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Functional Medicine

Editorial Board
There are many ways to use blood chemistry analysis to screen for and track infection processes in the body. I use blood testing for everything from investigating the presence of a viral infection to finding out how the body is responding to a chronic infection.

As those of you familiar with my work know, I use tighter ranges than the conventional lab ranges you see on a routine blood test result. For me, using optimal ranges rather than the standard reference ranges is a great tool in cutting edge functional assessment and preventative-oriented medicine.
In this article, I’ll focus on some of what to look for in the white blood cell count and related readings. In my book, Blood Chemistry and CBC Analysis: Clinical Laboratory Testing from a Functional Perspective, I cover these tests and the patterns that can guide us in diagnosis and treatment in depth, but for this article, I’ll provide a more basic overview.

White Blood Cell Count

Getting a white blood cell count on a patient is one of the best tools in accessing the presence and type of infection. It can also tell us a lot about the body’s ability to respond to infection and inflammation.

Background

White blood cells (WBCs), which are leukocytes of the peripheral blood, fight infection, defend the body via phagocytosis, and produce, transport, and distribute antibodies as part of the immune process. The body produces about 100 billion WBCs each day. WBCs are produced by the bone marrow and lymphoid tissue and travel in the blood to areas of the body where they are needed. They can be divided into two groups:

1. Granulocytes: This group is made up of neutrophils, basophils, and eosinophils, which are formed in the blood marrow and get their name from the granules present in the cytoplasm. They also contain a multi-lobed nucleus and are often referred to as “polys” or polymorphonuclear leukocytes (PMN’s).

2. Agranulocytes: This group consists of monocytes and lymphocytes. They have no granules in their cytoplasm and non-lobed nuclei. Monocytes originate in the bone marrow, and lymphocytes are formed from the lymphoblasts in the reticuloendothelial tissues of the spleen, lymph glands, tonsils, thymus and appendix.

Ranges

The conventional lab range for white blood cell count (in standard US units) is 3.7-11.0 X 103 /mm3, which I find a bit too broad. I consider 5.0-7.5 to be optimal, with anything below 3 or above 13 alarming.

High White Blood Cell Count Results

In the case of a high white blood cell count, so any reading above 7.5, I would consider the following possibilities:

  • Childhood diseases such as chicken pox, measles, mumps, rubella
  • Acute viral infection
  • Acute bacterial infection
  • Stressful situations
  • Diet and lifestyle influences: obesity, smoking, poor nutrition, highly refined diet

If none of the above fit, I would further consider: intestinal parasites, free radical pathology, adrenal exhaustion, asthma, emphysema, or influenza with secondary bacterial infection. Also be aware that late pregnancy can cause an increase in WBC count.

Low White Blood Cell Count Results

  • Anything below 5.5 can mean the body is using up its white blood cells faster than it can replace them. A common cause of this would be a chronic viral infection. Look for a pattern of low WBC with an increased lymphocyte count (above 44) and decreased neutrophils (less than 40).
  • A chronic bacterial infection could also result in a low white blood cell count, but with a different pattern: increased neutrophils (greater than 60) and decreased lymphocytes (less than 24).
  • Other things I consider investigating when I see a low WBC count are:
  • Pancreatic insufficiency, Systemic Lupus Erythematosis, hepatitis, adrenal dysfunction, parathyroid dysfunction, intestinal parasites, and rheumatoid arthritis, among others.
  • You also might investigate for influencing lifestyle and nutritional factors such as a raw food diet, food allergies, and vitamin B-12, B-6 or folic acid anemia.

Specific readings of Neutrophils, Bands, Lymphocytes, and Monocytes

These can be used to look more specifically at the white blood cell activity.

Neutrophils

Neutrophils are the white blood cells used to combat bacterial or pyrogenic infections. I like to see ranges between 40-60 %. When I see readings above 60%, I look for childhood diseases such as chicken pox, mumps, rubella, etc., as well as acute, localized and general bacterial infections. In a chronic viral infection, a frequent pattern is increased neutrophil count along with decreased total white blood cell count. Occasionally you may see multi-segmented neutrophils on a CBC report. Suspect B12 and/or folate deficiency if you see this.

Bands

Bands are non-segmented neutrophils or metamylocytes. They are immature neutrophils pushed out into general circulation and tend to be increased in acute infections even if there is no increase in the total WBC count. If you see an increase in bands suspect early acute infection. I consider the optimal range to be <5%.

Lymphocytes

Lymphocytes are the source of serum immunoglobulins. They play a very important role in cellular immune response, immunological reactions, and also migrate to areas of inflammation in the body. My optimal range for lymphocytes is 24-44%. If I see increased lymphocytes, I investigate for childhood diseases, acute viral or bacterial infection, and other causes of inflammation. Toxicity can cause high readings. When lymphocytes are decreased, I consider the possibility of a chronic infection. Occasionally you may see abnormal or atypical lymphocytes on a CBC report. Suspect infectious mononucleosis, viral hepatitis, or other viral infections if you see this.

Monocytes

Monocytes are the body’s second line of defense, active in removing the residues of viral, bacterial, and cellular infections. They tend to be increased after the first 3 days of an acute infection. In the absence of infection, the level of monocytes usually stays below 7%. Anything above that would indicate some sort of infection, though it can also be elevated in liver dysfunction and in the case of intestinal parasites. You can use the monocyte reading to track the course of an infection, expecting to see elevated levels in the recovery phase of an infection.

Taking it Further

There are other tests to consider based on the WBC count results, tests like C-Reactive protein, immunoglobulins, and more. WBC count is just a first step, and a very good one, but there are always more layers and patterns to look for in blood chemistry analysis. That’s what I love about blood work, so consider it as part of your diagnostic protocol, along with other important tools such as a physical exam and a good medical history.

Functional Diagnostic Medicine is a growing field of modern medicine. It offers a giant step forward in the diagnosis, treatment and prevention of many of societys chronic diseases.

Doctors practicing functional diagnostic medicine are able to identify the real causes of many health conditions by combining the results of scientifically documented tests.

These are not your standard medical tests but go the next level investigating the biochemical and metabolic glitches likely to cause a specific disease process.

Based on the results of these tests, physicians are then able to develop personalized patient specific treatment protocols designed to reverse, stop or prevent the disease and its related symptoms.

Unlike the disease specific approach which is geared to suppress the expression of symptoms, physicians practicing functional diagnostic medicine are delighted to discover that many diseases have a real underlying cause which when found and corrected, can have a dramatic impact on the health of their patients.

When was the last time you really felt healthy?

The reason you may not feel your best is because youve developed an unhealthy lifestyle. As we get older we tend to develop bad habits and take our health for granted.

Poor eating, stress, environmental and chemical toxins, lack of exercise, all take a toll on your natural defenses. For a while your body was able to cope.

But now, you may have noticed some changes: You probably dont get enough sleep and when you do sleep you may catch yourself having to get up two, three or more times during the night. The food you eat simply does not satisfy you. Losing weight has never been more difficult.

You may exercise, but something still does not feel right inside. You cant seem to put your finger on it. You simply dont feel well, but you dont have any obvious symptoms that would make you want to see your doctor. On the bad side, these puzzling non-specific symptoms may be an early warning that one or more of your bodys systems are malfunctioning.

Symptoms are Signals

Just like the red warning light in your car that flashes when there is a problem with your engine, a physical symptom is a signal telling you that an underlying health problem needs to be corrected.

Treating a symptom without uncovering the real cause is like placing a piece of black tape over the blinking red warning light. The consequences of this action are obviousan expensive engine overhaul.

Unfortunately our bodies cant be overhauled and ignoring these chronic symptoms could eventually lead to a serious illness.

Through functional diagnostic medicine, physicians are able to help their patients restore normal body function, thereby relieving symptoms that may result in life-threatening diseases (such as arthritis, fibromyalgia, diabetes, auto-immune diseases, heart diseases, osteoporosis and many other chronic degenerative illnesses.

Unlike most well meaning physicians that tend to focus on what drug to use to treat a symptom, doctors who practice functional diagnostic medicine give serious thought to what is causing the symptom in the first place.