Cancer Colon Cancer Understanding Mean Platelet Volume (MPV) By Suzanne Dixon, MPH, RD twitter linkedin Suzanne Dixon, MPH, MS, RDN, is an award-winning registered dietitian and epidemiologist, as well as an expert in cancer prevention and management. Learn about our editorial process Suzanne Dixon, MPH, RD Medically reviewed by Medically reviewed by Douglas A. Nelson, MD on June 20, 2020 linkedin Douglas A. Nelson, MD, is double board-certified in medical oncology and hematology. He was a physician in the US Air Force and now practices at MD Anderson Cancer Center, where he is an associate professor. Learn about our Medical Review Board Douglas A. Nelson, MD Updated on June 24, 2020 Print Table of Contents View All Purpose of Test How the Test Is Done Normal MPV High MPV Low MPV Further Testing Mean platelet volume (MPV) is a measure of the average size of your platelets, a type of blood cell that helps prevent bleeding. MPV is particularly important in determining the cause of thrombocytopenia (a low platelet count) or thrombocytosis (a high platelet count), and it can be a useful diagnostic tool even if your platelet count is normal. Your MPV may also increase or decrease with some conditions such as heart disease, lupus, thyroid disease, and infections. Purpose of Test Platelets, also referred to as thrombocytes, are the cells responsible for forming blood clots to slow down blood loss, prevent infection, and promote healing. When an injury occurs, platelets aggregate to plug the wound and send hormone signals through the blood to attract protein clotting factors, which assist in repairing the injury. Platelets are produced in the bone marrow by megakaryocytes, which are large precursor cells. The platelets themselves, which are released into the bloodstream from the bone marrow, are actually pieces of the megakaryocytes. Usually, younger platelets are larger in size than older platelets. MPV is often considered a reflection of the average age of your platelets. How the MPV Test Is Done Mean platelet volume is measured as part of your complete blood count (CBC), a blood test used in health screening and for monitoring many health conditions. To obtain an MPV value, your blood is drawn into a purple top tube that contains an anticoagulant so the blood won't clot and, consequently, render an abnormal result for both the platelet count and MPV. Complete Blood Count (CBC): What It Contains Normal MPV Your CBC includes your total platelet count as well as your platelet indices, such as MPV and platelet distribution width (PDW)—an indication of the variation in the width of your platelets. These indices are details about your platelets that provide a fuller description of what your actual platelets look like. In fact, even if you have a normal platelet count, abnormal indices may alert your doctor to a problem. Normal Ranges Platelets: 150,000 to 450,000 per milliliterMPV: 8.9 to 11.8 fL (femtoliters)PDW: 9.6 to 15.3 fLLabs vary as to reference ranges, so check your CBC report for the range for your results. Ordinarily, platelet levels around 50,000 are associated with bruising. A platelet level below 20,000 can predispose you to life-threatening bleeding. When the MPV value is high, the lab will usually check it with a blood smear. The technologist will stain a slide containing a sample of your blood and look at it under the microscope to see if the platelets are clumping together or if you actually have giant platelets. Causes of High MPV A high MPV is usually a sign that there are more young platelets circulating in your bloodstream. After blood loss due to trauma or a procedure such as major surgery, your body consumes platelets to repair lacerations and stop the blood loss. In response, your bone marrow produces more megakaryocytes, which become young, large platelets, and your MPV rises. You may have a high MPV with a low, normal, or high platelet count, and looking at these results together helps provide a diagnosis. A high MPV with the following platelet counts can suggest associated conditions: Low platelet count along with high MPV occurs when platelets are destroyed, usually by antibodies, an infection, or toxins. For example, immune thrombocytopenic purpura (ITP) is a platelet deficiency caused by the destruction of platelets without a known cause.High platelet count along with high MPV can occur when the bone marrow produces too many platelets, typically due to a genetic mutation or cancer.Normal platelet count along with high MPV suggests conditions such as hyperthyroidism or chronic myelogenous leukemia (CML)—a type of cancer. High MPV With Variable Platelet Counts Conditions that may be associated with an elevated MPV and variable platelet counts include: Bernard-Soulier Disease (giant platelet syndrome)Bone marrow stimulating drugs, such as erythropoietin or thrombopoietinDiabetes mellitusGenetic abnormalities in plateletsHeart disease or artificial heart valvesHyperthyroidismNon-alcoholic liver diseasePre-eclampsia (toxemia of pregnancy) and HELLP syndromeRespiratory diseasesSepsis Factors Affecting MPV Platelet count and volume can be affected by factors such as altitude, hormones, and health risk factors: People who live at low altitudes (below sea level) may have higher than average platelet counts. Those who live at high altitudes may have a high MPV, which has been considered a possible risk factor for heart disease.Smoking, high blood pressure, and high glucose levels (without a diagnosis of diabetes) have all been associated with a high MPV in men.Menstruation and oral contraceptives are associated with high MPV in women.Strenuous exercise has also been associated with an increase in platelet count if it is severe enough to cause tissue damage. It is important to keep these factors in mind, knowing that your platelet count and MPV may undergo some variation. Causes of Low MPV A low MPV generally suggests that most of your platelets are older and that your bone marrow has slowed down production of platelets. Here too, your total platelet count can help provide insight about the cause. A low MPV with the following platelet counts can suggest associated conditions: Low platelet count along with low MPV points toward bone marrow disorders that slow down or decrease the production of platelets, such as aplastic anemia.High platelet count along with low MPV often signifies an infection, inflammation, or cancer.Normal platelet count along with low MPV is common with chronic kidney failure. Low MPV and Variable Platelet Counts Conditions that may be associated with a low MPV and variable platelet counts include: Bone marrow failureLupusSplenomegaly (an enlargement of the spleen), which often causes platelets to be trapped in the spleenMedications that suppress platelet formation, such as chemotherapyHypothyroidismIron deficiency anemiaHIV/AIDS Further Testing While MPV is a helpful test, it is not diagnostic. And some conditions, such as cancer, can be associated with a low or a high MPV. Your MPV results are considered along with your other symptoms. For example, you may need a thyroid test if you have symptoms of hyperthyroidism or hypothyroidism. Similarly, if you have unexplained weight loss or bruising with an elevated or low MPV, you may need further testing with a bone marrow biopsy, which can identify certain types of cancer and may determine whether your bone marrow is not functioning as it should. What Is a Bone Marrow Biopsy? A Word From Verywell Some studies suggest that MPV may be associated with predicting conditions such as heart attacks and strokes. Similarly, there may be an association between MPV and some nutritional deficiencies such as vitamin D and vitamin B12. Overall, while it is certainly a helpful value to consider, MPV should be considered along with your overall health status and your other lab results. 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. Khan A, Haider I, Ayub M, Khan S. Mean Platelet Volume (MPV) as an indicator of disease activity and severity in lupus. F1000Res. 2017;6:126. doi:10.12688/f1000research.10763.3 Rivera FJ, Kazanis I, Ghevaert C, Aigner L. Beyond Clotting: A Role of Platelets in CNS Repair? Front Cell Neurosci. 2015;9:511. doi:10.3389/fncel.2015.00511 Rossi M, Lewis M, Hutchinson N. 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Mean platelet volume is decreased in HIV-infected women. HIV Med. 2013;14(9):549-55. doi:10.1111/hiv.12048 Ranjith MP, DivyaRaj R, Mathew D, George B, Krishnan MN. Mean platelet volume and cardiovascular outcomes in acute myocardial infarction. Heart Asia. 2016;8(1):16–20. doi:10.1136/heartasia-2015-010696 Additional Reading Alper AT, Sevimli S, Hasdemir H, et al. Effects of high altitude and sea level on mean platelet volume and platelet count in patients with acute coronary syndrome. J Thromb Thrombolysis. 2009 Feb;27(2):130-4. Epub 2007 Nov 4. Al-Sweedan SA, Alhaj M. The effect of low altitude on blood count parameters. Hematol Oncol Stem Cell Ther. 2012;5(3):158-61. doi: 10.5144/1658-3876.2012.158. Joergensen MK, Bathum L. Reference intervals for mean platelet volume and immature platelet fraction determined on a sysmex XE5000 hematology analyzer. Scand J Clin Lab Invest. 2016;76(2):172-6. doi: 10.3109/00365513.2015.1124448. Epub 2016 Feb 6. Maluf CB, Barreto SM, Vidigal PG. Standardization and reference intervals of platelet volume indices: Insight from the Brazilian longitudinal study of adult health (ELSA-BRASIL). Platelets. 2015;26(5):413-20.doi:10.3109/09537104.2014.942620. Epub 2014 Aug 7. Panova-Noeva M, Schulz A, Hermanns MI, et al. Sex-specific differences in genetic and nongenetic determinants of mean platelet volume: results from the Gutenberg Health Study. Blood. 2016 Jan 14;127(2):251-9. doi: 10.1182/blood-2015-07-660308. Epub 2015 Oct 30.