I have ITP. Can lifestyle changes prevent platelet drop?

Question

Hello doctor,

I am a 44-year-old female diagnosed with chronic ITP about a year ago. My platelet count was 28,000/µL initially and is now 45,000/µL on Eltrombopag 50 mg daily. I bruise easily, sometimes have nosebleeds, and occasionally have gum bleeding. CBC and liver tests are monitored monthly.

But, I have a few concerns which include-

Should I consider adjusting Eltrombopag if platelets do not rise further, or are there other safer alternatives?
How often should I see a hematologist for long-term follow-up?
Are there specific lifestyle changes or foods that could help prevent sudden drops in platelets?
What signs should prompt urgent care immediately?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and I understand that you have ITP (immune thrombocytopenia), and currently you are using Eltrombopag 50mg daily with a last platelet count of 45,000/µL (microliter) and mild bleeding tendency with these counts.

Your monthly frequency of CBC (complete blood count) and LFTs (liver function test) is adequate for someone on Eltrombopag.

Your last platelet count shows a good response. If counts drop or bleeding worsens, the dose can be increased up to 75 mg daily after consulting with your hematologist. There are alternatives to Eltrombopag, such as Romiplostim, that can be considered in case Eltrombopag does not work.

You should see your hematologist every two to three months if counts are stable. You may have to see him or her urgently if bleeding worsens or counts drop dramatically.

Unfortunately, the evidence regarding certain foods like papaya leaf increasing platelets is weak.

You should avoid using medications that can worsen bleeding, like NSAIDs (non-steroidal anti-inflammatory drugs), anticoagulants, and certain antibiotics. Keep a balanced diet, providing iron and vitamins for cell production.

Take precautions against viral infections such as dengue that can cause platelets to drop. If you develop severe bleeding from the nose, gums, menses, or blood in vomit, stool, and urine, see the doctor urgently.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.