Lab result explainedBlood count (CBC)Last updated November 11, 2026

Absolute eosinophils (eos abs): normal range, what a high count means and the 500 and 1,500 cutoffs

Absolute eosinophil count (AEC) · Complete blood count (CBC) with differential · reported in ×10³/µL (K/µL, thousand per microliter) or cells/µL; 0.5 ×10³/µL = 500 cells/µL = 0.5 ×10⁹/L

The absolute eosinophil count (shown as "eos abs", "eosinophils absolute" or AEC on a CBC with differential) is the actual number of eosinophils in a microliter of your blood, worked out by multiplying your total white cell count by the percentage of eosinophils. Eosinophils are the white cells that deal with parasites and drive allergic inflammation. For adults the normal range is about 0 to 0.5 ×10³/µL, which is 0 to 500 cells per microliter, and most healthy people sit between 0.05 and 0.3. Laboratories differ slightly, so use the range printed on your report.

The absolute count matters more than the percentage. A result of 8 percent eosinophils sounds high, but if your total white count is 4.0 ×10³/µL the absolute count is only 0.32, which is normal; the same 8 percent with a white count of 12 is 0.96, which is eosinophilia. Clinicians grade eosinophilia by the absolute number: mild from 500 to 1,500 cells/µL, moderate from 1,500 to 5,000 and severe above 5,000. The 1,500 line is where "hypereosinophilia" begins and where a more thorough work-up starts, because sustained counts at that level can damage the heart, lungs, skin and nerves whatever the cause.

In the United States the most common reasons for a mildly raised eos abs are allergic conditions (asthma, hay fever, eczema) and medications, with parasitic infections more likely in travelers and recent immigrants. Blood cancers are a rare cause and almost never the explanation for a count under 1,500. A low or zero eosinophil count is usually from stress, infection or steroid medication and is not a problem in itself. This page covers what the numbers mean, what to read them with and what usually happens next.

AEC at a glance

What it is: the number of eosinophils per microliter of blood, calculated from the white cell count and the differential; the cells that fight parasites and drive allergic inflammation.
Normal (adults): about 0–0.5 ×10³/µL (0–500 cells/µL); most people are 0.05–0.3. Some labs print 0.0–0.4 or 0.05–0.55. Labs differ.
Eosinophilia grades: mild 0.5–1.5 ×10³/µL (500–1,500), moderate 1.5–5.0, severe above 5.0. Above 1.5 on two tests a month apart is hypereosinophilia and gets a full work-up.
Common causes of a high count: asthma, allergic rhinitis, eczema, drug reactions, parasites (Strongyloides, Toxocara, hookworm), eosinophilic esophagitis; less often adrenal insufficiency, vasculitis (EGPA), lymphoma or myeloid cancers.
A low or zero count (eosinopenia) is common with acute infection, stress and corticosteroids and is not a disease; it usually needs no action.
Next step: repeat the test off steroids, review medications, allergy and travel history, then stool and serology for parasites, IgE, tryptase, and, above 1.5, organ checks (troponin, ECG, chest imaging) and hematology referral.

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What AEC measures

Eosinophils are granulocytes made in the bone marrow under the control of interleukin-5. They spend only 8 to 18 hours in the blood before moving into tissues, especially the gut lining, lungs and skin, where they live for days to weeks. For every eosinophil circulating there are roughly 100 to 300 in tissue, so the blood count is a window onto a much larger population. Their granules contain major basic protein, eosinophil cationic protein and eosinophil peroxidase, which are toxic to parasites but also to your own tissue when released in large amounts over months.

The analyzer counts eosinophils by their light scatter and staining properties as part of the five-part differential and reports both a percentage and an absolute number; the absolute number is simply the percentage multiplied by the total white cell count. When the analyzer flags an abnormal pattern, a technologist counts 100 to 200 cells on a stained smear instead, which is less precise at low percentages but confirms the cells really are eosinophils. Units vary between reports: 0.3 ×10³/µL, 0.3 K/µL, 0.3 ×10⁹/L and 300 cells/µL all mean the same thing.

The count has a daily rhythm that mirrors cortisol in reverse: it is highest between midnight and the early morning and lowest in the late morning, varying by up to 40 percent across the day. Corticosteroids, adrenaline, acute infection, surgery and intense exercise all drive eosinophils out of the blood within hours, so a count taken during a flare of illness or within a day or two of a prednisone dose can hide an eosinophilia that is really there. A single raised result is normally confirmed on a repeat sample taken when you are well and off steroids.

Normal range for AEC

Reference ranges vary between labs and by age, sex and pregnancy. Use the range printed on your own report.

Group	Typical range (×10³/µL (K/µL, thousand per microliter) or cells/µL; 0.5 ×10³/µL = 500 cells/µL = 0.5 ×10⁹/L)	Notes
Adults, normal	0–0.5 ×10³/µL (0–500 cells/µL); typically 0.05–0.3	Some labs print 0.0–0.4, 0.05–0.55 or 1–6 percent of white cells. Labs differ; use the printed range.
Children	About 0–0.7 ×10³/µL	Slightly higher percentages in infants and toddlers; absolute counts settle to adult values by school age.
Mild eosinophilia	0.5–1.5 ×10³/µL (500–1,500 cells/µL)	Allergy, eczema, asthma, drug reactions and mild parasitic infection. Repeat off steroids when well before investigating.
Moderate eosinophilia (hypereosinophilia)	1.5–5.0 ×10³/µL (1,500–5,000 cells/µL)	Above 1.5 on two occasions at least a month apart is hypereosinophilia. Parasites, drug reactions, EGPA, eosinophilic gastrointestinal disease, adrenal insufficiency, lymphoma.
Severe eosinophilia	Above 5.0 ×10³/µL (over 5,000 cells/µL)	Higher risk of organ damage; hypereosinophilic syndromes, chronic eosinophilic leukemia, severe drug reactions (DRESS), some lymphomas and tissue-invasive parasites.
Hypereosinophilic syndrome	Above 1.5 ×10³/µL plus eosinophil-related organ damage	Heart, lungs, skin, gut or nerves affected with no other cause found. Needs hematology care.
Low (eosinopenia)	Below 0.05 ×10³/µL, often reported as 0	Common during acute infection, after surgery and on corticosteroids. Not a condition on its own.

High absolute eosinophils (eosinophilia)

A high eos abs means something is stimulating interleukin-5 production or, far less often, that the marrow is making eosinophils on its own. The size of the count narrows the search. Between 500 and 1,500 cells/µL the usual explanations are allergic: asthma, allergic rhinitis, atopic dermatitis, chronic sinusitis with polyps and food allergy, as well as medications started in the past weeks to months. In this band the count is mostly a marker of the allergic disease rather than a problem in itself, and in asthma a blood eosinophil count above 300 is one of the things that predicts a response to inhaled steroids and the anti-IL-5 biologics.

Above 1,500 the list changes and the stakes rise. Parasites that pass through tissue (Strongyloides, Toxocara, hookworm, schistosomiasis, filariasis and Trichinella) can push the count to several thousand, as can drug hypersensitivity, particularly DRESS (drug reaction with eosinophilia and systemic symptoms) from anticonvulsants, allopurinol, sulfa drugs and some antibiotics. Eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg-Strauss) combines asthma, sinus disease and eosinophils over 1,500 with vasculitis. Adrenal insufficiency (Addison's disease) raises eosinophils because cortisol normally suppresses them. Hodgkin lymphoma, T-cell lymphomas, systemic mastocytosis, chronic myeloid leukemia and chronic eosinophilic leukemia (often carrying the FIP1L1-PDGFRA gene fusion) are the malignant causes; they usually produce higher counts, other blood abnormalities or an enlarged spleen.

No single eosinophil number indicates cancer. Cancer is considered when the count stays above 1,500 with no allergic, drug or parasitic cause, when it is above 5,000, when other cell lines are abnormal (anemia, low or high platelets, immature white cells), or when there is weight loss, night sweats, fever, enlarged lymph nodes or spleen. Whatever the cause, a count persistently above 1,500 can injure the heart (endomyocardial fibrosis), lungs, skin, gut and nerves, which is why hypereosinophilia is investigated even when you feel well.

Common causes

Allergic disease: asthma, allergic rhinitis, atopic dermatitis, chronic rhinosinusitis
The most common cause in the US, usually 500 to 1,500 cells/µL. Counts track disease activity and season, and a blood eosinophil count above 150 to 300 identifies the 'eosinophilic' form of asthma that responds best to steroids.
Medications and drug hypersensitivity
Antibiotics (penicillins, cephalosporins, sulfonamides, minocycline), anticonvulsants (carbamazepine, phenytoin, lamotrigine), allopurinol, NSAIDs, heparin, some antiretrovirals and checkpoint inhibitors. DRESS causes fever, rash, swollen nodes, liver injury and eosinophils often above 1,500, typically 2 to 8 weeks after starting the drug.
Parasitic infection
Tissue-invasive worms: Strongyloides (can persist for decades and become life-threatening if steroids are given), Toxocara, hookworm, Ascaris during lung migration, schistosomiasis, filariasis and Trichinella. Protozoa such as Giardia do not raise eosinophils. Travel, immigration and soil exposure are the clues.
Eosinophilic gastrointestinal disorders
Eosinophilic esophagitis causes food sticking and heartburn that does not respond to acid suppression; blood eosinophils are raised in only about half of cases. Eosinophilic gastritis, enteritis and colitis more often raise the blood count.
Eosinophilic granulomatosis with polyangiitis (EGPA)
Adult-onset asthma, nasal polyps and sinusitis, then eosinophils above 1,500 (often 5,000 or more) with nerve damage, skin nodules, lung infiltrates or heart involvement. Needs urgent rheumatology assessment.
Adrenal insufficiency
Cortisol normally holds eosinophils down; in Addison's disease or after stopping long-term steroids the count rises, usually modestly, alongside fatigue, low blood pressure, salt craving, low sodium and high potassium.
Lymphoma, leukemia and myeloproliferative neoplasms
Hodgkin lymphoma and T-cell lymphomas raise eosinophils through IL-5 secretion; chronic myeloid leukemia, systemic mastocytosis and chronic eosinophilic leukemia (FIP1L1-PDGFRA, PDGFRB, FGFR1 or JAK2 rearrangements) produce eosinophils directly. Counts above 5,000, abnormal other cell lines and splenomegaly are the pointers.
Hypereosinophilic syndrome (HES)
Eosinophils above 1,500 for more than a month with organ damage and no other cause. Subtypes include the myeloid form (responds to imatinib) and the lymphocytic form (an abnormal T-cell clone driving IL-5). Diagnosed by exclusion with bone marrow and genetic testing.
Skin diseases and other inflammatory conditions
Bullous pemphigoid, severe eczema, scabies, Kimura disease, inflammatory bowel disease, sarcoidosis and some connective tissue diseases cause mild to moderate rises.
Allergic bronchopulmonary aspergillosis and coccidioidomycosis
ABPA in asthma or cystic fibrosis raises eosinophils and total IgE (often above 1,000 IU/mL); acute coccidioidomycosis (valley fever) in the US Southwest causes eosinophilia in about a quarter of cases.

Symptoms that can go with it

Often none; a mildly raised count is usually found incidentally
Sneezing, itchy eyes, nasal congestion, wheeze or cough with allergic disease and asthma
Itchy rash or eczema; widespread rash with fever and swollen lymph nodes in a drug reaction
Abdominal pain, diarrhea, bloating or food getting stuck when swallowing
Fatigue, weight loss, night sweats or fever, which point to infection, vasculitis or lymphoma
Numbness, tingling or weakness in a hand or foot, nosebleeds and sinus pain with EGPA
Breathlessness, chest pain, palpitations or ankle swelling if the heart is involved in hypereosinophilia

Low absolute eosinophils (eosinopenia)

There is no lower limit of concern for eosinophils, and a result of 0.0 or 0.01 ×10³/µL is a normal finding on many healthy people's reports. The reasons eosinophils disappear from the blood are almost all temporary: cortisol and adrenaline, released during acute infection, surgery, injury or emotional stress, pull eosinophils out of the circulation within hours, and corticosteroid medicines do the same more powerfully. A low count during an illness is so predictable that an eosinophil count near zero is used in hospital as one of the signs that favors bacterial infection or sepsis over a less serious illness.

Persistently absent eosinophils in someone who is well and not taking steroids are occasionally a clue to Cushing's syndrome (too much cortisol) or, rarely, to a marrow problem affecting all cell lines, in which case the other counts will be low too. If your count is zero and everything else on the CBC is normal, nothing further is needed.

Common causes

Acute infection, sepsis and physical stress
Endogenous cortisol and adrenaline drive eosinophils into tissue; counts fall to near zero within hours of a serious bacterial infection, surgery, trauma, burns or a heart attack and recover as you get better.
Corticosteroid medication
Prednisone, dexamethasone, hydrocortisone and high-dose inhaled or injected steroids reduce the count by 60 to 90 percent within 4 to 8 hours; it recovers within a day or two of the last dose.
Cushing's syndrome
Chronic cortisol excess from a pituitary or adrenal tumor suppresses eosinophils and lymphocytes while raising neutrophils, alongside weight gain, easy bruising, high blood pressure and high glucose.
Acute alcohol intoxication and some drugs
Heavy alcohol, adrenaline (epinephrine) and beta-agonists transiently lower the count.
Bone marrow failure
Aplastic anemia, chemotherapy and marrow infiltration lower all white cells including eosinophils; the low eosinophils are then the least of the findings.

Symptoms that can go with it

None from the low count itself
Symptoms, if any, are those of the trigger: fever and malaise with infection, or the effects of steroid treatment
Weight gain around the trunk, round face, thin skin and easy bruising if Cushing's syndrome is the cause

Read it alongside

Total white cell count — the absolute eosinophil count is the percentage multiplied by this; a high percentage with a low total count can still be normal.
Eosinophil percentage — useful as a flag, but grade severity by the absolute number.
Absolute neutrophils, lymphocytes, basophils and monocytes — basophils and immature cells rising with eosinophils point toward chronic myeloid leukemia or another myeloproliferative neoplasm.
Hemoglobin and platelets — anemia or abnormal platelets alongside eosinophilia make a marrow cause more likely and prompt a smear review and hematology referral.
Total IgE — raised in atopy, ABPA (often above 1,000 IU/mL) and some parasitic infections; very high IgE with eczema and infections suggests a primary immune disorder.
Serum tryptase — raised in systemic mastocytosis and in the myeloid form of hypereosinophilic syndrome.
Troponin, ECG and echocardiogram — ordered when the count is above 1,500, because eosinophilic heart damage is the main early danger.
Stool ova and parasites, Strongyloides serology, cortisol — the first-line tests for parasites and adrenal insufficiency once drugs and allergy are excluded.

What usually happens next

A first mild rise (0.5 to 1.5 ×10³/µL) in someone with known allergies, asthma or eczema is usually just repeated in 4 to 8 weeks when well and off steroids; a persistent result prompts a medication review and a history of travel, soil exposure and new symptoms.
Any count above 1.5 ×10³/µL is repeated within about four weeks; if still above 1.5, expect stool tests and Strongyloides serology, IgE, tryptase, vitamin B12, a blood smear review, cortisol and basic organ checks (liver and kidney function, troponin, chest X-ray).
Strongyloides is tested for before any corticosteroid course in someone with unexplained eosinophilia who has ever lived in or traveled to the tropics or the southeastern US, because steroids can turn a silent infection into a fatal one.
A count above 1.5 that remains unexplained, or any count above 5.0, is referred to hematology for a bone marrow examination with testing for FIP1L1-PDGFRA and related gene fusions, T-cell clonality and flow cytometry.
In asthma, ask whether your eosinophil count (above 150 to 300) changes which inhaler or add-on treatment is recommended; it is one of the markers used to guide steroid and biologic therapy.

Diet, lifestyle and natural levers with evidence

What can move AEC once the cause is known. Nothing here replaces finding the cause.

Identify and remove the trigger: drug, allergen or parasite

Strong evidence

This is the lever that moves the count the most. Drug-induced eosinophilia typically resolves within one to four weeks of stopping the culprit (longer after DRESS), treated parasitic infection normalizes the count over weeks to a few months, and in allergic disease the count falls as exposure and symptoms are controlled. In the large population study by Hartl and colleagues, people with asthma, atopy, smoking and obesity had the highest eosinophil counts, and these were the main modifiable associations.

Never stop a prescribed medication on your own because of an eosinophil result; ask the prescriber whether it is a plausible cause.

Elimination diet for eosinophilic esophagitis

Moderate evidence

Diet is a first-line option for eosinophilic esophagitis. A meta-analysis of 33 studies found the six-food elimination diet (milk, wheat, egg, soy, nuts, seafood) produced histologic remission in about 72 percent of patients, and a 2023 multicenter randomized trial found that eliminating cow's milk alone achieved remission in 34 percent compared with 40 percent for six foods, so many clinicians now start with milk alone. The effect is on tissue eosinophils; the blood count falls only in those whose blood count was raised to begin with.

Elimination diets need dietitian supervision and repeat endoscopy to confirm response and to reintroduce foods; prolonged unsupervised restriction risks nutritional gaps, especially in children.

Stop smoking and reduce excess weight

Preliminary evidence

In a general-population study of more than 11,000 adults, current smoking, obesity and the metabolic syndrome were each independently associated with higher blood eosinophil counts, and smokers with asthma or COPD tend to have more eosinophilic and more steroid-resistant airway disease. The expected change from quitting or losing weight is modest (tens of cells per microliter) rather than a fix for eosinophilia, but both improve the asthma and reflux that commonly accompany a raised count.

Vitamin D repletion if you have asthma and low levels

Preliminary evidence

An individual-participant meta-analysis of seven trials (955 people) found vitamin D supplementation reduced the rate of asthma attacks needing oral steroids by about 26 percent overall, with the benefit concentrated in people whose starting 25-hydroxyvitamin D was below 25 nmol/L (10 ng/mL). Trials have not shown a consistent fall in blood eosinophils, so treat this as a lever on the underlying disease rather than on the number.

Doses above 4,000 IU a day without monitoring can raise blood calcium; check a level first.

Time the test correctly: steroids, stress and the daily rhythm

Strong evidence

Eosinophils are up to 40 percent higher in the early morning than at midday and fall by 60 to 90 percent within hours of a dose of prednisone or during an acute illness. A test taken during a flare, after surgery or within 48 hours of a steroid dose can read falsely normal, while a test at the end of allergy season or after stopping steroids can read high. For a repeat that will be compared with the first, use the same time of day and be off oral steroids for at least a week if your clinician agrees.

When to see a clinician promptly

An absolute eosinophil count above 5.0 ×10³/µL (5,000 cells/µL), or any count above 1.5 with chest pain, breathlessness, palpitations, new numbness or weakness, or a widespread rash with fever: possible organ involvement or a severe drug reaction, same-day assessment.
A count above 1.5 ×10³/µL on two tests about a month apart with no clear allergic cause, so that parasites, adrenal insufficiency, vasculitis and blood disorders can be excluded.
Eosinophilia with fever, swollen lymph nodes, liver tenderness or a rash within 2 to 8 weeks of starting a new drug (anticonvulsant, allopurinol, antibiotic): DRESS can be fatal and the drug must be stopped promptly under medical advice.
Eosinophilia with unexplained weight loss, night sweats, bone pain, an enlarged spleen or abnormal hemoglobin or platelets on the same report.
Eosinophilia with worsening asthma, sinus disease and new nerve symptoms (foot drop, numb patches) or skin nodules, which suggest EGPA.
Unexplained eosinophilia if you have ever lived in or traveled to the tropics or the rural southeastern US, before starting any steroid treatment, because of Strongyloides.

Frequently asked questions

What is a normal absolute eosinophil count?

For adults, 0 to 0.5 ×10³/µL (0 to 500 cells per microliter) on most US reports, with most healthy people between 0.05 and 0.3. Some labs use 0.0 to 0.4 or quote a percentage of 1 to 6 percent. A result of 0 is normal. Children can run slightly higher. Always compare with the range printed on your own report because laboratories differ.

Is an eosinophil count of 0.5 or 0.6 high?

A count of 0.5 ×10³/µL (500 cells/µL) is the upper limit of normal on most reports, and 0.6 is mild eosinophilia. In someone with allergies, asthma or eczema it is an expected finding and is usually just rechecked when well. It becomes worth investigating if it persists with no allergic explanation, if it climbs toward 1.5, or if you have symptoms such as rash, diarrhea, fever or weight loss.

What level of eosinophils indicates cancer?

There is no cutoff that means cancer. The overwhelming majority of raised counts, even above 1,500, are from allergy, drugs or parasites. Blood cancers become a consideration when the count is persistently above 1,500 with no other cause found, when it is above 5,000, when hemoglobin, platelets or other white cells are abnormal, when the spleen or lymph nodes are enlarged, or when there is weight loss, night sweats or fever. Those situations lead to a smear review, a bone marrow test and genetic studies rather than to a diagnosis from the number alone.

What does eos abs high mean on my blood test?

It means your absolute eosinophil count is above your lab's upper limit, usually 0.5 ×10³/µL. In most adults that reflects an allergic condition such as hay fever, asthma or eczema, a medication, or less often a parasitic infection. Your clinician will usually repeat the test when you are well, review new medicines started in the past few months and ask about travel and symptoms; a count that stays above 1.5 gets a fuller work-up.

Can allergies or asthma raise absolute eosinophils?

Yes. Allergic rhinitis, asthma, atopic dermatitis and chronic sinusitis with polyps are the most common reasons for a count between 500 and 1,500 cells/µL, and counts rise during pollen season or an asthma flare. In asthma, a blood eosinophil count above about 150 to 300 identifies the 'eosinophilic' type that responds well to inhaled steroids and, if severe, to anti-IL-5 biologic treatments, which is why your asthma clinician may track it.

What is the difference between eosinophil percentage and absolute eosinophils?

The percentage is the share of your white cells that are eosinophils; the absolute count is the actual number per microliter and is what clinicians use. The two can disagree: 10 percent of a white count of 3.5 is 0.35 (normal), while 5 percent of a white count of 14 is 0.7 (mildly high). If your report only shows a percentage, multiply it by the total white cell count to get the absolute value.

Can stress or steroids affect the eosinophil count?

Yes, strongly, in the downward direction. Cortisol, whether from stress, illness or a steroid medicine such as prednisone, drives eosinophils out of the blood within hours and can bring the count to zero. This is why a count taken during an acute illness or soon after a steroid dose may look normal when it is really raised, and why the test is repeated when you are well and off steroids before any conclusions are drawn.

Should I worry if my eosinophils are 0?

No. Zero or 0.01 is a normal result on many healthy people's reports, and transiently absent eosinophils are expected during infections, after surgery and on steroids. The only situations where a persistently absent count is a clue are Cushing's syndrome, where you would also have weight gain, bruising and high blood pressure, or marrow failure, where the other counts would be low too.

References

Eosinophil count – absolute. MedlinePlus Medical Encyclopedia, US National Library of Medicine (2023)
Blood differential test. MedlinePlus, US National Library of Medicine (2023)View source
Eosinophilia: causes. Mayo Clinic (2024)View source
Eosinophilia. Merck Manual Professional Version (2024)
Valent P, Klion AD, Horny HP, et al.. Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes. Journal of Allergy and Clinical Immunology (2012)
Shomali W, Gotlib J. World Health Organization-defined eosinophilic disorders: 2022 update on diagnosis, risk stratification, and management. American Journal of Hematology (2022)
Roufosse F, Weller PF. Practical approach to the patient with hypereosinophilia. Journal of Allergy and Clinical Immunology (2010)
Hartl S, Breyer MK, Burghuber OC, et al.. Blood eosinophil count in the general population: typical values and potential confounders. European Respiratory Journal (2020)
Arias Á, González-Cervera J, Tenias JM, Lucendo AJ. Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis. Gastroenterology (2014)
Kliewer KL, Gonsalves N, Dellon ES, et al.. One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trial. Lancet Gastroenterology and Hepatology (2023)
Jolliffe DA, Greenberg L, Hooper RL, et al.. Vitamin D supplementation to prevent asthma exacerbations: a systematic review and meta-analysis of individual participant data. Lancet Respiratory Medicine (2017)
Kovalszki A, Weller PF. Eosinophilia. Primary Care: Clinics in Office Practice (2016)

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This page is educational and is not medical advice or a diagnosis. Lab results have to be interpreted together with your history, symptoms and other results by a clinician who knows you. Do not start or stop a supplement to change a lab value before the cause is known.