Home Forums General Discussion Low WBC and Neutrophils

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  • #461041
    vinny
    Participant

    My last two blood work ups showed out of range low White Blood count and Neutrophils. I have been on 100mg daily Minocycline since 2008. Has anyone here had such a result?

    Psoriatic Arthritis: 100mg Minoz Minocycline TABLET daily; twice daily 400mg Pentoxifylline;125mcg Levotyroxine: Have been using some level of Minocycline since 2008

    #461049
    Airen
    Participant

    This is just too weird. I just got my lab results back today and they too show low WBC and neutrophils. Dr said it is probably just my body trying to fight something off but I still can’t help but worry some. I’ve been taking 100 mg mino twice daily for 1.5 years or so now and doing really well. My RF was 11 back in April. Waiting on labs for a more current number. I would also like to know if anyone has heard of this and what it could mean.

    Diagnosed with RA in October 2014, pain started in February 2014
    Started AP in June 2015
    Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

    #461050
    vinny
    Participant

    Airen,
    Keep me updated on your lab work as time goes by. I have more lab work done on Nov. 27. In the meantime I am backing off on Minocycline from 100mg daily to pulse M,W,F and see if that helps. My pain level has been good, so I hate to change anything, but my WBC dropped so quickly that it is a concern to my Primary care internist. In Oct. I changed my dosing from morning to bedtime and maybe that has changed something. Also I have been on Minocycline long enough(since 2008)that drug induced Lupus could be an issue, which would lower the WBC.

    Psoriatic Arthritis: 100mg Minoz Minocycline TABLET daily; twice daily 400mg Pentoxifylline;125mcg Levotyroxine: Have been using some level of Minocycline since 2008

    #461058
    Maz
    Keymaster

    Airen,
    Also I have been on Minocycline long enough(since 2008)that drug induced Lupus could be an issue, which would lower the WBC.

    Let’s hope not, Vinny. If this is any comfort, when I got DILE (from Atenolol and minocycline), it didn’t depress my WBCs or neutrophils, just esoinophils. In real lupus, WBCs can be low as well as platelets (ITP). If you have info on this, would be interested to read it.

    Airen, if this helps, I’ll paste info that Vinny already has:

    On the rheumatic.org site there iss some blurb about this in their FAQ #14

    ”14. MY DOCTOR HAS TOLD ME TO STOP THE MINOCYCLINE (MINOCIN) BECAUSE OF A LOW WHITE BLOOD COUNT.

    White blood cells are used to fight infection. A low white blood cell count is clinically called leukopenia. This occurs when there is a reduction in the normal number of circulating white blood cells in the blood stream. This condition involves the blood and the bone marrow. Patients may demonstrate a low white cell count before commencing the antibiotics. This can be due to the nature of their illness, or previous therapy such as methotrexate that causes suppression of white blood cells, platelets and red blood cells. This is caused by increased destruction or impaired production of these cells. Poor quality protein intake or digestion (impaired pancreatic enzyme or HCI production), inadequate trace mineral or essential fatty acid intake are other causes.

    A blood test called the Carbon test is enormously helpful at determining the cause of the decreased WBC. The company Body Bio (888-320-8338) can provide a clinician that can perform the test in your area.

    A doctor may be cautious and suggest that you cease the minocycline therapy. This is to check that this is not the trigger of the leukopenia. If the white count returns to normal then one can resume the minocycline and observe if the WBC count decreases again. If it decreases again it probably is not wise to continue with the Minocin.

    The minocycline assists the body in clearing the infection and once the infectious trigger which stimulates the increased production of white blood cells is gone, the WBC will drop to its normal non-infectious level.”

    So, it seems that the only ways to know if minocycline is the culprit is to (a) stop it and see if WBCs rebound, then re-try it to see if they bottom out again…and stop for good if they do. Or, (b) get a Carbon test to determine the cause. I don’t know anyone who has had the test the rheumatic.org folk recommend and unsure if the contact number to locate a lab to run this test is still live.

    There are also some infections that can lead to leukopenia and one that pops to mind is a rickettsia infection, called erhlichiosis. Some viruses and even flu shots can also temporarily lower WBCs. In fact, within the 2-week time-frame after receiving a flu shot it is commonly-agreed that this is when people are most susceptible to flu before any protective effect kicks in. Some simple things like folate deficiency can cause it, but also some more tricky things that should be ruled out if these blood anomalies persist (after trialing a break from mino).

    #461149
    vinny
    Participant

    The CBC blood work done on 11/27/17 was much improved with all of the parameters in range. WBC and Neutrophils increased above the lower limit. I had been off Minocycline for 12 days when the blood was drawn. No idea yet whether I had moved into Lupus. !2 days off Minocycline and my pain had increase to an unacceptable level waking me up at night. I am now doing a 6 day Prednisone dose pack which will get me back to normal and see if I can function at a lower level of Minocycline after the Prednisone is stopped.

    Psoriatic Arthritis: 100mg Minoz Minocycline TABLET daily; twice daily 400mg Pentoxifylline;125mcg Levotyroxine: Have been using some level of Minocycline since 2008

    #461159
    PhilC
    Participant

    Has your doctor been monitoring your C‐reactive protein (CRP) level?

    Here’s some relevant info:
    Minocycline‐induced lupus: clinical features and response to rechallenge

    Phil

    "Unthinking respect for authority is the greatest enemy of truth."
    - Albert Einstein

    #461160
    PhilC
    Participant

    Hi Airen and Vinny,

    I noticed that you are both taking thyroid medication.

    Here’s an article I just found:
    Effect of Thyroid Dysfunctions on Blood Cell Count and Red Blood Cell Indice

    So, something else to consider…

    Phil

    "Unthinking respect for authority is the greatest enemy of truth."
    - Albert Einstein

    #461164
    PhilC
    Participant

    I am now doing a 6 day Prednisone dose pack which will get me back to normal and see if I can function at a lower level of Minocycline after the Prednisone is stopped.

    If taking minocycline every day is a problem, then consider alternating with doxycycline. There are people who have done well by taking doxy and mino on alternate days (e.g., minocycline on M/W/F & doxycycline on Sun/Tu/Th/Sat). Also, unlike generic minocycline tablets, generic doxycycline tablets aren’t ridiculously expensive.

    Phil

    "Unthinking respect for authority is the greatest enemy of truth."
    - Albert Einstein

    #461207
    vinny
    Participant

    My ANA tests came back negative, so it is unlikely that my Psoriatic Arthritis has gone to Lupus. My PCP has added Plaquenil and gave me a script for Doxycycline. Phil, your suggestion of alternating Doxy with Minocycline sounds like a good plan and I will start that this week. Hopefully I can get back functional again without Prednisone.

    Psoriatic Arthritis: 100mg Minoz Minocycline TABLET daily; twice daily 400mg Pentoxifylline;125mcg Levotyroxine: Have been using some level of Minocycline since 2008

    #461210
    Airen
    Participant

    Good morning all, I just got my CBC results back Tuesday. WBC did go back up after a 12 day washout. This was the response from my dr:

    Got your Labs back and WBC went up to 4.0 off the minocycline. I feel OK with the slightly low WBC count on the minocycline because most RA drugs do this and that is why you tell them to be careful about being around sick people because you are immunosuppressed. I am ok if you restart. We can monitor your CBC every 3 months if you would like.

    I started back on the mino. Why are some drs so cautious about going back to mino? Is it dangerous for your wbc to go down like this? Is it dangerous to continue on mino when your WBC is reacting this way. My RF is “undetectable” and even my anti ccp is going down now! I would hate to stop this trend! Should I just lower my dosage?

    Diagnosed with RA in October 2014, pain started in February 2014
    Started AP in June 2015
    Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

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