Neutrophils (Absolute)
The number of neutrophils in a microliter of blood. Neutrophils are your most common white blood cell and a first line of defense against germs.
AI-drafted. Awaiting verificationAlso called ANC, Neut#, NEUT#LOINC 751-8
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What it is
Neutrophils are white blood cells made in your bone marrow. They are usually the first cells to reach an infection or injury, especially a bacterial one. This test counts how many neutrophils are in a set amount of blood. It is often called the absolute neutrophil count, or ANC. Your lab gets it from the automated count on a CBC with differential, or by multiplying your total white blood cell count by the share that are neutrophils.
Why it matters
The ANC shows how many of these defenders you actually have. That makes it more useful than the neutrophil percent. A very low count makes bacterial and fungal infections more likely, so clinicians watch it closely during treatments that lower blood counts. A high count most often means your body is reacting to infection, stress, inflammation or a medicine. Many healthy people also have a count that sits a little below the usual range, and that can be normal for them.
If it’s low
A low neutrophil count (neutropenia) means fewer infection-fighting cells in your blood. Mild drops are common. They often follow a virus. For some people, including many of African or Middle Eastern ancestry, a lower count is simply their usual. The lower the count, the higher the chance of infection, especially below 0.5 ×10³/µL (500 cells/µL).
Common causes
- A recent viral infection (the count often recovers within about 2 weeks)
- A count that is naturally lower for you, including the Duffy-null variant, which is common in people of African, Middle Eastern or West Indian ancestry
- Medicines, including some antibiotics, antithyroid, anti-seizure and psychiatric medicines, and chemotherapy
- Low vitamin B12, folate or copper
- Autoimmune conditions
- An enlarged spleen
- Bone marrow conditions
What can help
- Ask your clinician to repeat the count and review your recent illnesses and medicines
- Ask whether Duffy status testing could help explain a mildly low count that has stayed steady over time
- Ask whether vitamin B12 and folate are worth checking if the count stays low
- Ask what fever and infection signs to watch for while your count is low
If it’s high
A high neutrophil count (neutrophilia) is most often a temporary reaction to something else, such as an infection, physical or emotional stress, inflammation or a medicine. Less often it comes from a bone marrow condition. One hematology textbook defines it as above 7.0 ×10³/µL in adults. Your lab's range may differ.
Common causes
- Bacterial infection, and some viral infections
- Physical or emotional stress, hard exercise, pain, injury or surgery
- Inflammation or autoimmune conditions
- Cigarette smoking
- Corticosteroid medicines, lithium or growth-factor injections (G-CSF)
- Pregnancy, especially around labor and delivery
- Less often, bone marrow conditions such as chronic leukemia or other myeloproliferative disorders
What can help
- If the test followed a hard workout, an illness or a stressful day, ask whether to repeat it when you are rested and well
- Ask your clinician whether a medicine you take could be raising it
- If you smoke, ask about support to quit, since smoking raises the count
- If it stays high with no clear reason, ask whether a repeat count or a blood smear review makes sense
Usual ranges
What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.
The usual range depends on age. Choose an age to see the one that applies.
- 13+1.4–7 ×10³/µL
Sources: Labcorp, Mayo Clinic Laboratories, ARUP Laboratories, Te Whatu Ora Health New Zealand, Waikato, Elsevier, American Society of Hematology, Blood Advances, JAMA
See Neutrophils (abs) by age and sex, with the U.S. survey numbers where they exist.
Neutropenia severity categories (MSD Manual; CMAJ 2022)
- Severe neutropenia range (below 0.5)below 0.5 ×10³/µL
- Moderate neutropenia range (0.5 to under 1.0)0.5 to under 1 ×10³/µL
- Mild neutropenia range (1.0 to under 1.5)1 to under 1.5 ×10³/µL
- Above the neutropenia cut-off (1.5 or higher)1.5 and above ×10³/µL
If this applies to you
Neutrophils (abs) means a little more for some people. Open the one that fits you.
Thyroid condition
Antithyroid medicine can rarely cause a sharp drop in neutrophils, the white cells that fight infection. NICE suggests a blood count before starting, but not routine counts after that. Guidelines suggest a white cell count if fever or a sore throat develops while taking it.
Taking methotrexate
Neutrophils are the white cells that respond first to bacteria. The BSR lists a low neutrophil count among the results that should prompt an urgent call to the rheumatology team.
How common is your level?
NHANES describes the US civilian, non-institutionalized population, not a 'healthy' reference group. People with disease, on medication, fasting or not (except fasting-subsample markers), smokers and so on are all included. A percentile says where a value sits among Americans of that sex and age, not whether it is normal.
Use the left and right arrow keys to read each age. Shift moves five years.
Reference data derived from CDC/NCHS National Health and Nutrition Examination Survey (NHANES), cycles 2015-2016, 2017-March 2020 (pre-pandemic), August 2021-August 2023. Analysis by bloodtesttracker.com; not endorsed by CDC, NCHS or HHS.
Explore Neutrophils (abs) by age and sex: every percentile as a table, with a download.
What can affect your result
- Ancestry: the Duffy-null variant, common in people of African and Middle Eastern descent, lowers neutrophil counts without raising infection risk
- Age: babies and young children have different usual ranges than adults
- Recent exercise, stress, pain or injury can raise the count for hours
- Infections: bacterial infections usually raise it, and some viral infections lower it for days to weeks
- Medicines: steroids, lithium and growth-factor shots raise it, and chemotherapy and several other drug classes lower it
- Pregnancy: counts rise, especially around labor and delivery
- Smoking raises the count
- Lab method: whether band (young) neutrophils are included varies by lab
- Hard exercise, acute stress, pain, injury or surgery can raise the count for hours, because stress hormones release neutrophils that were resting along blood vessel walls.
- Corticosteroid medicines, lithium, growth-factor injections (G-CSF) and cigarette smoking raise the count.
- Many medicines can lower the count, including some antibiotics, antithyroid, anti-seizure and psychiatric medicines, and chemotherapy.
- Whether young "band" neutrophils are included depends on the lab. Some labs print only mature (segmented) neutrophils on this line when bands are counted separately.
- A difficult draw, a clotted sample or a sample that is too old can throw off cell counts. The lab may then repeat the count or check a blood smear under the microscope.
Can change within hours to days. Neutrophil counts are less steady than most other blood counts.
When to talk to a clinician
If your count is below 0.5 ×10³/µL (500 cells/µL), contact the clinician who ordered the test today. A fever above 38.0°C (100.4°F) with a low neutrophil count needs urgent medical care, because it can be a sign of a serious infection. If you feel very unwell, call 911 or your local emergency number. Also talk with a clinician if your count stays below about 1.0 ×10³/µL for months, or if you have repeated or unusual infections.
Questions you could ask
- How does my result compare with my earlier counts?
- Is the range on my lab report the right one for me?
- Could a recent infection, stress, smoking or a medicine explain this result?
- Should we repeat the count when I am rested and well?
- Should we repeat this count, and when?
- Could any of my medicines or a recent illness be lowering it?
Questions people ask
Why does my report show both a neutrophil percent and an absolute neutrophil count?
The percent is the share of your white blood cells that are neutrophils. The absolute count is how many there are. The absolute count matters more for infection risk, because the percent can look fine, or even high, when your total white count is low.
Does a mildly low neutrophil count mean I am at risk of infection?
Not usually. One review notes that a count in the neutropenic range shows up in about 5–10% of healthy people, and a mildly low count (1.0 to 1.5 ×10³/µL) is not linked to a substantially higher infection risk. Risk rises as the count falls below 1.0, and more so below 0.5. Your clinician will look at your trend, recent illnesses and medicines.
What is the Duffy-null variant, and how does it relate to my neutrophils?
It is a common inherited trait in which red blood cells lack the Duffy protein. It is most common in people with African or Arabian Peninsula ancestry, but ancestry is not a reliable stand-in for the test. It is linked to a lower neutrophil count without extra infection risk. A simple blood test can show your Duffy status. You can ask your clinician whether it is worth checking if your count is mildly low and steady.
Why do labs print different normal ranges for neutrophils?
Each lab sets its range using its own equipment and reference group. Among the labs reviewed here, the lower limit for adults ranges from about 1.4 to 2.0 ×10³/µL. The range printed on your report is the one to use for your result.
How do I convert between ×10³/µL, ×10⁹/L and cells/µL?
×10³/µL, K/µL, thou/mm³ and ×10⁹/L are the same number, so 4.5 in one is 4.5 in the other. Cells/µL is 1,000 times larger, so 4,500 cells/µL equals 4.5 ×10³/µL.
Show the science and sources
Units
- 1 ×10³/µL = 1 ×10³/µL
- 1 ×10³/µL = 1 ×10⁹/L
- 1 ×10³/µL = 1000 cells/µL
Open the Neutrophils (abs) unit converter
Is a change real?
Neutrophils (abs) naturally varies about 13.61% from test to test in the same healthy person. Between two results from the same lab, a change of roughly 42% or more is unlikely to be day-to-day noise or lab variation (95% reference change value). Source: Systematic review and meta-analysis of within-subject and between-subject biological variation estimates of 20 haematological parameters (Coskun A et al., EFLM WG-BV).
For clinicians and researchers
ANC is the WBC multiplied by the fraction that are neutrophils, counting band (immature) forms as well as segmented forms. Automated 5-part analyzers report it directly. Labs doing a manual differential calculate it, and some clinicians also add metamyelocytes and myelocytes when there is a left shift. Neutropenia is graded by ANC as mild (1.0–1.5), moderate (0.5–1.0) and severe (<0.5 ×10⁹/L), with agranulocytosis below 0.1, and infection risk rises as the ANC falls below 1.0 (Rodak) and is proportional to severity, greatest below 0.5 (MSD). About 5–10% of healthy people have a count in the neutropenic range, and reference limits are population-specific. The MSD Manual gives a lower limit of about 1.5 in White patients and about 1.2 in Black patients. Much of the difference comes from the Duffy-null phenotype (no Duffy antigen, encoded by ACKR1, on red cells). Merz et al. (2023) proposed replacing the term benign ethnic neutropenia with Duffy-null associated neutrophil count. In 120 healthy self-identified Black adults at one primary care centre, 66.7% were Duffy-null, with a median ANC of 2,820 against 5,005 cells/µL in Duffy non-null adults, and 23.8% of Duffy-null adults were below 2,000 cells/µL. A single-centre Duffy-null interval of 1.21–5.39 ×10⁹/L was proposed (JAMA 2023, as reported by the ASH validation protocol), compared with 1.92–7.60 for that centre's standard interval. Counts are less stable than other cell counts and swing with exercise, stress, steroids and infection. Rodak's Hematology defines neutrophilia as above 7.0 ×10⁹/L in adults (8.5 in children), and a reactive neutrophilic leukocytosis above 50 ×10⁹/L with a left shift is called a leukemoid reaction. Labs set their own call limits. Labcorp calls results below 0.5 ×10³/µL and Quest's Priority 1 value is below 500 cells/µL.
LOINC 751-8 (primary), 26499-4, 753-4, 30451-9, 768-2. Specimen: whole-blood.
Sources
- Critical Values: critical (panic) limits with adult and pediatric reference intervals, Labcorp (2024)
- CBC With Differential/Platelet, sample patient report (test 005009), Labcorp
- Complete Blood Cell Count (CBC) with Differential, Blood (test ID CBC), Mayo Clinic Laboratories
- CBC with Platelet Count and Automated Differential (test 0040003), hotline effective March 1, 2021, ARUP Laboratories (2021)
- CBC reference intervals (HEM-2597.01), Te Whatu Ora Health New Zealand, Waikato (2024)
- Quest Diagnostics Priority Result Reporting Policy (Client Synopsis), Quest Diagnostics (2025)
- Critical Value List, University of Chicago Medicine
- Neutropenia (Five things to know about…), CMAJ (2022)
- Neutropenia, MSD Manual Professional Edition
- Nonmalignant leukocyte disorders (Rodak's Hematology, 6th edition), Elsevier (2019)
- Validating and Developing Duffy Null Specific Absolute Neutrophil Count Reference Ranges for Adults and Pediatrics, American Society of Hematology (2023)
- Absolute neutrophil count by Duffy status among healthy Black and African American adults, Blood Advances (2023)
- Development of Duffy Null-Specific Absolute Neutrophil Count Reference Ranges, JAMA (2023)
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