What level of platelets is dangerous

“Platelets are the cells that circulate within our blood and bind together when they recognize damaged blood vessels,” says Marlene Williams, M.D., director of the Coronary Care Unit at Johns Hopkins Bayview Medical Center. “When you get a cut, for example, the platelets bind to the site of the damaged vessel, thereby causing a blood clot. There’s an evolutionary reason why they’re there. It’s to stop us from bleeding.”

What makes platelets change their shape?

Platelets, the smallest of our blood cells, can only be seen under a microscope. They’re literally shaped like small plates in their non-active form. A blood vessel will send out a signal when it becomes damaged. When platelets receive that signal, they’ll respond by traveling to the area and transforming into their “active” formation. To make contact with the broken blood vessel, platelets grow long tentacles and then resemble a spider or an octopus.

What is a healthy platelet count?

A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood. Having more than 450,000 platelets is a condition called thrombocytosis; having less than 150,000 is known as thrombocytopenia. You get your platelet number from a routine blood test called a complete blood count (CBC).

What it means to have too many platelets

The medical term for having too many platelets is thrombocytosis, and there are two types:

• Primary or essential thrombocytosis – Abnormal cells in the bone marrow cause an increase in platelets, but the reason is unknown.
• Secondary thrombocytosis – The same condition as primary thrombocytosis, but may be caused by an ongoing condition or disease such as anemia, cancer, inflammation, or infection.

When there are symptoms, they include spontaneous blood clots in the arms and legs, which if untreated can lead to heart attack and stroke. In severe cases, the patient might have to undergo a procedure called a platelet pheresis. This lowers the platelet count by removing the blood, separating out the platelets, and returning the red blood cells back to the body.

With secondary thrombocytosis, the symptoms are usually related to the associated condition. For example, if you have an infection or anemia, you treat those conditions and the platelet count comes down.

What it means to have too few platelets

When you don’t have enough platelets, it’s called thrombocytopenia. Symptoms include easy bruising, and frequent bleeding from the gums, nose, or GI tract. Your platelet count drops when something is preventing your body from producing platelets. There are a wide range of causes, including:

• Medications
• An inherited condition
• Certain types of cancer, such as leukemia or lymphoma
• Chemotherapy treatment for cancer
• Kidney infection or dysfunction
• Too much alcohol

How platelets relate to cardiovascular disease

If you have too many platelets, it can increase your risk for clotting. But often your cardiovascular risk has more to do with platelet function than platelet number. For example, you could have a healthy number of platelets, but if they’re sticking together too much it can increase your chance of having a heart attack or stroke.

Keeping track of your platelets

Too many platelets, too few platelets, abnormally functioning platelets, and related conditions such as blood clots, strokes, and heart attacks can be inherited. So it’s a good idea to alert your doctor when there’s a family connection.

“Although you may feel fine, your physician might want to keep a close eye on you and investigate whether or not you need medications to reduce the functioning of your platelets,” says Williams. “The most common blood-thinning medication is aspirin, although recent studies have shown that women under 65 who are otherwise healthy do not receive the same benefit from aspirin as men do. There is no concrete answer to that yet.”

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Low Platelet Count (Thrombocytopenia)

What are Platelets?

Your blood contains different types of cells. Each type has a different job to do. Platelets are the cells that help your blood to clot. The bone marrow produces them. It’s very important to have enough platelets in your blood. The medical name for platelets is thrombocytes (THROM-bo-sites).

What is a Normal Platelet Count?

Platelet count is the number of platelets in the blood. A normal platelet count ranges from 150,000 to 350,000. If the number of platelets is too low, excessive bleeding can occur. The medical name for a low platelet count is thrombocytopenia (throm-bo-sigh-toe-PEE-nee-uh).

What Causes a Low Platelet Count?

Some things can affect how well the bone marrow can produce platelets. When not enough platelets are made, the platelet count in your blood is too low. Chemotherapy and some radiation therapy can cause this temporarily. These cancer treatments can slow the production of platelets in the bone marrow. Another cause of a low platelet count is cancer of the bone marrow. Other conditions can result in a low platelet count as well.

How Will a Low Platelet Count Affect Me?

A platelet count below 50,000 is low. When your platelet count is low, you may bruise or bleed more easily than usual. A platelet count below 20,000 is very low. When it’s this low, you may bleed even when you are not injured. If your platelet count is very low, your doctor may order platelet transfusions until your count returns to a safe level.

What Should I Do for a low Platelet Count?

For a low platelet count below 50,000, you must take precautions. Follow the guidelines below to help prevent or stop bleeding.

• Do not take any medicine, including over-the-counter drugs, without your doctor’s approval. It is very important to avoid aspirin and other drugs that contain aspirin. If you are not sure about a medicine, ask your doctor.
• Use a soft-bristle tooth brush. Do not use dental floss.
• Do not have dental work without your doctor’s approval. If you must have dental work, tell your dentist that you have a low platelet count.
• Do not do heavy lifting, contact sports, or strenuous exercise.
• Do not walk in bare feet.
• If you feel weak and unsteady, have someone help you when walking.
• Avoid cutting your nails. Use an emery board to care for your nails.
• When shaving, do not use a razor blade. Use an electric razor instead.
• Be careful when using household tools, such as knives and scissors.
• If you get a cut, place a clean cloth or a piece of gauze over the cut, then apply pressure for a few minutes. If your cut continues to bleed, lie down and stay calm. Keep applying pressure. If possible, use an ice pack to apply pressure. Get emergency care for any of the following:
• Do not bend over with your head lower than your shoulders. Bend from the knees, and keep your head up.
• Do not blow your nose forcefully.
• If you get a nose bleed, sit upright. Tilt forward to allow the blood to drip out. Then apply firm pressure to your nostrils, below the bridge of your nose. Get emergency care for any of the following:
• Do not wear tight clothing.
• Do not use alcohol.
• Prevent constipation. Drink plenty of fluids, and get enough fiber in your meals.
• Do not strain to move your bowels. Tell your doctor if you are constipated. He or she may prescribe a stool softener.
• Do not use rectal suppositories, enemas, or vaginal douches.
• If you are a woman having your period, do not use tampons. Use pads instead. If you have menstrual flow that is heavier or lasts longer than usual, tell your doctor or nurse.
• Keep the phone numbers of your doctor and the local EMS (emergency medical service) at hand.

When Do I Call the Doctor?

If you have any of the following, call your doctor or nurse right away:

• Bleeding from your mouth or gums
• Nose bleeds
• Bruises on your arms or legs, with or without an injury
• Pinpoint-size, red or purple spots on your skin
• Brown or red urine
• Black, tarry stool or bloody stool
• Blood in your mucus
• Vomiting blood
• Vaginal spotting
• Long or heavy menstrual flow
• Persistent headache
• Blurred or double vision
• Abdominal pain 

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