Understanding: What Nutritional Deficiency Can Cause Low Neutrophils?

October 10, 2025 •

4 min read

Studies show that nutritional deficiencies, such as low levels of vitamin B12, folate, and copper, are a recognized cause of neutropenia. Learning what nutritional deficiency can cause low neutrophils? is crucial for understanding immune health and maintaining a balanced diet.

Quick Summary

Nutrient deficits, particularly vitamin B12, folate, copper, and severe protein-calorie malnutrition, can impair bone marrow function and reduce neutrophil production, often leading to wider blood cell issues.

Key Points

Vitamin B12 and Folate Deficiencies: These are common nutritional causes of low neutrophils, disrupting DNA synthesis in bone marrow and leading to megaloblastic anemia.
Copper Deficiency: This rare but significant cause of neutropenia impairs blood cell maturation, and can be misdiagnosed as more serious conditions like myelodysplastic syndrome.
Excess Zinc Intake: Over-supplementation with zinc can block copper absorption, indirectly causing copper deficiency and neutropenia.
Severe Malnutrition: Generalized protein-calorie deficiency can suppress bone marrow activity and result in low neutrophil counts, often alongside other cytopenias.
Iron Deficiency Link: Some studies suggest a connection between iron deficiency anemia and neutropenia, which can be reversed with iron therapy.
Diagnosis is Key: A proper medical diagnosis is essential to identify the specific deficiency and create an effective treatment plan, which may involve supplements.

The Link Between Nutrition and Neutrophil Production

Neutrophils are a type of white blood cell and a vital part of the body's immune system, playing a critical role in fighting off infections. When the number of neutrophils drops below a certain level, the condition is known as neutropenia. The bone marrow is responsible for producing these cells, a process called hematopoiesis, which requires a steady supply of specific vitamins and minerals. Inadequate intake of these essential nutrients can disrupt this production, leading to a low neutrophil count and a compromised immune response. This disruption can range from mild and reversible to severe, especially when accompanied by other cytopenias (low counts of multiple blood cell types).

Vitamin B12 and Folate Deficiencies

Among the most well-documented nutritional causes of neutropenia are deficiencies in vitamin B12 (cobalamin) and folate (vitamin B9). These B vitamins are crucial cofactors for DNA synthesis and cell division.

Impact on Hematopoiesis: Without sufficient B12 or folate, the body's ability to produce new blood cells is impaired, leading to a condition called megaloblastic anemia.
Visible Effects: This can cause the precursor cells in the bone marrow to grow abnormally large, and often results in macrocytosis (abnormally large red blood cells) and hypersegmented neutrophils, which are characteristic findings on a blood smear.
Sources: Both vitamins are critical for healthy blood cell formation, and deficiencies can be caused by poor dietary intake, malabsorption issues (like pernicious anemia for B12), or increased physiological demands.

The Critical Role of Copper

Copper deficiency is a recognized, though less common, cause of neutropenia. It is an essential cofactor for several enzymes involved in blood cell maturation and iron utilization.

Impaired Maturation: Some studies suggest that copper enzymes are critical to the maturation of hematopoietic cells, and a deficiency can impair effective blood cell production.
Mimics Other Conditions: The bone marrow findings in copper deficiency can sometimes mimic more serious hematological disorders like myelodysplastic syndrome (MDS), highlighting the importance of a proper diagnosis.
Reversible Condition: With proper diagnosis, neutropenia due to copper deficiency is often reversible with copper supplementation.

Excess Zinc and Induced Copper Deficiency

A less direct but increasingly recognized cause is excessive zinc intake, which can lead to a secondary copper deficiency.

Competition for Absorption: High levels of zinc compete with copper for absorption in the gut, effectively blocking the body's ability to take in enough copper.
Symptom Lag: This zinc-induced hypocupremia can cause neutropenia and anemia, and there is often a significant delay between the onset of symptoms and diagnosis, leading to unnecessary invasive procedures like bone marrow biopsies.
Treatment: The treatment involves stopping the zinc supplement and providing copper supplementation.

The Connection to Iron Deficiency

While not as strongly linked as B vitamins or copper, some studies have noted an association between iron deficiency anemia (IDA) and neutropenia.

Mechanism: The exact mechanism is not fully understood, but it may involve iron's role in the bone marrow's microenvironment and its effect on hematopoietic progenitor cells.
Improvement with Therapy: Crucially, studies have shown that in some cases, the neutropenia associated with IDA can be reversible with iron replacement therapy.

Severe Protein-Calorie Malnutrition

Beyond specific micronutrients, severe overall protein-calorie malnutrition is a direct cause of neutropenia.

Impaired Cell Production: Malnutrition can cause a decrease in the proliferation of blood cells in the bone marrow, leading to neutropenia.
Multiple Cytopenias: As noted, this form of nutritional deficiency typically results in multiple cytopenias rather than isolated neutropenia, affecting other blood cell lines as well.

Comparison of Key Nutritional Deficiencies and Neutropenia


Deficiency	Hematological Impact	Primary Mechanism	Dietary Sources
Vitamin B12	Megaloblastic anemia, neutropenia, pancytopenia	Impaired DNA synthesis leading to ineffective cell production	Meat, eggs, dairy, fortified cereals
Folate (B9)	Megaloblastic anemia, neutropenia, pancytopenia	Impaired DNA synthesis and cell division	Leafy greens, liver, legumes, fortified grains
Copper	Neutropenia, anemia (microcytic, normocytic, or macrocytic)	Impaired maturation of blood cells, ineffective iron use	Shellfish, nuts, seeds, dark chocolate
Iron	Iron deficiency anemia (IDA), potentially neutropenia	Affects bone marrow microenvironment, possibly down-regulating neutrophil production	Red meat, poultry, beans, spinach
Protein/Calories	General malnutrition, neutropenia, pancytopenia	Decreased proliferation of blood cells in the bone marrow	Complete and varied diet with all macronutrients

How to Address Nutritional Neutropenia

Seek Medical Diagnosis: If you suspect a nutritional deficiency, consult a healthcare professional. They can run blood tests to measure specific vitamin and mineral levels and rule out other potential causes of neutropenia.
Tailored Treatment: Based on the diagnosis, a doctor may recommend supplements or dietary changes. Never self-treat with high-dose supplements, as this can cause other issues, such as zinc-induced copper deficiency.
Balanced Diet: Focus on a whole-food, nutrient-dense diet. Ensure adequate intake of lean proteins, a variety of fruits and vegetables, whole grains, nuts, and seeds to cover a broad spectrum of nutrients.
Avoid Excess Zinc: Be mindful of over-the-counter zinc supplements, as excessive amounts can lead to copper deficiency and subsequent neutropenia. Always follow recommended dosage guidelines.

Conclusion

Neutropenia can be a complex condition with numerous potential causes, but certain nutritional deficiencies are a clear factor. The crucial connection lies in the bone marrow's need for specific nutrients like vitamin B12, folate, copper, and iron to properly produce neutrophils. While a severe case requires medical evaluation and targeted therapy, maintaining a balanced, nutrient-rich diet is a proactive strategy for supporting overall immune health and healthy blood cell production. Prompt and accurate diagnosis is key to addressing the underlying deficiency and restoring a healthy neutrophil count. For more detailed information on neutropenia, consult resources like the Cleveland Clinic.

Frequently Asked Questions

Deficiencies in vitamin B12 and folate are among the most common nutritional causes of neutropenia, as they are essential for the production and division of blood cells in the bone marrow.

Yes, excessive zinc intake can interfere with the body's absorption of copper, leading to a secondary copper deficiency. This copper deficiency can then result in neutropenia.

No, neutropenia from nutritional deficiencies often presents alongside other cytopenias, meaning low counts of other blood cell types like red blood cells and platelets.

Diagnosis typically involves a blood test to check for low neutrophil count, followed by specific tests to measure levels of nutrients like vitamin B12, folate, copper, and iron, to identify the underlying deficiency.

In many cases, yes. Neutropenia caused by nutritional deficiencies is often reversible with targeted supplementation and correction of the underlying dietary issue, as seen with vitamin B12, folate, and copper deficiencies.

A balanced diet rich in foods containing vitamin B12 (meat, dairy), folate (leafy greens, legumes), copper (shellfish, nuts), and iron (lean meat, beans) is important for supporting healthy neutrophil production.

The time it takes for neutrophil counts to recover can vary depending on the specific deficiency and its severity. For example, in copper deficiency, neutropenia often improves within a few weeks of supplementation, while anemia takes longer to resolve.