Thrombocytopenia: Symptoms, Stages & Treatment (2023)


Thrombocytopenia: Symptoms, Stages & Treatment (1)

What is thrombocytopenia?

Thrombocytopenia (pronounced “THROM-bo-sigh-toe-PEE-ne-ah”) occurs when your bone marrow doesn’t make enough platelets. Platelets are blood cells that form blood clots to help stop bleeding. If you have thrombocytopenia, you may bleed a lot, and the bleeding may be hard to stop.

Thrombocytopenia often affects people with certain medical conditions, like autoimmune disease or who take certain medications. Healthcare providers typically treat thrombocytopenia by treating the underlying condition and/or changing the medication that caused the issue.

How common is this condition?

People may have thrombocytopenia and not realize it because their symptoms are so mild. That’s why healthcare providers aren’t sure exactly how many people have this condition. They do know a related condition, immune thrombocytopenia, affects 3 to 4 in 100,000 children and adults. About 5% of people who are pregnant develop mild thrombocytopenia just before giving birth.

What are the complications of thrombocytopenia?

People with severe thrombocytopenia may have an increased risk of developing the following conditions:

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  • Severe internal bleeding: Thrombocytopenia may cause gastrointestinal bleeding or bleeding in your brain. Bleeding into your brain is a life-threatening issue.
  • Heart attack: Thrombocytopenia may decrease the amount of blood flow to your heart.

What are normal platelet levels?

A normal platelet count or level in adults ranges from 150,000 to 450,000 platelets per microliter of blood. Thrombocytopenia levels are:

  • Mild thrombocytopenia: Platelet levels between 101,000 and 140,000 per microliter of blood.
  • Moderate thrombocytopenia: Platelet levels between 51,000 and 100,000 per microliter of blood.
  • Severe thrombocytopenia: Platelet levels between 51,000 and 21,000 microliters of blood.

Symptoms and Causes

What are thrombocytopenia symptoms?

Some people with mild cases of thrombocytopenia don’t have symptoms. When they do, one of the first symptoms is a cut or nosebleed that won’t stop bleeding. Other symptoms include:

  • Bleeding gums: You may notice blood on your toothbrush and your gums may appear swollen.
  • Blood in poop (stool): Your poop may appear very dark.
  • Blood in urine (pee): If toilet water is pale pink after you pee, you may have blood in your urine.
  • Blood in vomit: Hematemesis, or blood in vomit, is a sign of bleeding in your upper gastrointestinal tract.
  • Heavy menstrual periods: If your periods last longer than seven days or you’re bleeding more than usual, you may have menorrhagia.
  • Petechiae: This symptom appears as tiny red or purple dots on your lower legs that resemble a rash.
  • Purpura: You may have red, purple or brown spots on your skin. This happens when small blood vessels under your skin leak blood.
  • Bruises: Bruises happen when blood pools under your skin. You may notice you’re developing bruises more easily than usual.
  • Rectal bleeding: You may notice blood in the toilet water or after you wipe.

What causes thrombocytopenia?

Thrombocytopenia causes fall into one of three categories:

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  • Your bone marrow doesn’t make enough platelets. This may happen if you have blood cancers like leukemia or lymphoma.
  • Your bone marrow makes enough platelets, but your platelet supply runs low because you have conditions that use up your platelet supply or destroy your platelets.
  • Your spleen traps platelets so they can’t circulate through your bloodstream. Normally, your spleen stores about one-third of your platelet supply.

Specific factors affecting platelet supply include:

  • Autoimmune diseases: Autoimmune diseases, like immune thrombocytopenia (ITP), lupus and rheumatoid arthritis, that attack your immune system may destroy platelets.
  • Blood cancers: Leukemia and lymphoma may damage your bone marrow and affect its ability to make enough blood cells, including platelets.
  • Cancer treatments: Treatments — including chemotherapy and radiation therapy — sometimes destroy stem cells that would have become platelets.
  • Thrombotic thrombocytopenic purpura (TPP): This blood disorder causes blood clots in small blood vessels throughout your body. Platelets make blood clots. Your platelet supply may run low if you have TPP or a similar condition, disseminated intravascular coagulation, which uses up platelets.
  • Infections: Bacterial and viral infections may lower your platelet levels.
  • Alcohol use disorder: Alcohol slows platelet production. Drinking a lot of alcohol may cause your platelet level to drop.
  • Toxic chemicals: Exposure to toxic chemicals, including arsenic, benzene and pesticides, may affect your platelet level.
  • Medications: Antibiotics that treat bacterial infections, medication for seizures and heart conditions, and the blood thinner heparin may affect platelet levels.

Diagnosis and Tests

How do healthcare providers diagnose thrombocytopenia?

Healthcare providers will do a physical examination. They’ll check for bruises, rashes and other thrombocytopenia symptoms. They’ll ask about your medical history, including any medications you take. They may do tests including:

  • Complete blood count (CBC): Providers will check your platelet levels and your white and red blood cell levels.
  • Peripheral blood smear: Providers examine your platelets under a microscope.
  • Blood clot test: A blood clot test measures the time it takes blood to clot. These tests include partial thromboplastin time (PTT) and prothrombin time (PT) test.
  • Bone marrow biopsy: If blood tests show a low platelet count, your healthcare provider may do a bone marrow biopsy.

Management and Treatment

How do healthcare providers treat thrombocytopenia?

You might not need treatment if a low platelet count isn’t causing significant issues. Often, healthcare providers can improve platelet counts by treating the underlying cause. This approach may involve changing your medications. Other treatments include:

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  • Steroids: These medications may boost your platelet production.
  • Blood transfusion: If your platelet level is very low, your healthcare provider may use blood transfusions to temporarily increase your platelet levels. Transfusions may boost levels for about three days.
  • Splenectomy: This is surgery to remove your spleen. Your surgeon may do this if tests show your spleen is trapping large numbers of platelets. People who have splenectomies have an increased risk of developing infections. They may receive vaccinations to prevent infections.


How can I reduce my risk of developing thrombocytopenia?

The most important thing is to understand if you have medical conditions or take medication that increases your risk of developing thrombocytopenia. If you do, ask your healthcare provider if there are medications or activities you should avoid.

Outlook / Prognosis

What can I expect if I have this condition?

Many things can cause your platelet levels to drop so you develop thrombocytopenia. For example, you may have an autoimmune disease that affects your platelet levels. You may have low platelet levels because you drink lots of alcohol or are exposed to certain toxic chemicals.

Bottom line — once your healthcare provider finds out why your platelet levels are low, they’ll take steps to help you. If you have thrombocytopenia, ask your healthcare provider what caused the issue and what treatment or lifestyle changes they recommend.

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If your provider recommends treatment, you may need ongoing treatment to maintain a normal platelet level. Your provider will monitor your overall health and platelet levels.

Living With

How do I take care of myself?

If you have thrombocytopenia, here are some suggested ways to take care of yourself:

  • Make healthy lifestyle changes: If you smoke, quit. Smoking increases your risk of blood clots. If you drink alcohol, do so in moderation. Heavy alcohol use may affect platelet levels. Practice good dental hygiene to avoid dental treatments that may cause bleeding.
  • Take care with over-the-counter (OTC) medication: Some OTC medications contain ibuprofen or aspirin that may make your blood too thin. Talk to your provider before using supplements and herbal remedies.
  • Avoid activities that may cause bruising and bleeding: Most contact sports, like football, soccer or basketball, increase the chance you’ll have an injury that involves bleeding. Ask your healthcare provider about activities you can do without increasing your risk of injury.
  • Travel safe: Wear your seatbelt while driving or riding in a vehicle.
  • Tell your healthcare providers about your medications: You may receive medication to thin your blood. If you have surgery or dental procedures, tell your providers about your medications before your surgery or procedure.

When should I seek care?

Thrombocytopenia symptoms can develop very quickly or over time. It may also cause bleeding in many parts of your body. Seek medical care if:

  • You notice changes in your body that could be thrombocytopenia symptoms, such as new bruises and unusual bleeding.
  • You have a fever or other signs of infection. If you had a splenectomy, you’re at increased risk of infection.

What questions should I ask my healthcare provider?

You may want to ask your healthcare provider:

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  • Why did I get thrombocytopenia?
  • What’s the best treatment for me?
  • Are there any treatment risks or side effects?
  • What changes can I make to minimize bleeding and bruising?
  • Should I watch for signs of complications?

A note from Cleveland Clinic

Thrombocytopenia — low platelet levels — may increase your risk of issues like excessive bleeding and bruising. Severe thrombocytopenia increases your risk of internal bleeding or heart attack. If you have this condition, it’s important to understand why you have low platelet levels. Your healthcare provider can explain what’s causing the low platelet count and discuss treatment options. They’ll also discuss lifestyle changes that may boost your platelet levels.


What are the treatment of thrombocytopenia? ›

  • Blood or platelet transfusions. If your platelet level becomes too low, your doctor can replace lost blood with transfusions of packed red blood cells or platelets.
  • Medications. ...
  • Surgery. ...
  • Plasma exchange.
19 Apr 2022

What are the levels of thrombocytopenia? ›

Degrees of thrombocytopenia can be further subdivided into mild (platelet count 100,000 to 150,000/microL), moderate (50,000 to 99,000/microL), and severe (<50,000/microL) [1].

Does mild thrombocytopenia need treatment? ›

If you have mild thrombocytopenia, you may not need treatment. A fully normal platelet count is not necessary to prevent serious bleeding, even with serious cuts or accidents. If you have serious bleeding or a high risk of complications, you may need medicines or procedures.

How long does it take to treat thrombocytopenia? ›

The response to treatment is usually seen in four to six weeks after the first infusion, although it can take longer. Thrombopoietin mimetics (Eltrombopag/"Promacta" and Romiplostim/"Nplate") — These medications increase the bone marrow production of platelets.

Which medicine improve platelets? ›

Romiplostim is in a class of medications called thrombopoietin receptor agonists. It works by causing the cells in the bone marrow to produce more platelets.

Can thrombocytopenia get better? ›

Acute ITP in children often goes away on its own within a few weeks or months and does not return. For a small number of children, ITP does not go away on its own, and the child may need treatment. Chronic ITP varies from person to person and can last for many years.

Is 7 a low platelet count? ›

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.

How can I increase my platelets fast? ›

Vitamin C. Vitamin C helps your platelets group together and function efficiently. It also helps you to absorb iron, which may also help to increase platelet counts. The book Vitamin C: Its Chemistry and Biochemistry reported a rise in platelet count in a small group of patients who received vitamin C supplementation.

When is thrombocytopenia an emergency? ›

A platelet count less than 5 × 103 per μL may cause spontaneous bleeding and constitutes a hematologic emergency. Patients who present with thrombocytopenia as part of a multisystem disorder usually are ill and require urgent evaluation and treatment.

Should I worry about mild thrombocytopenia? ›

When to see a doctor. Make an appointment with your doctor if you have signs of thrombocytopenia that worry you. Bleeding that won't stop is a medical emergency. Seek immediate help for bleeding that can't be controlled by the usual first-aid techniques, such as applying pressure to the area.

Is thrombocytopenia a lifelong? ›

Chronic thrombocytopenic purpura.

The onset of the disorder can happen at any age, and the symptoms can last a minimum of 6 months, several years, or a lifetime.

Which medicine is best for low platelet count? ›

Drugs that boost platelet production.

Medications such as romiplostim (Nplate) and eltrombopag (Promacta) help your bone marrow produce more platelets.

Can you live with thrombocytopenia? ›

For most people with ITP, the condition isn't serious or life-threatening. For example, acute ITP in children often resolves within 6 months or less without treatment. Chronic ITP, though, can last for many years. Still, people can live for many decades with the disease, even those with severe cases.

Which fruit is good for platelets? ›

Foods rich in folate, vitamin B 12, vitamin C, D, K and iron are known to increase the platelet counts.
  • Papaya leaf. ...
  • Wheatgrass. ...
  • Pomegranate. ...
  • Pumpkin. ...
  • Vitamin C rich foods. ...
  • Raisins. ...
  • Brussel sprouts. ...
  • Beetroot.
16 Oct 2019

What foods to avoid if you have low platelets? ›

Eat Less...
  • Canned and frozen foods and leftovers. The nutritional value of food deteriorates with time.
  • White flour, white rice and processed foods. ...
  • Hydrogenated, partially hydrogenated or trans-fats. ...
  • Sugar. ...
  • Dairy products. ...
  • Meat. ...
  • Alcoholic beverages. ...
  • Foods that can interfere with blood clotting.

Can Egg increase platelets? ›

Even egg whites helps in boosting your platelet count as they contain albumin which is a vital protein found in the blood plasma.

Can thrombocytopenia lead to death? ›

ITP (immune thrombocytopenic purpura) is generally considered a benign disease. Despite what may be severe thrombocytopenia, most patients with ITP do not suffer significant bleeding episodes. Mortality is rare, and the majority of cases are managed successfully with conventional treatments.

How much platelets increase per day? ›

A normal platelet count is between 150,000 and 400,000 per microliter of blood. Because platelets only live in the body for about 10 days, your bone marrow creates millions of platelets each day. @my1blood For women, the average platelet count is between 157,000 and 371,000 per microliter of blood.

Is 27 a low platelet count? ›

low platelet count (30 to 50): you might bruise more easily than usual and bleed for longer than you'd expect if you cut yourself. very low platelet count (10 to 30): you might bleed after very minor injuries that wouldn't normally bleed, bleed for longer than usual, and bruise very easily.

What cancers cause low platelets? ›

Certain cancers such as leukemia or lymphoma can lower your platelet count. The abnormal cells in these cancers can crowd out healthy cells in the bone marrow, where platelets are made.

Can banana increase platelets? ›

Iron is a vital nutrient that helps in the production of red blood cells in the body. Iron deficiency is associated with low platelets and low haemoglobin too, which can cause the disease called anaemia. Food rich in iron includes leafy vegetables like spinach, lentils, pumpkin seeds, raw bananas and guava.

How can I increase my platelets in 3 days? ›

Spinach is rich in Vitamin K, which helps in prevention of blood loss from cuts and injuries. Also, daily consumption of spinach juice can drastically improve the number of blood platelets.

Does Apple increase platelets? ›

Conclusions: The results indicate that in healthy volunteers 6-week diets differing markedly in the amounts of vegetables, berries and apple do not differ in their effects on platelets or inflammation.

When should you be hospitalized for thrombocytopenia? ›

Hospitalization has been suggested for children with ITP who have severe life-threatening bleeding or platelet counts of less than 20×109/L and mucous membrane bleeding; but the value of hospitalization for patients presenting with platelet counts of less than 20×109/L, petechiae and purpura, who are otherwise ...

What happens if you don't treat thrombocytopenia? ›

Thrombocytopenia — low platelet levels — may increase your risk of issues like excessive bleeding and bruising. Severe thrombocytopenia increases your risk of internal bleeding or heart attack. If you have this condition, it's important to understand why you have low platelet levels.

What is the most common reason for thrombocytopenia? ›

Thrombocytopenia can be an inherited condition, or it can be caused by medications or other medical conditions. The platelet count in your bloodstream is reduced by one or more of the following main processes: Decreased production of platelets. Increased destruction of platelets.

Does thrombocytopenia get worse? ›

Does it get worse over time? No, unlike autoimmune diseases such as rheumatoid arthritis and multiple sclerosis it is not a progressive disease, but the risk of bleeding is present from the day the disease develops. ITP can go into temporary or permanent remission.

What infections cause low platelets? ›

Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia.

How does thrombocytopenia affect daily life? ›

ITP leads to fatigue, challenges with daily activities, reduced physical functioning, anxiety, and depression. Aside from the constant risk for serious bleeding, patients experience both physical and emotional consequences living with their disease on a daily basis.

What is the survival rate for thrombocytopenia? ›

Compared with survivors, non-survivors were older, were more likely to have thrombocytopenia, and had lower nadir platelet counts. The in-hospital mortality was 92.1%, 61.2%, 17.5%, and 4.7% for (0, 50], (50, 100], (100-150], and (150-) groups, respectively.

Does thrombocytopenia make you tired? ›

Fatigue is not a known symptom of thrombocytopenia, so this symptom is probably not directly related. There could be a "unifying" cause, i.e. one problem that causes both low platelets and fatigue, so ask your doctor about that possibility.

Does sleep affect platelet count? ›

Drs. Everson and Toth, together with Anne Folley present exciting results indicating that sleep deprivation in rats arrests new bone formation, decreases fat within the red marrow and increases platelet levels.

What injection is used for low platelets? ›

Romiplostim injection is used to treat low blood platelet counts (thrombocytopenia) and help prevent bleeding in patients with a blood disorder called immune thrombocytopenia (ITP).

What happens to the body when a person has thrombocytopenia? ›

If you have thrombocytopenia, you don't have enough platelets in your blood. Platelets help your blood clot, which stops bleeding. For most people, it's not a big problem. But if you have a severe form, you can bleed spontaneously in your eyes, gums, or bladder or bleed too much when you're injured.

What blood products treat thrombocytopenia? ›

Platelet concentrates (PC) are widely used to support patients with severe thrombocytopenia. These could be patients with hematologic malignancy, bone marrow failure, or other immune and non-immune causes of platelet destruction, though rare cases could warrant transfusion with normal platelet counts.

What are 3 causes of thrombocytopenia? ›

Factors that can decrease platelet production include:
  • Leukemia and other cancers.
  • Some types of anemia.
  • Viral infections, such as hepatitis C or HIV.
  • Chemotherapy drugs and radiation therapy.
  • Heavy alcohol consumption.
19 Apr 2022

What medications should be avoided with thrombocytopenia? ›

  • Furosemide.
  • Gold, used to treat arthritis.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Penicillin.
  • Quinidine.
  • Quinine.
  • Ranitidine.
  • Sulfonamides.
22 Jul 2021

What are the complications of thrombocytopenia? ›

Complications of thrombocytopenia include:
  • Adverse effects of treatment.
  • Anemia.
  • Excessive or uncontrollable bleeding.
  • Gastrointestinal bleeding.
  • Intracerebral hemorrhage (bleeding in the brain)
  • Severe nosebleeds.

Who is at risk for thrombocytopenia? ›

ITP is more common among young women. The risk appears to be higher in people who also have diseases such as rheumatoid arthritis, lupus and antiphospholipid syndrome.

Can B12 increase platelets? ›

This vitamin plays a key role in red blood cell formation, and some research suggests low platelet levels may be linked to B12 deficiency. Salmon, trout and tuna all pack a big B12 punch, so add more of these fatty fishes to your diet to help boost your platelet count.

Is vitamin B12 good for low platelets? ›

Improve Your Diet

Vitamin B12 or folate (vitamin B9) deficiency can both cause mild to moderate low platelet counts.

Does lack of sleep affect platelet count? ›

Drs. Everson and Toth, together with Anne Folley present exciting results indicating that sleep deprivation in rats arrests new bone formation, decreases fat within the red marrow and increases platelet levels.

What foods can cause thrombocytopenia? ›

Many medications are known to cause immune thrombocytopenia, but convincing reports of this complication triggered by foods and beverages are rare. Examples reported were associated with consumption of an African bean,2 sesame seeds,3 cranberry juice,4 cow's milk, and Jui (a Chinese herbal medicine).

What platelet count is thrombocytopenia? ›

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.


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