Low Platelets - Symptoms, Causes, and Treatments

by Jane Ashley

Nothing is more frustrating to hear on the morning of chemo than, “No chemo for you today. Your platelet count is too low.” The chemo that we once feared has become our friend. We want our chemo because we’re afraid for it to even be delayed for a week. We realize that chemo is our best hope to beat this.

Low Platelets

But now, our oncologist is telling us that we can’t have chemo today. So we’re wondering, “What are platelets? Why are they so important that I can’t have chemo if there are low?”

What are platelets? Why are they so important?

When a person experiences a low platelet count, it is called thrombocytopenia. If your platelet count is low, your body can’t form clots. Platelets clump together and form clots to prevent excessive bleeding if a blood vessel is cut or damaged.

Normal platelet counts range between 150,000 and 450,000 per microliter of blood and are shown on your CBC (Complete Blood Count) as values from 150 to 450. In most instances, chemo will be delayed if counts fall between 75 and 100. Patients with extremely low platelet counts are at risk for internal bleeding.

Use A Soft Bristle Toothbrush

Symptoms

The symptoms of early thrombocytopenia are subtle. A patient may not have an overt symptom until they bang their elbow against a door or stub their toe – in these situations, you’ll immediately get a huge bruise. Symptoms include:

Bleeding from the gums or nose
• Dizziness
• Heavy menstrual periods
• Joint pain
• Petechiae (purple or red spots under the skin)

You might not be able to stop a nosebleed or stop the bleeding from a cut, prompting a trip to the emergency room.

Why do cancer patients develop low platelets?

1. Some blood cancers, like leukemia and lymphoma, may crowd out platelet cells.
2. Chemotherapy and radiation therapy may damage the bone marrow, slowing the production of platelets.
3. Cancer that metastasized to the bone, stressing the bone marrow.
4. Cancer of the spleen where extra platelets are stored.

Precautions to take when you’re told that your platelet count is low

First and foremost, avoid injury. Be extra careful. If your job involves physical work where injuries are likely to occur, tell your supervisor and ask for a less-physical task until your platelet count recovers.

Postpone Being On A Ladder

Here are some lifestyle changes to help prevent a serious bleeding incident. You might not have even thought of some of these:

• Drink 8 to 10 glasses of water and other nonalcoholic fluids daily to help prevent a dry mouth and avoid constipation.
• Wear shoes or slippers to prevent a foot injury.
• Ask your oncologist about sexual activity. Yes, even this could cause serious bleeding if you are suffering from a low platelet count.
• Don’t wear tight-fitting jeans or tight undergarments as they may cause bruising.
• Postpone sports activities like skiing, ice skating, roller-blading and even fishing – a fish hook in your finger could cause a serious bleeding event
• Delay yardwork including lawn mowing, cutting limbs, and using the weed eater.
• Reschedule dental work.

Everyday tasks that you normally do may cause bleeding. Here are some suggestions to avoid bleeding:

• Use an electric razor.
• Postpone your manicure or pedicure.
• Use a soft-bristle toothbrush. Don’t floss.
• Don’t use a rectal thermometer.
• Don’t use suppositories or tampons.
• Use stool softeners if you’re constipated.
• Wear gloves for pulling weeds or minor household repairs.
• Be careful using scissors, knives, and needles.

Avoid Dangerous Sports

Don’t take aspirin, vitamin E or anti-inflammatory medicines like Advil, Aleve or Motrin.

When to call your doctor

The following may be signs of serious internal bleeding. Call your doctor immediately.
• Blood in your urine
• Blurred vision
• Coughing up blood
• A nosebleed that doesn’t stop
• Dizziness
• A headache that may be severe and doesn’t get better
• Tarry or black stools

How are low platelets treated?

If you’re on chemotherapy, your oncologist will delay your treatment by a week or two, and your platelet counts will, most likely, recover on their own. If your thrombocytopenia is acute, your oncologist might give you oprelvekin (Neumega).

Your medical team will delay surgery if you have a low platelet count.

Some patients with critically low platelet counts may receive a platelet transfusion to prevent excessive and/or unexpected bleeding.

The Bottom Line …
Despite some hype on the internet, there are no “magic” foods that will increase your platelet counts. Save your money and follow your treatment center’s recommendations regarding activities to avoid or modify. It’s much better to avoid a bleeding incident, which could be life-threatening than to take a chance and end up in the emergency room or hospital.

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