Platelet Count - Too Less, Too Many, Risk Factors, and Management

Introduction

Platelets, also known as thrombocytes, are the cells that circulate within our blood. They bind together with each other (form a clot) and to the damaged vessel wall. They are smaller than red or white blood cells and are formed in the bone marrow.

What Is a Healthy Platelet Count?

A quick, common test to measure platelet is done by taking a complete blood count (CBC).

A normal count of platelets ranges from 150,000 to 400,000 per microliter of blood. Each platelet lives only about ten days; your body normally regulates your platelet supply continually by generating new platelets in your bone marrow.

What Is a Low Platelet Count?

When you do not have enough platelets, or below the count of 150,000, it is called thrombocytopenia. Below 50,000 is an alarmingly low platelet count. Below 10,000 is severe thrombocytopenia, often resulting in internal bleeding.

Low platelet count can be divided into three main causes:

1. Inadequate platelets are being made in the bone marrow.

2. Platelets are being demolished in the bloodstream.

3. More platelets are being destroyed in the spleen or liver.

Symptoms include easy or excessive bruising, and frequent bleeding from the gums, nose, or GI tract, fatigue. The platelet count drops when one or more causes prevent the body from producing platelets, such as:

• Medications.

• Inherited condition.

• Certain types of cancer, such as leukemia (blood cancer).

• Chemo and radiation therapy for cancer.

• Infectious kidney or its malfunction.

• Frequent alcohol consumption.

• Autoimmune disorder.

What does a Low Platelet Count mean?

Low platelets (thrombocytopenia) mean less or delayed clot formation resulting in profuse bleeding. Low platelet can result from one or more of the following reasons:

• Presence of bone marrow function damage. Undergone toxic treatments, such as chemo or radiation therapy.

• Certain cancerous diseases, such as leukemia or lymphoma.

• Certain medicaments.

• Spleen deformity.

• Alcohol uptake.

• Hemolytic uremic syndrome (a disease that reduces platelets).

• Immune thrombocytopenia (bleeding spots or bruises under the skin due to low platelets).

• Profuse bleeding caused by an injury.

• Thrombotic thrombocytopenic purpura (formation of blood clots in small blood vessels throughout the body).

• Viral and bacterial infections.

• Liver disease.

• Nutritional deficiency.

What Does It Mean to Have Too Many Platelets?

Having too many platelets is called thrombocytosis, and there are two types:

• Primary or Essential Thrombocytosis – A rare bone marrow condition in which abnormal cells produce a huge number of platelets. It is a chronic condition and is caused by a genetic mutation; its occurrence is uncertain.

• Secondary Thrombocytosis – The same condition as primary thrombocytosis, but caused by a present ongoing condition or diseases such as anemia, cancer, inflammation, infection, or genetic disorder.

• Secondary or reactive thrombocytosis is a temporary rise seen in the blood cells in response to an underlying condition. At the same time, the response itself is usually a normal part of acute inflammatory processes.

• It rectifies when the underlying condition is treated. The symptoms include spontaneous blood clots in the arms and legs, which, if untreated, can lead to heart attack and stroke.

• In severe cases, the treatment that is performed is called plateletpheresis. It lowers the total platelet count by extracting the blood, separating the platelets, and returning the red blood cells to the body. The symptoms that appear are usually related to the associated condition.

A high platelet (thrombocytosis) count can cause multiple clot formation in your blood vessels resulting in blockage of arteries. Or it may cause profuse bleeding if the platelets interfere with clotting. It could be a sign of:

• Weakened Immune system.

• Inflammation with infection.

• Defective genes that control platelet production.

• Toxic treatments.

Symptoms and complications of too many platelets (thrombocytosis) include:

• Bruising easily.

• Chest pain.

• Thrombosis (clotting of blood, when not required).

• Profuse bleeding from minor cuts, gums, or noses.

• Lump formation in legs.

• Lungs abnormality.

• Blockage formation, causing a stroke.

• Tingling sensation or burning in your fingertips, hands, and feet (extremities).

• Illness, dizziness, or fatigue.

How Do Platelets Relate to Cardiovascular Disease?

If you have too many platelets, it increases the risk of clotting. The risk of cardiovascular malfunction has more association with platelet function and not the number of platelets. Meaning even if you have a healthy number of platelets, if they are sticking together too much, it becomes thick, and their mobility is reduced. You are more prone to having a heart attack or stroke.

What Makes Platelets Change Their Shape?

Platelets; are the smallest among the blood cells. They are shaped like small plates in their inactive form (hence the name). A blood vessel signals platelets when damaged. Platelets react by reaching the area and changing into their “active” form. Platelets reach out to the broken blood vessel by growing long tentacles, resembling a spider or an octopus.

Are There Any Risks in Taking the Test?

There is little to no risk involved with having your blood taken for a platelet count test. Withdrawing a blood sample from some people may be more difficult than from others as veins and arteries vary in size. Other risks are slight but may include:

• Profuse bleeding.

• Collapsing or feeling lightheaded.

• Multiple punctures to locate veins.

• Hematoma (accumulation of blood).

• Infection (open wound).

How Can I Increase My Platelet Count?

An abnormally low platelet count can be treated and managed numerous times. If the thrombocytopenia is not showing any of the above-mentioned symptoms, then unnecessary medication should be avoided. For certain forms of thrombocytopenia, a Corticosteroid drug Prednisolone is prescribed, which suppresses the immune system.

Foods to eat to increase platelet count include:

• Folate-rich foods.

• Foods that are rich in vitamins B-12, C, D, and K.

• Iron-rich foods.

Supplements of these nutrients are also available and may help raise a person’s platelet count. Foods to avoid include:

• Alcoholic drinks.

• Artificial sweetener.

• Cranberry juice.

• Quinine- a substance in tonic water and bitter lemon.

Supplements:

• Chlorophyll.

• Papaya leaf extract.

• Melatonin.

• Platelet boosters such as Eltrombopag and Romiplostim are prescribed as well.

How to Decrease High Platelet Count?

So far, there have not been any proven treatments for essential thrombocythemia; treatments can control symptoms and reduce complications. Life span is not affected for people with this condition. Aspirin makes platelets less adhesive, so your blood forms fewer clots. If you're also pregnant, Aspirin has a low risk of causing side effects to the fetus to reduce your platelet count. Your doctor may suggest one of the following prescription drugs, perhaps along with low-dose Aspirin:

• Hydroxyurea (Droxia, Hydrea).

• Anagrelide.

(These drugs come with a range of side effects, including nausea, dizziness, diarrhea, ulcers in the mouth, hair loss, heart problems, depression, and more).

Are There Any Emergency Procedures For Decreasing Platelet Count?

A medical procedure called platelet-pheresis is done in emergencies, such as after a stroke or other dangerous blood clotting. It involves passing your blood through a device that removes platelets and then returns the blood containing RBC and others to your body. This is a temporary measure to lower your platelet count.

How Can Healthy Platelet Count be Maintained?

Choosing healthy lifestyle habits can lower your risk of developing conditions such as high blood sugar, high blood pressure, and high blood cholesterol.

• Eat healthy foods. Choose a varied diet rich in whole grains, vegetables, and fruits and low in saturated fats. Avoid trans fats. Maintain correct portion control to obtain a normal weight.

• Everyone should have 30 minutes of intense physical activity a day. Go for a brisk walk daily, bicycle riding, or swimming, meditate and do yoga.

• Stop smoking. Smoking causes increased blood clots.

Conclusion

A platelet count is a quick, easy test that counts the total number of platelets in your blood. Platelets are cell fragments that help your blood to form a clot when necessary. A low platelet count might be a sign of certain infections or certain diseases. A high platelet count can increase the risk of unnecessary blood clots or stroke.