Neutrophils · low result
Low neutrophils (neutropenia): what it means, causes and when it matters
Short answer
A low neutrophil count (neutropenia) is an absolute count below about 1.5 × 10³/µL (1,500 per microliter). It is often benign: a temporary dip after a viral infection, or a lifelong lower baseline — benign ethnic neutropenia — that is normal in many people of African, Middle Eastern and West Indian ancestry and carries no infection risk. Medications are the next most common cause, then vitamin B12 or folate deficiency, autoimmune disease, HIV, an enlarged spleen and alcohol; bone-marrow disorders are uncommon and usually affect other counts too. Risk tracks the number and the trend: mild (1.0–1.5) and stable is watched; below 0.5, falling, or paired with fever is treated as urgent.
Medically reviewed by Youmna DiStefano, MD · Last reviewed November 2026
When does this result need same-day care?
- Fever of 100.4 °F (38 °C) or higher with neutrophils below 1.0 × 10³/µL — emergency care the same day (febrile neutropenia)
- Neutrophils below 0.5 × 10³/µL on any result — same-day contact with a clinician, even without symptoms
- A falling count alongside new bruising, bleeding, severe fatigue or pallor
What is the normal range for Neutrophils?
- age 18+: 40.0 – 70.0 %
Can reflect viral infection, certain medications (especially chemotherapy), or autoimmune conditions.
Full reference table, citations and testing options: Neutrophils biomarker page.
What are the common causes of low Neutrophils?
- Recent viral infection — influenza, COVID-19, mononucleosis, hepatitis, HIV seroconversion; the count recovers over two to four weeks
- Benign ethnic (constitutional) neutropenia — a lifelong baseline of about 1.0–1.5 × 10³/µL in people of African, Middle Eastern and West Indian ancestry, with normal infection resistance
- Medications — chemotherapy, methimazole and propylthiouracil, clozapine, sulfa drugs, carbamazepine and valproate, rituximab and other immunosuppressants, interferon, some antibiotics with prolonged use
- Vitamin B12, folate or copper deficiency; alcohol use disorder and malnutrition
- Autoimmune neutropenia — on its own or with lupus, rheumatoid arthritis (Felty syndrome) or Sjögren's
- Chronic infections — HIV, hepatitis B and C, tuberculosis; and sepsis, where demand outstrips production
- An enlarged spleen (liver disease, portal hypertension, blood disorders) sequestering cells
- Bone-marrow disorders — myelodysplasia, aplastic anemia, leukemia, large granular lymphocyte leukemia; usually with low hemoglobin or platelets as well
- Rare inherited forms (cyclic neutropenia, with counts that swing every three weeks)
What symptoms go with low Neutrophils?
- Usually none when mild — most are found on routine blood work
- Recurrent or unusually severe infections: mouth ulcers, gum infections, sore throat, skin abscesses, sinus and ear infections
- Fever with a very low count is an emergency even when you feel reasonably well
What do clinicians usually check next?
- Confirm the absolute neutrophil count and compare with earlier results — a lifelong mild low is a different situation from a new one
- Repeat the CBC with differential in 2–4 weeks when well; a post-viral dip will have recovered
- Medication review, including anything started in the last few months
- Vitamin B12, folate, HIV test, hepatitis B and C screening, liver and kidney panel
- ANA and rheumatoid factor when there are joint, skin or dry-eye symptoms; a peripheral smear if the lab flags abnormal cells
- Serial counts two or three times a week for six weeks when cyclic neutropenia is suspected (infections in a regular rhythm)
- Hematology referral — often with a marrow examination — when neutrophils are persistently below about 1.0 × 10³/µL, falling, or accompanied by anemia or low platelets
Follow-up tests available at TestWell: Vitamin B12 Test ($19.99), Autoimmune Antibody Screen (ANA) ($32.99), Rheumatoid Factor Test (RF) ($19.99), HIV 1/2 Antigen & Antibodies Test (4th Gen) ($38.99), Folate Test (Vitamin B9) ($21.99).
How do you recheck Neutrophils?
Prices are cash-pay; every order adds one $6 lab processing fee. Physician authorization is included; no insurance or referral needed.
| Test or panel | Type | Price | Fasting | Results |
|---|---|---|---|---|
| Biological Age Panel | Panel · 3 tests | $59.99 | Yes | 1–3 business days |
| General Wellness Panel | Panel · 4 tests | $49.99 | Yes | 1–3 business days |
| Blood Clotting Panel | Panel · 4 tests | $149.99 | No | 3–7 business days |
| CBC with Differential Test | Test · 14 biomarkers | $17.99 | No | 1–3 business days |
Common questions
What is a low neutrophil count?
An absolute neutrophil count below about 1.5 × 10³/µL (1,500 per microliter). Mild neutropenia is 1.0–1.5, moderate 0.5–1.0, severe below 0.5. The percentage alone can mislead — a low percentage with a normal total count is usually just high lymphocytes.
My neutrophils are 1.4 and I feel fine. Should I worry?
Mild neutropenia that is stable and symptom-free is usually benign, especially if it has always been that way. A repeat and a medication check are the usual steps.
What causes low neutrophils?
A recent viral infection and an inherited lower baseline are the most common; then medications, B12 or folate deficiency, autoimmune disease, HIV and an enlarged spleen. Marrow disorders are uncommon and rarely affect neutrophils alone.
Is benign ethnic neutropenia a problem?
No. About a quarter to a third of people of African ancestry, and many of Middle Eastern ancestry, have a lifelong neutrophil count in the 1.0–1.5 range with completely normal infection resistance. It needs no treatment — but it should be documented so it is not re-investigated every time.
Can a virus cause low neutrophils?
Yes — it is the single most common cause. Influenza, COVID-19, mononucleosis and many other viruses temporarily suppress the marrow or shift neutrophils into tissues, and the count recovers within two to four weeks.
How do you raise neutrophils?
Treat the cause: wait out a viral illness, replace B12 or folate, stop or switch the responsible medication, treat the autoimmune condition. No diet or supplement reliably raises neutrophils; G-CSF injections are used for chemotherapy-related and severe chronic neutropenia under a hematologist.
Educational content, not a diagnosis. Lab results are one input; a clinician interprets them with your history and exam.