<s>[INST] Hi doctor, I am a 29 year old female. I am overweight. My regular doctor noticed my WBC has been high every single time he has drawn my blood. He even asked me to come back several times to double check. It has been like this and climbing slowly for a year. He referred me to an oncologist. But in the mean time, I am going crazy on what could this be. I am scared and unsure of what I can expect. I understand that everyone is a different case. But I am curious as to if this is something small or potentially something life changing. Following details are from my last draw, WBC count 15 on a 10 scale, MCV 77, MCH 24, RDW 16.2, neutrophils 10.1 and lymphs 3.8. [/INST] Hi. Based on your query and report (attachment removed to protect patient identity), my opinion is as follows: A rising WBC (white blood cell) count in the absence of any infection, however mild is sometimes worrisome and that is being at present felt by your doctor. Mild increase in neutrophil is present. I assume there is nothing abnormal in the peripheral smear. Peripheral smear is most important here to confirm the absence of any immature cells. Rising count sometimes signifies leukemia. However, in leukemia, the count is usually more than 100000 or less than 4000 on a 10000 scale. The absence of any immature cells virtually rules out any leukemia. Possible causes here could be stress; lipid abnormalities induced inflammation in blood vessels or liver (over weight) or mild infection somewhere, which is currently asymptomatic. Reduced MCV (mean corpuscular value) and MCH (mean corpuscular hemoglobin) indicate possibly early iron deficiency anemia. Iron studies can confirm or start of treatment with Ferrous Fumarate daily will help. If anemia is present with rising WBC count, a chronic inflammation cause will require evaluation. C-reactive protein levels and ESR (erythrocyte sedimentation rate) can help in the evaluation of chronic inflammation if any.Do get a C-reactive protein, ESR study and iron studies done. Nothing worrisome at present. If not sure, attach your whole report as a PDF for better opinion. Revert back with your new report and PDF to a hematologist online --> </s>