White blood cell count low and neutrophil count low since starting T3 medication.

[McPammy]

I started combined treatment of Liothyronine T3 with my regular Levothyroxine T4 a couple of years ago now. I’ve really improved and gone from strength to strength.

What I’ve noticed when looking back within my NHS Patient Access is that my white blood count and my neutrophil counts are abnormally low. This started as I started T3 medication. My TSH, T3 and T4 levels are all within range and I feel energised and very well. But does the effect of low white blood cells which protect us against infections and bacteria need addressing. My vitamin levels are all good. I’m having regular B12 injections and Ferris Fumerate 210mcg for low ferritin as I’m a vegetarian. I get my bloods checked every 3 months all are good with exception to white blood cells.

Any ideas how to improve if your vitamins are already optimal. Or will low white blood cells be something I have to live with.

[SlowDragon Administrator]

How low ….what’s the difference between before and after

Do you supplement vitamin B complex?

Or just folate?

blog.insidetracker.com/low-...

Some vitamins and minerals like vitamin B12 and folate play a crucial role in WBC formation. Low levels of vitamin B6, copper, and zinc may also play a role in low WBC production. A blood test can identify whether these nutrients are low, as you should not take supplements of these nutrients if your levels are normal. Chronic malnutrition and alcoholism can also result in these deficiencies, and can therefore also be a cause of low WBC.

[McPammy in reply to SlowDragon]

It changed to being low in 2019 when I introduced T3. I was already on Levothyroxine T4 for many years.

White cells:

3.2 (4-11) Feb 22

3.8 (4-11) July 21

3.8 (4-11) Nov 19

3.7 (4-11) June 19

Prior 4.8 (4-11) March 19 not taking T3. Prior always in range.

Neutrophil 1.6 (2.0-6.0) Feb 22

Prior 2.2 always before and in range.

Feb 22: vitamins results:

B12 958 (150-750) injections

Folate 15.0 (4.0-25.0)I do not supp

Ferritin 107.7(22-322) on Ferris Fumerate 210mcg

Vit D 110.3 (50-150) I do not supplement.

I feel good within myself but was wondering if others with thyroid issues have low white blood cells generally. Is it something that we have to be more mindful of to wash hands more often etc to avoid any infections.

Thanks.

[radd in reply to McPammy]

McPammy,

I don't think its the T3 per se but a gradual decline of WBC's, and the duration of unmanaged hypothyroidism and Hashi pre diagnosis. Theoretically the T3 should help your immune system as thyroid hormone stimulates bone marrow erythropoiesis so increasing WBC's.

A little inflammation (WBC’s) fights off infection & heals a cut but once we initiate inflammatory cells in the absence of an infection or cut we have chronic inflammation which is bad news.

Usually with autoimmune disease we see elevated lymphocyte levels as attacks take place but years later WBC levels drop low due the long term chronic, low-grade inflammation autoimmune disease causes. This is why we aim to keep thyroid antibodies as low as possible.

There is a condition where the immune system attacks itself resulting in low levels of neutrophils which does increase your risk of infection but you are doing the right things to help build your immune system by optimising thyroid meds, and nutrients which take stress off the adrenal glands.

Low levels of cortisol mean we miss out on its anti-inflammatory properties and long term elevated levels mean WBC’s regulatory patterns will down regulate their cortisol receptors reducing the cells capacity to respond to anti-inflammatory signals, and so the inflammation just keeps increasing and increasing. There is also a large part of the immune system located in the gut so a good reason to keep off inflammatory foods such as gluten when we have Hashi.

[McPammy in reply to radd]

Thank you for your detailed reply to my question on low white blood cells. I think you’re right that it isn’t due to T3 per se. I think it’s due to high thyroxine in your system. I’ve just rechecked my Patient Access and noticed that in 2014 my white cells and neutrophil counts where very low also. At this point I was only on T4 Levothyroxine. I checked my T4 and TSH levels for same date and low and behold my T4 was over range and TSH suppressed. I now remember that my GP increased my Levothyroxine dose around this time and I remember feeling very unwell until my dose my dropped back to where it was previously. My TSH was always too high as I needed T3 medication but T3 never tested until recent years and now I finally get T3 Liothyronine. Which has had a huge positive impact on my life. I do think there is a correlation between high thyroxine and low white cells. I’ve read that people with Graves’ disease live with low white cells also. There must be a connection. Next time I speak with my private only Endocrinologist I will question this with him. My GP ignores low white blood cells he told me. Why I asked. He said many people have low white cells. When I asked him why he couldn’t answer me. I think it’s thyroid/thyroxine related myself in my case.

Thanks again for your response. It’s interesting.

[radd in reply to McPammy]

McPammy,

Yes, its the whole package and the elevated/excess T4 will be converted into excess amounts of RT3 which actually impairs the effectiveness of the small amount of working T4.

Less working thyroid hormone equals less bone marrow erythropoiesis & less WBC's. It is common to have a low CBC in hypothyroidism, and probably why your GP was disinterested but no reason for him not to advise/encourage how to rectify it!

More than we actually need is never better regarding thyroid hormone, and adding T3 completely changed my life too, eliminating brain fog, raising low adrenal reserves, relieving muscle pain, keeping me warm, blah, blah, blah .. ........ 😊.