Dr. Toshi Is In! "Lab Results Part 2"

Dear Dr. Toshi, (Lab Results Part 2)

   I went to see my doctor, and she showed me my lab results, but I had no idea what they mean. Can you explain them to me?

We started talking about the family of white blood cells last week. They're cells that are part of your immune system, and they circulate in the pipelines in your body--that is, in your blood vessels and your lymphatic system.

When your white blood cell counts are too high or too low in your blood lab results, we look at the details in terms of each member of the white blood cell family to see what's going on. When your white blood cell count is too high, it often indicates you have some kind of infection, but it could also mean that your body is over-reacting to something else. When your white blood cell count is too low, it usually indicates a weak immune system because cells are being destroyed more quickly than the body can replenish them, and your doctor will have to look into it.

Last week we talked about neutrophils (and macrophages) which increase in number when there's a bacterial infection in the blood. This raises the white blood cell count. Neutrophils and macrophages are like the "Pac-Mans" of the white blood cell family.

Today, we'll talk about some other members of the white blood cell family that you might see in your blood test results. They are lymphocytes, monocytes, basophils, and eosinophils. I will be mentioning the names of some diseases but please remember, the actual list is much larger and more diverse. If you have any specific questions, ask your doctor or medical provider.

There are more lymphocytes in the lymphatic system than in the blood. Some lymphocytes make antibodies, while other lymphocytes bind to cells in the body that have been infected by viruses and kill those cells. (Many weeks ago, I discussed the differences between viruses and bacteria. Do you recall how viruses work in our body? They invade our cells and take over the "machinery" in our cells to turn the cells into factories that make more copies of the virus to release into our bodies!) So, when your lymphocytes are high, you may be fighting some kind of infection such as hepatitis, mono (infectious mononucleosis), HIV, syphilis, tuberculosis, or another infection. But they can also be high when you have cancer of the blood or lymphatic system or if you have chronic inflammation.

Monocytes are the largest cells in the white blood cell family, and they become macrophages in the tissues in the body. So, monocytes/macrophages eat bacteria like Pac-Man, as I mentioned last week. They also clean up the debris of dead cells. So, when the number of these cells is high, it means that your body is fighting something like a virus, parasite, mono, mumps, or measles.

Both basophils and eosinophils respond when you are exposed to an allergen (such as pollens) causing you to have a seasonal allergy, for instance. They also fight against parasites. They release a chemical called a histamine to help fight the invaders, but unfortunately, histamines can overdo it, damaging our good tissues as well as the invaders. So, sometimes we use a medicine called an ANTIhistamine to counteract that, such as Benadryl.

White blood cells actually do a lot more work than what I described today and last week. But the main message is that they're very important cells that are part of our immune system. In other words, they fight off things that invade our bodies!

So, it's good to help them by eating healthy food, keeping well-hydrated, and getting enough sleep every night!

Next week we'll talk about platelets, which are the last major type of cell in the complete blood count (CBC) lab report.

Dr. Toshiko (Toshi) Luckow, MD is a Family Medicine physician at the West River Health Services hospital and clinics.