Why platelet count is important and how to help to maintain healthy platelet counts

What are platelets and why is platelet count important?

Platelets are the smallest blood cells in our bodies. They are so small that they can only be seen under a microscope. These cells take their name from the fact that they are literally shaped like a tiny plate, in their ‘non-active’ form. Platelets are ‘activated’ when they receive a signal that a blood vessel is damaged somewhere in our body. Our platelets travel to the area of damage and transform into their ‘active’ form, in which they attach to the damaged blood vessel by growing long ‘tentacles’ resembling those of an octopus, but at a micro scale.

The job of our platelets is to essentially stop bleeding. On becoming active at the point of blood vessel damage, our platelets bind together to form a blood clot. This blood clot stops you bleeding, such as when you get a cut.

What is normal platelet count?

Normal platelet counts are in the range of 150,000 to 450,000 per microliter of blood. A microliter is one millionth of a litre. Considering these mind boggling numbers for a second gives a sense of just how small our platelets are.

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What causes low platelets count?

Thrombocytopenia is the medical name for having too few platelets in your blood.

Thrombocytopenia causes

Thrombocytopenia is often caused by another separate disorder such as immune system problems or leukaemia. It can also be a side effect of taking certain medications, including heparin, quinine, sulpha-containing antibiotics and anticonvulsants.

Thrombocytopenia symptoms

Low platelet counts (thrombocytopenia) may not cause any noticeable symptoms. However, in rare cases at the other end of the scale, the number of platelets may be so low that it causes dangerous internal bleeding.

Signs of thrombocytopenia can include:

• A rash of pinpoint sized dark red or purple coloured spots, which usually occurs on the lower legs
• Bleeding from your nose or gums
• Blood in stools or urine
• Fatigue
• Jaundice
• Cuts which continue to bleed
• Tendency to bruise easily

You should seek medical attention if you show any symptoms that you are worried about. Bleeding that won’t stop is a medical emergency and you should seek medical help immediately.

Thrombocytopenia treatment

If you have mild thrombocytopenia you may not need treatment. However some people develop a severe or chronic (long term) thrombocytopenia condition. Depending on the cause, treatments for thrombocytopenia can include treating the underlying cause, blood or platelet transfusions, medications, plasma exchange or surgery.

What causes high platelets count?

Thrombocytosis is the medical name for having excessively high platelets counts in your blood.

Thrombocytosis causes

There are two forms of thrombocytosis classified by the medical profession:

Essential thrombocytosis– also known as primary thrombocytosis is a rare disorder were your body produces excessive platelets. Bone marrow abnormalities can cause an increase in platelets, but the reason for this is unknown.

Reactive thrombocytosis – also known as secondary thrombocytosis, this form of thrombocytosis is caused by an underlying condition such as infection.

Thrombocytosis symptoms

Reactive (secondary) thrombocytosis is unlikely to cause noticeable symptoms. Signs and symptoms of secondary thrombocytosis are more often caused by the underlying condition. When symptoms of secondary thrombocytosis do occur they are usually not life threatening and include

• Headache
• Dizziness
• Chest pain
• Feeling weak
• Fainting
• Temporary vision changes
• Numb or tingling hands and feet

Essential (primary) thrombocytosisalso may not cause noticeable symptoms. Developing a blood clot (thrombus) can be the first symptom indicating that you have the disorder. Although the clotting can develop anywhere in the body, it’s occurs in the brain, hands and feet more commonly. Symptoms depend on the location of the blood clotting in the bodyandinclude the symptoms listed above.Less commonly, symptoms of essential thrombocytosis can also cause bleeding:

• Nosebleeds
• Bruising
• Bleeding in the mouth
• Bloody stools

Untreated blood clots can lead to heart attacks and strokes, so it’s vitally important to see your doctor immediately.

Seek urgent medical attention:

You show any signs of a mini-stroke (TIA) or stroke which include:

• Numbness or weakness in your face, arm or leg which is usually on one side of your body
• Difficulty speaking or understanding speech
• Blurred, double vision or reduced ability to see

You show any signs of a heart attack which include:

• Shortness of breath
• Central chest pain lasting longer than for just a few minutes
• Pain which extends outwards down one side of your body
• Excessive sweating

If you have any signs of bleeding or abnormal blood clotting, it’s vitally important to seek medical attention immediately.

Thrombocytosis treatment

Your doctor may prescribe medication if you’re over 60 and have had blood clots or strokes in the past, or if you are at high risk of heart attack and strokes. In severe cases of essential thrombocytosis, the patient may need to undergo a treatment known as platelet pheresis, in which the platelet count is lowered.

With secondary thrombocytosis, symptoms are usually related to the underlying condition. As the associated condition is treated, the platelet count usually lowers.

How can I find out my platelet count?

Thrombocytosis may be detected by your doctor in routine blood tests that show excessive platelet levels. It’s important for your doctor to determine if the high platelet counts are reactive thrombocytosis (secondary) or essential thrombocytosis (primary). Essential thrombocytosis is more likely to lead to blood clots.

Your doctor can run a routine blood test known as a ‘complete blood count’ (CBC test) to determine your platelet count.