From the Guidelines
Eating disorders can indeed contribute to low White Blood Cell (WBC) and neutrophil counts, primarily due to malnutrition and its effects on the body's ability to produce healthy blood cells. This condition, known as leukopenia and neutropenia, respectively, can occur in individuals with anorexia nervosa, bulimia, and other restrictive eating disorders, as the bone marrow's ability to generate new blood cells becomes compromised due to insufficient nutritional building blocks 1.
The American Psychiatric Association recommends that patients with eating disorders undergo laboratory assessments, including a complete blood count, to monitor for signs of malnutrition or purging behaviors 1. Malnutrition can lead to specific nutritional deficiencies, such as protein malnutrition, vitamin B12, folate, copper, and zinc deficiencies, which can contribute to low WBC counts.
Key factors contributing to low WBC and neutrophil counts in eating disorders include:
- Malnutrition and its impact on bone marrow function
- Specific nutritional deficiencies, such as protein, vitamin B12, folate, copper, and zinc
- Increased cortisol levels due to the stress response triggered by severe malnutrition, which can suppress immune function and white blood cell production
- The body's prioritization of essential functions during starvation, potentially reducing immune cell production to conserve energy
Treatment for low WBC and neutrophil counts in individuals with eating disorders typically involves medical nutrition therapy with gradual refeeding, monitoring for refeeding syndrome, and addressing specific nutrient deficiencies, as recommended by the American Psychiatric Association 1. In most cases, WBC and neutrophil counts will normalize with proper nutritional rehabilitation, though recovery may take weeks to months depending on the severity and duration of the eating disorder.
From the Research
Eating Disorders and Immune System
- Eating disorders, such as anorexia nervosa and bulimia nervosa, can lead to malnutrition, which impairs the immune system 2, 3.
- Malnutrition can suppress immune functions, including cell-mediated immunity, complement system, phagocyte function, cytokine production, and antibody response 4.
- Studies have shown that malnourished individuals, including those with eating disorders, may have altered immune parameters, such as changes in lymphocyte subset counts and response to delayed hypersensitivity tests 5.
White Blood Cell (WBC) and Neutrophil Counts
- Malnutrition can lead to changes in WBC and neutrophil counts, although the exact mechanisms are not fully understood 6.
- One study found that severely malnourished individuals had similar WBC counts to those with normal BMI, but had impaired neutrophil function and increased levels of certain cytokines 6.
- Another study suggested that anorexic patients may have altered immune responses, including changes in lymphocyte subset counts, but may not necessarily have low WBC or neutrophil counts until the most advanced stages of debilitation 5.
Relationship between Eating Disorders and Low WBC and Neutrophil Counts
- While there is evidence that eating disorders can lead to malnutrition and impaired immune function, the direct relationship between eating disorders and low WBC and neutrophil counts is not fully established 2, 3, 4, 6, 5.
- More research is needed to understand the specific effects of eating disorders on WBC and neutrophil counts, and to determine the underlying mechanisms involved.