What do low blood platelets mean?

Blood is like a river that our body uses to take nutrition, and oxygen, and also transport the waste out. It is composed of blood cells that are suspended in blood plasma which is mostly water and the rest is protein, glucose, minerals, hormones, carbon dioxide, and blood cells. Read on to learn what do low blood platelets mean? why does it happen? symptoms, causes, diagnosis, and treatment.

What do low blood platelets mean
Photo by Roger Brown: https://www.pexels.com/photo/red-bloodcells-on-white-surface-5149400/

What are platelets and what is the normal platelet count?

Platelets (thrombocytes) are one of the major blood cells, they help to stop bleeding by forming blood clots. The normal platelet range is 1,50,000 to 4,50,000 per microliter of blood, if the platelets exceed this range then this condition is known as thrombocytosis and if the platelets are lower than this range then this condition is known as thrombocytopenia.

1. Easy Bruise

If you get easily bruised with the slightest collision then your blood vessels are probably weakened due to the low clot-forming platelets in your blood. You must visit a doctor immediately as this condition can turn fatal if left untreated.

2. blood spots under the skin

Bleeding under the skin starts when small blood vessels burst or get damaged. It can range from small blood spots to large blood patches appearing over hands or legs mostly, however they can appear in any part of the body too. The small spots generally look like red spots or rashes over the skin which can be confusing for people to understand whether they are just a skin allergy or happening due to platelet deficiency.

3. Purpura

when blood starts to spread over a larger area under the skin then it is probably due to a blood clotting disorder. Purpura is a condition where the affected person starts developing red or purple patches under the skin. They commonly develop on the knees, buttocks, and feet as these parts of the body undergo more pressure than other parts.

If you notice blood discharge in urine along with the symptoms that are mentioned above then you should immediately seek medical help as it is an indication of worsening purpura.

4. Petechiae

The clearest indication of petechiae is tiny red, brown, or purple color spots on the skin. However, there can be other reasons apart from platelet deficiency for petechiae namely bug bites, skin injuries or trauma, or reaction to a medicine. common symptoms that are seen along petechiae are as follows:

  • Heart palpitations
  • Problem in breathing
  • High fever
  • Petechiae, itself is not a disease but a symptom of some underlying disease, reaction to a medicine, infection, Or a virus attack.

Treating the underlying cause helps to get rid of petechiae. Antibiotics for infections, suitable medicines for suppressing the immune system, and sometimes taking proper rest and pain relievers can also help.

5. Bleeding from the nose:

Apart from medical conditions such as platelet deficiency and allergies, there are a variety of reasons that can cause nose bleeding such as trauma, nose picking, and alcohol or drug abuse. Certain allergies can also result in a nose bleed. for example, allergic rhinitis can cause a stuffy nose or nose bleeding. However, nose bleeding alone is not proof of platelet deficiency but continuous nose bleeding and that too from minor injuries along with other symptoms is an indication of platelet deficiency or some other serious medical condition such as brain cancer or tumor.

6. Spleen enlargement:

Spleen is a soft, spongy organ under the left rib cage, its main function is to destroy old red blood cells (RBCs) while filtering the blood, storing platelets and RBCs, and producing white blood cells to fight off harmful organisms.

The spleen can become enlarged in the following cases:

  • Bacterial, parasitic, or viral infections
  • blood cancer
  • metabolic disorders
  • pressure on the veins in the spleen due to blood clots
  • malaria, anemia, and cirrhosis are also known to cause spleen enlargement

An enlarged spleen traps more red blood cells and platelets from the bloodstream which causes a disproportion of blood cells.

7. Bleeding gums:

Bad oral hygiene is the most common reason for bleeding gums but medical conditions such as hemophilia; an inherited disease where blood does not clot easily to stop bleeding and thrombocytopenia; platelet deficiency in the body, both of these conditions are also known to cause easy bruising and uncontrolled bleeding that can be a reason behind your bleeding gums.

8. Blood in the urine (Hematuria) :

If you have visible pink or red color urine then it is due to the presence of blood in the urine. Common medical conditions that can cause hematuria are kidney problems, lymphoma, and autoimmune diseases. Platelet deficiency can cause internal bleeding which can be spotted through the presence of blood in the urine and stool.

9. Fatigue:

Feeling tired after going through strenuous activity is normal and there is nothing to worry about, however, at times you start feeling tired, sleepy, or low for no reason at all, this condition is not normal and can be caused by some underlying disease, infection, or sickness. 1

Platelet deficiency is known to cause acute inflammation of the neural and endocrine system, in response to this sickness behavior the body

10. Heavy menstrual flow:

Women with low platelet count or blood disorders such as Von Willebrand disease and platelet function disorder are known to suffer from heavy menstrual bleeding.

If you have to change your pads repeatedly in a few hours intervals and you find big blood clots along with blood then it is not normal and you should visit a doctor. Heavy menstrual bleeding can cause anemia, breathing, and heart-related problems.

What are the causes of low platelets?

Thrombocytopenia or low platelet count simply means that you have less than 1,50,000 per microliter of blood. Normally platelet count is maintained by production in the bone marrow and lungs. However, platelet deficiency can be caused by decreased platelet production, a spike in platelet destruction, or stuck platelets in the spleen.

Decreased platelet production:

A decrease in blood platelet production can be caused by a variety of reasons such as dehydration, Vitamin deficiency, cancer, liver failure, sepsis, bacterial or viral infection, and hereditary diseases.

Increased platelet destruction:

Autoimmune disease, blood disorders, spleen enlargement, dengue fever, zika virus, and genetic disorders such as Gaucher disease; all of these can become a reason for increased platelet destruction.

Certain medications such as aspirin, warfarin, ibuprofen, cancer medications, hydrogen blockers, and proton pump inhibitors are also known to cause thrombocytopenia.

Spleen enlargement can be caused by bacterial or viral infections due to which it starts holding more than the normal amount of platelets in it which causes a disbalance of platelets in the bloodstream and causes thrombocytopenia.

Diagnosis:

Several laboratory tests might be involved in the diagnosis such as:

  • Full blood count: reports concentration of white blood cells, red blood cells, platelets, and hemoglobin in the blood.
  • Liver enzymes: Research suggests that people with liver disease or high liver enzymes are known to have low platelets count. 1
  • Kidney function: Kidney patients sometimes suffer from uremic acid accumulation in their blood due to decreased renal function. The uremic acid in the blood causes platelet dysfunction. 2
  • Vitamin deficiency: Vitamin B12 and folic acid deficiency are known to cause thrombocytopenia.
  • ESR test: Erythrocyte sedimentation rate tests how fast the red blood cells (RBC) sediments settle down in a test tube. Faster sedimentation than normal signals infection. Normally, the blood cells do not stick together and form stacks but if there is any infection present then blood starts sticking and sediments.
  • Bone marrow biopsy: It involves taking a small sample of bone marrow from inside your bones. It is done to rule out cancer and aplastic anemia (low production of red blood cells by the body).

Treatment:

Platelet decrease in the body does not always need treatment. Sometimes, it might be a result of a particular medication that you have been taking. The doctor will normally change the medicine so that you don’t suffer from side effects.

Other treatment:

  • Platelet transfusion: Platelet concentrate is injected through veins in the body in people with low platelets or platelet dysfunction.
  • Immunosuppressants: Auto-immune disease can cause platelet destruction, immunosuppressants are prescribed by the doctor to control the immune system.
  • Spleen removal: Spleen is an organ that holds platelets. If it enlarges beyond its regular size then it starts holding more platelets and this causes a disbalance of platelets in the blood. Hence, surgery is performed to remove the spleen (splenectomy).
  • Plasma exchange therapy (PET): Plasma is extracted and replaced with new donor plasma.

Tips:

  • Avoid getting injured by indulging in sports such as football, boxing, hockey, or any activity involving a high chance of injury.
  • Avoid alcohol
  • Avoid blood-thinning medications. Consult your doctor before taking any.
  • Eat right, eat healthily, and avoid eating canned, processed, and high sodium food items.
  • Stay active by taking long walks, performing yoga, indulge in indoor activities such as tennis, badminton, or swimming.

So, what do low blood platelets mean? It means having less than 1,50,000 platelets in your blood. However, you won’t know how many platelets you have lost already if you have some underlying cause or disease. Hence, it is advised to consult the doctor if you suffer from any symptoms or signs discussed above and a yearly full-body health check-up is a must to prevent any disease that might come your way or cause thrombocytopenia.

About the author

Deepanshu has a Master's in chemistry. He has worked extensively on research subjects regarding cancer and radio nuclear science and has continually reviewed nutrition science.

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