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White cell count and RA symptoms

Hi all,

I've had RA for about 5yrs now,and I've been on subcutaneous MTX and Enbrel for 4 of them, so I should know by now, but I'm confused.

My white cell count is low, (3.5 and neutrophils are 1.79) I'm feeling really fatigued, pain is up, but no inflammation at the moment and the glands in my neck and behind my knees are up, does this correlate?

I thought the point of DMARDS and biological was to dampen the immune system to stop the RA, ie trying to lower white cells, but reading online RA can lower white cell count when it's flaring? Hmmmmm? I'm confused.

Is there anybody who can explain the link between symptoms and white cell count? Or is there none?

All help greatly appreciated x

1 Reply

The immune system is shorthand for a number of processes in your body, some of which are horribly detailed cell interactions. So although white blood cells are a critical part of the immune system, there's much more to it. Having an auto-immune disease like RA means that the immune system is set wrongly, so trying to calm it down isn't just about white blood cells either. Your Enbrel for example is using the anti-TNF factor to block a protein cell that is part of the immune system, and not squashing the whole of the system.

And because all these things are interrelated, and because your body is also responding to other things at the same time, then the reactions aren't straightforward. Which is why we have specialist doctors.....

You can have periods of being completely fatigued, or have major inflammation, and the effect on your white blood cell levels may be a bit different each time. And sometimes it's nothing to do with the RA but you just have a bit of an infection. I've given up trying to expect my RA to obey the rules, especially as my inflammation levels are generally very slow to respond.

Not much of a helpful answer I'm afraid.

Your levels aren't dangerously low so hopefully your doctors will have an explanation and advice about how best to restore them.

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