Cancer Leukemia Living With What You Need to Know About Living With Low Platelets By Karen Raymaakers linkedin Karen Raymaakers RN, CON(C) is a certified oncology nurse that has worked with leukemia and lymphoma patients for over a decade. Learn about our editorial process Karen Raymaakers Medically reviewed by Medically reviewed by Cristian Zanartu, MD on February 03, 2020 twitter Cristian Zanartu, MD, is board-certified in internal medicine. He works at a cancer center in New York, focusing on pain and palliative medicine, and has a primary care practice with an emphasis on LGBT care. Learn about our Medical Review Board Cristian Zanartu, MD on February 03, 2020 Print Table of Contents View All What's Normal? Causes Symptoms Managing Low Platelets What to Do If Bleeding Starts Treatment Platelets are small cells circulating in your bloodstream that affix themselves to the wall of a blood vessel following injury. They are specifically designed for clotting; they clump together to prevent bleeding. If you have low platelets in your blood, known as thrombocytopenia, your ability to form clots and stop bleeding may be impaired. It's important that you're aware of how your condition affects your overall health and what you can do to stay well. Marc Volk / Getty Images What's Normal? Your platelets are analyzed during a complete blood count (CBC) test, which is a standard panel of bloodwork. Platelet count is one of the measures the CBC delivers. Here is the normal range and concerning levels of low platelets: A normal platelet count is considered between 150,000 and 450,000 platelets per microliter of blood.A low platelet count is considered anywhere below 150,000 platelets per microliter.Mild bleeding risk occurs with 50,000 platelets per microliter and below.Serious bleeding risk occurs if platelet count drops to 10,000 to 20,000 platelets per microliter or lower. Causes Thrombocytopenia may be hereditary or caused by several circumstances that result in your blood platelet count falling below normal levels. Increased Platelet Destruction While you may have ample platelets being produced, these possible causes of thrombocytopenia can destroy them, reducing your levels: Autoimmune conditions: Diseases such as lupus and rheumatoid arthritis may cause immune thrombocytopenia as the immune system starts to attack itself, destroying platelets in the process.Bacterial blood infections: Bacteremia, or a bacterial infection affecting the blood, may destroy platelets.Medications: Certain classes of medications called anticoagulants, for example, heparin, may cause platelet destruction by triggering your immune system to destroy them. What Is Immune Thrombocytopenia? Decreased Platelet Production Thrombocytopenia can also result when your body simply isn't making an adequate number of platelets. Possible causes include: Pregnancy: Gestational thrombocytopenia is a fairly common condition during the third trimester due to increased blood dilution, as blood volume continues to increase and platelet counts fail to increase at the same rate. It's important to note that this decline is usually not associated with risk for serious bleed.Chemotherapy and radiation: These treatments are highly effective at killing cancer cells, but unfortunately, they are unable to distinguish between cancer cells and healthy ones. Chemotherapy and radiation particularly target cells that reproduce quickly, such as those in bone marrow. Cancer treatments may unintentionally kill the cells in bone marrow that are dedicated to producing platelets, resulting in thrombocytopenia.Leukemia: Another cause of thrombocytopenia may be the effect of blood cancer itself on the marrow. If bone marrow is invaded by cancer cells, the healthy cells may get crowded out by the cancer cells, ultimately affecting the production of platelets.Nutritional deficiencies: As with anemia, iron deficiency or vitamin deficiencies (B12, folate) can lead to low platelet counts, since the body doesn't have the basic nutrients to create them.Viral infections: Certain viral infections such as hepatitis C or HIV may result in decreased production of platelets.Heavy alcohol use: Because heavy alcohol consumption often results in malnutrition, you may be unable to form new blood platelets due to bone marrow abnormalities. Also, alcohol in of itself has a toxic effect on the bone marrow. Enlarged Spleen Several conditions may result in an enlarged spleen, which is responsible for storing up to one-third of the body's platelets at any time under normal conditions. An enlarged spleen may trap a larger number of platelets, not allowing them to escape into circulation. Symptoms If you have a low platelet count, you may experience a variety of symptoms. Call your doctor if any of the following issues increase in frequency, severity, or become worrisome to you: Easy bruising called purpuraTiny red spots on your skin called petechiaeExcessive bleeding following even minor injuriesPain in your joints, particularly large joints like the knees and hips.Frequent nose bleedsBleeding from the mouth or gumsBlood in your urine or stoolHeadaches It is important to call your healthcare provider immediately if you have any of the following symptoms:Headache, confusion, or dizzinessBlood when you cough or difficulty breathingBlood in your urine, vomit, or bowel movementsVaginal bleeding after menopause or unusually heavy vaginal bleeding Managing Low Platelets There are several steps you can follow to avoid complications from low platelets; specifically working to minimize the risk of bleeding wherever possible. Avoid medications that contain aspirin, anti-inflammatories (like ibuprofen), or blood thinners, unless your healthcare professional recommends otherwise. Ask your pharmacist if you are unsure.Use an electric razor to shave, which may result in fewer nicks and cuts.Use extra care when working with sharp objects such as knives or scissors, so as not to accidentally cut yourself.Avoid contact sports to minimize the potential risk of injury and bleeding.Use an extra-soft toothbrush and perform diligent mouth care to reduce gum inflammation, as inflamed gums bleed more easily when flossing. Avoid flossing when your platelet count gets very low.Blow your nose gently so as not to trigger a nose bleed.Limit or avoid drinking alcohol. What to Do If Bleeding Starts Bleeding can become a very serious concern in someone with a low platelet count. If you begin bleeding, follow these steps and contact your care provider: Have a seat or lie down. Try to remain calm.Apply pressure to the wound if you can see it.Apply an ice pack to the site to slow the bleeding.If the wound is on an arm or leg, elevate the limb above the level of your heart.If you notice blood in your urine, keep drinking increased fluids and report to your doctor.If you notice blood in your vomit, take anti-nausea and stomach antacids as directed by your doctor.If you are bleeding vaginally or having your period, do not use tampons. Keep track of how many sanitary pads you are using and note any clots. Treatment A low blood platelet count will often return to a normal level if the cause can be clearly identified and treated. This allows your bone marrow to recover normal function, such as post-pregnancy or post-cancer treatment, though the timeline will differ for everyone. However, in some cases, a platelet transfusion may be warranted to prevent complications from bleeding. If this is required, you can expect to receive the platelets through an infusion into your vein. If an autoimmune condition is causing your thrombocytopenia, you may be prescribed an immune-suppressant medication to help cease platelet destruction. If a reaction to another medication is causing your thrombocytopenia, you may be placed on a different medication by your prescribing physician. A Word From Verywell Low platelets, or thrombocytopenia, are a common side effect of blood cancers and their treatment, but may also be a result of autoimmune diseases, pregnancy, heavy alcohol consumption or certain medications. As a result of thrombocytopenia, you may experience frequent or excessive bleeding. It is important to do your best to avoid injury to prevent complications from occurring. An Overview of Platelet Disorders Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Jinna S, Khandhar PB. Thrombocytopenia. In: StatPearls. Updated November 25, 2019. Nagalla S, Sarode R. Recent advances in understanding and management of acquired thrombocytopenia. F1000Res. 2018;7:68. doi:10.12688/f1000research.12309.1 Moses S. Family Practice Notebook. Thrombocytopenia Causes. Updated August 2016. Smock J, Perkins S. Thrombocytopenia: an update. Int J Lab Hematol. 2014;36(3):269-78. doi:10.1111/ijlh.12214 National Heart, Lung, and Blood Institute. Thrombocytopenia. Memorial Sloan Kettering Cancer Center. Low platelet count. Updated. January 2020. Izak M, Bussel J. Management of thrombocytopenia. F1000Prime Rep. 2014;6:45. doi:10.12703/P6-45 Additional Reading Thrombocytopenia: Symptoms and Causes. Mayo Clinic. April 2018. Aster RH. Drug-induced Thrombocytopenia. Platelets 2019 Jan 1 (pp. 725-739). Academic Press.