White Blood Cell Count and Differential

There are two types of cells in our blood. Red blood cells which carry oxygen and white blood cells which are part of our immune system. There are five types of white blood cells:

• Neutrophils
• Lymphocytes
• Monocytes
• Eosinophils
• Basophils

On blood tests you will typically see the White Blood Cell count or WBC. This should be followed by the “differential.” The differential is a break down of what percent of the total WBC is each type of white blood cell. Seeing some kinds of white blood cells elevated or suppressed can give information about the state of your immune system.

Elevated eosinophils indicate parasites or allergies.

Convention ranges for eosinophils go up to about 7%. This reference range is in reality far to large. Optimally, eosinophils should be no more than 3%.

Why does it matter if eosinophils are above 3%?

When eosinophils go up this indicates a nonspecific inflammatory response by your immune system against something it does not like. Much more may be going on than just an elevated blood test markers. There may very well be other symptoms caused by whatever is triggering the elevation in eosinophils.

How elevated eosinophils are does not necessarily tell you how bad the problem is. For example intestinal parasites can raise eosinophils (or sometime there is no elevation whatsoever). There may be a very mild increase, perhaps from 2.0 to 4.0, yet this slight elevation can signal a problem which can lead to many other symptoms or diseases.

Regardless, very elevated eosinophils (10% or higher) may be best interpreted as positive for parasite unless proven otherwise.

Some conditions which may be associated with elevated eosinophils are:

• Cancer
• Polycythemia
• Hyperthyroidism
• Anterior pituitary dysfunction
• Adrenal dysfunction
• Phlebitis
• Edema
• Rhinitis
• Gastroenteritis
• Eosinophila myalgia syndrome

Won’t by doctor treat the problem if eosinophils are elevated?

Not necessarily. First you medical doctor may be using the very conservative conventional reference range, which misses everyone in the 3-7% range. Even if you are over 7% the labs may still be ignored.

If eosinophils are elevated then either allergies or parasites should be investigated. Often the conventional tests for these are not adequate. Typically some IgE and maybe IgG tests are run for environmental and food allergies. These tests are not perfect and allergenic reactions to foods are easily missed.

Then there are microscopic exams for parasites. Stool tests for parasites are very unreliable. Just because you submitted a stool sample and it came back negative for parasites that doesn’t mean you don’t have parasites. All it means is that they didn’t see any parasites in that particular sample. A comprehensive functional stool tests for a lab such as diagnostechs is much better and includes markers such as saliva antibodies to catch parasites that may otherwise be missed visually.

My eosinophils are optimally low – does that mean I don’t have allergies or parasites?

This is just one marker. Allergies and parasites do not always cause an increase in eosinophils. If other symptoms/labs indicate allergies or parasites the it’s best to pursue a course of treatment based on that. These problems can not be ruled out based on normal eosinophils.