Low lymphocytes - what can I do?

Both my WBC and lymphocyte counts have always been on the low normal side, with WBC in particular occasionally dropping into the 3s during treatment.

After my second bout of covid last September, I had a major resurgence of what I suspect to have been babesiosis (just a suspicion, never lab confirmed), and at the time (two weeks post covid), my absolute lymphocyte count had dropped to 450. CRP was 20. I was freaked out, but the doctors I saw (in Thailand) weren't at all concerned.

After foolishly taking prednisolone (thinking I was still dealing with covid), my WBCs shot up to 13,000, and lymphocytes 3,000. A week later, WBC had dropped to 8,600 (still very high for me), and lymphocytes to 950. My neutrophils-lymphocyte ratio was out of proportion (76% neutrophils, 14.4% lymphocytes). I consulted with an LLMD (but not my usual doctor - he declined to treat me since I had left the country) and started IV vitamin C and glutathione, and some herbs (including houttuynia). My major symptoms went into remission, and I stopped actively treating.

It was obvious covid had done something to my immune system, opening a window for at least one latent infection to resurface. But most of the research I've seen indicates that immune dysregulation from covid is temporary, so I didn't recheck my lymphocytes (partly due to the massive anxiety I was suffering at the time - I couldn't face it).

Over the months, however, I did notice I was getting sick every 3-4 weeks, in spite of taking a lot of precautions to avoid covid reinfection. I suspect at least one of those illnesses was covid, although rapid tests were negative.

In the last two months alone, I've had severe food poisoning, one of the worst sore throats of my life, and a "cold" that lasted for nearly two weeks in spite of following the FLCCC protocol for covid (I assumed it was).

So last week (two weeks post recovery from whatever my latest illness was), I finally decided to recheck my lymphocytes, and the results weren't great. Total WBC is 5,000, but absolute lymphocytes are 750, 14.9%. My hs-CRP is 5.7, when the past, even during active treatment, it was pretty much always under 1.

As I mentioned at the start, my lymphocytes have always been low normal, usually ranging between 1,200 and 1,500 (1,500 is sometimes the cut-off for lymphocytopenia; sometimes it's 1,000). They hit 1,000 once, but quickly rebounded).

From what I've seen online, a lymphocyte count under 1,000 likely means a CD4 count of under 200 - which is the level at which AIDS is diagnosed. Needless to say, I'm worried.

I came across some extremely informative posts from Running Wild, and I see that he/she has experienced similar levels (though I don't have any of the other abnormalities, aside from elevated hs-CRP). RW, I sincerely hope you're doing better now, and you've figured out what was causing your frightening blood markers. Thank you for sharing your experiences.

I have started a massive immune support stack and will test again in 2-3 weeks. But in the meantime, it's hard not to worry. What might be causing this? Is it a resurgence of tick-borne infections? Or persistent covid infection (which appears to be much more common than we first thought)? Or is it possibly just an "exhaustion program" (as Anthony Leonardi terms it) kicked off by whenever I last had covid?

I think the cause matters, because it will determine treatment. If, for example, the low lymphocyte count is caused by chronic SARS2 infection, stimulating the immune system won't really help - it will just lead to more die off of my lymphocytes. If it's caused by Lyme+, then I can go back on treatment for that. If it's just immune dysregulation, then immune boosters should help.

I'm at a loss. This group has been an incredible resource for me over the years, and even if I'm not a very frequent poster, I am hugely appreciative of everyone here, and the knowledge and experience you all so generously share with others. And just the fact that this forum exists has offered tremendous emotional/psychological support, because I can usually find answers to my questions just by coming here - and I know that I'm not alone in suffering from these illnesses.

So that's a long-winded way of saying thank you to everyone here. If anyone has any thoughts on what I'm experiencing, I would certainly appreciate hearing them.

For reference, my current immune stack is below. I started in on August 13, but I'm slowly easing into it - I haven't yet added everything here.

Hawthorn
Taurine
Niacin
Vitamin C
Houttuynia (I need to re-order this; mine was moldy. I haven't taken it yet).
Licorice
Tryptophan
Probiotic
NAC
Astaxanthin
Resveratrol
Glutamine
CoQ10
Magnesium
K2
Vitamin D
Vitamin E
Zinc
Nattokinase
Fish Oil
Berberine
Olive leaf
Multi-vitamin
Fucoidan
Glycine
Melatonin
Tryptophan

Thanks again.

ps meant to add that the supplement stack doesn't look bad to me
just to be aware that:
- berberine is a powerful antimicrobial and can cause strong herx symptoms
( it does for me )

- nattokinase is a proteolytic enzyme that breaks down fibrin. bartonella and babesia both promote excess fibrin in the circulation system - and breaking it down can expose lots more infected cells to the immune system and drive herx reactions - again just to be aware

- some herx from olive leaf and NAC ( biofilm activity) also

- houttuynia was pretty potent for me - doses are a bit higher than some antimicrobial herbs - but the herx was powerful and long lasting for me

- the others seem benign

perhaps just go one at a time with these and see how you respond

I'm so sorry to hear this, Scroggins. I'm curious what your ongoing symptoms are. Do you feel fine aside from the frequent infections you listed, and are just worried about the abnormalities in your blood work?

Long COVID is very common. It's very reasonable to assume that's what's going on. Though it is discussed very rarely, other viruses can produce a "long" version afterward as well, sometimes causing extensive disability. At the very least, I would try to take the basic precautions to avoid viruses for a while (if you can) until things normalize for you, just to give your system a chance to recover.

One of the common features of long COVID (and chronic tick-borne infections) is mast cell activation syndrome. MCAS can raise your lymphocytes, and cause fluctuations in WBCs. Mast cells are immune cells all over the body, so symptoms can be wide-ranging - skin, respiratory, digestive, joints, cognitive, mood, nervous system, etc. If you are dealing with MCAS, then your supplement list might simply be too many things, and might overload your system. I find that when my system is overwhelmed, my body needs a break from things to process. This might not be part of the picture for you, but it was the biggest part of the picture for me, so I wanted to mention it.

I have not had COVID, but I had a completely disabling "post-viral syndrome" following the worse sore throat of my life in 2018. I know it's so frightening to feel so awful and have doctors have no idea why (even though of course they like to guess and throw drugs at you to address symptoms - that is, if they believe you at all!). One LLMD said reactivated EBV, so take transfer factor and liposomal glutathione. Another LLMD said reactivated Bartonella and adrenal fatigue, so take Bartonella herbs and liposomal glutathione and adaptogenic herbs and adrenal glandular supplements. Primary care doctor said "post-viral syndrome" so take vitamin C, glutathione, and steroids. ER doctors said "post-viral syndrome" and to take steroids. My instinct was that they were all wrong, but I tried a lot of that and didn't improve. Eventually I figured out that I had MCAS, so treated that as well as limbic system dysfunction, and rapidly improved. Again, I don't know if that's relevant to your situation, but I wanted to share just in case.

just to follow up on the immune system recovery part

a lot of this comes down to what model we choose to use to think about this illness / group of illnesses

the more i research this and treat myself and understand others experiences - the more i come to think that Dr J's model is about the best out there

he talks about the immune systems natural condition and target state - where it is under control - any infections that are present ( we all have some microbes inside us ) are all kept at very low levels by the well tuned and dominant immune system and we are healthy

when stealth infections start to get the upper hand these roles are reversed - the immune system is overwhelmed and the infections are in control of the system
in other words the needle has swung all the way the other way - and we have symptoms not just from the infections themselves - but from the dysregulation to the immune system also - so things like hyper reactivity to foods or chemicals - or just bloating after meals - fatigue - etc etc

this model implies that the sicker we are the more dysfunction in our immune system we have and visa versa - so the sickest people have the most - and the more well people the least - so its a scale

he seems to be able to get people well again - no matter how sick they are - it just takes longer to get the immune system back in control in the sicker patients

this all makes a lot of sense to me and fits with what i have experienced personally - and what i see in others too

this implies that while a person can get sicker -eg if infections are not treated - they are not necessarily getting "immune fatigue" beyond the point of no return - but more that infections are just keeping the immune system suppressed - as otherwise the very sick people would not recover after being so sick for so many years

so it seems to point to us humans having remarking resistance and powers of recovery - if the infectious load can be brought down and our immune systems given a chance to recover.

all the best !

Thanks, garzie and astroman.

Garzie: I tend to agree with the view you describe here. I guess my concern is for T-cells specifically, because we lose the ability to produce them as we age. I'm turning 40 next month, which is around the age the thymus disappears, so I don't really know what my capacity for T-cell generation might be.

I really wish I had seen Dr. J when I first sought professional treatment back in 2019. It was a choice between him and Dr. P in Wilton, CT, but I went with the latter. He was good (but expensive), and we made a lot of progress together, but as I mentioned he stopped treating me when I moved abroad in early 2022. At the time I was feeling mostly recovered, so I wasn't overly concerned, but covid derailed all of that. Dr J, on the other hand, apparently is happy to treat patients anywhere in the world, provided they visit him in person at least once a year.

Astroman: Thank you for sharing your thoughts - I'll definitely look up some of your posts when I have some time.

I share your hatred of cities and love of the outdoors, but that's kind of what got me in this position to begin with...

Looking back through old blood tests, I can see that my LLMD did indeed test globulin protein, total protein and CD-57 as part of the initial workup in 2019. All were within normal range at the time (1.9, 6.6, and 93, respectively), though globulin was right on the edge of the normal range. 93 for CD-57 seems low, but the range given (by Quest) is 60-360. It doesn't appear that he tested any of these again during treatment over the next ~2 years.

Interestingly, I note that my lymphocytes were 1084 at that first appointment, so not outrageously higher than they are now. I think it's not unreasonable to conclude I had some immune dysfunction then.

My numbers improved over the course of treatment (until late 2021), though as mentioned above round 2 of covid seems to have made everything much worse. I breezed through the first round of covid without any obvious ill effects - it's the second infection that got me. I now think reinfections are anything but benign, especially for people like us with complex chronic infections.

Thanks Annie23 - I appreciate the suggestions. I'm sorry to hear you're facing a similar situation, but I hope you're making progress with the strategies you mentioned.

Would you mind sharing your age? I'm not sure how active my thymus would be at my age (40 in October), so I don't know if those particular supplements would be beneficial.5

My cd57+ value was 37 absolute (1 year ago). I did not test it again so i don't know if there is progress but i feel the immune supplements are helping me a bit now.
I'm 35 years old.

Annie23 said...
I readed your post and the reactions which are supportive. I imagine you are concerned. I think it's good to optimally support your immune system.

I have low values of cd57 and my immune system is also bad for many years. I now try
* thymus glandular capsules swanson, spleen glandular capsules swanson
* biophoton therapy
* activating the thymus by tapping
* vit c, zinc and selenium sometimes
* arabionogalaction (this stimulates the natural killer cells)
* lactobaccilus plantarum (probiotics)
* mushrooms: cordyceps, maiitake,...
* z app (free app with rife frequencies to listen, i listen for example: immune stimulation,...)

I wish your lymphocites will raise. A lot of courage.

Please keep us posted if your CD-57 improves. The only way you'll know is by re-testing.

I was monitoring it myself for $50 a test thru a Quest walk in lab, with blood draw purchased online. LabCorp dropped this from their test menu. Its also called HNK-1.

Thanks all, and apologies for the late reply - I had some laptop issues yesterday, now resolved.

Annie23: Thanks for responding. I do indeed hope you've made some improvement since then, but it sounds like your result is in line with what other Lyme sufferers experience.

garzie and astroman: Thanks for sharing that information on the thymus and CD57 numbers. My knowledge of all of this is admittedly quite rudimentary - it's reassuring to know my thymus is likely still there and functioning. I assume my CD57 would be lower now, since lymphocytes have dropped so much. If lymphocytes remain low, I will test.

Again I will reveal my ignorance on these matters... but is it possible that I have sufficient numbers of lymphocytes, but they are engaged in fighting infections outside the bloodstream? The reason I ask is because when I took prednisolone last year, my lymphocytes shot up to 3,000 (and CD4 was over 700 at the time, which I had tested). A week later, lymphocytes had dropped to 950.

So my question is: did my body produce/release 2,000 lymphocytes after a few days on prednisolone, then they were destroyed after I stopped taking it? Or is that they were fighting infection somewhere outside the bloodstream, and by taking prednisolone it triggered my immune system to stand down, so they returned to the bloodstream? Then, when I stopped taking the corticosteroids, they returned to the tissue to battle infection once more.

Is this a reasonable explanation of what's happening, or did I just experience substantial turnover of lymphocytes in a very short period of time?

If the explanation holds water, then it seems like pulsed corticosteroids could conceivably be used (very carefully) as an immune stimulant.

Scroggins said...


So my question is: did my body produce/release 2,000 lymphocytes after a few days on prednisolone, then they were destroyed after I stopped taking it? Or is that they were fighting infection somewhere outside the bloodstream, and by taking prednisolone it triggered my immune system to stand down, so they returned to the bloodstream? Then, when I stopped taking the corticosteroids, they returned to the tissue to battle infection once more.

Is this a reasonable explanation of what's happening, or did I just experience substantial turnover of lymphocytes in a very short period of time?

If the explanation holds water, then it seems like pulsed corticosteroids could conceivably be used (very carefully) as an immune stimulant.

i have to admit also that i do not know a great deal about how exactly the immune system responds to corticosteroids
from what i have read i am a bit surprised to hear that your white blood cell count actually went up dramatically when or just after taking them, as generally corticosteroids (these are those natural and synthetic hormones - including prednisone - that act on the same pathway as cortisol)
as all of these are known to suppress the immune system quite broadly.

in fact because neuro-lyme was known to be an inflammatory disease in the brain - with severe risk to long term brain function - corticosteroids were in fact trailed in the treatment of neuro lyme to try to bring that inflammation down rapidly - this was relatively early on in the history of Lyme disease - but this was found to cause worse outcomes - so are no longer used - even in acute neuro lyme cases.

later studies showed much higher levels of bacteria in the host tissues if the host was given corticosteroids
i have seen studies on this for both lyme and babesia

i would have generally expected white cell counts to fall with falling immune function - but it could be that this is not the case - and that the number of white cells is not strictly lined to immune function
ie white cells counts could perhaps go up - but immune function could go down
as after all - immune function is not so much how many cell you have - but more - what are those cells doing

i am not sure about the theory that cells are migrating in and out of tissues
the body does adapt to do this - eg locally if you step on a splinter
but here its more a case that local inflammation opens up pathways for white cells to get at bacteria - and call ore white cells to that site - causing significant swelling

if this were to happen systemically all over - i think you would know about it from signs of pain and swelling everywhere.

i suspect there is another explanation

For my money Ewot seems better and can be a one time purchase-I think it works better because the exercise created some pressure to move the o2 throughout the body-and watch the video-the immune system gets stronger