Lymphopenia Likely a Marker of Increased Mortality

While it’s not pleasant to talk about the possibility of death, it is helpful to know about factors that might work in your favor as well as those to watch out for. Researchers from the University of Copenhagen might have hit on something of importance related to early warnings: the possibility that lymphopenia signals a higher risk of sudden death.

Lymphopenia is the condition of having a low number of lymphocytes, a type of white blood cell. Some people refer to it as lymphocytopenia or lymphocytic leukopenia.¹

The Danish study team found that people with lymphopenia are 1.6 times more likely to die from any condition, regardless of age or gender.² Stated another way, having lymphopenia means having a 60% higher rate of passing from any condition, according to the results from the study.³

As noted in the article, published in the Canadian Medical Association Journal, “We found that lymphopenia was associated with an increased risk of all-cause and cause-specific mortality.”⁴ The scientists followed 108,135 people for about 11.5 years, from November 2003 to April 2015. Participants were part of the Copenhagen General Population Study; their average age was 68.

By the end of the study, the team found that people with hematologic cancers or cardiovascular diseases and lymphopenia had a mortality risk that was 1.88 times greater than that of individuals with normal white blood cell counts.

Lymphopenia Linked to Increased Risk of Death

The implications of these findings are significant, as lymphocyte counts are typically collected in routine blood tests, but it’s not really known whether this number held any special significance in understanding a patient’s overall health.⁵

Since white blood cells fight infection, a low count could mean that a person is more susceptible to infections and certain diseases than those who have normal levels of lymphocytes. It’s also more difficult for a person with lymphopenia to put up a good defense against these types of threats.⁶ As described by International Business Times:⁷

“Low lymphocyte count (lymphopenia) can be attributed to several reasons including risks of cancer, respiratory diseases, infections, heart diseases, and other causes. Since chronic diseases are quite common among older individuals, their low lymphocyte count can indicate an early demise.”

Indeed, the condition has been associated with mortality related to a number of health issues, including heart disease, cancer, alcoholic liver disease and various infections.^8,9,10,11 The researchers were careful to note, however, that their results do not indicate causality, meaning that having lymphopenia was not necessarily the reason why some study participants died:¹²

“Our study showed that participants with lymphopenia were at high risk of dying from any cause, regardless of any other risk factor for all-cause mortality including age. This might be due to a reduced immune surveillance, which makes these patients less able to survive potentially deadly diseases.

Lymphopenia could also be a more passive marker of general frailty that confers high risk of death from any cause …

The higher mortality risk shown among those with lymphopenia who were younger than 70 years of age compared with those aged 70 years or older suggests that factors other than age might contribute to the high mortality risk, such as poor immune surveillance, iatrogenic causes (i.e., medications) and blood donations or transfusions.”

Causes of Lymphopenia and Treatment Options

As you get older, your lymphocyte count naturally goes down. This doesn’t automatically equate to lymphopenia, though; a blood test is needed to make that determination. The condition can be caused by lymphocytes being destroyed or by getting stuck in the lymph nodes or spleen.

Individuals who are immune-compromised, such as those with HIV/AIDS, may have lymphopenia. Cancer and treatments for cancer can also destroy your lymphocytes.¹³ Treatments will vary depending on the cause; research is being conducted on stem cell transplants as well as pharmaceutical options.

Lymphopenia + Neutropenia = Protenuria in Some Cases

Lymphopenia is not the only type of low white blood cell condition; neutropenia is a condition in which someone’s neutrophils are low. The neutrophils in your blood are the most common type and they are the ones that fight fungi and bacteria. Together with lymphocytes and three other types of white blood cells, your body’s defense system works to protect you against all types of invaders.¹⁴

In 2019, another group of researchers — from the same academic medical center in Denmark — published results from a similar study.¹⁵ They wanted to know if lymphopenia and neutropenia signaled the likely development of proteinuria, or high levels of protein in the urine, in patients with systemic lupus erythematosus (SLE).

They studied 260 patients with SLE and found that lymphocyte and neutrophil counts, but not the ratio of the two, did in fact predict the development of proteinuria, regardless of immunosuppressants.

Proteinuria is of concern because it typically points to kidney problems, congestive heart failure or immune disorders; symptoms include sleepiness and fatigue; muscle cramping; frequent urination; swelling and puffiness as well as nausea.¹⁶

Interestingly, lymphopenia was one of the “independent risk factors for the development of severe infections in SLE patients” noted by scientists from Mexico City. In 2013, their article, “Lymphopenia as Risk Factor for Development of Severe Infections in Patients With Systemic Lupus Erythematosus: a Case-Control Study,” was published in QJM: An International Journal of Medicine.¹⁷

They looked back through five years of medical records of 167 people with SLE and compared lymphocyte levels of those with infection to those without:¹⁸

“Our results are in agreement with previous reports that have shown that lower counts of lymphocytes at SLE diagnosis or along different time points confer increased risk of infections. However, these reports are more related to opportunistic infections as the outcome.

We found that almost half of our patients (49.4%) with severe infections had genitourinary or skin/soft tissue involvement.

Interestingly, a high percentage of patients (23%) developed infections related to high mortality (almost 20%) (bacteremia, central nervous system and disseminated infections), suggesting that these patients may be the target of lethal infections.”

What Blood Tests Reveal About Your Overall Health

Getting a complete blood count (CBC) may be an important step in determining your overall health status. Doctors frequently order this test to augment routine physicals as well as investigations into the nature of troubling health problems.

In addition to providing lymphocyte and neutrophil counts, the results from blood work can reveal your blood sugar level, cholesterol level, iron level and blood viscosity.

The Intermountain Health Risk Score may be the most telling, however, as it was created based on the basic blood chemistry markers of tens of thousands of patients in a hospital setting, including CBC, sodium, potassium bicarbonate, mean platelet volume and other basics.

Based on these markers, you end up with a 30-day, one-year and five-year mortality risk. Naturopath Dr. Bryan Walsh said in our 2019 interview:

"That five-year mortality risk score is so valuable. You might have somebody who's relatively healthy, self-prescribing a bunch of supplements, maybe exercising a little bit, trying to eat as healthy as they can. But physiologically, something's abnormal.

They go to their doctor and everything looks pretty good. Let's say their glucose is good. If they were to enter in all these markers and it came out with a slightly high score, that's an indication that not everything is going well …

Again, if the antithesis of optimal health is death, you can see where you are on this score. If your score doesn't come up great, you can take it to someone who will actually take a look at what you're doing and make some recommendations to try and improve some of these things.

That's just another example of there's more data inside of a blood chemistry test than the blood chemistry test is actually even reporting on. Things like osmolality. Things like viscosity. Things like the fatty liver index. Things like the Intermountain risk score."

Boost Your Immune System, Naturally

I've often stressed that boosting your immune system is a key component of health and disease prevention, and this is true year-round. The good news is, there are a number of things you can do on your own to protect your health and that of your family:

Get regular exercise	Breastfeed your baby
Quit smoking	Eat shiitake, maitake and oyster mushrooms
Consume cardamom	Get plenty of probiotics
Add black pepper and turmeric to your diet	Spend adequate time in the sun to boost vitamin D production

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