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Zhang Jun Jun
Endocrinology
About me
Zhang Junjun, female, member of the Communist Party of China, master's degree student, chief physician, currently working at Hunan Provincial People's Hospital, member of the Chinese Women Doctors Association Youth Committee, director of the Hunan Health Services Association Metabolism and Endocrine Health Branch, engaged in endocrine work for 5 years, authored several papers and popular science articles on endocrine diseases.
Proficient in diseases
Have extensive experience in endocrine diseases such as diabetes, thyroid, adrenal gland, gonad, osteoporosis, etc.
Voices
Is leukopenia leukemia?
Leukopenia is not necessarily indicative of leukemia. There are many causes for a decrease in white blood cells, some of which can be due to medications. Currently, many drugs can cause a reduction in white blood cells, and in such cases, stopping the drug will typically allow the white blood cells to return to normal. A second scenario, especially in patients with an enlarged spleen or those suffering from cirrhosis, can also lead to a decrease in white blood cells. In these cases, it is mainly the abnormal function of the spleen that causes the reduction in white cells. Additionally, there are blood-related diseases, which might be leukemia or other types of blood disorders. In these situations, not only is there a reduction in white blood cells, but there is also a decrease in hemoglobin and platelets. Moreover, a significant increase in white blood cells is also a manifestation of leukemia, thus a decrease in white cells is not definitively indicative of leukemia.
What to check for the cause of leukopenia?
If there is a decrease in white blood cells, we mainly look at the total number of white blood cells and the absolute value of neutrophils in our routine blood test. The causes of leukopenia are inseparable from neutrophils, and can be mainly divided into three categories. The first category is a production defect of neutrophils, the second is excessive destruction and consumption of neutrophils, and the third is abnormal distribution of neutrophils. A major cause of decreased production of white cells and neutrophils is damage to hematopoietic stem cells by ionizing chemicals. Additionally, immune reactions and bone marrow diseases can also lead to decreased production. Another cause is a production defect due to maturation disorders in neutrophils within white blood cells, leading to reduced white blood cell production. Maturation disorders are mainly due to a lack of raw materials needed for white blood cell production. Excessive destruction and consumption of white blood cells are often due to immune factors. Immune factors are common in autoimmune diseases, thus such diseases can also lead to leukopenia. The last category, abnormal distribution, can be a severe infection that causes an abnormal distribution of white cells, retaining them alongside other substances, such as in patients with enlarged spleens, which can provoke leukopenia by causing granulocytes to be retained in circulation, especially in areas like the spleen.
How is thyroiditis treated?
Thyroiditis is primarily divided into acute, subacute, and chronic types, along with some painless and postpartum thyroiditis. If it is acute or subacute thyroiditis, it is a self-limiting disease caused by viral infections, and there is no need to use drugs that adjust thyroid function. Treatment mainly involves the use of non-steroidal or hormonal medications, as well as drugs that control heart rate. If it is autoimmune thyroiditis, commonly referred to as Hashimoto's thyroiditis, it often presents with positive thyroid antibodies. In the early stages, thyroid function may be normal, but typically progresses to reduced thyroid function over time. When thyroid function tests reveal reduced thyroid function, timely supplementation of thyroid hormone levels can control this type of autoimmune thyroiditis within a normal range. Additionally, for painless thyroiditis and postpartum thyroiditis, particularly the latter, which is often related to the mechanism of postpartum immune changes, it primarily depends on whether thyroid function has changed. If there is no change in thyroid function, treatment is temporarily unnecessary. (Medication should be administered under the guidance of a doctor.)
What to eat to quickly recover from leukopenia?
There are mainly three reasons for leukopenia: the first is the impaired production of white blood cells, the second is the excessive destruction of white blood cells, and the third is the redistribution of white blood cells. Therefore, for leukopenia, the main approach is etiological treatment. If leukopenia is suspected to be caused by certain drugs or other pathogenic factors, generally, stopping the use of these drugs and avoiding contact can lead to the recovery of white blood cells to normal levels. For this kind of secondary decrease of white blood cells, we usually treat the primary disease. Once the symptoms of the primary disease are alleviated and controlled, the white blood cell count can return to normal without the need for additional medication. Moreover, the greatest risk of leukopenia is the fear of infection, but mildly reduced patients generally do not require special treatment. However, as the severity of leukopenia increases, the risk of infection increases, and at this point, some preventative measures against infection can be taken. Particularly for patients with neutropenia who are highly susceptible to severe infections, sterile isolation may be employed, and the specific sites and types of infections identified. This allows for the use of sensitive antibiotics; for viral infections, antiviral drugs can be administered. Additionally, broad-spectrum antibiotics capable of covering both Gram-negative and Gram-positive bacteria can be used. Furthermore, while preventing infection, it is also important to promote the production of granulocytes. This typically requires ruling out serious hematologic diseases before using medications that promote white blood cell production, such as B vitamins and squalene. However, these treatments are only symptomatic. The primary focus should still be on correcting the underlying cause to maintain white blood cells within a normal range. (Please consult a doctor before using any medication and do not self-medicate.)
Symptoms of thyroiditis and hypothyroidism
Because the onset of hypothyroidism is gradual, its early symptoms are atypical. Specific symptoms only appear when there is a decrease in basal metabolic rate and a reduction in sympathetic nerve excitability. Generally, symptoms include cold intolerance, fatigue, swelling of hands and feet, drowsiness, memory decline, reduced sweating, joint pain, weight gain, constipation, and menstrual irregularities such as heavy or light periods, or infertility in women of childbearing age. Additionally, some common clinical signs include expressionless face, slow response, hoarse voice, hearing impairment, pale complexion, edema around the eyelids, face and lower limbs, thick tongue coating often with teeth marks. Moreover, there are also associated symptoms such as dry skin, flaky skin, low skin temperature, and the hands and feet turning a yellowish-orange color.
What does a decrease in white blood cells mean?
Leukopenia indicates a decrease in the body's resistance. The most common causes of leukopenia are: First, viral infections, which often coincide with an increase in lymphocytes and a decrease in neutrophils. The second cause is severe bacterial infections. During severe bacterial infections, there is a significant reduction in white blood cells, which may even lead to a decrease in platelets. The third cause is primarily diseases of the hematologic system, where leukopenia is often accompanied by a reduction in other red blood cells and platelets. Other possible causes include drug-induced leukopenia, as medications can also lead to a decrease in white blood cells. Therefore, the primary approach to leukopenia is to clearly identify the cause, and then determine the next steps for treatment based on that cause.
How to treat leukopenia?
The treatment plan for leukopenia primarily depends on the cause of the decreased white blood cells. If the cause is related to blood cancer, further examinations like bone marrow biopsy are needed, followed by treatment of the primary disease. The second most common scenario is liver cirrhosis, which can lead to a decrease in all three blood cell lines, causing reduction in white blood cells, platelets, and hemoglobin. In such cases, treatment options may include splenectomy or the use of oral medications that increase white blood cell count. However, these treatments only address the symptoms and not the root cause, which is liver cirrhosis, thus the primary disease still requires treatment. The third scenario involves severe bacterial and viral infections, where a decrease in white blood cells indicates a serious condition, necessitating further antiviral or anti-infection treatments. (Please follow the guidance of a professional physician for medication use, and do not self-medicate.)
Leukopenia and thrombocytopenia are what diseases
Diseases caused by decreased white blood cells and platelets are often related to our hematological system, since both white blood cells and platelets are produced by our hematopoietic factors. When there is a decrease in both white blood cells and platelets, we generally consider that there might be an issue with our hematopoietic system. The most common conditions could be diseases related to the hematological system, such as leukemia, or aplastic anemia. These conditions can cause a decrease in the mentioned indices. Another disease is cirrhosis, especially in patients in the compensatory stage, which can lead to hyperfunctioning of the spleen. The spleen is also an immune organ, as well as a part of our hematopoietic system, so when the spleen is hyperactive, it can also result in decreased white blood cells and platelets.