Your bloodstream has several types of cells flowing through it. Each cell type has an important job. Red blood cells help deliver oxygen throughout the body. White blood cells help your immune system fight infections. Platelets, which are small colorless cells, help your blood clot.
If you have low platelet levels in your blood, it’s known as thrombocytopenia, or “thin blood.” A normal platelet count is between 150,000 and 450,000 platelets per microliter of blood. Anything less than 150,000 platelets per microliter is considered thrombocytopenia.
Although mild cases usually aren’t cause for concern, serious complications are possible if your levels get into the 10,000 to 20,000 platelet range.
Keep reading to learn more about why low platelet levels happen, how to recognize the symptoms, and more.
A number of things can lead to low platelet levels. For example, your bone marrow may not make enough platelets. Or, your bone marrow may manufacture plenty of platelets, but they don’t survive in the body.
Underlying medical conditions can also reduce your platelet levels. Some of the more common conditions include:
If your diet is low in iron, folate, or vitamin B-12, you may be at risk for thrombocytopenia. This is especially true if you also consume large quantities of alcohol. Excessive alcohol consumption can affect your body’s ability to absorb vitamin B-12.
Changing your diet to include less alcohol and more foods rich in iron, folate, and vitamin B-12 may help restore your platelet levels. Your doctor may also recommend a daily supplement to help supply these important nutrients.
Although an infection can sometimes suppress your body’s platelet production, it can also spark the opposite. That said, more platelet activity can also lead to faster platelet destruction. Both cases result in fewer platelets circulating in your bloodstream.
Common infections resulting in a low platelet count include:
Platelet levels can drop for several other reasons, including:
- Pregnancy. According to the National Heart, Lung, and Blood Institute, approximately 5 percent of women develop temporary thrombocytopenia while pregnant.
- Autoimmune diseases. An autoimmune disease is a condition in which the body’s immune system mistakenly attacks healthy cells and tissue as though they were foreign objects or infections. Lupus and rheumatoid arthritis are two common autoimmune diseases that affect platelet levels.
- Surgery. When blood passes through tubes for a blood transfusion or a heart-lung machine during heart surgery, platelets can be lost along the way.
- Cancer. Certain cancers, such as leukemia and lymphoma, can cause low platelet production. Chemotherapy and radiation therapy can also affect platelet counts.
Certain medications can also cause platelet levels to drop. These include:
- diuretics, commonly used to treat high blood pressure
- heparin, which is prescribed to help prevent blood clots
- over-the-counter pain relievers like aspirin (Bayer) and ibuprofen (Advil)
If you have mild thrombocytopenia, you may not have any noticeable symptoms. The condition is often discovered during routine blood work when lab results show low levels of platelets.
The more obvious signs of thrombocytopenia are changes in external bleeding. Platelets help blood clot by clumping together to stop an injury from bleeding too much. If you’ve ever cut your finger and noticed that it stops bleeding soon and begins to heal, that’s healthy blood clotting.
If the same kind of cut bleeds longer than it should, it could be thrombocytopenia. The same is true if brushing or flossing your teeth start to cause bleeding. Other signs of thin blood include nosebleeds and abnormally heavy menstrual flow.
Thin blood can also cause bruises to appear under the skin. A minor bump can cause the tiny blood vessels under the skin to bleed. This can result in purpura, which are small purple, red, or brown bruises. These bruises can develop easily and frequently.
Another sign of thrombocytopenia is petechiae. These are small red or purple spots on the skin.
If you’re experiencing internal bleeding, you may notice blood in your urine or stool.
At your appointment, your doctor will review your medical history and your current health and behaviors. You should be prepared for questions about your:
- diet and alcohol intake
- medication and supplement use
- family history of low platelet levels or other blood disorders
- history of blood transfusions and any intravenous drug use
Your doctor will measure your platelet levels with a blood test. They may also recommend a bone marrow test to see if and why your bone marrow isn’t making enough platelets.
In some cases, they may also recommend an ultrasound of your spleen to check for any irregularities.
Treating thrombocytopenia often means treating the condition causing thin blood. For example, if the drug heparin is causing your platelet count to drop too low, your doctor may recommend you switch to a different anti-platelet drug. If alcohol use is a factor, you may be advised to reduce or avoid alcohol consumption entirely.
There are also medications that can help treat thrombocytopenia. Corticosteroids, such as prednisone, can help slow down platelet destruction. Drugs like eltrombopag (Promacta) and romiplostim (Nplate) can actually help your body produce more platelets.
In some cases, your doctor may recommend a platelet transfusion to help restore your levels.
Even with treatment, managing thrombocytopenia means being on the lookout for signs that your platelet levels have dropped. Pay attention to signs of excessive bleeding. Report them to your doctor immediately.
Your outlook depends primarily on the cause of your thrombocytopenia. If pregnancy is the cause, then your levels should be back up soon after you deliver your baby. If you take a drug to restore your platelet levels, it could be a few months or a year before your levels are healthy again.
Take your medications and follow the advice of your doctor. It’s the surest way to recover completely and as quickly as possible.