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. Sometimes your doctor may hold radiation or chemotherapy until your low platelet count recovers back to a normal or safe range.  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:
    • A large loss of blood
    • Bleeding that continues after 10 minutes of pressure
    • Dizziness or lightheadedness
  • 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:
    • Bleeding that gets worse after 10 minutes
    • Bleeding that does not stop completely after 30 minutes
  • 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