Low Platelet Count – Symptoms, Causes & Treatment

Introduction

Blood cells known as platelets help stop bleeding by the formation of blood clots. In adults, an ordinary platelet count or level is between 150,000 and 450,000 platelets per microliter of blood. However, sometimes these levels might differ and get reduced due to certain conditions.

Insufficient platelet count known as thrombocytopenia, causes easy bruising and bleeding tendencies. It lead to lack of blood clot formation making it difficult for the bleeding to stop after an injury¹. In this blog, we will discuss about low platelet counts in detail- their causes, presentation and management.

Signs and Symptoms of Low Platelet Count

One of the initial signs, when they do occur, is a cut that will not stop bleeding. Additional signs include^2,3:

• Nose bleeding: Sudden profuse bleeding that won’t stop.
• Gum bleeding: Blood on your toothbrush or swollen-looking gums.
• Blood in stool: Dark-coloured stool due to the presence of blood.
• Blood in the pee (urine): Blood in your urine (toilet water may turn into a pale pink colour after urination).
• Hematemesis: Having blood in your vomit (a symptom of upper gastrointestinal haemorrhage).

Symptoms of low platelet count²:

• Heavy menstrual periods: Menorrhagia may be present if your periods run longer than seven days or if you are bleeding more heavily than normal.
• Petechiae: In this condition, the skin of your lower thighs has tiny, red, or purple dots.
• Purpura: It involves purple, crimson, or large brown spots on your skin. This happens when small blood vessels underneath your pores and skin leak blood.
• Bruises: Bruises appear while blood pools underneath your skin. You may develop bruises more easily than usual.
• Rectal bleeding: You might also spot blood in the toilet water or when you wipe¹.

Some patients with moderately low platelet count do not exhibit any symptoms. They may also report nonspecific symptoms like easy bruising, skin rashes and bleeding from gums and other areas of mouth^1,2.

Causes of Low Platelet Count

There are three primary causes of reduced platelets:

Insufficient platelets are produced in the bone marrow

If you suffer from either of the following kinds of disorders, your bone marrow might not produce enough platelets.

1. Aplastic anaemia or myelodysplastic syndrome

In aplastic anaemia, the bone marrow fails to produce enough blood cells. This might be due to¹:

• Bone marrow cancer
• Liver scarring caused by cirrhosis
• Folate/Vitamin B9 deficiency

In the case of myelodysplastic syndrome, the bone marrow either produces insufficient or faulty blood cells. This might be due to¹:

• Vitamin B12 insufficiency
• Chemotherapy, as many cancer medications may cause bone marrow damage.

2. Increased platelet deterioration in the blood

• Certain types of cancers (such as leukaemia or lymphoma) can lower platelet count. The unusual cells in such cancers can outnumber healthy cells inside the bone marrow, where platelets are made¹.

3. Increased platelet deterioration in the liver or spleen

• It may be due to a disorder in which the proteins responsible for blood clotting become overly active, usually occurring during a severe illness.
• This can be due to an enlarged spleen.
• May also be due to a condition in which the immune system mistakenly destroys platelets (referred to as ITP- idiopathic or immune thrombocytopenia)¹.

4. Infections

• Viral infections such as HIV, hepatitis C, Epstein-Barr virus, parvovirus, mumps, varicella (chickenpox), rubella (German measles), and Zika virus can lead to low platelet count.
• Sepsis, a severe infection in the body, can cause suppression of bone marrow function.
• The bacteria Helicobacter pylori and tick-borne infections like leptospirosis, brucellosis, and anaplasmosis are associated with low platelet count.
• Infections caused by malaria and parasites can result in both low platelet count and hemolytic anaemia (breakdown of red blood cells)¹.

Risk Factors for Low Platelet Count

The factors that contribute to a low platelet count are crucial for identifying individuals who may be at risk⁴:

• Age
• Genetics
• Autoimmune conditions such as lupus, rheumatoid arthritis, etc.
• Leukaemia and lymphoma
• Chemotherapy and radiation therapy
• Already existing bacterial infections
• Use of alcohol 
• Exposure to toxic chemicals like arsenic, benzene, and pesticides
• Medications like Heparin (a blood thinner), medications for seizures and heart disorders, and antibiotics used to treat bacterial infections can all have an impact on platelet levels. Just before giving birth, moderate thrombocytopenia may impact about 1% of pregnant women⁵.

Diagnosis of Low Platelet Count

Diagnostic methods for low platelet count:

Physical examination

• A physical examination will be performed by medical professionals.
• They will look for bruises, rashes, and other signs of thrombocytopenia.
• They will take your medical history, along with any drugs you are now taking¹.

Blood tests

• Complete blood count (CBC): Healthcare professionals will measure your white and red blood cell, platelet, and haemoglobin levels.
• Peripheral blood smear: Using a microscope, healthcare professionals will look at your platelets.
• Prothrombin time (PT) and partial thromboplastin time (PTT) assays: To determine the time taken by the blood to clot.
• Bone marrow biopsy: Your healthcare practitioner might do a bone marrow biopsy if blood tests reveal a low platelet count².

Treatment of Low Platelet Count

Healthcare providers can often improve platelet counts by addressing the underlying cause, which may involve changes in medication. Additional treatment options may include:

Diet and medicine

• Mediterranean diet: Adopting a Mediterranean diet helps keep platelet counts in the normal range, which is important for reducing the risk of chronic diseases⁶.
• It lowers the chances of developing thrombocytopenia, a condition characterised by low platelet count.
• It lessens the link between changes in platelet count and the risk of mortality.
• Steroids: The doctor might prescribe steroids to help increase platelet production².

Medical procedures

• Platelet transfusion: In cases of very low platelet levels, a healthcare provider may administer a blood transfusion to raise platelet levels for approximately three days temporarily⁷.
• Splenectomy: This surgical procedure involves removing the spleen if tests indicate that it is trapping an excess number of platelets. It is important to note that individuals who undergo splenectomy have an increased risk of developing infections and may receive vaccinations to prevent them¹.

Also Read: How To Increase Platelet Count Naturally

Prevention of Low Platelet Count

It is important for your doctor to know if you have any medical conditions or take medications that increase your risk of developing thrombocytopenia. If you are not sure, consult your doctor to find out if there are any prescription drugs or activities you should avoid.

• There is currently no cure for genetic platelet disorders.
• Many platelet problems are caused by other diseases or medications and cannot be prevented or avoided.
• Maintaining a healthy lifestyle, such as quitting smoking and limiting alcohol intake, may help reduce the chances of having low platelet levels⁴.
• As mentioned earlier, adopting a Mediterranean diet helps to keep platelet counts in a healthy range, which is important for reducing the risk of various chronic diseases that tend to worsen over time.

Complications of Low Platelet Count

Severe low platelet count can make patients more prone to^1,8:

• Severe internal bleeding: Low platelet count can lead to serious bleeding in the brain or gastrointestinal tract, which can be life-threatening.
• Increased risk of heart attack: Low platelet count may make it more difficult for the heart to receive an adequate blood supply.
• Pregnancy complications: Maintaining a pregnancy can be more challenging for women with low platelet count.
• Menorrhagia: Low platelet count can cause prolonged and heavy menstrual bleeding that lasts for more than a week.

When to See a Doctor?

Thrombocytopenia symptoms can develop suddenly or over the years. It might also cause bleeding in more than one part of your body. Seek immediate medical help if¹:

• When you notice any signs of low platelet count, such as unexpected bleeding or spots that cannot be categorised otherwise.
• You have a fever or other symptoms of infection.
• If you had a splenectomy, you are at increased risk of infection.

Conclusion

Low platelet count, or thrombocytopenia, can arise from various causes ranging from infections and medications to chronic health conditions. Therefore, recognising symptoms such as easy bruising, prolonged bleeding, or unexplained fatigue is crucial for timely diagnosis.

With proper medical evaluation and treatment, whether through lifestyle changes, medications, or targeted therapies, most cases can be effectively managed. Keep in mind that early detection and appropriate care play a key role in preventing complications and ensuring better health outcomes.

Frequently Asked Questions (FAQs)

References

1. Jinna S, Khandhar PB. Thrombocytopenia. [Internet]. StatPearls Publishing; [cited 2025 Sep 16]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542208/

2. National Heart, Lung, and Blood Institute. Platelet Disorders – Thrombocytopenia [Internet]. NHLBI, NIH; [cited 2025 Sep 16]. Available from: https://www.nhlbi.nih.gov/health/thrombocytopenia

3. Wilson ID. Hematemesis, Melena, and Hematochezia. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston: Butterworths; 1990. Chapter 85. Available from: https://www.ncbi.nlm.nih.gov/books/NBK411/

4. National Heart, Lung, and Blood Institute. Platelet Disorders – Causes and Risk Factors [Internet]. NHLBI, NIH; [cited 2025 Sep 16]. Available from: https://www.nhlbi.nih.gov/health/platelet-disorders/causes

5. Mangla A, Hamad H. Thrombocytopenia in Pregnancy [Internet]. StatPearls Publishing; [cited 2025 Sep 16]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547705/

6. Hernáez Á, Lassale C, Castro-Barquero S, Ros E, Tresserra-Rimbau A, Castañer O, et al. Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial. Nutrients. 2021 Feb 8;13(2):559. Available from: https://pubmed.ncbi.nlm.nih.gov/33567733/

7. Izak M, Bussel JB. Management of thrombocytopenia. F1000Prime Rep. 2014 Jun 2;6:45. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4047949/

8. Ashworth I, Thielemans L, Chevassut T. Thrombocytopenia: the good, the bad and the ugly. Clin Med (Lond). 2022 May;22(3):214-217. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9135082/

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Links and product recommendations in the information provided here are advertisements of third-party products available on the website. PharmEasy does not make any representation of the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.

18

1