What Customers are Asking

Answer Provided by:

Internal Medicine
Experience : 7 Years
United States

Question:

I had my prostate examined today and the Urologist feels no prostatitis. My urine is clean, but they did send it out for a culture. I have been having chills without fever for weeks and some tingling in my feet. I had a comprehensive blood exam and the only test that was a little low was the lymphocytes at 800. It seems I could have an infection somewhere, or the medications I have taken in the last 4 weeks, off and on, Bactrim, Dexilant, Antivan, Advil, Tylenol, a muscle relaxer, and a lot of supplements. My lymphocytes have always been on the low end, but never below the normal. How does anxiety play a part in all this?

Answer:

First off, I apologize for the delay. This system was down today, and I could not respond to my questions.

Chills can be caused by a variety of things, mainly viral illnesses. Influenza, varicella (chickenpox), Rubella, viral gastroenteritis, Coxsackie virus, and Parvovirus B19, are all known causes. If you had one of these illnesses, we would expect other symptoms consistent with the virus involved. Autoimmune diseases, such as lupus and rheumatoid arthritis are potential causes also. Cancer, including blood related cancers (lymphoma, leukemia) are potential causes too. Anxiety should not make a white blood cell count be low, though it may exacerbate the symptoms of the chills if you are very worried about it.

It would be reasonable in this situation to ask for a peripheral smear (where the lymphocytes, red blood cells, and platelets would be looked at under a microscope and not just counted by a machine), as well as an ANA antibody that is a good screening test for autoimmune disease. A sed rate (ESR) would be helpful also. This is a marker of inflammation which, if elevated, could indicate the presence of one of the autoimmune diseases or cancer indirectly.

I hope this was helpful to you. Let me know if you have any further questions.