What Are Low Blood Counts?

A low blood count occurs when one or more types of blood constituents —red cells, white cells, or platelets—are below normal levels. This can cause symptoms such as fatigue, infections, or excessive bruising and bleeding.

Types of Low Blood Counts:

  • Anaemia (Low Red Blood Cells or Haemoglobin)

    • Symptoms include: fatigue, dizziness, breathlessness, chest pain, tinnitus and pale skin.

    • Common causes include iron deficiency, vitamin B12 or folate deficiency, chronic diseases, or bone marrow disorders.

  • Leukopenia / neutropenia (Low White Blood Cells, Especially Neutrophils)

    • Can increase the risk of infections, sometimes leading to fever.

    • Can be due to infections, medication effects, autoimmune conditions, or bone marrow failure, amongst other causes.

  • Thrombocytopenia (Low Platelets)

    • May cause easy bruising, prolonged bleeding, or spontaneous bleeding (e.g., nosebleeds or gum bleeding).

    • Can result from immune conditions (particularly ITP), infections, bone marrow disorders, or medication side effects.

Investigations for Low Blood Counts:

As a haematologist, I conduct a thorough evaluation to determine the cause of low blood counts. As well as taking a targeted history and performing a clinical examination this may include:

1. Blood Tests

  • Full Blood Count (FBC): Measures levels of red cells, white cells, and platelets.

  • Blood Film Examination: A microscopic review of blood cells for abnormal shapes or immature cells.

  • Iron Studies, Vitamin B12 & Folate: To check for nutritional deficiencies.

  • Kidney & Liver Function Tests: To assess organ-related causes of low blood counts.

  • Autoimmune Screening: To detect immune conditions affecting blood cells.

  • Viral & Infection Screening: To check for infections like HIV, hepatitis, or Epstein-Barr virus.

2. Bone Marrow Investigation (if needed). If the clinical picture and blood tests indicate a possible problem with the bone marrow, the body’s factory of blood cells, then a bone marrow test may be needed.

  • Bone Marrow Aspiration & Biopsy: I perform bone marrow examinations at Frimley Park Hospital Parkside suite with the assistance of nursing staff. A sample from the bone marrow (taken from the back of the hip/pelvis) is taken to assess blood cell production. The procedure is done using local anaesthetic and typically takes approximately 20 minutes to perform. I would discuss the indication for this and the procedure in more detail in a clinic consultation, where relevant.

3. Imaging such as x-rays and CT/PET-CT scans where indicated.