8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

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Complete Blood Count (CBC)

Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — Written
by Danielle Moores — Updated on September 17, 2018

Blood cell types Purpose Preparation Procedure Results

What is a CBC?
A complete blood count, or CBC, is an easy and very common test that
screens for certain disorders that can affect your health.

A CBC determines if there are any increases or decreases in your blood

cell counts. Normal values vary depending on your age and your gender.
Your lab report will tell you the normal value range for your age and
gender.

A CBC can help diagnose a broad range of conditions, from anemia and
infection to cancer.
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The three basic types of blood cells

Measuring changes in your blood cell levels can help your doctor
evaluate your overall health and detect disorders. The test measures the
three basic types of blood cells. 
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Red blood cells Privacy - Terms

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

Red blood cells carry oxygen throughout your body and remove carbon
dioxide. A CBC measures two components of your red blood cells:

hemoglobin: oxygen-carrying protein

hematocrit: percentage of red blood cells in your blood

Low levels of hemoglobin and hematocrit are often signs of anemia, a

condition that occurs when blood is deficient in iron.

White blood cells

White blood cells help your body fight infection. A CBC measures the
number and types of white blood cells in your body. Any abnormal
increases or decreases in the number or types of white blood cells could
be a sign of infection, inflammation, or cancer.

Platelets

Platelets help your blood clot and control bleeding. When a cut stops
bleeding, it’s because platelets are doing their job. Any changes in
platelet levels can put you at risk for excessive bleeding and can be a
sign of a serious medical condition.

When is a CBC ordered?

Your doctor may order a CBC as part of a routine checkup or if you have
unexplained symptoms such as bleeding or bruising. A CBC can help your
doctor do the following.

Evaluate your overall health. Many doctors will order a CBC so they
can have a baseline view of your health. A CBC also helps your
doctor screen for any health problems.
Diagnose a health problem. Your doctor may order a CBC if you
have unexplained symptoms like weakness, tiredness, fever,
redness, swelling, bruising, or bleeding.
Monitor a health problem. Your doctor may regularly order CBCs to
monitor your condition if you have been diagnosed with a disorder
that affectsA blood
D V E R T I S Ecell
M E N T counts.
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

Monitor your treatment. Certain medical treatments can affect your

blood cell counts and may require regular CBCs. Your doctor can
evaluate how well your treatment is working based on your CBC.
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Getting ready for a CBC

Make sure to wear a short-sleeved shirt or a shirt with sleeves that you
can easily rollup.

You can typically eat and drink normally before a CBC. However, your
doctor may require that you fast for a specific amount of time before the
test. That’s common if the blood sample will be used for additional
testing. Your doctor will give you specific instructions.

Everything You Need to Know About Fasting Before a Blood Test »

What happens during a CBC?

During a CBC, a lab technician will draw blood from a vein, typically from
the inside of your elbow or from the back of your hand. The test will take
only a few minutes. The technician:

1. cleans your skin with an antiseptic wipe

2. places an elastic band, or tourniquet, around your upper arm to help
the vein swell with blood

3. inserts a needle in the your and collects a blood sample in one or

more vials 
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4. removes the elastic band

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

5. covers the area with a bandage to stop any bleeding

6. Label your sample and send it to a lab for analysis

A blood test can be slightly uncomfortable. When the needle punctures

your skin, you might feel a prick or pinching sensation. Some people also
feel faint or light-headed when they see blood. Afterwards, you may have
minor bruising, but it will clear up within a few days.

Most CBC results are available within a few hours to a day after testing.

For infants

In young infants, a nurse will typically sterilize the heel of the foot and use
a small needle called a lancet to prick the area. The nurse will then gently
squeeze the heel and collect a small amount of blood in a vial for testing.

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What do the results mean?

Test results will vary based on your blood cell counts. Here are the normal
results for adults, but different labs may deliver slight variations:

Blood component Normal levels

In men: 4.32-5.72 million cells/mcL

red blood cell
In women: 3.90-5.03 million cells/mcL
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In men: 135-175 grams/L
hemoglobin
In women: 120-155 grams/L
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

hematocrit In men: 38.8-50.0 percent

In women: 34.9-44.5 percent

white blood cell count 3,500 to 10,500 cells/mcL

platelet count 150,000 to 450,000/mcL

A CBC is not a definitive diagnostic test. Blood cell counts that are too
high or too low could signal a wide variety of conditions. Specialized tests
are needed to diagnose a specific condition. Conditions that could cause
an abnormal CBC and may require additional testing include:

iron or other vitamin and mineral deficiencies

bleeding disorders

heart disease
autoimmune disorders

bone marrow problems

cancer

infection or inflammation
reaction to medication

If your CBC shows abnormal levels, your doctor may order another blood
test to confirm results. They may also order other tests to help further
evaluate your condition and confirm a diagnosis.

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

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Last medically reviewed on June 26, 2017

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What Is a White Blood Cell (WBC) Count?

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Medically reviewed by Kevin Martinez, M.D. — Written by Valencia Higuera — Privacy - Terms

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure
Updated on March 11, 2022

Purpose Normal range High and low WBC count Symptoms

Preparation Procedure Complications Increasing your count

White blood cell count test

A white blood cell (WBC) count is a test that measures the number of
white blood cells in your body. It may also be called a leukocyte test. This
test is often included with a complete blood count (CBC), which is
commonly used to screen for different conditions that may affect your
overall health.

The term “white blood cell count” is also used more generally to refer to
the number of white blood cells in your body.

There are several types of white blood cells, and your blood usually
contains a percentage of each type. Sometimes, however, your white
blood cell count can fall or rise out of the healthy range. This may be due
to an underlying condition or infection.

Keep reading to learn the normal white blood cell count range is and what
high or low white blood cell counts may mean.
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Purpose of a white blood cell count

A WBC count is often done as part of a CBC. These tests may be ordered
as part of a routine blood test.
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White blood cells, also called leukocytes, are an important part of the
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immune system. They originate in the bone marrow but move throughout
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

the bloodstream. These cells help fight infection by attacking bacteria,

viruses, and germs that invade the body.

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.

White blood cell differential

Doctors may also order a white blood cell count differential, which
provides a breakdown of your white blood cell count. It separates the
count out by the different types of white blood cells and looks to see if
they are in the normal range.

There are five major types of white blood cells. They have different roles
in protecting your body from infection and dealing with infected cells.
These types of white blood cells include:

neutrophils

lymphocytes

eosinophils

monocytes

basophils

A normal WBC count

A normal white blood cell count can indicate that your immune system is
functioning as normal. The normal range for a white blood cell count is
typically between 4,000 and 11,000/microliters.

Factors like age and sex may determine what a normal range looks like.

According to the Leukemia and Lymphoma Society (LLS), these are the
normal white blood cell count ranges for people in the following groups:

AgeA Drange WBC range per μL of blood 

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Adult men 5,000 to 10,000 Privacy - Terms

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

Adult women 4,500 to 11,000

Children 5,000 to 10,000

Note that pregnant people may have a white blood cell count that differs
from these ranges. Newborns and children under two may also have
ranges that differ from those listed above.

These normal ranges can also vary by lab. The lab performing your test
may include a reference range listed on your report.

Another common measurement for the volume of blood is cubic

millimeter, or mm3. A microliter and cubic millimeter equal the same
amount.

The types of cells that make up WBCs usually fall within a normal
percentage of your overall WBC count.

The normal percentages of the types of WBCs in your overall count are
usually in these ranges, according to the LLS:

Type of WBC Normal percentage of overall WBC count

neutrophil 55% to 70%

lymphocyte 20% to 40%

eosinophil 1% to 4%

monocyte 2% to 8%

basophil 0.5% to 1%

Having a higher or lower percentage of a certain type of white blood cell

can also be a sign of an underlying condition.
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

A high or low WBC count

If your test results are abnormal, it may mean that your numbers are
higher or lower than the normal range for your age.

A low or high WBC count can point to a blood disorder or other medical
condition. To identify the exact cause of a high or low WBC count, your
doctor will take several factors into consideration, such as your list of
current medications, any symptoms you have, and your medical history.

Low white blood cell count

Leukopenia is the medical term used to describe a low WBC count. This
can be triggered by:

HIV/AIDS

autoimmune disorders

bone marrow disorders or damage

lymphoma
severe infections

liver and spleen diseases, such as an enlarged spleen

lupus

radiation therapy

some medications, such as chemotherapy and antibiotics

alcoholism

malaria

Sometimes, the term neutropenia is also used to indicate a low blood

count. This term actually refers to a low number of neutrophils but
because this type of white blood cell makes up 55 to 70 percent of your
overall white blood cells, leukopenia is often driven by a low number of
neutrophils.
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

Having neutropenia may put you at an increased risk for infection, illness,
and death. This is because you may not have enough white blood cells to
protect you from germs and bacteria. If you have this condition, it is
important to take precautions such as wearing a mask in public settings to
limit your exposure and reduce your risk of infection.

High white blood cell count

Leukocytosis is the medical term used to describe a high WBC count. This
can be triggered by:

infections such as tuberculosis, sepsis, or septic shock

fever

injury or burn

pregnancy
allergies

asthma

a recent vaccination
some medications, such as corticosteroids, epinephrine, and non-
steroidal anti-inflammatory (NSAID) drugs

stress

tissue damage

acute hemolysis

hemorrhage

leukemoid reaction

heart attack

surgery

An elevated white blood cell count may also be chronic or long lasting
with the following conditions:

smoking

tumors in the bone marrow

leukemia ADVERTISEMENT
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

obesity

vasculitis, or inflammation of the blood vessels

The doctor may run additional tests to determine the cause of your
abnormal white blood cell count.

After diagnosing the cause of a high or low WBC count and

recommending a treatment plan, your doctor will periodically recheck
your WBCs with additional blood tests.

If your WBC count remains high or low, this can indicate that your
condition has worsened. Your doctor may use this information to adjust
your treatment.

If your WBC count shows a normal range, this usually indicates that the
treatment is working.

Symptoms of an abnormal WBC count

The symptoms of a low WBC count include:

body aches

fever
chills

headaches

High WBC counts don’t often cause symptoms, although the underlying
conditions causing the high count may cause their own symptoms.

The symptoms of a low WBC count may prompt your doctor to

recommend a WBC count. It’s also normal for doctors to order a CBC and
check your WBC count during an annual physical exam.

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

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How to prepare for a WBC count

A WBC count requires no specific preparation. You simply schedule an
appointment with a doctor or set up an appointment at a local medical
laboratory.

Certain medications can interfere with your lab results and either lower or
increase your WBC count. Drugs that may affect your test results can
include:

corticosteroids

quinidine

heparin

clozapine

antibiotics

antihistamines

diuretics

anticonvulsants

sulfonamides
chemotherapy medication

Prior to having your blood drawn, tell your doctor about all prescription
and nonprescription medications that you’re currently taking.

What to expect from a WBC count

A healthcare professional or lab technician needs to draw blood to check
your WBC count.

This blood sample is typically taken either from a vein in your arm or a
vein on the back of your hand. It only takes a couple of minutes to draw
your blood, and you may experience minor discomfort. 
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

The healthcare professional first cleans the site to kill any germs. Then,
they will typically tie an elastic band around the upper section of your arm.
This elastic band helps the blood fill your vein, making it easier for the
blood to be drawn.

They may then insert a needle into your arm or hand to collect the blood
in an attached tube. After, they will remove the elastic band from around
your arm and remove the needle. Finally, the technician may apply gauze
or a bandage to the site to stop the bleeding.

There’s typically a different technique for drawing blood from young

children and infants. This may include first puncturing the skin with a
lancet (a pricking needle) and then using a test strip or a small vial to
collect the blood.

A laboratory typically processes these results. You may receive your

results online, over a phone call, or during a follow-up visit.

Complications from a WBC count

Having your blood drawn is a simple procedure, and complications are
rare.

However, it can be difficult to take blood from people with small veins.
The lab technician may be unable to locate a vein the first time, or once
the needle is inside the arm or hand, they may have to move the needle
around in order to draw blood. This can cause sharp pain or a stinging
sensation.

Rare complications of a blood test may include:

infection at the needle site

excessive bleeding

lightheadedness or fainting
bleeding underneath the skin (hematoma)

Q&A: Increasing your WBC count

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

Are there any foods I can eat that will help increase my WBC
count?

― Anonymous

A:
No specific foods or diet is proven through research to increase
the production of white blood cells.

It’s important to include a good source of protein in your diet, as

amino acids found in protein are needed to build WBCs.

Vitamins B12 and folate are also needed to produce WBCs, so

consider adding a multivitamin and mineral supplement daily.
Though not proven, some believe that adding vitamin C, vitamin
E, zinc, garlic, selenium, and even spicy foods to your diet can
boost the immune system.

If you’re being treated for cancer or other causes of leukocytosis,

talk to your doctor before taking any supplements, as they might
interfere with treatments.

― Deborah Weatherspoon, PhD, RN, CRNA

Answers represent the opinions of our medical experts. All content is strictly
informational and should not be considered medical advice.

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Eosinophil Count: What It Is and What It

Means
Medically reviewed by Judith Marcin, M.D. — Written by Corinna Underwood
— Updated on September 17, 2018

Purpose Preparation Procedure Results Complications

Follow-up

What is an eosinophil count?

White blood cells are an important part of your body’s immune system.
They’re vital to protecting you from invading bacteria, viruses, and
parasites. Your bone marrow produces all five of the different kinds of
white blood cells in the body.

Each white blood cell lives anywhere from several hours to several days
in the blood stream. An eosinophil is a type of white blood cell.
Eosinophils are stored in tissues throughout the body, surviving for up to
several weeks. The bone marrow continually replenishes the body’s white
blood cell supply.

The number and type of each white blood cell in your body can give
doctors a better understanding of your health. Elevated levels of white
blood cells in your blood can be an indicator that you have an illness or
infection. Elevated levels often mean your body is sending more and
more white blood cells to fight off infections.

An eosinophil count is a blood test that measures the quantity of

eosinophils in your body. Abnormal eosinophil levels are often discovered
as part of a routine complete blood count (CBC) test.

Ongoing research continues to uncover an expanding list of roles

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performed by eosinophils. It appears now that nearly every system of the
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

within your immune system. Eosinophils destroy invading germs like

viruses, bacteria, or parasites such as hookworms. They also have a role
in the inflammatory response, especially if an allergy is involved.

Inflammation is neither good nor bad. It helps isolate and control the
immune response at the site of an infection, but a side effect is tissue
damage around it. Allergies are immune responses that often involve
chronic inflammation. Eosinophils play a significant role in the
inflammation related to allergies, eczema, and asthma.
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Why do I need an eosinophil count?

Your doctor may discover abnormal eosinophil levels when a white blood
count differential is performed. A white blood count differential test is
often done alongside a complete blood count (CBC) and determines the
percentage of each kind of white blood cell present in your blood. This
test will show if you have an abnormally high or low count of white blood
cells. White blood cell counts can vary in certain diseases.

Your doctor may also order this test if they suspect specific diseases or
conditions, such as:

an extreme allergic reaction

a drug reaction

certain parasitic infections

How do I prepare for an eosinophil count?

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There are no special preparations necessary for this test. You should
inform your doctor if you’re taking any blood-thinning drugs such as
warfarin (Coumadin). Your doctor may advise you to stop taking certain
medications.

Medications that may cause you to have an increased eosinophil count

include:

diet pills

interferon, which is a drug that helps treat infection

some antibiotics

laxatives that contain psyllium

tranquilizers

Before the test, be sure to tell your doctor about any current medications
or supplements you’re taking.
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What happens during an eosinophil count?

A healthcare provider will take a sample of blood from your arm by
following these steps:

1. First, they’ll clean the site with a swab of antiseptic solution.

2. They’ll then insert a needle into your vein and attach a tube to fill
with blood.

3. After drawing enough blood, they’ll remove the needle and cover 
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

What do the results mean?

Normal results

In adults, a normal blood sample reading will show fewer than 500
eosinophil cells per microliter of blood. In children, eosinophil levels vary
with age.

Abnormal results

If you have over 500 eosinophil cells per microliter of blood, then it
indicates you have a disorder known as eosinophilia. Eosinophilia is
classified as either mild (500–1,500 eosinophil cells per microliter),
moderate (1,500 to 5,000 eosinophil cells per microliter), or severe
(greater than 5,000 eosinophil cells per microliter). This can be due to any
of the following:

an infection by parasitic worms

an autoimmune disease

severe allergic reactions

eczema

asthma

seasonal allergies

leukemia and certain other cancers

ulcerative colitis

scarlet fever

lupus

Crohn’s disease

a significant drug reaction

an organ transplant rejection

An abnormally low eosinophil count can be the result of intoxication from

alcohol or excessive production of cortisol, like in Cushing’s disease.
Cortisol is a hormone naturally produced by the body. Low eosinophil
counts may alsoAbe due 
DVER T I S E Mto
E N Tthe time of day. Under normal conditions,

eosinophil counts are lowest in the morning and highest in the evening.
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Unless alcohol abuse or Cushing’s disease is suspected, low levels of

eosinophils are not usually of concern unless other white cell counts are
also abnormally low. If all white cells counts are low, this can signal a
problem with the bone marrow.

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What are the complications associated with an

eosinophil count?
An eosinophil count uses a standard blood draw, which you have likely
had many times in your life.

As with any blood test, there are minimal risks of experiencing minor
bruising at the needle site. In rare cases, the vein may become swollen
after blood is drawn. This is called phlebitis. You can treat this condition
by applying a warm compress several times each day. If this isn’t
effective, you should consult your doctor.

Excessive bleeding could be a problem if you have a bleeding disorder or

you take blood-thinning medication, such as warfarin (Coumadin) or
aspirin. This requires immediate medical attention.

What happens after an eosinophil count?

If you have an allergy or parasitic infection, your doctor will prescribe a
short-term treatment to alleviate symptoms and revert your white blood
cell count to normal.
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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

have. A wide variety of other conditions can cause high levels of

eosinophils, so it’s important to work with your doctor to figure out the
cause.

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Last medically reviewed on August 2, 2017

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Neutropenia
Medically reviewed by Emelia Arquilla, DO — Written by Anna Giorgi —
Updated on February 12, 2021

Types Symptoms Causes Risk factors Diagnosis Treatments

Outlook Prevention

What is neutropenia?
Neutropenia is a blood condition characterized by low levels of
neutrophils, which are white blood cells that protect your body from
infections.

Without enough neutrophils, your body can’t fight off bacteria. Having
neutropenia increases your risk for many types of infection.
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Types of neutropenia
There are four types of neutropenia:

Congenital

Congenital neutropenia is present at birth. Severe congenital neutropenia

is also called Kostmann syndrome. It causes very low neutrophil levels
and in some cases, complete lack of neutrophils. This puts infants and
young children at risk for serious infections.

Cyclic

Cyclic neutropenia is present at birth and causes neutrophil counts to

vary in a 21-day cycle. A period of neutropenia may last a few days,
followed by normal levels for the rest of the cycle. The cycle then begins
again.

Autoimmune

With autoimmune neutropenia, your body makes antibodies that fight

your neutrophils. These antibodies kill the neutrophils, causing
neutropenia.

Autoimmune neutropenia is most common in infants and young children,

with the average age of diagnosis between 7 and 9 months  .

Idiopathic
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Idiopathic neutropenia develops any time in life and can affect anyone.
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What are the symptoms of neutropenia?

Neutropenia symptoms can range from mild to severe. The lower the
level of neutrophils, the more intense the symptoms.

Typical symptoms include:

fever
pneumonia

sinus infections
otitis media (ear infection)

gingivitis (gum inflammation)

omphalitis (navel infection)
skin abscesses

Severe congenital neutropenia can have serious symptoms. The

symptoms often include bacterial infections. These infections can grow on
the skin and in the digestive and respiratory systems.

The symptoms of cyclic neutropenia recur in 3-week cycles. Infections

can increase when neutrophil levels fall.

The symptoms of autoimmune and idiopathic neutropenia include

infections. They’re usually not as severe as those in congenital forms.
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What causes neutropenia? 

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Neutropenia can be triggered by: Privacy - Terms

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

chemotherapy

radiation therapy
the use of certain drugs

Other causes include:

Shwachman-Diamond syndrome, which is an inherited condition

affecting many organs and often characterized by bone marrow and
pancreatic failure
glycogen-storage disease type 1b, which is a rare inherited disorder
that affects blood sugar levels

leukemia
viral illnesses
severe aplastic anemia

Fanconi anemia
conditions that affect bone marrow

infections, both viral and bacterial, including HIV, hepatitis,

tuberculosis, and Lyme disease
deficiencies in certain vitamins and minerals, including B12, folic
acid, and copper

According to the U.S. National Library of Medicine, most people with

severe congenital neutropenia have no family history of the condition.

Who is at risk?
The risk of neutropenia is increased by certain conditions, such as:

cancer

leukemia
a weakened immune system

Chemotherapy and radiation therapy also raise the risk.

Idiopathic neutropenia affects people of all ages, but people over 70 are

at higher risk. Men and
ADVE R T I S Ewomen
MENT are at equal risk.

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Diagnosing neutropenia
Your doctor can use these tests to diagnose neutropenia:

Complete blood count (CBC). This test measures neutrophil counts.

Intermittent CBC tests can help your doctor check for changes in
neutrophil count three times per week for 6 weeks.
Antibody blood test. This test checks for autoimmune neutropenia.

Bone marrow aspirate. This procedure tests bone marrow cells.

Bone marrow biopsy. This involves testing a piece of the bony part
of bone marrow.
Cytogenetic and molecular testing. This testing helps your
healthcare provider study the structures of the cells.

Treating neutropenia
Most cases of neutropenia can be treated with granulocyte-colony
stimulating factors (G-CSF). This is a synthetic copy of the hormone that
causes neutrophils to grow in the bone marrow. G-CSF can increase the
number of neutrophils.

G-CSF is usually given as a daily subcutaneous (under the skin) injection.

The treatment sometimes includes bone marrow transplants. This is
usually when leukemia is present or G-CSF doesn’t work.

The following therapies can also treat infections that occur due to the
disorder:
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antibiotics
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anti-inflammatory drugs
corticosteroids

cytokines
glucocorticoids

immunoglobulins
immunosuppressive drugs

white blood cell transfusions

vitamins

Outlook
Neutropenia can last for months or years. It’s called acute when it lasts for
fewer than 3 months. When it lasts for a longer time, it’s called chronic.

Lower neutrophil levels can cause dangerous infections. These infections

can be life threatening when they’re untreated.

Having severe congenital neutropenia increases your risk for other

conditions. According to the U.S. National Library of Medicine, about 40
percent of people with congenital neutropenia have decreased bone
density. This puts them at a higher risk for osteoporosis.

About 20 percent have leukemia or blood and bone marrow disease in

adolescence.

Treatment of neutropenia emphasizes helping you live a normal life.

Managing it involves:

annual bone marrow monitoring

monthly CBC tests

emotional support
psychological therapy

Can you prevent neutropenia?

No specific prevention for neutropenia is known. However, the National
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Neutropenia Network advises the following to reduce complications:

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Maintain good oral hygiene. Get regular dental exams, and use an
antibacterial mouthwash.
Keep vaccinations current.

Get medical care for a fever above 101.3°F (38.5°C).

Wash your hands thoroughly.

Care for cuts and scrapes.

Use antibiotics and antifungals as directed.

Know how to reach your doctor and hospital.

Talk with your doctor before traveling out of the country.

These preventive lifestyle measures can help you to reduce potential

complications of neutropenia. Talk with your doctor about any symptoms
that arise, and always know how to reach your doctor and hospital.

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Last medically reviewed on February 12, 2021

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Blood Differential Test

Medically reviewed by Judith Marcin, M.D. — Written by Heather Ross — 
UpdatedA Don
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Why do I need it? How it’s done Complications Test results

After the test

What is a blood differential test?

The blood differential test can detect abnormal or immature cells. It can
also diagnose an infection, inflammation, leukemia, or an immune system
disorder.

Type of white blood cell Function

helps stop microorganisms in infections by

neutrophil eating them and destroying them with
enzymes

–uses antibodies to stop bacteria or viruses

from entering the body (B-cell lymphocyte)
lymphocyte –kills off the body’s cells if they’ve been
compromised by a virus or cancer cells (T-cell
lymphocyte)

becomes a macrophage in the body’s tissues,

monocyte eating microorganisms and getting rid of dead
cells while increasing immune system strength

helps control inflammation, especially active

during parasite infections and allergic
eosinophil
reactions, stops substances or other foreign
materials from harming the body

produces enzymes during asthma attacks and

basophil
allergic reactions
The blood differential test can detect abnormal or immature cells. It can
also diagnose an infection, inflammation, leukemia, or an immune system
disorder.

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Why do I need a blood differential test?

Your doctor may order a blood differential test as part of a routine health
exam.

A blood differential test is often part of a complete blood count (CBC). A

CBC is used to measure the following components of your blood:

white blood cells, which help stop infections

red blood cells, which carry oxygen

platelets, which help clot the blood
hemoglobin, the protein in red blood cells that contains oxygen

hematocrit, the ratio of red blood cells to plasma in your blood

A blood differential test is also necessary if your CBC results are not
within the normal range.

Your doctor may also order a blood differential test if they suspect that
you have an infection, inflammation, bone marrow disorder, or
autoimmune disease.

How is a blood differential test performed?

Your doctor checks your white blood cell levels by testing a sample of
your blood. This test is often performed at an outpatient clinical
laboratory.

The healthcare provider at the lab uses a small needle to draw blood from
your arm or hand. No special preparation before the test is necessary.

A laboratory specialist puts a drop of blood from your sample on a clear

glass slide and smears it to spread the blood around. Then, they stain the
blood smear with a dye that helps to differentiate the types of white blood
cells in the sample.

The lab specialist then counts the number of each white blood cell type.
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The specialist may do a manual blood count, visually identifying the

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number and size of cells on the slide. Your specialist might also use an
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automated blood count. In this case, a machine analyzes your blood cells
based on automated measurement techniques.

Automated count technology uses electrical, laser, or photodetection

methods to provide a highly accurate portrait of the size, shape, and
number of blood cells in a sample.

A 2013 study showed that these methods are very accurate, even across
different types of machines that do automatic blood counts.

Eosinophil, basophil, and lymphocyte count levels might not be accurate if

you’re taking corticosteroid medications, such as prednisone, cortisone,
and hydrocortisone, at the time of the test. Let your doctor know if you’re
taking any of these medications before taking the test.
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What are the complications associated with a

blood differential test?
The risk of complications from having blood drawn is very slight. Some
people experience mild pain or dizziness.

After the test, a bruise, slight bleeding, an infection, or a hematoma (a

blood-filled bump under your skin) might develop at the puncture site.

What do the test results mean?

Intense exercise and high levels of stress can affect your white blood cell
count, especiallyA Dyour
V E R T I Sneutrophil
EMENT levels. 

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Some studies show that a vegan diet can cause your white blood cell
count to be lower than normal. However, the reason for this isn’t agreed
upon by scientists.

An abnormal increase in one kind of white blood cell can cause a

decrease in another kind. Both abnormal results can be due to the same
underlying condition.

Lab values may vary. According to the American Academy of Pediatric

Dentistry, the percentages of white blood cells in healthy people are as
follows:

54 to 62 percent neutrophils
25 to 30 percent lymphocytes
0 to 9 percent monocytes

1 to 3 percent eosinophils
1 percent basophils

An increased percentage of neutrophils in your blood can mean that you

have:

neutrophilia, a white blood cell disorder that can be caused by an

infection, steroids, smoking, or rigorous exercise
an acute infection, especially a bacterial infection

acute stress
pregnancy

inflammation, such as inflammatory bowel disease or rheumatoid

arthritis
tissue injury due to trauma

chronic leukemia

A decreased percentage of neutrophils in your blood can indicate:

neutropenia, a white blood cell disorder that can be caused by a

lack of neutrophil production in the bone marrow

aplastic anemia, a decrease in the number of blood cells produced 

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by your bone marrow

a severe or widespread bacterial or viral infection Privacy - Terms

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recent chemotherapy or radiation therapy treatments

An increased percentage of lymphocytes in your blood may be due to:

lymphoma, a white blood cell cancer that starts in your lymph nodes
a chronic bacterial infection

hepatitis
multiple myeloma, a cancer of the cells in your bone marrow

a viral infection, such as mononucleosis, mumps, or measles

lymphocytic leukemia

A decreased percentage of lymphocytes in your blood can be a result of:

bone marrow damage due to chemotherapy or radiation treatments

HIV, tuberculosis, or hepatitis infection

leukemia
a severe infection, such as sepsis

an autoimmune disorder, such as lupus or rheumatoid arthritis

A heightened percentage of monocytes in your blood can be caused by:

chronic inflammatory disease, such as inflammatory bowel disease

a parasitic or viral infection

a bacterial infection in your heart

a collagen vascular disease, such as lupus, vasculitis, or rheumatoid

arthritis
certain types of leukemia

An increased percentage of eosinophils in your blood can indicate:

eosinophilia, which can be caused by allergic disorders, parasites,

tumors, or gastrointestinal (GI) disorders
an allergic reaction

skin inflammation, such as eczema or dermatitis

a parasitic infection
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an inflammatory disorder, such as inflammatory bowel disease or

celiac disease
certain cancers

An increased percentage of basophils in your blood might be caused by:

a serious food allergy

inflammation

leukemia

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What happens after the blood differential test?

Your doctor will likely order more tests if you have a persistent increase
or decrease in the levels of any of the listed types of white blood cells.

These tests can include a bone marrow biopsy to determine the

underlying cause.

Your doctor will discuss management options with you after identifying
the cause of your abnormal results.

They may also order one or more of the following tests to determine the
best options for your treatment and follow-up:

eosinophil count test 

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

flow cytometry, which can tell if a high white blood cell count is
caused by cancers of the blood
immunophenotyping, which can help find the best treatment for a
condition caused by abnormal blood cell counts
polymerase chain reaction (PCR) test, which measures biomarkers in
bone marrow or blood cells, especially blood cancer cells

Other tests might be necessary based on the results of the differential

test and follow-up tests.

Your doctor has many ways of determining and treating causes of

abnormal blood cell counts, and your quality of life will likely remain the
same, if not improve, once you find the cause.

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Last medically reviewed on August 30, 2016

 16 sources

 v   FEEDBACK: 

Red Blood Cell (RBC) Count

Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP — Written by
Jacquelyn Cafasso — Updated on February 16, 2022

Symptoms of an abnormal count Purpose Procedure Preparation

Risks Normal count Low count High count Blood cancers
Next steps Lifestyle changes Takeaway

A red blood cell count is a blood test that your doctor uses to find out
how many red blood cells (RBCs) you have. It’s also known as an
erythrocyte count.

The test is important because RBCs contain hemoglobin, which carries

oxygen to your body’s tissues. The number of RBCs you have can affect
how much oxygen your tissues receive. Your tissues need oxygen to
function.
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Symptoms of an abnormal count

If your RBC count is too high or too low, you could experience symptoms
and complications.

If you have a low RBC count, symptoms could include:

fatigue
shortness of breath

dizziness, weakness, or lightheadedness, particularly when you

change positions quickly

increased heart rate

headaches

pale skin

If you have a high RBC count, you could experience symptoms such as:

fatigue
shortness of breath
joint pain

tenderness in your palms or soles of your feet

itching skin, particularly after a shower or bath

sleep disturbance

If you experience these symptoms your doctor can order an RBC count.

Why do I need an RBC count?

According to the Association for Clinical Biochemistry and Laboratory
Medicine, the test is almost always part of a complete blood count (CBC).
A CBC measures all components in the blood, including:

red blood cells

white blood cells

hemoglobin
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hematocrit

platelets Privacy - Terms

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Your hematocrit is the volume of red blood cells in your body. A

hematocrit test measures the ratio of RBCs in your blood.

Platelets are small cells that circulate in the blood and form blood clots
that allow wounds to heal and prevent excessive bleeding.

Your doctor may order the test if they suspect you have a condition that
affects your RBCs, or if you show symptoms of low blood oxygen. These
could include:

bluish discoloration of the skin

confusion

irritability and restlessness

irregular breathing

A CBC will often be part of a routine physical exam. It can be an indicator

of your overall health. It may also be performed before a surgery.

If you have a diagnosed blood condition that may affect RBC count, or
you’re taking any medications that affect your RBCs, your doctor may
order the test to monitor your condition or treatment. Doctors can use
CBCs to monitor conditions like leukemia and infections of the blood.
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How is the RBC count performed?

An RBC count is a simple blood test performed at your doctor’s office. A
healthcare professional will draw blood from your vein, usually on the
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inside of your elbow. They will then:
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1. clean the puncture site with an antiseptic

2. wrap an elastic band around your upper arm to make your vein swell
with blood
3. gently insert a needle into your vein and collect the blood in an
attached vial or tube
4. remove the needle and elastic band from your arm

After collecting your blood sample, your doctor’s office will send it to a
laboratory for analysis.

How should I prepare for an RBC count?

There’s typically no special preparation needed for this test. But you
should tell your doctor if you’re taking medications. These include any
over-the-counter (OTC) drugs or supplements.

Your doctor will be able to tell you about any other necessary
precautions.

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What are the risks of getting an RBC count?

As with any blood test, there’s a risk of bleeding, bruising, or infection at
the puncture site. You may feel moderate pain or a sharp pricking
sensation when the needle enters your arm.

What is the normal range for an RBC count?

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RBC ranges are measured in terms of cells per microliter (µL). Normal
ranges for RBC differ based on age and sex assigned at birth.

Normal RBC range (million cells/µL)

Adult, assigned female at birth 4.2 – 5.4

Adult, assigned male at birth 4.7 – 6.1

Child, 1 – 18 years 4.0 – 5.5

Infant, 6 – 12 months 3.5 – 5.2

Infant, 2 – 6 months 3.5 – 5.5

Infant, 2 – 8 weeks 4.0 – 6.0

Newborn 4.8 – 7.1

These ranges may vary depending on the laboratory or doctor. Ranges

may also differ for those who are pregnant.

What does a lower than normal RBC count mean?

If your number of RBCs is lower than normal, you have anemia. This can
be caused by a decrease in RBC production or by the destruction or loss
of RBCs. There are many possible causes for anemia.

Nutritional Deficiency

Iron-deficiency anemia is the most common type of anemia, but lack of

other nutrients can also cause your RBC count to decrease. These
include:

copper
folate (vitamin B9)

vitamin B6
vitamin B12

Bone marrow failure

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In rare cases, your bone marrow might stop making new blood cells. This
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Aplastic anemia might be an autoimmune disorder. Certain drugs, viruses,

toxins, or radiation may also cause aplastic anemia.

Hemolysis

Hemolysis is the destruction of red blood cells. Common causes of

hemolysis include:

autoimmune reaction to blood transfusion

infection
inherited conditions, like sickle cell anemia

Chronic conditions

Underlying health conditions that cause inflammation may affect the way
your body processes erythropoietin (EPO). EPO is a hormone that causes
bone marrow to produce RBCs.

EPO is produced in the kidneys. If you have chronic kidney disease, you
might produce less EPO than normal.

Other chronic conditions that may cause a low RBC count include, but are
not limited to:

autoimmune diseases, like rheumatoid arthritis or lupus

infections, like HIV or tuberculosis

cancers, like leukemia or multiple myeloma

IBD, including Crohn’s disease and ulcerative colitis

Other conditions

Other possible reasons for a lower than normal RBC count include:

internal or external bleeding

pregnancy
thyroid disorders
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Medications
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Certain drugs can also lower your RBC count, especially:

chemotherapy drugs
chloramphenicol, which treat bacterial infections

quinidine, which can treat irregular heartbeats

hydantoins, traditionally used to treat epilepsy and muscle spasms

What does a higher than normal RBC count mean?

If your RBC count is higher than normal, you have erythrocytosis. This
causes your blood to be thicker than normal and can increase your risk of
blood clots.

Primary erythrocytosis

Primary erythrocytosis is when your own body causes you to produce

more RBCs. This is usually due to a problem with cells in your bone
marrow. The condition is often inherited.

One such condition is polycythemia vera, a bone marrow disease that

causes overproduction of RBCs and is associated with a genetic mutation.

Secondary erythrocytosis

Secondary erythrocytosis is when an external factor increases your RBC

count. This could be due to a disease, drug, or another cause.

Some medical conditions that can cause a high red blood cell count
include:

congenital heart disease

respiratory disorders, like COPD, pulmonary fibrosis, or sleep apnea

renal disorders, such as cysts or kidney disease
certain tumors, like renal cell carcinoma or hepatocellular carcinoma

Certain drugs can increase your RBC count, including:


gentamicin,A Dan
V E Rantibiotic
TISEMENT used to treat bacterial infections in the
blood
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methyldopa, often used to treat high blood pressure

performance-enhancing drugs, like anabolic steroids or protein
injections
diuretics

Tell your doctor about any medications you take.

Other potential reasons for an elevated RBC count include:

cigarette smoking

living at a higher altitude

dehydration

blood doping
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Red blood cells and blood cancers

Blood cancers can affect the production and function of red blood cells.
They can also result in unusual RBC levels.

Each type of blood cancer has a unique impact on RBC count. The three
main types of blood cancer are:

leukemia, which impairs the bone marrow’s ability to produce

platelets and red blood cells
lymphoma, which affects the white cells of the immune system

myeloma, which prevents normal production of antibodies 

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Your doctor will discuss any abnormal results with you. Depending on the
results, they may need to order additional tests.

These can include blood smears, where a film of your blood is examined
under a microscope. Blood smears can help detect abnormalities in the
blood cells (such as sickle cell anemia), white blood cell disorders such as
leukemia, and bloodborne parasites like malaria.

A bone marrow biopsy can show how the different cells of your blood are
made within your bone marrow. Diagnostic tests, such as ultrasounds or
electrocardiograms, can look for conditions affecting the kidneys or heart.

Treatment for a low RBC count

All types of anemia require treatment. Your treatment will depend on

what’s causing your anemia.

Iron deficiency. You can take iron supplements or receive iron

infusions through your veins.

Vitamin deficiency. You can take vitamin supplements.

Bone marrow failure. Your doctor may prescribe certain

medications. If medications don’t help, you may need a bone
marrow transplant.

Chronic conditions. Your doctor will usually focus on treating the

underlying condition. Sometimes, they may prescribe an EPO-
stimulating agent.

Blood loss. A blood transfusion can bring in more RBCs to your

body.

Treatment for a high RBC count

If you have erythrocytosis, you may need a regular phlebotomy. This

removes a small amount of blood from your body in order to lower your
RBC count.

If phlebotomies don’t work, your doctor may prescribe hydroxyurea

(Hydrea or Droxia) to reduce your RBC count.
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Lifestyle changes
Lifestyle changes can affect your RBC count. Some changes that can help
increase your RBC count include:

maintaining a healthy diet and avoiding vitamin deficiencies

exercising regularly, which requires the body to use up more oxygen

avoiding aspirin

reducing alcohol consumption

If you need to decrease your RBC count, the following lifestyle changes
may help:

reducing the amount of iron and red meat that you consume
drinking more water

avoiding diuretics, such as drinks containing caffeine or alcohol

quitting smoking

Dietary changes

Dietary changes can play a major part in home treatment by managing

your RBC count.

You may be able to increase your RBC with the following dietary changes:

adding iron-rich foods (such as meat, fish, poultry, tofu), as well as

dried beans, peas, and leafy green vegetables (such as spinach) to
your diet
increasing copper in your diet with foods like shellfish, poultry, and
nuts
getting more vitamin B12 with foods like eggs, meats, and fortified
cereals

Takeaway
An RBC count that is either too high or too low can have serious health
complications. 
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There is much you can do on your own to manage your RBC count,
staring with a balanced diet and regular exercise. If you have blood
cancers or chronic conditions that can affect RBC count, these lifestyle
and dietary habits may be especially important.

Consult a doctor if you experience fatigue or shortness of breath. These

are often symptoms of an abnormal RBC count.

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Last medically reviewed on February 16, 2022

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Hematocrit Test
Medically reviewed by Carissa Stephens, R.N., CCRN, CPN

A hematocrit test is a measurement of the red blood cells in your blood.

Learn how it's done and what the results can mean.

READ MORE

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

Blood Smear
Medically reviewed by Stacy Sampson, D.O.

Learn about a blood smear, including why it's done, what to expect during
it, and how to interpret its results.

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8/8/22, 2:00 PM Complete Blood Count (CBC): Types, Preparation & Procedure

Coagulation Tests
Medically reviewed by University of Illinois

Coagulation tests measure your blood’s ability to clot and how long it
takes. Testing can help assess your risk of excessive bleeding or…

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