Lets compare CBCs

So I posted some of this info on a question RW posted in the EBV thread, but ill repeat it.

Basically, what I want to know is can we learn anything from the CBC (complete blood count) that might clue us in on what kind of infection we are dealing with.

As I posted on RWs blog, there's an interesting video by Dr Hannelie at the Spero Clinic where she talks about the fact that a low WBC + high % Lymphocytes typically represents a chronic viral issue. I've seen this idea repeated in other places. High absolute neutrophils I think often represents an acute bacterial infection. I cant find any information on what happens in a chronic bacterial infection. High % monocytes can be viral or parasitic. I know eosinophils is parasitic.

Basically, according to Dr H, in a normal person the PERCENT neutrophilis/lyphocytes/monocytes should be around 60/30/7. Deviations from this can clue you in on what you are dealing with.

It's interesting because my WBC is usually super low (3.0-3.2). My % lymphocytes and % monocytes are often high (38-40 and 11 respectively). This would imply a viral or parasitic infection, not bacterial. This aligns with what I've noticed anecdotally. When I use Rx antibiotics, I notice nothing. If I use an herb like berberine or monolaurin that could also be hitting viruses, yeasts or helminths, I burn.

I guess my questions is this. I cant find what kind of footprint a chronic bacterial infection leaves. I.e. do % neutrophils go high? Do they go super low? Whats the WBC look like? If we figure out what this looks like, then maybe we can say something about those of us who dont react to antibiotics. Maybe we have a parasite or virus and the clues are there.

So for those w/ a diagnosed/confirmed bacterial infection (Lyme + coinfections) what is your WBC and your % neutrophils/lymphocytes/monocytes.

Just looking to get a general discussion going on some of these markers and what they may mean.

Dr Hanneli's video:
https://www.youtube.com/watch?v=zq21szxh3uk

Basic info on CBC and what some of these different white blood cells react to:

https://www.glowm.com/lab-text/item/98

The most common parasitic infections associated with eosinophilia in refugees are the soil-transmitted helminths (trichuris, ascaris and hookworm), strongyloides, and schistosoma as well as many tissue-invasive parasites (e.g. parasites that migrate through human tissues as a part of their life cycle).

Tissue-dwelling helminths (“worms”) are parasitic infections that often produce mild to moderate eosinophilia. Strongyloides infection is a common cause, whereas Giardia, a luminal parasite, does not cause eosinophilia.

Looking back on my bloodwork for the past two years I have probably had 30+ CBC's. They bounce all over the place. If I had to write a paper on my bloodwork for college I would say something that there isn't a correlation. Maybe I have too much wrong with me . The one correlation I did see when I was in the hospital with appendicitis my NEUT % was 92%.

My labs these days are all fairly normal except my ECP (Eosinophil
Catatonic Protein) always comes back
High. Have been told it could be parasitic or allergic response?

Over the many years of all this, most of my CBC counts have been on the low end. But during the joyful times I have felt 80%-85%, the reds and whites go up - white once went as high as 6.5 and red to 4.80. Recently, felt better and all numbers were in normal range, which is rare. Neutrophils were 55, lymphs 28 and monocytes at 12. So very close to numbers dcd mentioned.

Yet I feel like hell again but the recent tests would tell me I should feel better, based on history.

So I’m with dcd concerning what a bacterial infection would show. There seems to be no true pattern except when I’ve felt almost “normal.” But they have been up and down when I feel worse. The question dcd poses is a good one. But based on the numbers Dr. Hannelie mentions about EBV and my EBV tests, the neutrophils, lymph’s and monocytes should be different than what they are. Or maybe there is a question if I really do have EBV.

The thought on if we can establish a pattern, though, is a good one. Just mine don’t seem to fit over the years, unless I’m almost totally back.

It’s all relative would be a better way to put it. The WBC was not low, which is better than normal, and reds were up higher than low end. But white was 4.5 with 4.4 being low normal. Platelets were also up a decent amount (170) as they always hover at 150.

So nothing to brag about but better. Over the years when I feel good (rare times) the numbers are really up. But your subject is a good one. I look forward to more responses.

Interesting skinny, so you think something was brewing that whole time, or you're saying there's no correlation?

I just checked mine from 2013, as far back as it goes. WBC was a 3.2, low, RBC 4.25 so just barely low-normal. At this time I was starting to get symptoms, vestibular migraines daily. And I've always had the exercise intolerance. Really wish I knew what it was in the mid 2000s.

What's also interesting is that my lymphocytes were 48%. That's quite high. That would indicate viral load as mentioned above.

But I just have trouble buying that these things are low for no reason, even if it precipitates symptoms. Its the same pattern for a lot of us here. Low WBC, borderline/low RBC. Must be something festering under the surface and suppressing them.

I also know my Testosterone was low as far back as 2010ish.

As I mentioned in another post, the only time my WBC ever rose above a 4.0, and this was for 2 consecutive readings 2 months apart so not a fluke (4.4 and 4.5), was while I was on keto. Gluten free, stomach bacterial levels lower. Dunno what the mechanism was that caused it to rise.

Post Edited (dcd2103) : 5/25/2021 8:29:16 PM (GMT-6)

I did have a Reticulocyte Count done once as well. It was low. Usually an indication of anemia but I have always tested normal levels for iron b12 and normal kidney function. Can also be an indicator of chronic infection though. PCP brushed it off, said it probably was related to how stiff and sore my muscles were. BINGO! Offered no advice on it.

Here’s what I’m getting out of all your comments and personal experiences- it seems most everyone has off blood counts at different points. Dcd mentioned low testosterone also, which I have also experienced for years. Platelets that can go low then lower side of normal.

Garzie mentioned a CBC “all over the place,” which most have experienced. MCV off also.

Skinny joe mentioned doctor, basically, blowing off his concerns about low RBC.

Common thread must be Lyme and coinfections that impact tests, yet we get no reasonable answers.

All this brings in autoimmune concerns and, in my case, a EBV IgM that has been high for years. No one can explain it except to point out IgG remains high. That’s avoiding an answer. My mind just tells me fix Lyme and co-infections and odd tests go away. This happened to me from January 2015 to June 2016. Make sense?

hope this helps - i have been down the path of trying to glean some useful data from my standard blood tests before - its a comparison of my CBC results from:

- 2years before i was chronically ill ( a single result)
-the average of the results from the 1st 2 years of illness ( 4 tests)
-a single test while experiencing severe herx from herbs( if any worse i would have had to go to ER)
-average of the last 2 years or so - while improving ( 5 tests)

https://ibb.co/kbzcvg8

the formatting just highlights the higher numbers in each row as darker green to make the trends easier to see

i have also had occasional out of range results in
-haemoglobin conc,
-haematocrit,
-plasma viscosity
-mean cell haemoglobin level

and others - a different one on each test

the white cell ratios are around 58/32/6/2/1 - so show a v slight (2%) bias towards lymphocytes

Post Edited (Garzie) : 5/27/2021 4:50:13 AM (GMT-6)

there as quite a story there dcd.

basically, i was researching some interesting biology in the gut that i got into after reading a paper that found that mammals can develop and acquired Intestinal Alkaline Phosphatase (IAP) deficiency after repeated exposure to food borne pathogens - even subclinical exposures - eg mild food poisoning or "Delhi belly".

this is very intriguing as IAP has many important functions in the gut to do with regulation of the environment there, permeability of the intestinal membrane and regulation of endotoxins from commensal bacteria.

IAP regulates lipid absorption across the apical membrane of enterocytes, participates in the regulation of bicarbonate secretion and of duodenal surface pH, limits bacterial trans-epithelial passage, and finally controls bacterial endotoxin-induced inflammation by dephosphorylation.

basically it is responsible for de-activating LPS endotoxins in the gut so they do not inflame the immune system. without it - or with a deficiency of it - the gut become hyper reactive to the normal gut bacteria living inside it..... sound familiar?

the mechanism the autors of teh paper found is that neuraminidases in the gut get chronically upregulated and this causes the IAP deficiency.

in theory if you could down regulate these again then the IAP would normalise.

it turns out there are quite a few known neuraminidase inhibitors - both in the pharmaceutical world ( many antiviral drugs work by inhibiting viral neuraminidases - viruses use them as part of their infection strategy) - but also many plant chemicals (herbs) have neuraminidase inhibiting actions ( probably to protect them from plant viruses).

my thoughts were that it might be interesting to trial some of these - perhaps herbs that could be taken orally - as a test to see if this mechanism might be at work.

i shortlisted the following herbs that are all documented to have neuraminidase inhibiting activity
i was familiar with most of them - and started out gradually - increasing the dose every few days to feel my way through effects

tincture / dose per 10ml measure (ml )
Chinese skullcap 2.5
Berberine (mahonia) 0.5
Elder leaf 2
Isatis 1.5
Licorice 1.5
Houttuynia 1.5

i got up to around 2x 10ml measures 3x a day and had an almighty flare

my best guess is the herbs killed off lots of gut bacteria and that caused a massive herx
i have since leaned i am super sensitive to berberine herbs - that could cause this reaction all on its own after only around 1ml of tincture a day - so i think it was mainly the Berberine herb that caused it. Houttuynia is also a pretty broad anti-microbial so could have been involved. i tolerate Licorice, skullcap, elder and isatis pretty well.

this was interesting as berberine pretty much all stays in the gut - so systemic reactions are rare - unless taking mega doses - which i was not.

my flare symptoms were - fever, chills, all over pain , rapid heartbeat, feeling very very ill ( basically had to lie in a darkened room for 2 days and took about 1 week to recover)
the CBC test during the herx like reaction recorded were taken a couple of days past the peak i think.

not much happened good or bad until i hit the level where i suddenly got very ill. it doesn't look like i could tolerate enough of the herbs to get useful effects before running into the fallout from the direct anti-microbial actions of the herbs i used. So as an experiment into trying to test the potential mechanism of IAP deficiency the experiment was not a great success.

however, i still believe there is something to the theory though. As i dug into it it became clear to me that such an IAP deficiency could well trigger a long term chronic state with many cascading downstream effects that would include or could be linked to many common chronic conditions :
SIBO,
dysbiosis
systemic inflammation
oxidative stress
fatigue
auto-immunity,
diseases like diabetes, skin conditions, arthritic conditions, IBD, osteoporosis

this is the original paper that initially triggered my interest
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5824721/

there is quite a lot going on - and many of the downstream mechanisms themselves may well have self perpetuating loops - so its certainly possible to see how such a condition, once initiated, might become stuck..

here is a diagram that tries to capture the main mechanism and interconnectedness that i researched at that time:

https://ibb.co/7yjvflb

i had intended to write a post on it with some of the references for further discussion - but i now think its similar to the SIBO discussion - in that something is going on there for sure - but if Lyme and Co's are the trigger in my case - it makes more sense to focus on those first and then see where i am after getting that under control

Post Edited (Garzie) : 5/27/2021 9:43:16 AM (GMT-6)

Garzie said...
there as quite a story there dcd.

basically, i was researching some interesting biology in the gut that i got into after reading a paper that found that mammals can develop and acquired Intestinal Alkaline Phosphatase (IAP) deficiency after repeated exposure to food borne pathogens - even subclinical exposures - eg mild food poisoning or "Delhi belly".

this is very intriguing as IAP has many important functions in the gut to do with regulation of the environment there, permeability of the intestinal membrane and regulation of endotoxins from commensal bacteria.

IAP regulates lipid absorption across the apical membrane of enterocytes, participates in the regulation of bicarbonate secretion and of duodenal surface pH, limits bacterial trans-epithelial passage, and finally controls bacterial endotoxin-induced inflammation by dephosphorylation.

basically it is responsible for de-activating LPS endotoxins in the gut so they do not inflame the immune system. without it - or with a deficiency of it - the gut become hyper reactive to the normal gut bacteria living inside it..... sound familiar?

the mechanism the autors of teh paper found is that neuraminidases in the gut get chronically upregulated and this causes the IAP deficiency.

in theory if you could down regulate these again then the IAP would normalise.

it turns out there are quite a few known neuraminidase inhibitors - both in the pharmaceutical world ( many antiviral drugs work by inhibiting viral neuraminidases - viruses use them as part of their infection strategy) - but also many plant chemicals (herbs) have neuraminidase inhibiting actions ( probably to protect them from plant viruses).

my thoughts were that it might be interesting to trial some of these - perhaps herbs that could be taken orally - as a test to see if this mechanism might be at work.

i shortlisted the following herbs that are all documented to have neuraminidase inhibiting activity
i was familiar with most of them - and started out gradually - increasing the dose every few days to feel my way through effects

tincture / dose per 10ml measure (ml )
Chinese skullcap 2.5
Berberine (mahonia) 0.5
Elder leaf 2
Isatis 1.5
Licorice 1.5
Houttuynia 1.5

i got up to around 2x 10ml measures 3x a day and had an almighty flare

my best guess is the herbs killed off lots of gut bacteria and that caused a massive herx
i have since leaned i am super sensitive to berberine herbs - that could cause this reaction all on its own after only around 1ml of tincture a day - so i think it was mainly the Berberine herb that caused it. Houttuynia is also a pretty broad anti-microbial so could have been involved. i tolerate Licorice, skullcap, elder and isatis pretty well.

this was interesting as berberine pretty much all stays in the gut - so systemic reactions are rare - unless taking mega doses - which i was not.

my flare symptoms were - fever, chills, all over pain , rapid heartbeat, feeling very very ill ( basically had to lie in a darkened room for 2 days and took about 1 week to recover)
the CBC test during the herx like reaction recorded were taken a couple of days past the peak i think.

not much happened good or bad until i hit the level where i suddenly got very ill. it doesn't look like i could tolerate enough of the herbs to get useful effects before running into the fallout from the direct anti-microbial actions of the herbs i used. So as an experiment into trying to test the potential mechanism of IAP deficiency the experiment was not a great success.

however, i still believe there is something to the theory though. As i dug into it it became clear to me that such an IAP deficiency could well trigger a long term chronic state with many cascading downstream effects that would include or could be linked to many common chronic conditions :
SIBO,
dysbiosis
systemic inflammation
oxidative stress
fatigue
auto-immunity,
diseases like diabetes, skin conditions, arthritic conditions, IBD, osteoporosis

this is the original paper that initially triggered my interest
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5824721/

there is quite a lot going on - and many of the downstream mechanisms themselves may well have self perpetuating loops - so its certainly possible to see how such a condition, once initiated, might become stuck..

here is a diagram that tries to capture the main mechanism and interconnectedness that i researched at that time:

https://ibb.co/7yjvflb

i had intended to write a post on it with some of the references for further discussion - but i now think its similar to the SIBO discussion - in that something is going on there for sure - but if Lyme and Co's are the trigger in my case - it makes more sense to focus on those first and then see where i am after getting that under control

Interesting I did not know about this mechanism.

I will do some reading. I’ve wondered myself if it were possible to lose tolerance to commensal bacteria, I guess this answers it.

I’m currently in the middle of a flare from experimenting just like this. Tried 8 pellets of monolaurin. I counted a normal serving (1 scoop) is about 80 pellets, so 1/10th of a serving. My whole body is vibrating I want to crawl out of my own skin. Will never touch the stuff again.

Neuropathy is so frustrating it’s impossible to to continue to flare it’s so painful so you try things and give up immediately. I feel so trapped

Good luck RW! Have you continued to take them or was it just that one day?

Funny i started 2 days ago too! Flared almost immediately but today caused quite a bad flare all morning. Just woke up from a nap and i feel a bit better. Unsure if i should try again. This stuff is strong, but would be nice if i could "pull a garzie" 😂 and just keep going till the flares stop and i can go up.

Ironically, as i mentioned before, my WBC did rise while i was in strict ketosis, to a 4.5 (first time i was ever above a 4.0). And i had tons of energy and a feeling of health. I guess I didnt do it long enough to reach "escape velocity" because now that I'm eating more normal its dropped (2.7 least reading). Makes me think yeasts and gut bacteria play a role as well. The monolaurin hits the yeast i know that.