low blood counts: Hi After having to stop MTX twice... - NRAS

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low blood counts


After having to stop MTX twice now due to my bloods dropping, and taking my last ones a month ago, I thought my bloods had picked up. A fortnight ago, I was back up to "normal" then this Monday's results came back neutophils down to 1.4 and white blood cells 4.7. The rheumy nurse rang and told me and she doesn't know why they have dropped again considering I stopped taking MTX over a month ago now, can anyone suggest anything. Just when you feel on top of things and things are picking up, you get another slap in the face again and back to square one. Not seeing the consultant for another 2 weeks and 5 days yet, (not that I'm counting) starting to get anxious about what drugs I will try next. Feeling abit low again !



2 Replies

Hi Alison,

I also suffer low white counts, and when they have dropped really low in the past have been put on folic acid every day after stopping mtx. That seems to help 'build them back up' since mtx destroys folate in the body..

Have you tried any other dmards besides mtx? I have suffered low counts on mtx, twice, and also leflunomide, except when taking prednisolone which seems to boost them in my case! However have just had my mtx reduced to 10mg, and told I won't be able to go any higher, and next step will be biologics, so there are other options for you....


Hi Allison, I think I might be able to shed some light...Your neutrophils are low, and at 4.7 your total white cell count is still relatively low. But there is a shift in what cells are predominant. Normally Neutrophils predominate, Lymphocyts are secondary. Except in viral infections, when Lymphocytes are the WBCs used to fight viruses. Neutrophils predominate to fight bacterial infections. There is a possibility that you may have been exposed to a virus of some sort, thus your lymphocyetes are reacting.

If we were to be able to look at your white cells under the microscope, after being stained on a glass slide, the lymphocytes would appear larger , ie reactive, as compared to normal size lymphs. Now are you totally confused?

I am a retired Medical Laboratory Technologist, and spent a good bit of my adult life peering down a microscope every day, counting by hand and differentiating white blood cells ,and also commenting on the condition of red blood cells. Now it is all done by automated equipment and calculations, but I still believe nothing can take the place of the educated eye!

But alas, they have turned us all out to pasture. Especially if you have RA and Psoriatic arthritis, Fibromyalgia, and lots of corrective spine surgeries.

Hang in there, it might all resolve itself by the time you see your Rheumy in 2 weeks and 3 days. All the best, Loretxxx


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