Reviewed By: Pramod Kerkar, MD, FFARCSI

If you wish to know all about platelet count, effects of low platelet count, its causes and ways to increase the platelet count, here’s an interesting article for you!

What is Meant by Low Platelet Count or Thrombocytopenia?

Platelet is one of the cellular components of the blood along with red and white blood cells. Like other cells in the blood, platelets are also made in the bone marrow. Platelets generally have a small lifespan of around 7 to 10 days in the blood, after which they are eliminated from circulation. Platelets participate in coagulation and play a vital role in clotting and bleeding. The term platelet count refers to the number of platelets in the blood stream. The normal platelet count is 150000 to 400000 platelets per micro litre. Low platelet count, or thrombocytopenia, is a condition wherein an individual has less than 150,000 platelets per microliter in blood.

Thrombocytopenia can be inherited or acquired during certain conditions. Even though platelet numbers are decreased in thrombocytopenia, their function generally remains completely intact. But the existence of underlying medical conditions can affect the functioning of the platelets in spite of having a normal; platelet count. In mild thrombocytopenia, adverse effects in the clotting or bleeding pathways may not be observed. A platelet count under 10,000 in an individual is referred to as severe thrombocytopenia and can result in spontaneous bleeding. These effects differ from person to person depending on the various low platelet counts.

What Causes Low Platelet Count or Thrombocytopenia?

What Causes Low Platelet Count or Thrombocytopenia?

Low platelet counts or thrombocytopenia can occur due to a variety of reasons to include:

Lesser Platelet Production. Diminished production of platelets is caused by vitamin deficiencies, viral infections, certain drugs and aplastic anemia. Decreased platelet production is generally linked to bone marrow problems which affect RBC and WBC production. Some viral infections which adversely affect the bone marrow are rubella, mumps, parvovirus, hepatitis C, HIV, chickenpox, and EBV. Aplastic anemia caused by certain viral infections, medications or radiations can lead to decrease in platelet production too. Deficiency of folic acid and vitamin B12, prolonged alcohol consumption, bone marrow and blood cancer, chemotherapy drugs, and certain medications like thiazide diuretics can also reduce the platelet production.

Greater Platelet Consumption or Destruction. Increased platelet consumption or destruction is observed in a number of medical conditions. They can be classified into immune related and non-immune related causes. Some rheumatologic conditions like systemic lupus erythematosus (SLE) and other autoimmune conditions like Idiopathic thrombocytopenic purpura (ITP) can result in platelet destruction and cause low platelet count. Organ transplantation, transfusion of blood products can also decrease the platelet count due to immunological disturbances. A number of medications can cause low platelet count by triggering immunologic reaction against the platelets. This is called drug-induced thrombocytopenia. Some of the medications that can cause this condition are digoxin, quinine, quinidine, Sulfonamide antibiotics, rifampin, and acetaminophen. Thrombocytopenia is also caused by the use of the blood thinners like Heparin, and other similar medications. Thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), HELLP syndrome and disseminated intravascular coagulopathy (DIC) are some other conditions that can cause low platelet counts due to non-immune thrombocytopenia. Vasculitis can cause destruction of blood vessels. Severe infections like sepsis or an injury or trauma can lead to a condition called consumptive thrombocytopenia. Increased destruction of platelets can also be caused by pregnancy.

Increased Splenic Sequestration. Splenic sequestration can also lead to decreased platelet counts resulting from enlargement of spleen or change in spleen function due to a host of reasons. Common causes of thrombocytopenia resulting from splenic enlargement include advanced liver disease with portal hypertension and blood cancers.

What are the Effects of Low Platelet Count or Thrombocytopenia?

Many a times, low platelet count or thrombocytopenia does not display any symptoms, especially if mild, and can be identified only by chance in routine blood work done for other reasons. However, some common symptoms of thrombocytopenia are petechiae, fatigue, easy or excessive bruising, bleeding from the skin, gums and nose, prolonged bleeding cuts, jaundice, enlarged spleen, heavy menstrual bleeding, blood in urine and stool, difficulty in stopping bleeding, and deep vein thrombosis (DVT). Individuals experiencing any one or more of these symptoms should seek in-time medical care.

How is Low Platelet Count or Thrombocytopenia Diagnosed?

Thrombocytopenia is mostly detected incidentally in routine blood work done for other reasons. Sometimes, urinalysis and bone marrow biopsy may also be required to confirm the diagnosis.

What Are The Ways To Increase The Platelet Count Naturally?

In case of mild thrombocytopenia, the platelet count can be raised through diet and supplements. Foods with high vitamins and minerals content can help the body produce and maintain platelets in the blood. Consuming more of vitamin B12, vitamin C, iron and folate helps to keep the platelets and the overall body, healthy. While these nutrients are available in supplement form, it is always advisable to try and get them naturally from foods. Vitamin B12 rich foods are beef liver, eggs, clams, dairy products such as milk and cheese, while good sources of vitamin C include mangoes, pineapples, cauliflower, tomatoes, broccoli, red and green bell peppers. Foods like mussels, lentils, pumpkin seeds, beef have high iron content and folate is amply present in foods like peanuts, kidney beans, black-eyed peas and orange.

Certain natural extracts and supplements also help to improve platelet counts. Papaya leaf extract is believed to significantly boost platelet count if taken in recommended doses. Papaya leaf extract are available in pill form in many health food stores. For patients with Dengue fever, papaya leaf juice has proven to effectively improve the rate of increase of platelet count. Colostrum is the first substance which a baby cow receives from its mother. Colostrum supplements render beneficial effects on platelet counts and immune responses. Taking a chlorophyll supplement has also proven useful in relieving symptoms, like fatigue, in thrombocytopenia patients. Melatonin, which is naturally produced in the human body, helps to relieve thrombocytopenia symptoms too. Melatonin improves sleep and increases platelet counts. Melatonin is also available in the form of a tablet or liquid, or lotion, in many health food stores. However, since supplements and herbs are not monitored by the FDA, one should only take them after consulting a health care practitioner.

How is Low Platelet Count or Thrombocytopenia Treated?

The treatment of Low Platelet Count or Thrombocytopenia largely depends upon the cause and the severity of the condition. While some cases may need specific or emergent treatments, others can be managed simply with occasional blood draws and monitoring of the platelet levels. The doctors can prescribe steroids to suppress the immune system in patients with auto-immune thrombocytopenia and impair the destruction of platelets. Intravenous immunoglobulins or monoclonal antibodies are at times also given to suppress the immune system in severe cases. In cases where the condition becomes refractory, a splenectomy may be required to treat. To manage drug-induced Low Platelet Count or Thrombocytopenia, the patient would need to discontinue or limit the use of the causal medication, under the guidance of a doctor. For patients diagnosed with TTP or HUS, the treatment would include plasmapheresis, plasma exchange, or eculizumab. Dialysis may be essential in cases of patients with severe kidney failure. Generally, platelet transfusion is only necessary if an individual with low platelets has an active bleeding or hemorrhage, or requires a surgery or other invasive procedures. A platelet transfusion is often recommended when the platelet count is less than 10000, even if no bleeding is experienced. In suspected cases of TTP or HIT, transfusion of platelets is not advisable as the new platelets can potentially worsen and prolong the condition.

What Are The Foods & Drinks That Can Decrease The Platelet Count?

While some foods and drinks can spike up the platelet count, others can lower it. Some of these platelet count lowering foods and drinks include tahini, cow’s milk, alcohol, cranberry juice and tonic water. Consumptions of these should be avoided. Ones with very low platelet count, i.e. severe thrombocytopenia, are however advised to seek immediate medical treatment to avoid serious complications.

What is the Prognosis for Low Platelet Count or Thrombocytopenia?

Thrombocytopenia, if not treated properly, can cause complications like organ damage and even fatality. So one should immediately seek medical attention if experiencing any severe symptoms of thrombocytopenia or low platelet count. Depending upon the cause, thrombocytopenia can be prevented. However, many causes are still not preventable. If treated effectively and early, the prognosis for thrombocytopenia or low platelet count is generally good. However, low platelet count is diagnosed in the later course of the disease, or if caused by HIT, then the prognosis worsens.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: January 23, 2019

This article does not provide medical advice. See disclaimer

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