Neutrophils
Neutrophils are the largest group of white blood cells and the first on the scene at a bacterium or a wound. The count rises with a bacterial infection, stress, exercise and smoking, and falls after a virus or through medicines. Read the absolute count, not the percentage, and always beside lymphocytes and CRP.
Neutrophils reference ranges
What does your value mean?
Normal: 1.8 to 7.0 ×10⁹/L
Enter your value as it appears on your results. Range for adults.
Neutrophils high or low: what it means
Neutrophils too low
The bone marrow is temporarily making less, cells have been drawn into the tissue, or your count is naturally lower.
| Cause | How often |
|---|---|
| A virus slows production for a few days and draws cells out of the blood; the count stays low for up to a few weeks and recovers by itself | Often |
| Some painkillers, antibiotics, thyroid blockers and drugs for rheumatoid arthritis, epilepsy or psychosis suppress production | Often |
| In many people with African or Middle Eastern ancestry the count sits around 1.0 to 1.5, with an immune system that simply works | Sometimes |
| The bone marrow makes all cells more slowly; then the MCV is usually raised and haemoglobin lowered as well | Rare |
| In lupus or rheumatoid arthritis antibodies can break down neutrophils; then there are usually symptoms and other abnormalities too | Rare |
Neutrophils too high
Your body is mobilising neutrophils, from the bone marrow or from the vessel wall, and with or without fever makes the difference.
| Cause | How often |
|---|---|
| The classic reason: the bone marrow releases extra cells, young forms appear in the blood and CRP rises along | Often |
| Adrenaline loosens cells from the vessel wall; the count doubles within an hour and is back a few hours later | Often |
| Prednisone releases cells from the bone marrow and keeps them in the blood longer; during a course the count sits high without an infection | Often |
| An operation, an injury, a burn or a heart attack give the same response as a bacterium | Sometimes |
| Smokers have persistently more neutrophils; after stopping, the count falls over months | Sometimes |
| With a count far above the band, with immature cells on the report, the bone marrow is making cells uncontrolled | Rare |
What you do about it. With a high count from an infection nothing, and with a count that stays at the high end without an infection, stopping smoking is the biggest step, followed by less belly fat, better sleep and less chronic stress. Have blood drawn on a rest day, because yesterday's training is in your blood today. With a low count from a medicine the question is whether that medicine stays necessary, and that is a conversation with whoever prescribed it. With a B12 or folate deficiency the bone marrow recovers as soon as you top up.
How does a neutrophils blood test work?
- Which test. Neutrophils is in the comprehensive test (€229) and in .
- Fasting. Every draw is fasted: nothing to eat or drink from midnight, only water. Appointments are therefore in the morning, until 12:00.The count responds to exertion and stress, so come to the draw calmly.
- Referral. Not needed. Neutrophils are in every blood count with differential, and you can have that measured yourself.
- When. On a rest day, not the morning after a hard training session, and not during or in the weeks after an infection if you want to know your usual level.
- The draw. One tube of blood from a vein in your arm. The lab counts the white cells and sorts them into five types; CRP can come from the same draw.
- Repeating. With a low count after two to four weeks, to see whether it was a virus that passed. With a low count from make-up one repeat is enough; after that it need not be more often than once a year.
- Where to draw. You can draw at 400+ locations near you, no referral needed. See the locations
More about neutrophils
Neutrophils explained
Of all white blood cells, neutrophils are the most numerous: more than half of what your blood count tallies. They are the first responders. They live only a day, are made in your bone marrow in enormous numbers, and move within minutes to the place where a bacterium enters or tissue is damaged. There they swallow bacteria and destroy them with enzymes and oxygen radicals. Pus is largely dead neutrophils. Because they live so briefly, the count in your blood is a snapshot of supply and demand. Your bone marrow keeps a large reserve ready, and part of the cells sit stuck to the wall of your blood vessels rather than flowing along. Adrenaline loosens them: with stress, a hard training session or a fright the count doubles within an hour and is back a few hours later. Cortisol and prednisone do the same, and keep the cells in the blood longer as well. A bacterial infection sets the bone marrow to extra production, and then young forms appear in your blood too. Your report shows the count in ×10⁹/L, and read it as an absolute count, not as a percentage. Normal is about 1.8 to 7.0 ×10⁹/L, where the labs overlap. Below 1.5 ×10⁹/L the defence against bacteria gets thinner, and below 0.5 ×10⁹/L an ordinary infection is an emergency.
Why are neutrophils relevant?
Neutrophils are the value that says whether an infection is bacterial. A bacterium lifts the count, with a high CRP alongside and often young forms on the report; a virus leaves the neutrophils normal or low and lifts the lymphocytes. That difference is the reason a blood count with differential says more than the total of white cells, and it is the question a doctor answers before deciding on antibiotics. Outside an infection, neutrophils say something about the state of your body. Smoking keeps the lungs in a light inflammatory state and lifts the count persistently, belly fat does so more mildly, and poor sleep and chronic stress through cortisol. A count that sits against the upper bound year after year without you being ill is therefore a sign of smouldering inflammation, and it goes with more cardiovascular disease. It is also the numerator in the ratio with lymphocytes, the NLR, which measures exactly that balance between stress and recovery. A low count is the side that counts for your safety. Most falls are harmless: a virus that has just passed, a medicine, or a make-up that is common in people with African or Middle Eastern ancestry and in which the immune system simply works. But below 0.5 ×10⁹/L your body has hardly any defence against bacteria, and fever is then a reason to be seen the same day. That is why a low count is phoned through and a high one not.
How do you read neutrophils?
A low count usually means the bone marrow is temporarily making less or cells have been drawn into the tissue. From common to rare: a viral infection in the past weeks, which keeps the count low for up to a few weeks; medicines, such as some painkillers, antibiotics, thyroid blockers, drugs for rheumatoid arthritis, epilepsy or psychosis; and make-up, in which the count sits around 1.0 to 1.5 without you being ill more often. Rarer are a B12 or folate deficiency, which makes the bone marrow slower at all cells, and an autoimmune disease. A count that keeps falling without explanation, or falls together with anaemia and few platelets, should be investigated. A high count means your body is mobilising neutrophils. With fever and a high CRP it is a bacterial infection or tissue damage, and then the count falls with recovery. Without fever it is almost always something else: a hard training session the day before, stress, smoking, prednisone, a pregnancy or belly fat. The difference sits in the young forms: with an infection the bone marrow releases immature cells, with stress only mature cells from the vessel wall. A count far above the band with immature cells alongside is a different picture, and a doctor assesses that the same day. Set neutrophils beside the lymphocytes, because together they show whether it is a bacterium or a virus, beside CRP, which says whether inflammation is running, and beside the total of white cells. With a low count, haemoglobin, platelets and B12 and folate belong with it too.
Frequently asked questions
The largest group of white blood cells and the first responders of your immune system. They live only a day, are made in your bone marrow in enormous numbers, and move within minutes to a bacterium or damaged tissue, where they swallow bacteria and destroy them. Pus is largely dead neutrophils. The count in your blood is a snapshot of supply and demand.
Related biomarkers
Sources 5
- 1.Unilabs, test catalogue (Dutch): white cell differential. 2026. bepalingenklapper.nl
- 2.Star-shl, test catalogue (Dutch): neutrophils. 2026. star-shl.nl
- 3.Certe, test catalogue (Dutch): neutrophil granulocytes. 2026. bepalingenwijzer.certe.nl
- 4.Clinical Diagnostics, lab guide (Dutch): neutrophils. 2026. clinicaldiagnostics.nl
- 5.LESA Laboratory diagnostics (Dutch primary-care laboratory agreement). 2026. richtlijnen.nhg.org
Was this what you were looking for?
Share
Educational information only, not medical advice. Consult a healthcare professional for clinical decisions.
Read about our scientific approach
