Platelets are a type of blood cell. They play an important role in healing injuries that result in bleeding. Platelets help your body to form blood clots and stop bleeding.
Some people’s platelets don’t function the way they should. This is known as a platelet function disorder. Such disorders may be inherited, but they can also be “acquired.” Acquired platelet function disorders may be caused by medications, diseases, or even certain foods. They are some of the most common types of blood disorders.
Symptoms of these disorders vary. They can be either mild or severe. They can include:
- unexplained bruising throughout the body
- bleeding from your nose, mouth, or gums
- heavy or prolonged menstrual bleeding
- bleeding under your skin
- bleeding into your muscles and joints
- blood in your vomit or feces
- internal bleeding
- small red bumps on your skin (petechiae)
Platelets work with proteins known as clotting factors to help the body stop bleeding after an injury. When a blood vessel is damaged, platelets are the first on the scene. They cover the injured spot in layers to block the flow of blood. Eventually they form a temporary plug. This is the first stage of blood clotting. Later stages strengthen the clot and the body gets ready to heal.
When someone has a platelet disorder, the plug doesn’t form properly. Bleeding may go on longer than it should. Platelet disorders can also affect later stages of clotting. This can be particularly dangerous after an injury or surgery.
Platelet function disorders have three main causes — medications, diseases, and foods. They can also be caused by supplements.
Platelet function can be affected in different ways. There may be changes in how the body signals to platelets. Platelets can become less sticky. Platelet disease can also affect other stages of the clotting process.
Scientists don’t always understand why or how platelet function is affected. However, they can still see the changes that occur. Some things that are known to affect platelets include:
- pain relievers such as ibuprofen and naproxen
- asthma medications
- sildenafil (Viagra)
- drugs used to prevent blood clots, such as clopidogrel (Plavix)
- antidepressant and antipsychotic drugs
- chemotherapy drugs
- cholesterol-lowering drugs (statins)
- calcium channel blockers
- nitrites in foods, such as lunch meat and bacon
- omega-3 fatty acids (like fish oil)
- vitamin E
- ginkgo biloba
- dong quai
- willow bark
- chronic myeloproliferative disorders
- myelodysplastic syndrome
- acquired von Willebrand disease
- autoimmune responses
- thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS)
- liver failure
- kidney failure
- disseminated intravascular coagulation (DIC)
- heart disease
Foods and Dietary Supplements
Diagnosing a platelet problem takes several steps. Your doctor will ask you about bleeding problems. They will also ask about any medications and supplements you take. It’s important to be honest as even natural products can affect your platelet function.
Lab tests can also be used to look for bleeding problems. These tests look for different things:
- A complete blood count (CBC) details the number of blood cells by type. It tells your doctor if you have healthy numbers of red blood cells, white blood cells, and platelets. It also checks if your blood cells are found in the right proportions.
- Prothrombin time (PT) shows how fast your blood clots.
- Partial thromboplastin time (PTT) is another test of blood clotting time.
- Bleeding time studies test how long it takes for you to stop bleeding after an injury.
- Platelet aggregation studies check how sticky your platelets are.
- Platelet counts count your platelets.
- The blood urea nitrogen (BUN)/creatinine test evaluates kidney function.
Your doctor may also test you for underlying conditions that can cause platelet function disorders.
There are a number of treatments for this condition. Your doctor’s choice of treatment will depend on whether they want to:
- quickly stop you from bleeding
- treat the condition that is causing your clotting problem
- reduce your risk of bleeding during surgery
Doctors have several options to stop active bleeding. They can give you an infusion of donated platelets. They can prescribe a clotting factor to make it easier for your blood to clot. Sometimes a drug called desmopressin (DDAVP) is also used. It tells your body to release any hidden stores of clotting factor. This gives you a quick, but short-term, boost in clotting ability.
Treating Underlying Conditions
If you are not actively bleeding, your doctor will want to try to prevent future bleeds. This means they have to fix whatever is causing your clotting problem. That may be easy, if it just means stopping a supplement or medication. However, it can also require diagnosing and treating an underlying illness. Sometimes, treating the cause of the platelet disorder isn’t possible. In those cases, your doctor may focus on managing your symptoms.
Reducing Bleeding Risks Before Surgery
If you have a platelet disorder, talk to your doctor before you have surgery. There are ways to minimize your bleeding risk. Your doctor might try to boost your natural clotting factors and platelets with medication. In severe cases, you might also need an infusion of platelets before, during, and/or after surgery. You should also avoid taking aspirin or other over-the-counter medications that can increase bleeding risk.
Sometimes platelet problems are easily solved. You may just need to avoid a certain food or switch to a different drug. Other times, control can be more difficult. If your platelet problems are caused by a serious disease, your outlook may depend on how well you manage that condition.