Low white blood cell count


My wbc is below 4 it has always been low but dropped again I am currently on 20mg methotrexate, 1000mg salazopyrin and 400mg hydroxocloroquine, my GP has told me to stop salaz and methotrexate until rheumatology has replied back to his email for what to do, is this normal or anything to worry about I was diagnosed with rheumatoid arthritis a year ago



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7 Replies

  • Hi

    My white cell count is low too. The meds we take can lower the white cell count making us more susceptible to infections. This is probably what has happened to you.

    Stopping the meds for a while allows you white cell count to recover. Your doc will check for any other possible causes. At least this is my understanding.

  • Thanks for sharing .

  • I remember the fear I had when my white blood count droped to below 4. It went down to 3.2 and I was upset. I phoned my rheumy and he said my wcb will go up and down while taking mtx, sulfa and hydroxy. As long as the readings go up and down over a period of time, then all is well.

    I am not a doctor, but one bad reading is not enough to panic.

  • I take Mycophenolate and my WBC is consistently 2.20 - 2.50. Rarely higher. If it gets to 4, I have a virus. It's my norm, the docs would like them higher but no-one is worried. Hope this reassures xx

    Ps. I rarely catch any infections

  • Thanks guys x

  • Has your doctor tested you for Haemochromatosis, its a genetic disease giving you iron overload, and your white blood cell count drops with it, plus the symptoms are joint pain, fatigue and lethargy. My partner has had a low white blood count for over 20 years, but it took a relocation to the western isles for it to be diagnosed . haemochromatosis society uk

  • My WBC is often below 4. A "good" reading is usually around 3.8 or 3.9. My current rheumy's receptionist is often calling me to tell me to quit a med for 2 weeks bc of low WBC. But I don't know why you'd start taking the med again without knowing what your WBC is after those two weeks (my labs are done monthly). Anyhow, I'm off my lef (Arava) until next Thurs per doctor's orders bc my WBC was down to 3.2.

    So, you're not unique (and thanks for this post to know that I'm not unique either!).

    Best of luck,


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