White blood cells (Leukocytes / WBC)

Optimal Result: 3.4 - 10.8 x10E3/µL, 3.40 - 10.80 x10^9/L, or 3.40 - 10.80 x10/9/l.

What are other names for the white blood cell count?

Leukocyte count; White blood cell count; White blood cell differential; WBC differential; Infection - WBC count; Cancer - WBC count

What is a white blood cell count?

A WBC count is a blood test to measure the number of white blood cells (WBCs) in the blood.

What are white blood cells?

WBCs are also called leukocytes. White blood cells help your body fight infections. There are five major types of white blood cells:

- Neutrophils: Neutrophils make up the greatest percentage of WBCs and are produced by the bone marrow to fight a diverse array of inflammatory and infectious diseases.

- Lymphocytes: Lymphocytes such as B-cells and T-cells are found primarily in the lymph system and fight bacteria and other pathogens in the blood.

- Monocytes: Monocytes work in conjunction with neutrophils to combat infections and other illnesses while removing damaged or dead cells.

- Eosinophils: Eosinophils are WBCs activated in response to allergies and some types of infections.

- Basophils: Basophils are involved in the early identification of infections as well as wound repair and allergic reactions.

A higher level could be a sign of inflammation, infection, a medical reaction, or another health condition. If it’s low, you could be at a higher risk for infection. A medication, a viral infection, or a bone marrow disease could also cause a low count.

Why do you have a white blood cell count tested?

You will have this test to find out how many WBCs you have.

The white blood cell count is part of a complete blood count -- a standard blood test. A white blood cell count can detect hidden infections within your body and alert doctors to undiagnosed medical conditions, such as autoimmune diseases, immune deficiencies, and blood disorders. This test also helps doctors monitor the effectiveness of chemotherapy, radiation treatment, and other therapies in people with cancer.

What is a complete blood count (CBC)?

A complete blood count (CBC) is a blood test. It is used to look at your overall health and find a wide range of conditions, including anemia, infection and leukemia. A complete blood count can show you unusual increases or decreases in cell counts. Those changes might point to a medical condition that calls for more testing.

A complete blood count test measures the following:

- Red blood cells, which carry oxygen

- White blood cells, which fight infection

- Hemoglobin, the oxygen-carrying protein in red blood cells

- Hematocrit, the amount of red blood cells in the blood

- Platelets, which help blood to clot

If you have a CBC with a WBC differential, your test report will show the specific levels of each kind of WBC. These are known as neutrophils, lymphocytes, monocytes, eosinophils, and basophils.

What is a normal level of white blood cells?

The normal number of WBCs in the blood is 3,800 to 10,800 WBCs per microliter (3.8 to 10.8 × 109/L).

Normal value ranges may vary slightly among different labs. Some labs use different measurements or may test different specimens. Talk to your provider about your test results.

What do your white blood cell count results mean?

If one or more of your blood cell counts is higher or lower than normal, your doctor will try to find out why. Many noncancerous conditions can contribute to low or high blood cell counts, such as those below:

High counts:

- Infection

- Inflammation

- Severe physical or emotional stress (such as fever, injury or surgery)

- Burns

- Kidney failure

- Lupus

- Rheumatoid arthritis

- Malnutrition, thyroid problems

- Certain medicines

Low counts:

- Infection

- Chemotherapy and other medicines

- Malaria

- Alcoholism


- Lupus

- Enlarged spleen


Chernecky CC, Berger BJ. Differential leukocyte count (Diff) - peripheral blood. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:441-450.

Vajpayee N, Graham SS, Bem S. Basic examination of blood and bone marrow. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 30.

What does it mean if your White blood cells (Leukocytes / WBC) result is too low?

A low number of WBCs is called leukopenia. A decrease in total white blood cell count is unusual and generally a cause for concern.

There are a few conditions within the body that cause white blood cell levels to drop, including:

- A severe infection, such as sepsis, which is wiping out blood cells faster than the body can make them

- A disease affecting the bone marrow, like lupus or HIV

- Medications that impact the bone marrow (e.g chemotherapy)

- Bone marrow deficiency or failure (for example, due to infection, tumor, or abnormal scarring)

- Cancer treating drugs, or other medicines (see list below)

- Certain autoimmune disorders such as lupus (SLE)

- Disease of the liver or spleen

- Radiation treatment for cancer

- Certain viral illnesses, such as mononucleosis (mono)

- Cancers that damage the bone marrow

- Very severe bacterial infections

- Severe emotional or physical stress (such as from an injury or surgery)

If you follow a whole food, plant-based (i.e., vegan) diet, your white blood cell count (including Neutrophils and Monocytes) might be on a lower level. Research studies are supporting the hypothesis that people on a vegan diet have overall lower WBC counts. For those individuals, the optimal reference range should be adjusted downwards to 3.11 - 8.83 x10E3/µL  [L, L, L, L].

What does it mean if your White blood cells (Leukocytes / WBC) result is too high?

A higher than normal WBC count is called leukocytosis. A white blood cell count that's higher than usual most commonly is due to an infection or inflammation.

In the instance of infection, the source is likely bacterial. The causes of inflammation are varied. Physical stressors like exercise, seizures, anxiety, tobacco use, burn injuries, heart attack, appendicitis, and splenectomy can result in inflammation. There are a few chronic conditions that lead to inflammation, such as inflammatory bowel disease and arthritis. Some cancers (like those of the bone marrow) can cause an abnormal white blood cell count.

A high white blood cell count hence may be due to:

- Certain drugs or medicines

- Cigarette smoking

- After spleen removal surgery

- Infections, most often those caused by bacteria

- Inflammatory disease (such as rheumatoid arthritis or allergy)

- Leukemia or Hodgkin disease

- Tissue damage (for example, burns)

What are symptoms of a high white blood cell count?

In most instances, there are no specific symptoms related to an elevated white blood cell count, though symptoms associated with the underlying medical condition may occur. However, in extreme cases, such as when leukocytosis occurs because of a condition affecting the bone marrow, symptoms directly related to an elevated white blood cell count may occur.

Here is a look at why the specific types of white blood cells could be increased:

Elevated neutrophils: Your bone marrow may make a higher number of neutrophils if you have a bacterial infection or are experiencing acute stress or trauma.

Elevated eosinophils: Allergies can cause an increased number of eosinophils. Also, if you have Addison disease, collagen vascular disease, parasitic infection, or cancer, you may have increased eosinophil production.

Elevated lymphocytes: Your bone marrow may produce excess lymphocytes if you have a viral or chronic bacterial infection, lymphocytic leukemia, or multiple myeloma.

Elevated monocytes: This can be due to chronic inflammatory disease, leukemia, parasitic infection, tuberculosis, or viral infection.

Elevated basophils: This can result as a side effect of splenectomy, allergic reaction, chronic myelogenous leukemia, collagen vascular disease, myeloproliferative diseases, and chickenpox.

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