeing or double vision
Caution:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about low blood count and other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice. See your doctor!
  1. Mullally A, et al. Thrombocytopenia. In: Nilsson KR, et al. The Osler Medical Handbook. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2006. Accessed Jan. 15, 2010.
  2. Thrombocytopenia. National Heart, Lung, and Blood Institute. Accessed Jan. 15, 2010.
  3. McMillan R. Hemorrhagic disorders: Abnormalities of platelet and vascular function. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. Accessed Jan. 15, 2010.
  4. ^ "Platelet count aka thrombocyte count". Lab Tests Online UK. 2004-05-28. Retrieved 2008-05-22. 
  5. ^ Correia, Maria C.B.; Domingues, Ana L.C.; Lacerda, Heloisa R.; Santos, Emília M.; MacHado, CíNtia G.F.; Hora, Viviane; Neves, Maria A.; Brito, Anelita et al. (2009). "Platelet function and the von Willebrand factor antigen in the hepatosplenic form of schistosomiasis mansoni". Transactions of the Royal Society of Tropical Medicine and Hygiene 103 (10): 1053–8. doi:10.1016/j.trstmh.2008.11.017. PMID 19118853. 
  6. ^ Cheung, R; McAuley, R; Pollard, J (2005). "High mortality rate in patients with advanced liver disease independent of exposure to general anesthesia". Journal of Clinical Anesthesia 17 (3): 172–6. doi:10.1016/j.jclinane.2004.06.016. PMID 15896582. 
  7. ^ Scaradavou, A (2002). "HIV-related thrombocytopenia". Blood Reviews 16 (1): 73–6. doi:10.1054/blre.2001.0188. PMID 11914001.

Please Note: Although many of us are dying faster than we like, ethnic groups are dying even faster from heart disease, diabetes, cancer, etc. Why? Read this web page about why people are "droppin' like flies."

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