This article will explain more about nadir and what it entails, as well as how to manage it and what you should watch out for.
Why Nadir Occurs
While chemotherapy directly targets cancer cells, it also affects other normal rapidly dividing cells in the process. This includes cells found in the gut, lining of the mouth, hair, and bone marrow, where the blood cells are produced.
During chemotherapy, bone marrow activity may be decreased, resulting in lowered blood cell counts within the body, including red blood cells, white blood cells, and platelets.
Timeline and Risks
Each blood cell type reaches nadir at different times. Low counts have varying effects as well.
White Blood Cells
White blood cells (WBCs) generally drop to their lowest count about seven to 14 days after chemotherapy.
WBCs, especially a specific type called neutrophils, are a vital component of the immune system as they keep invading bacteria at bay. Because of this, you are at a heightened risk of developing infections when counts are low.
Red Blood Cells
Red blood cells (RBCs) generally live longer than WBCs and reach a nadir period several weeks after treatment. Their job is to carry oxygen from the lungs to tissues throughout the body.
RBCs contain hemoglobin, an iron-rich protein that transports oxygen and also gives blood its red color. When RBC counts are too low, the result is called anemia.
Platelets
Platelets generally reach their nadir period at about the same time as WBCs. Platelets serve an important function by helping blood clot, which prevents bleeding.
When the number of platelets in the body falls too low, the condition is called thrombocytopenia. It is marked by bruising, nosebleeds, excessive bleeding from cuts, and fatigue. A reddish-purple skin rash that looks like small dots is also a symptom of a low platelet count.
Managing Lowered Blood Cell Counts
When blood counts become too low, WBCs, RBCs, and platelets can be increased through drugs that boost cell production, as well as through transfusions.
The following vitamins and minerals help increase the body’s production of RBCs. Consider adding supplements and/or eating foods that are rich in the following:
Iron: Found in leafy green vegetables like kale and spinach, organ meats, lean red meat, egg yolks, beans, and legumesVitamin A (retinol): Found in cod liver oil, sweet potatoes, spinach, broccoli, black-eyed peas, carrots, squash, pumpkin, cantaloupe, mango, and apricotsVitamin B6 (pyridoxine): Found in salmon, poultry, eggs, potatoes, sweet potatoes, bananas, avocado, pistachios, peanuts, whole grains, and brown riceVitamin B9 (folate): Found in citrus, banana, papaya, beets, asparagus, brussels sprouts, avocado, walnuts, and flax seedsVitamin B12 (cobalamin): Found in organ meat, beef, tuna, trout, salmon, sardines, clams, and eggsVitamin C: Found in citrus, cantaloupe, kiwi, papaya, strawberries, sweet potatoes, tomatoes, bell peppers, broccoli, cauliflower, and kaleCopper: Found in shiitake mushrooms, spirulina, almonds, cashews, sesame seeds, lobster, oysters, organ meats, Swiss chard, spinach, and kaleVitamin E: Found in salmon, trout, shrimp, goose, spinach, broccoli, turnip greens, squash, avocados, wheat germ oil, olive oil, sunflower seeds, almonds, hazelnuts, pine nuts, peanuts, Brazil nuts, mango, and kiwi
Increasing your consumption of certain healthy meats, fruits, and vegetables can also help boost the body’s natural production of blood cells.
Protein sources like poultry and fish may promote the production of WBCs. Platelets can be increased by eating foods rich in vitamins B9 and B12.
Precautions to Take During Nadir
It’s important to avoid infection or any activities that could induce bleeding, as WBCs that fight infection and platelets that help with clotting are diminished. Follow some simple tips, including:
Washing hands oftenThoroughly washing and cooking food before consumingAvoiding contact with those who may carry infection, as well as pet wasteAvoiding getting scratches or cuts
Help boost your immune system by:
Getting enough sleepEating a healthy, balanced diet rich in fruits and vegetablesAvoiding caffeine and alcoholDrinking plenty of water
Summary
“Nadir” is a term describing when white blood cells are at their lowest, putting an individual at risk for infection and other complications. It’s important to take extra precautions to reduce the risk of infections and boost the immune system.
Since bone marrow production may also reach a low point during nadir, it’s also important to boost red blood cell and platelet production. Eating a diet rich in vitamins and minerals can help your body build up blood cell counts and keep you as healthy as possible.
A Word From Verywell
During chemotherapy, it’s important to try to stay as healthy as possible. Talk with your treatment team about ways you can keep yourself safe when your blood cell counts fall into unhealthy ranges. Medical interventions, as well as making dietary changes and taking extra precautions, may be of help.
