What Not to Do with Low White Blood Cells (Leukopenia)

December 16, 2025 •

4 min read

According to the National Cancer Institute, a low white blood cell count, or neutropenia, is a common side effect of chemotherapy, affecting up to 50% of patients. Taking proactive steps to avoid infections is crucial when your immune system is compromised. This guide will outline the key precautions and actions you should not take to protect your health.

Quick Summary

Individuals with a low white blood cell count must implement strict precautions to minimize infection risk. This includes avoiding undercooked or raw foods, steering clear of crowds and sick people, and practicing impeccable personal hygiene. Following these guidelines is essential for preventing serious complications related to a weakened immune system.

Key Points

Avoid Raw Foods: Do not consume raw or undercooked meats, fish, eggs, or unpasteurized dairy to prevent foodborne illness.
Limit Crowds: Steer clear of crowded public places and sick individuals to minimize exposure to infectious germs.
Practice Strict Hygiene: Wash hands frequently, use an electric razor, and do not share personal items to prevent bacterial and viral transfer.
Protect Your Skin: Be cautious with gardening, sharp objects, and injuries, as breaks in the skin can lead to infection.
Report Symptoms Immediately: Do not ignore potential signs of infection like fever, chills, or rashes; contact your healthcare provider immediately.
Avoid Animal Waste: Do not handle pet litter or other animal waste, which can harbor bacteria harmful to a weakened immune system.

Understanding the Risk of Low White Blood Cells

Low white blood cell (WBC) count, medically known as leukopenia, can leave the body highly vulnerable to infections. A subset of leukopenia called neutropenia, referring to low neutrophils, is particularly concerning as these are the primary cells that fight bacteria. This condition often has no symptoms of its own, but the risk of infection, which can be life-threatening, increases significantly as the count drops. Your healthcare provider will monitor your blood counts, and it's essential to follow their specific instructions, which often include a list of 'don'ts' to protect yourself.

Foods and Dining Habits to Avoid

Foodborne bacteria pose a major threat when your immune system is weak. Therefore, a neutropenic diet or adhering to strict food safety protocols is vital. This is not about boosting your WBC count, but rather about preventing new bacterial exposures.

Do not eat or drink the following:

Raw or undercooked meats, poultry, and fish: This includes rare steaks, sushi, sashimi, and other uncooked seafood. Always cook meat to well-done temperatures.
Runny or undercooked eggs: Eggs should be cooked thoroughly, with no runny yolks. Avoid foods containing raw eggs like some homemade mayonnaise, hollandaise sauce, or raw cookie dough.
Unpasteurized dairy products: This includes unpasteurized milk, yogurt, and cheese. Stick to products labeled "pasteurized".
Soft and mold-ripened cheeses: Avoid soft cheeses like Brie, Camembert, feta, and blue-veined cheeses, even if pasteurized, as they carry higher risks.
Raw fruits and vegetables that cannot be peeled: While some sources have differing advice, many strict guidelines suggest avoiding raw, unpeeled fruits and vegetables. Thoroughly wash and peel thick-skinned fruits and cook vegetables completely.
Raw nuts and sprouts: Nuts should be roasted. Raw sprouts, such as alfalfa and bean sprouts, are high-risk.
Deli meats and cold cuts: Unless reheated to a steaming hot temperature, these should be avoided.
Buffets and salad bars: These are breeding grounds for germs and cross-contamination.

Activities and Situations to Limit or Avoid

Your lifestyle needs adjustment to reduce exposure to pathogens. Staying aware of your environment and taking simple steps can make a big difference.

Do not participate in these activities or frequent these places:

Crowded public areas: Avoid crowds in places like shopping malls, movie theaters, buses, and concerts, especially during peak hours. If you must go, wear a mask.
Contact with sick people: Stay away from anyone with a cold, the flu, chickenpox, measles, or any other infectious illness. This includes family members. Remind sick housemates to wear a mask and practice excellent hygiene.
Handling animal waste: Do not clean cat litter boxes, handle pet waste, or clean fish tanks, as these can contain harmful bacteria.
Gardening or yard work without protection: Wear gloves if you must work with soil or plants, which can harbor bacteria and fungi.
Strenuous or injurious activities: Avoid contact sports or activities that could lead to cuts, scrapes, or injuries. Even small breaks in the skin can become serious infections. Use an electric razor to prevent nicks.
Live virus vaccines: Do not receive any immunizations, including the flu shot, without first consulting your healthcare team.
Shared hygiene items: Avoid sharing cups, utensils, towels, toothbrushes, or makeup.

Medical and Personal Care Practices to Reconsider

Certain medical procedures and personal care routines can also increase your risk of infection. Discuss these with your healthcare provider.

Table: High-Risk vs. Safer Practices for Low WBC


High-Risk Practice (DO NOT DO)	Safer Alternative (DO INSTEAD)
Taking rectal temperatures, using rectal suppositories, or having rectal exams.	Taking oral or under-arm temperatures.
Using tampons (for menstruating women).	Using sanitary napkins.
Using antiperspirant (can block sweat glands).	Using deodorant.
Getting dental work (unless an emergency).	Delaying non-essential dental work until counts improve.
Ignoring symptoms of infection (fever, sore throat, rash).	Reporting any signs of infection to your doctor immediately.
Vigorous sexual intercourse.	Consult your healthcare provider about safe sexual practices.

Conclusion: Your Role in Infection Control

Managing a low white blood cell count requires vigilance and a commitment to infection prevention. It's a proactive approach to safeguard your health during a time of increased vulnerability. While many factors are beyond your control, following these 'don'ts'—avoiding high-risk foods, limiting exposure to germs, and being mindful of personal care—empowers you to take an active role in your well-being. Always maintain open communication with your healthcare team, especially if you notice any potential signs of infection, to ensure the best possible outcome. For more information on supportive care during cancer treatment, consult resources from reputable institutions like the National Cancer Institute (NCI).

Frequently Asked Questions

You should avoid raw or undercooked meat, fish, and eggs, as well as unpasteurized dairy products, soft cheeses, raw nuts, sprouts, and buffets. Any food that carries a risk of bacterial contamination should be handled with extreme care.

No, it is not safe to go to crowded places like shopping malls or concerts when you have a low WBC count. The risk of exposure to infectious germs is significantly higher. If you must be in a public setting, try to go during off-peak hours and consider wearing a protective mask.

Common signs of infection include a fever (often the first and only sign), chills, swelling and redness, mouth sores, sore throat, or a persistent cough. Report these or any other unusual symptoms to your doctor right away.

You can have pets, but you must avoid handling their waste. Do not clean cat litter boxes or pick up animal feces, as these can contain harmful pathogens. If you cannot avoid these tasks, wear gloves and wash your hands thoroughly afterward.

Practice frequent and meticulous handwashing, use an electric razor instead of a blade to avoid nicks and cuts, and avoid sharing any personal items like utensils, toothbrushes, or makeup. Use sanitary napkins instead of tampons during menstruation to reduce infection risk.

Yes, you should avoid rectal thermometers, suppositories, and enemas. It is also important to avoid non-emergency dental work. Any procedure that could cause a break in the skin or mucous membranes should be discussed with your healthcare provider first.

While some exercise is beneficial for general health, you should avoid strenuous activities and contact sports that increase the risk of injury. Falls, cuts, and scrapes can easily become infected. Discuss a safe exercise plan with your doctor.