Thrombocytopenia is a condition where your blood has a lower-than-normal number of platelets. Platelets, also known as thrombocytes, are produced in the bone marrow and help form clots to stop bleeding. A normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood. If the count falls below 150,000, it’s considered low.
When your platelet count is low, it may be difficult to stop bleeding effectively. Bleeding can happen internally, beneath the skin, or on its surface. Serious bleeding issues arise when the platelet count becomes very low, potentially leading to life-threatening situations, especially if bleeding occurs in the brain. Getting medical help early is important to prevent severe complications. Platelets can also detect and respond to foreign invaders by releasing proteins to fight infections. Therefore, thrombocytopenia can increase your chances of not stopping bleeding and fighting infections effectively.
The exact number of people with thrombocytopenia is uncertain because it’s often underdiagnosed and underreported. The main signs of thrombocytopenia usually relate to bleeding. You might not notice any symptoms initially, but they can appear suddenly or develop over time. Many cases are identified during routine blood tests. Common signs include easy bruising, frequent nosebleeds, prolonged bleeding from cuts, or excessive bleeding during surgery.
Thrombocytopenia can result from three main causes: inadequate platelet production in the bone marrow, increased breakdown of platelets in the bloodstream, or their increased breakdown in the spleen or liver. Other factors, such as certain medications, including chemotherapy, and environmental toxins like pesticides, arsenic, and benzene, can also impact platelet production. Unhealthy habits, like heavy alcohol consumption, can temporarily reduce your platelet count, particularly if your vitamin B12 or folate levels are low.
Diagnosing thrombocytopenia involves your healthcare provider reviewing your medical history, asking about symptoms, and conducting a physical exam to look for bleeding signs. Additional blood tests like a complete blood count (CBC) or a blood smear test might be necessary, and sometimes, bone marrow tests are done to assess its health.
If thrombocytopenia or another bleeding disorder is suspected, you might be referred to a hematologist, a specialist in blood disorders. Treatment depends on the cause and severity of symptoms. Mild cases might not need treatment, but severe cases with significant bleeding might require medications or procedures. Addressing the underlying cause of low platelet counts is vital. If a medication is lowering your platelet count, switching medications might be advised. For instance, if an immune response is involved, immunosuppressants might be prescribed. Corticosteroids like prednisone, or medicines like Promacta (eltrombopag) and Nplate (romiplostim), can help boost platelet production.
If medications aren’t working, blood or platelet transfusions might be necessary, particularly for those with severe bleeding risks. In some cases, surgery to remove the spleen, called a splenectomy, may be considered, but it’s typically a last resort due to potential risks like bleeding, infection, and abnormal blood clots.
Currently, there is no way to prevent thrombocytopenia, but you can manage your risk by discussing any health conditions or medications with your provider, and working together on a plan to minimize risks. Stay alert for symptoms of infections, as having your spleen removed increases this risk. Preventive measures like vaccinations might be discussed. If you smoke, quitting can improve your health significantly, as smoking raises the risk of clots. Avoid contact sports and check with your provider about safe physical activities. Use safety precautions like seatbelts and protective gear when necessary.
Always take medicines as prescribed, and inform your healthcare provider about your medications before any surgery or dental work, as some medicines can increase bleeding risks. Avoid substances that might lower your platelet count or interfere with their function, such as aspirin and ibuprofen. Regular check-ups with your provider can help manage low platelet levels and prevent complications. Though thrombocytopenia is not cancer, it can stem from cancerous conditions like leukemia or non-cancerous conditions such as liver disease.
Your treatment for thrombocytopenia will depend on the root cause. If medications are responsible for your low platelet count, a change in medication might be suggested. Consulting your healthcare provider is crucial to understanding what’s causing your thrombocytopenia.
