Platelets are small, flat-shaped cell bodies found in the bloodstream that play an important role in healing, blood clot formation, and other essential bodily processes. People with a medical condition called thrombocytopenia (or thrombocytopenia) have low levels of platelets in their blood which cause symptoms that can be just plain annoying, but also serious. Dietary changes, medications, surgery, or transfusions may be needed to treat this problem. In order to assess which type of treatment is best suited to your specific situation, it is essential to seek medical advice. Don't simply rely on tips or directions you find online as an alternative to a personal medical visit. Read on for more information.
Steps
Part 1 of 3: Understanding Thrombocytopenia
Step 1. Get examined by a doctor
The first step in understanding and treating any health problem (including thrombocytopenia) is to undergo a medical examination. In addition to accurately diagnosing the disease, a professional can also help you choose a therapy that suits your needs. If your doctor thinks you have low platelet levels, they will most likely recommend blood tests and a physical exam.
Even if you are sure that you have a low platelet count, it is highly recommended that you seek professional advice from a doctor before starting a treatment plan. Some symptoms of thrombocytopenia are similar to other conditions. Also, low platelet levels sometimes do not exhibit any external symptoms
Step 2. Look for symptoms of a low platelet count
A normal level ranges from 150,000 to 450,000 platelets per micro-liter of blood. Platelet levels below this range do not always show obvious symptoms. However, even those with no symptoms can respond to therapy and increase platelet production. In many cases, however, thrombocytopenia is accompanied by a variety of symptoms. Because platelets have the function of forming blood clots, many signs of their low level are the body's inability to control the bleeding. The most common are:
- Prolonged bleeding from minor cuts and scrapes or after surgery.
- Epistaxis.
- Bleeding from the mouth or gums (especially after using a toothbrush).
- Very heavy menstrual bleeding.
- Blood in the urine and stool.
- Unexplained bruises or small red spots on the skin called petechiae.
Step 3. Know the causes of low platelet counts
Thrombocytopenia does not have a single cause. There can be a variety of natural and non-natural origins. It can also be the result of a more serious illness. For this reason it is especially important to have a thorough investigation with your doctor to determine the cause. Here are some of the more common causes of thrombocytopenia:
- Hereditary (genetic) diseases.
- Bone marrow disease (leukemia, etc.) or dysfunction.
- Enlarged or malfunctioning spleen.
- Side effects of a drug or treatment you are undergoing (radiation, etc.).
- Autoimmune diseases (lupus, arthritis, AIDS, idiopathic thrombocytopenic purpura, etc.).
- Bacterial infection in the blood.
- Pregnancy and childbirth (although thrombocytopenia is usually mild in these cases).
- TTP (thrombotic thrombocytopenic purpura), a rare disorder in which platelets are activated when many small clots form throughout the body.
Part 2 of 3: Treating Thrombocytopenia with Drugs
Step 1. Tell your doctor about the medications you are taking
Because thrombocytopenia has many possible causes, doctors can determine different types of treatment based on who is primarily responsible for the low platelet count. Sometimes the therapies are quite simple; if your doctor determines that the problem is a side effect of a drug you are taking, it may be enough to stop or change the medicine.
Keep in mind that if you are taking some powerful blood thinners such as heparin, your platelet count may not rise when you stop taking the drug. In this case it may be necessary to take additional medications to heal
Step 2. Increase platelet levels with medications
Your doctor may prescribe certain medications that increase platelet production and thus fight thrombocytopenia. These drugs, such as eltrombopag and romiplostim, come in a variety of forms: they can be given in pills or injections. They can also be taken in conjunction with one of the many other treatment options for thrombocytopenia, depending on the specific cause.
Step 3. Undergo steroid treatment
Steroids can reduce the function of the body's immune system. Thanks to this characteristic, they are useful for treating thrombocytopenia due to an autoimmune disease, i.e. a disease in which the immune system mistakenly attacks the body itself rather than external pathogens. Since steroids weaken the immune system, they can alleviate the effects of a case of thrombocytopenia related to a dysfunction of the immune system. However, a weakened immune system carries a greater risk of infection, so further treatments may be needed to compensate for this new problem.
- Be aware that the steroids prescribed in this case by the doctor (such as prednisone) are different from those that are illegally used by athletes to improve physical performance.
- In the most extreme cases of autoimmune thrombocytopenia, your doctor may prescribe intravenous immunoglobulins (IVIGs) or antibodies to further slow down the body's immune response.
Step 4. Undergo plasmapheresis or plasma exchange
For rarer blood disorders associated with thrombocytopenia (such as TTP and uremic-haemolytic syndrome also called HUS), doctors may recommend a procedure that involves treating the blood plasma. Plasma is the part of blood that contains, among other things, autoantibodies, the malfunctioning components of the immune system that cause autoimmune diseases. For this reason, treating or replacing plasma can be effective in treating blood disorders and autoimmune diseases. Plasmapheresis and plasma exchange are similar, but separate procedures are followed to treat blood plasma.
- In plasma exchange, blood is separated into cells and plasma. The plasma is discarded and replaced with that of a donor, a saline or albumin solution. This process is done gradually so as not to remove too much blood in one moment.
- In plasmapheresis, after separating the blood cells, the plasma is treated and returned to the patient.
Step 5. Remove the spleen
In cases of particularly resistant thrombocytopenia, a surgery called splenectomy may be necessary, which consists of the removal of the spleen. Although the function of the spleen is not 100% clear, researchers know that it acts as a filter for the blood, removing old red blood cells and platelets from the bloodstream. In some cases, the spleen enlarges and sheds more platelets than normal, causing thrombocytopenia. A splenectomy can solve this problem; however, doctors typically look for more conservative solutions as a first approach, as once the spleen is removed, it is no longer possible to undo the splenectomy.
- Splenectomy is usually successful in about 66% of cases. However, thrombocytopenia may recur over time.
- People under 40 who undergo a splenectomy have a greater chance of increasing their platelet count.
- After the spleen is removed, the platelet count often becomes abnormally high, leading to a medical condition called thrombocytosis. In more severe and / or prolonged cases, this can cause a specific set of problems.
Step 6. Get a platelet transfusion
If you have fewer than 50,000 platelets per micro-liter of blood and are bleeding, your doctor may recommend a platelet or blood transfusion to reduce bleeding. Or, if you have fewer than 50,000 platelets per micro-liter of blood and you are not actively bleeding but need to have surgery, your doctor may possibly prescribe a transfusion. In both cases, the procedure consists of an intravenous administration of healthy blood or platelets that are inserted directly into the bloodstream.
In some cases, a transfusion may be prescribed even when there is no bleeding and no surgery is planned. But these are cases reserved for those who have fewer than 10,000 platelets per micro-liter of blood
Step 7. Do nothing
Not all cases of thrombocytopenia require treatment. For example, if your platelet count is low because you are pregnant, you can simply choose to wait until the baby is born to see if the levels rise. Mild cases may also show no obvious symptoms - you may not even experience increased bleeding. In cases like these, when the condition can improve in a short time or when life is not affected in any way, the doctor may recommend a very conservative (or nonexistent) treatment plan.
Part 3 of 3: Treating Thrombocytopenia with Lifestyle Changes
Step 1. Supplement your diet with vitamin B12 and folic acid
Both are two nutrients necessary for the healthy production of various blood elements, including platelets. Since the body is unable to store these nutrients for a long time, you need to make sure you consume them often. To increase your intake, you can take food supplements that contain them or eat foods rich in these vitamins.
Foods like spinach, citrus fruits, kiwis and dried beans are high in folate, while eggs, milk, cheese, liver and mutton are high in vitamin B12
Step 2. Reduce or eliminate alcohol consumption
Alcohol interferes with the normal production and function of platelets. The immediate effect of alcohol intake (in regular users) is to limit the platelet response within 10 to 20 minutes of ingestion. However, in severe alcoholics, platelet function actually increases dramatically and can cause various health problems. In both cases, reducing alcohol consumption can help restore platelet function to normal.
Step 3. Reduce activities that can cause bleeding
If you suffer from low clinical platelet levels, you need to avoid bleeding, as it can be difficult to stop and can lead to potentially dangerous complications. This can mean avoiding contact sports, woodworking, construction work, or other physical activities that carry a high risk of injury.
Step 4. Ask your doctor about over-the-counter pain medications
Some drugs available on the market without a prescription, especially those containing aspirin or ibuprofen, can inhibit platelet production and function. For example, aspirin reduces the ability of platelets to bind to each other, blocking the function of certain key protein structures on platelets, inhibiting the formation of blood clots. In these cases, your doctor may advise you to stop taking these medications or point you to a suitable alternative.
