Low platelets

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Eddy Edson

Eddy Edson

Well-Known Member
Relationship to Diabetes
Type 2
Every time I have a blood test there's one damn thing out of line; this time (and last time) it's the very last item on my results sheet, platelets.

The lab tells me I have "mild thrombocytopenia" which sounds like an appalling easy-listening electronic jazz fusion trio (Thrombo, Cyto & Penia) but actually means a low platelet count: 101 vs ref range 150-450.

Doc says no reason at the moment to suspect any bone marrow disease and my spleen doesn't seem enlarged, so probably Just One of Those Things to monitor.

I don't think there's any med side effect explanation in this case & the only diet thing I can find is weak evidence that maybe aspartame has an effect & I use a bit of that in coffee.

Any other hints?
 
A few of my blood tests came back like this and eventually returned to normal. I believe there are a few things that can cause this.
 
Just been back on mine 245 in May 21, 252 in June 2020, so I'm not at the top end, but within normal.
Have they offered any further tests or treatments?
 
travellor said:
Just been back on mine 245 in May 21, 252 in June 2020, so I'm not at the top end, but within normal.
Have they offered any further tests or treatments?
Click to expand...
Re-do blood cells in a month; maybe think about referral to hematologist if it keeps going down, but don't seem very worried about it if it stays around where it is.
 
Eddy Edson said:
Every time I have a blood test there's one damn thing out of line; this time (and last time) it's the very last item on my results sheet, platelets.

The lab tells me I have "mild thrombocytopenia" which sounds like an appalling easy-listening electronic jazz fusion trio (Thrombo, Cyto & Penia) but actually means a low platelet count: 101 vs ref range 150-450.

Doc says no reason at the moment to suspect any bone marrow disease and my spleen doesn't seem enlarged, so probably Just One of Those Things to monitor.

I don't think there's any med side effect explanation in this case & the only diet thing I can find is weak evidence that maybe aspartame has an effect & I use a bit of that in coffee.

Any other hints?
Click to expand...

I’d be inclined to ask for a referral to a haematologist Eddy. A platelet count of 101 is quite low and needs some kind of clinical explanation. Are you particularly fatigued or bruise/bleed easily? How does your GP know your spleen isn’t enlarged? He may palpate (examine) it manually but really only a scan can reveal splenomegaly (enlarged spleen).
I‘ve had a chronic form of leukaemia for many years and have lived and breathed these kind of blood results. Sometimes certain kinds of anaemia can cause thrombocytopenia and higher alcohol use can too. Your GP is obviously reassured by your other labs (he’ll be particularly watching the RBC/haemoglobin levels) as an enlarged spleen tends to gobble those up along with platelets in certain conditions.

If he can’t explain it and it continues, I’d be asking for a referral to a haematologist especially if your platelets drop below 100.
 
Hope your further investigations shed some light on things @Eddy Edson and that it’s nothing untoward.
 
Amigo said:
I’d be inclined to ask for a referral to a haematologist Eddy. A platelet count of 101 is quite low and needs some kind of clinical explanation. Are you particularly fatigued or bruise/bleed easily? How does your GP know your spleen isn’t enlarged? He may palpate (examine) it manually but really only a scan can reveal splenomegaly (enlarged spleen).
I‘ve had a chronic form of leukaemia for many years and have lived and breathed these kind of blood results. Sometimes certain kinds of anaemia can cause thrombocytopenia and higher alcohol use can too. Your GP is obviously reassured by your other labs (he’ll be particularly watching the RBC/haemoglobin levels) as an enlarged spleen tends to gobble those up along with platelets in certain conditions.

If he can’t explain it and it continues, I’d be asking for a referral to a haematologist especially if your platelets drop below 100.
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Thanks @Amigo !

I found this summary of the recs here in Oz for "incidentally detected thrombocytopenia" like mine to be useful for getting a handle on how my doc approaches this: https://www.racgp.org.au/afp/2014/october/incidentally-detected-thrombocytopaenia-in-adults/

With this flow-chart:

1631823062155.png

The lab says that all cell morphology looks normal and none of my other labs etc show anything untoward either - no red flags. So I guess my doc gets led to the bottom box - "watch", but particularly as I'm 60, refer to haematologist if it dips below 100.

I'll get a retest in a month. In the meantime, I see that there are weak suggestions that maybe the low-dose aspirin I take for PAD management could have a noticeable impact on platelets so what the hell, I'll temporarily drop it leading up to the retest.
 
Eddy Edson said:
Thanks @Amigo !

I found this summary of the recs here in Oz for "incidentally detected thrombocytopenia" like mine to be useful for getting a handle on how my doc approaches this: https://www.racgp.org.au/afp/2014/october/incidentally-detected-thrombocytopaenia-in-adults/

With this flow-chart:

View attachment 18569

The lab says that all cell morphology looks normal and none of my other labs etc show anything untoward either - no red flags. So I guess my doc gets led to the bottom box - "watch", but particularly as I'm 60, refer to haematologist if it dips below 100.

I'll get a retest in a month. In the meantime, I see that there are weak suggestions that maybe the low-dose aspirin I take for PAD management could have a noticeable impact on platelets so what the hell, I'll temporarily drop it leading up to the retest.
Click to expand...
Good chart Eddy. It‘s trends that matter because platelets are notoriously difficult to measure because of their fragility and tendency to clump. It doesn’t take much poor handling for the results to be skewed. My doctor once had mine manually counted.
Anti inflammatories certainly impacted on my platelet count but of course I could attribute it to my leukaemia. I’d never considered a link with diabetes.
It could be a ‘flash in the pan’ finding and things will stabilise. Your doctor does sound to be looking at the wider picture which is reassuring. All the best, Amigo
 
So I had blood taken for a re-test of blood cell counts last Friday, and at the same time I did periodic PSA, FOBT and microalbuminin tests.

Today I get a call that my doc wants to see me about my test results (which one unspecified) - when he gets back from leave, on Tuesday next week. No further details from receptionist.

Nice!

I'm fairly certain I don't have all of prostate cancer, bowel cancer, leukemia, lymphoma and CKD. But I may be a little anxious for the next week.
 
ROFL - but as eg prostate cancer can have virtually no symptoms - eg my husband was aware he couldn't 'piss up the wall as high as he used to' we both assumed when you're over 60, that happens naturally. Ooops.
 
Just to say I have low platelets, not even sure when it began as I wasn't told, but it has been over 25 years now for sure. I have my bloods tested every year as a matter of course (my mother having high cholesterol, which could be hereditary - 40 years on, mine is still fine), but I guess there was no concern. I did check it out once I found out (just a chance remark from a Dr), if it was to get worse it would incorporate a round of steroids, if that failed then the removal of the spleen. I have only been diagnosed with diabetes this year, so I cannot say there is any connection between that and low platelets. The only "issues" I have is that I bruise very easily, often not even knowing why I have a bruise appear, just a brush against something can cause it. Do not scratch an itchy bruise, it will get worse! Also blood takes a little longer to coagulate, but nothing I've had cause to worry about. When I do my finger pricks sometimes I find putting the finger under cold running water stops the flow almost at once, should it seem to be taking its sweet time. Most of the time I don't even think of it and it never stops me from doing anything. Hope this might help put your mind to rest.
 
janw said:
Just to say I have low platelets, not even sure when it began as I wasn't told, but it has been over 25 years now for sure. I have my bloods tested every year as a matter of course (my mother having high cholesterol, which could be hereditary - 40 years on, mine is still fine), but I guess there was no concern. I did check it out once I found out (just a chance remark from a Dr), if it was to get worse it would incorporate a round of steroids, if that failed then the removal of the spleen. I have only been diagnosed with diabetes this year, so I cannot say there is any connection between that and low platelets. The only "issues" I have is that I bruise very easily, often not even knowing why I have a bruise appear, just a brush against something can cause it. Do not scratch an itchy bruise, it will get worse! Also blood takes a little longer to coagulate, but nothing I've had cause to worry about. When I do my finger pricks sometimes I find putting the finger under cold running water stops the flow almost at once, should it seem to be taking its sweet time. Most of the time I don't even think of it and it never stops me from doing anything. Hope this might help put your mind to rest.
Click to expand...
Thanks @janw !
 
So saw the doc. He wasn't quite sure why he wanted to see me ... nice guy, good doc, almost as disorganised as me. Didn't have heart to give him a serve for worrying me.

Anyway, no blood hiding in poo; no protein detectable in urine; I'm not sure what PSA actually is but reading very low which apparently is good re prostate cancer risk.

Platelets still low (110) but not declining. He thinks probably a touch of ITP and no need to do more than monitor, check again in 6 months.

So platelets go into the "things to worry about when you don't have anything else to worry about" basket, like an asteroid strike or hell actually existing.
 
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Just to close this off ... a year later my latest bloods show platelets back up to 150, ie the low end of "normal" range. The thrombocytopenia resolved by itself, with no apparent reason why it srarted or stopped & without causing any issues along the way.

Anyway, may be of interest to anybody else scratching their head over a low platelet count with no apparent cause.
 
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