Neutropenia
What is Neutropenia?
Neutropenia is a condition where your body has too few neutrophils in your blood. Neutrophils are a type of white blood cell that fights off infections, especially from bacteria and fungi. When neutrophil levels drop too low, your immune system cannot protect you as well as it should.
Your bone marrow makes neutrophils every day to replace old ones. In a healthy person, neutrophils make up about 50 to 70 percent of all white blood cells. Doctors diagnose neutropenia when your absolute neutrophil count drops below 1,500 cells per microliter of blood. Severe neutropenia occurs when levels fall below 500 cells per microliter, putting you at serious risk for infections.
This condition can be temporary or long lasting. It may develop from infections, certain medications, or problems with your bone marrow. Some people are born with conditions that cause neutropenia, while others develop it later in life. Early detection through blood testing helps you and your doctor take steps to prevent infections and address the root cause.
Symptoms
- Frequent infections, especially in the mouth, throat, or skin
- Fever without an obvious cause
- Painful mouth sores or ulcers
- Swollen or bleeding gums
- Skin infections or abscesses
- Sore throat or difficulty swallowing
- Ear infections that keep coming back
- Pneumonia or other lung infections
- Slow healing of cuts or wounds
- Unusual tiredness or weakness
Many people with mild neutropenia have no symptoms at all. The condition often shows up during routine blood testing before any infections occur. This is why regular blood work is so important for catching problems early.
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Causes and risk factors
Neutropenia happens when your body destroys neutrophils faster than it makes them, or when your bone marrow cannot produce enough. Medications are one of the most common causes. Chemotherapy drugs, antibiotics, and some medications for mental health conditions can lower neutrophil production. Infections like HIV, hepatitis, and severe bacterial infections can also reduce neutrophil counts. Autoimmune diseases such as lupus and rheumatoid arthritis sometimes cause your immune system to attack your own neutrophils.
Other risk factors include vitamin deficiencies, especially B12 and folate, which your bone marrow needs to make blood cells. Bone marrow disorders like leukemia and myelodysplastic syndromes can prevent normal neutrophil production. Some people inherit genetic conditions that affect how their body makes white blood cells. Exposure to toxins like benzene and radiation can also damage bone marrow. Heavy alcohol use over time may reduce neutrophil counts as well.
How it's diagnosed
Doctors diagnose neutropenia with a simple blood test called a complete blood count, or CBC. This test measures your white blood cell count and calculates your absolute neutrophil count. Rite Aid offers testing that includes these markers, making it easy to check your levels regularly. Your doctor may order the test if you have frequent infections or if you take medications known to affect white blood cells.
If your first test shows low neutrophils, your doctor may repeat it to confirm the results. They might also order additional tests to find the underlying cause. A peripheral blood smear lets your doctor look at your blood cells under a microscope. In some cases, a bone marrow biopsy helps identify problems with how your body makes blood cells. Blood tests for vitamin levels, autoimmune markers, and infections can also help pinpoint why your neutrophil count is low.
Treatment options
- Stopping or changing medications that lower neutrophil counts
- Treating underlying infections with antibiotics or antiviral medications
- Taking vitamin B12 or folate supplements if you have deficiencies
- Using growth factors like G-CSF to help your bone marrow make more neutrophils
- Managing autoimmune conditions with appropriate medications
- Avoiding people who are sick to reduce infection risk
- Practicing good hygiene, including frequent handwashing
- Eating a balanced diet rich in protein and nutrients to support immune health
- Avoiding raw or undercooked foods that may carry bacteria
- Seeing your doctor right away if you develop a fever or signs of infection
Concerned about Neutropenia? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
A normal absolute neutrophil count ranges from 1,500 to 8,000 cells per microliter of blood. Mild neutropenia occurs between 1,000 and 1,500 cells per microliter. Moderate neutropenia is 500 to 1,000, and severe neutropenia is below 500 cells per microliter.
Yes, many cases of neutropenia are temporary and resolve once the underlying cause is treated. If a medication caused your low neutrophil count, levels usually return to normal after you stop taking it. Neutropenia from infections often improves as you recover. However, some people have chronic neutropenia that requires ongoing monitoring and treatment.
Testing frequency depends on the severity of your condition and its cause. People with mild neutropenia may need blood tests every 3 to 6 months. Those with moderate to severe neutropenia or who take medications that affect white blood cells may need testing every 2 to 4 weeks. Your doctor will create a monitoring schedule based on your specific situation.
The danger depends on how low your neutrophil count drops. Mild neutropenia may not cause problems for many people. Severe neutropenia significantly increases your risk of serious bacterial and fungal infections. Without enough neutrophils to fight germs, even minor infections can become life threatening if not treated quickly.
Avoid raw or undercooked meat, eggs, and seafood that may contain harmful bacteria. Stay away from unpasteurized dairy products and juices. Skip raw sprouts, unwashed fresh fruits and vegetables, and deli meats unless heated until steaming. These foods carry higher infection risks when your immune system is weakened.
Stress alone does not directly cause neutropenia. However, chronic stress can weaken your immune system over time and may contribute to other conditions that affect white blood cell production. Managing stress through exercise, sleep, and relaxation techniques supports overall immune health but will not treat neutropenia caused by other factors.
This depends on your neutrophil count and workplace environment. People with severe neutropenia should avoid crowded places and stay home during illness outbreaks. Those with mild neutropenia can usually work but should practice extra caution with hygiene. Talk to your doctor about whether your specific job poses infection risks you should avoid.
Yes, children can develop neutropenia from infections, medications, or inherited conditions. Some babies are born with genetic disorders that affect neutrophil production. Children may also have benign ethnic neutropenia, a harmless condition common in people of African, Middle Eastern, or West Indian descent. Regular blood testing helps monitor children with neutropenia.
Not necessarily. Treatment depends entirely on the cause of your neutropenia. If a medication triggered it, your counts may recover after stopping that drug. People with temporary infections may not need any treatment once they heal. Those with chronic conditions or bone marrow disorders may require long-term medications like growth factors to maintain healthy neutrophil levels.
Moderate exercise is generally safe and healthy for people with mild to moderate neutropenia. Physical activity supports immune function and overall health. However, avoid contact sports or activities that increase injury risk, as cuts and scrapes heal more slowly. Stay away from gym equipment during cold and flu season, and always practice good hygiene after exercising.