High Neutrophils, Low Lymphocytes: What Does It Mean?

What Are Neutrophils and Lymphocytes?

Your blood contains different types of cells, and one important group is white blood cells (WBCs). Its two main components are neutrophils and lymphocytes.

Just in case you’re wondering, white blood cells (WBCs) are also made up of eosinophils, basophils, and monocytes.

Each type has its own job, but neutrophils and lymphocytes are two of the most important when it comes to protecting your body from infections.

You’ll probably (or in most cases) see these levels reported as part of a Complete Blood Count (CBC) test, which is one of the most common blood tests ordered by doctors.

Neutrophils: Your Body’s First Responders

Neutrophils are the most common type of white blood cell. Their job is to quickly fight infections, destroy bacteria, and clear damaged cells to keep you healthy.

These levels can appear on your blood test as either an absolute number (cells/µL) or a percentage (%) of your total white blood cells.

• Normal levels: 1,500 to 8,000 cells/µL or 40–60%.

Think of neutrophils as the emergency responders of your immune system—they’re the first on the scene, ready to tackle any problem.

Lymphocytes: Your Long-Term Defenders

Lymphocytes are another key type of white blood cell. 

Unlike neutrophils, lymphocytes work slower. They identify viruses, create antibodies, and help your body build immunity for the future.

• Normal levels: 1,000 to 4,800 cells/µL or 20–40%.

Lymphocytes are like the strategists in your immune system, creating long-term defense plans to keep you healthy.

What Does High Neutrophils and Low Lymphocytes Mean?

High neutrophils (neutrophilia) and low lymphocytes (lymphocytopenia) often indicate an acute bacterial infection or inflammatory condition. 

You may also experience symptoms of an infectious process, such as fever, fatigue, swollen lymph nodes, or localized pain. 

These results may also be seen in:

• Corticosteroid Use: These medications can suppress lymphocytes and increase neutrophils.
• Chronic Inflammation: Conditions like rheumatoid arthritis or inflammatory bowel disease.
• Severe Infections: Such as sepsis or abscesses.
• Bone Marrow Disorders: Rarely, certain cancers like leukemia can cause similar changes.
• Stress Response: Physical or emotional stress, like surgery, an intense workout, or a rough week, can cause temporary slight changes in white blood cell levels.

Always check with your doctor to get a clear understanding and an accurate diagnosis.

Well, now you know what your results mean. This could have been the end of the article, huh?

But let’s be honest—you’ve probably already searched the internet and come across the term NLR. 

Now you’re wondering, “What does that even mean?” 

Well, let’s figure it out together.

What Does the Neutrophil-to-Lymphocyte Ratio (NLR) Tell You?

The neutrophil-to-lymphocyte ratio (NLR) is calculated using your blood test results. 

Just take the number of neutrophils and divide it by the number of lymphocytes—easy, right? 

NLR=Absolute Lymphocyte Count (ALC)/ Absolute Neutrophil Count (ANC)​

It’s a simple way to measure your body’s immune and inflammatory response.

P.S.: You won’t see the NLR directly listed on your test results—it’s something you (or your doctor) calculate.

Quick-Explanation

• Normal NLR: 1–2.
• High NLR: Often linked to inflammation, infections, or stress.
• Very High NLR: Could indicate severe conditions like sepsis, cancer, or critical illnesses.
• Low NLR: May suggest certain viral infections, bone marrow problems, or conditions affecting lymphocyte production.

What to Do Next?

The first step is to consult your doctor. They’ll look at your results alongside your symptoms and medical history to figure out what’s going on. Here’s what might happen next:

1. Your doctor might order additional blood tests, such as a complete blood count (CBC) to confirm the results and check for any other abnormalities. They could also request specific tests to rule out infections, inflammation, or more serious conditions.
2. They’ll ask about recent illnesses, stress, medications, or other factors that could be influencing your immune system.
3. In some cases, they may recommend imaging tests (like X-rays or CT scans) or specialized labs to investigate infections, inflammation, or organ-related issues.
4. Based on the findings, your doctor may recommend antibiotics, adjusting medications, or lifestyle changes.
5. If the changes in your neutrophils and lymphocytes seem temporary, they might suggest keeping an eye on your symptoms and retesting after a few weeks.

These steps are all about finding the cause and helping you move forward with a solution. 

Don’t be shy about asking your doctor questions—they’re there to make sure you feel clear and confident about what’s next.

When Can High Neutrophils and Low Lymphocytes Be Normal?

Don’t rush with the panic—sometimes, high neutrophils and low lymphocytes are completely normal.

For example, during pregnancy, especially in the third trimester, it’s normal for neutrophils to increase and lymphocytes to decrease. This is just your immune system adapting to protect both you and your baby. 

Another scenario? Recovering from an infection. After your body has fought off a bacterial illness, neutrophil levels can stay elevated for a while as lymphocytes slowly return to normal. In this case, your doctor may recommend retaking the test after some time to ensure your levels have balanced out.

Aging can also play a role, as older adults naturally tend to have slightly higher neutrophils and lower lymphocytes compared to younger people.

And yes, even habits like smoking can influence your white blood cell counts, creating a similar pattern as your body responds to ongoing exposure to irritants.

The key takeaway? These numbers don’t exist in a vacuum. Without symptoms or other abnormal findings, high neutrophils and low lymphocytes might not be anything to worry about. 

It’s always a good idea to discuss your results with your doctor—they’ll help you figure out what’s normal for your body and whether any follow-up is needed. That said, you can also use online tools to get a better understanding of your results before your appointment.