Cancer Leukemia Living With What Causes a Low Platelet Count and How to Treat It By Karen Raymaakers Updated on September 15, 2023 Medically reviewed by Richard N. Fogoros, MD Print Table of Contents View All Table of Contents Platelet Counts Causes Symptoms Management Treatment Complications A low platelet count means your blood lacks the small cells it needs to form clots. Some of the most common causes of low platelets include an autoimmune disease called idiopathic thrombocytopenic purpura (ITP), leukemia, infection, nutritional deficiencies, pregnancy, and certain medications. Symptoms include bruising easily, a rash of tiny red spots, nosebleeds or bleeding gums, blood in the urine or stool, painful joints, or bleeding too much after minor injuries. Treatment of low platelets varies depending on the cause, but a platelet infusion through an IV can replenish platelets while the root cause is addressed. Having low platelets, known as thrombocytopenia, can be life-threatening. Your body might be unable to stop blood flow if you're injured, and you could be at risk for excessive bleeding. This article discusses normal and abnormal platelet counts, some causes of low platelets, and symptoms you may experience. It also describes strategies for managing the condition and how it is usually treated. Normal and Abnormal Platelet Counts A complete blood count (CBC) test is a standard panel of bloodwork. The platelet count is one of things this test measures. Here is what various platelet counts mean: Normal: Between 150,000 and 450,000 platelets per microliter of bloodLow: Below 150,000 platelets per microliterMild bleeding risk: Below 50,000 platelets per microliterSerious bleeding risk: 10,000 to 20,000 platelets per microliter or lower. What Causes Low Platelets? The causes of thrombocytopenia include reduced platelet production in the bone marrow, drug-induced thrombocytopenia, leukemia, deficiency in vitamin B12 and folate, cirrhosis (liver disease), enlarged spleen, immune thrombocytopenia (a disorder that causes the immune system to attack platelets), and thrombotic thrombocytopenic purpura (abnormal clotting that leads to lower platelet count). Platelet Dysfunction or Destruction Your body may produce enough platelets, but some conditions and medicines may destroy or stop them from working correctly (dysfunction). Autoimmune Conditions: When you have an autoimmune condition, your immune system attacks healthy cells. Diseases like lupus and rheumatoid arthritis may cause the immune system to destroy platelets. Bacterial Blood Infections: Bacteremia, also called blood poisoning, is a bacterial infection that affects the blood. This infection may lead to a reduction in platelets. Medication: Medications that can cause low platelets include nonsteroidal anti-inflammatory drugs (NSAIDs), furosemide (diuretic), chemotherapy drugs, penicillin, quinine, sulfonamides, statins, linezolid, and other types of antibiotics. When low platelet counts arise from drug use, it is known as drug-induced thrombocytopenia. What is Immune Thrombocytopenia? Decreased Platelet Production Your body may not produce enough platelets because of certain health conditions. Some of these common causes are: Pregnancy: Gestational thrombocytopenia is relatively common in the third trimester of pregnancy. It happens because of an increase in blood volume. The platelet counts stay the same in this condition, but since the blood volume is higher, the platelets are more diluted. There is usually a low risk of severe bleeding. Chemotherapy and Radiation: Chemotherapy and radiation are common therapies for cancer. They are very effective at killing cancer cells. Unfortunately, cancer treatments may unintentionally kill the cells in the bone marrow that produce platelets. When this happens, your body won't be able to produce the platelets it needs. Leukemia and Lymphoma: When bone marrow is invaded by cancer cells, it affects the immature blood cells, called stem cells, that are supposed to grow into healthy blood cells like platelets. This will affect the production of platelets. Nutritional Deficiencies: Poor nutrition can cause low platelet counts. To make platelets, your body needs nutrients like vitamin B12 and folate. Viral Infections: Certain viral infections, such as hepatitis C or HIV, can prevent bone marrow from making platelets. Heavy Alcohol Use: Heavy drinking can cause malnutrition, which is when your body doesn't get enough nutrients. People who drink a lot of alcohol may have bone marrow abnormalities. When this happens, your body has trouble making new platelets. Alcohol itself may have a toxic effect on bone marrow. Aplastic anemia: Like leukemia and lymphoma, aplastic anemia is a disease that affects the normal production of blood cells in bone marrow. This can lead to decreased production of platelets. Genetic Causes of Low Platelets Thrombocytopenia can be genetic, which means it is passed down through families. Genetic forms are rare. They are sometimes misdiagnosed as other forms of the disease. Von Willebrand Disease: Von Willebrand disease is the most common bleeding disorder in the United States. There are three different types of this disease, and type 2 is known to cause low platelet count. Treatment is available with medication. Evans Syndrome: Evans syndrome is a rare disease where the body's immune system attacks the body's blood cells, including platelets. In addition to symptoms of low platelets, people with Evans syndrome may also experience paleness, lightheadedness, and fatigue. Trapped Platelets A healthy spleen stores up to one-third of the body's platelets. If the spleen becomes enlarged, it can retain more platelets than it should. This will prevent them from entering the bloodstream and lead to a low platelet count. An enlarged spleen–or splenomegaly–can be caused by blood disorders, including leukemia and lymphoma; liver disease; infection; and inflammatory disease. Symptoms of Low Platelets A low platelet count can cause a variety of symptoms. Call your doctor if you notice these issues or if they become more frequent or severe: Easy bruising, also called purpura Petechiae, tiny red spots on your skin Excess bleeding after even minor injuries Pain in your joints, particularly large joints like the knees and hips Frequent nosebleeds Bleeding from the mouth or gums Blood in the urine or stool Headaches It is important to call your healthcare provider at once if you have any of the following symptoms: Headache, confusion, or dizziness Blood when you cough or difficulty breathing Blood in your urine, vomit, or stool Vaginal bleeding after menopause or unusually heavy vaginal bleeding Managing Low Platelets You can limit problems caused by low platelets by doing things that lower your risk of bleeding: Avoid certain medications. This includes nonsteroidal anti-inflammatories (NSAIDs) like aspirin and Advil (ibuprofen). If you are taking blood thinners, ask your doctor about the risk of bleeding.Use an electric razor to shave. This may result in fewer nicks and cuts.Use extra care when working with sharp objects such as knives or scissors.Avoid contact sports.Use an extra-soft toothbrush. Inflamed gums bleed more easily when flossing. Diligent mouth care will reduce gum inflammation. Avoid flossing when your platelet count gets very low.Blow your nose gently. This will help you avoid a nosebleed.Limit or avoid alcohol. Treatment of Low Platelets It is important to identify the cause of low platelets. When the cause is clear, treatment can help your levels return to normal. If you are receiving therapies that affect your platelet count, such as cancer treatment, your platelets should return to normal once the treatment ends. Keep in mind that the timeline is different for everyone. In some cases, a platelet transfusion may be needed. This is a procedure where you receive platelets from a donor through a vein. A transfusion can help prevent complications from bleeding. Autoimmune conditions can be treated with drugs that suppress your immune system. This will help stop the destruction of platelets. When low platelets are caused by medication, the solution is often just switching medications. Your doctor will help you find the right alternative drug. Complications The risk of complications from low platelet count increases the lower the platelet count is. One of the primary risks is bleeding. Bleeding can be a serious concern in someone with a low platelet count. If you begin bleeding, contact your doctor at once. Follow these steps to minimize bleeding: Sit or lie down. Try to stay 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, raise the limb above the level of your heart.If you see blood in your urine, increase your fluid intake and call your doctor immediately.If you notice blood in your vomit, call your doctor. Take anti-nausea medications and antacids as instructed by your doctor.If you are bleeding vaginally, do not use tampons. Keep track of how many sanitary pads you are using. Note any clots. See a healthcare professional if you begin bleeding excessively or are concerned about low platelet count. Summary People with thrombocytopenia have a low number of blood platelets. This can lead to problems with excessive bleeding. Typically, low platelets are caused by conditions that either lead to the destruction of platelets or prevent platelets from forming. Certain medications or therapies like cancer treatment may also cause low platelets. Low platelets may be genetic. People with low platelets have a variety of symptoms, including excessive bleeding and easy bruising. When you have low platelets, you may have frequent or excessive bleeding. It is important to try to avoid injury. This will help prevent dangerous complications. The condition usually improves once the cause is understood and the patient receives treatment. An Overview of Platelet Disorders 14 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. National Heart, Lung, and Blood Institute. Platelet disorders - thrombocytopenia. National Institutes of Health. Moses S. Family Practice Notebook. Thrombocytopenia Causes. Johansson D, Rasmussen M, Inghammar M. Thrombocytopenia in bacteraemia and association with bacterial species. Epidemiol Infect. 2018;146(10):1312-1317. doi:10.1017/S0950268818001206 Vayne C, Guéry EA, Rollin J, Baglo T, Petermann R, Gruel Y. Pathophysiology and diagnosis of drug-induced immune thrombocytopenia. J Clin Med. 2020;9(7):2212. doi:10.3390/jcm9072212 Arnoldussen IAC, Witkamp RF. 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Front Pediatr. 2021;9:704635. doi:10.3389/fped.2021.704635 National Heart, Lung, and Blood Institute. Thrombocytopenia. Memorial Sloan Kettering Cancer Center. Low Platelet Count. Izak M, Bussel J. Management of thrombocytopenia. F1000Prime Rep. 2014;6:45. doi:10.12703/P6-45 Additional Reading Mitta A, Curtis BR, Reese JA, George JN. Drug-induced thrombocytopenia: 2019 Update of clinical and laboratory data. Am J Hematol. 2019;94(3):E76-E78. doi:10.1002/ajh.25379 Nagalla S, Sarode R. Recent advances in understanding and management of acquired thrombocytopenia. F1000Res. 2018;7:68. doi:10.12688/f1000research.12309.1 By Karen Raymaakers Karen Raymaakers RN, CON(C) is a certified oncology nurse that has worked with leukemia and lymphoma patients for over a decade. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit