The Biomarker Handbook is a curated series that seeks to provide readers with insights on each biomarker we cover in our blood test packages and its relation to our body.
A full blood count (FBC) is a laboratory test that measures three key cell components of your blood: 1. Red cells that carry oxygen to all the cells of our body; 2. White cells that protect us from foreign agents and constitute key part of our immune system; and 3. Platelets (or thrombocytes) that play an important role in normal blood clotting.
What is a Platelet?
Platelets, also called thrombocytes, are tiny fragments of cells that are essential for normal blood clotting. They are formed from very large cells called megakaryocytes in the bone marrow and are released into the blood to circulate. The platelet count is a test that determines the number of platelets in a person’s sample of blood.
Why is Thrombocyte Count Important?
Since platelets have a major role in the clotting process, any fluctuation in their numbers can cause bleeding disorders. Thus, tracking your thrombocyte count can help in identifying and diagnosing diseases and disorders that affect the platelet count.
The normal thrombocyte count is 150,000 to 450,000 platelets per microliters of blood.
Thrombocytopenia: Platelet counts that fall below the normal range (called thrombocytopenia) could indicate an underlying disease that disrupts the normal production of platelets. Some common causes of thrombocytopenia are chemotherapy, the use of certain drugs (such as furosemide, penicillin and quinidine), dengue fever, and autoimmune disorders.
A low platelet count puts the individual at risk of bleeding profusely with a marked increase in the bleeding time.
Thrombocytosis: Sometimes the platelet count increases above the upper normal limit. This condition is medically called thrombocytosis.
Thrombocytosis can be multifactorial, commonest causes being infections, cancer, surgery, anemia and bone marrow disorders, just to name a few.
Signs and Symptoms of an Abnormal Platelet Count
Thrombocytopenia: A low blood platelet count can manifest itself in various ways. If you notice any of the following symptoms please consult your doctor immediately.
- Frequent and easy bruising
- Pin-point hemorrhages (petechiae) on the skin, usually in the lower limbs.
- Increased bleeding time
- Frequent bleeding from the gums or nose (epistaxis)
- Heavy menstrual flow
- Splenomegaly (enlarged spleen)
- Rarely, blood in the urine or stool
Thrombocytosis: An increase in the levels of platelets can cause different clinical signs, some of which are listed below:
- Blurred vision
- Chest ache
- Tingling sensations in the finger and toes
- Paradoxically, bleeding
Consequences of an Abnormal Platelet Count
Low circulating levels of platelets predisposes an individual to bleeding disorders. Furthermore, healing and repair is retarded, clot formation is poor and severe bleeding can occur.
On the other hand, abnormally high levels of platelets can cause clotting disorders where clots can form in the blood vessel with real danger of dislodge and causing embolism, also known as a blocked artery.
Managing an imbalanced Platelet Count
Fluctuations in platelet counts usually require medical attention. If the platelet levels are slightly below the normal range, changes in your lifestyle and diet can help improve your condition.
Vitamin B12 and folic acid supplements can help combat low platelet counts. People with Vitamin B12 deficiency, in particular, are at an increased risk of thrombocytopenia. These vitamins can be obtained directly by consuming supplement capsules or by including vitamin-rich foods in your diet. Some of the best sources for Vitamin B12 are beef, tuna, salmon and yogurt while lentils, beans and spinach are rich in folic acid.
Along with adding certain items to your diet, it is important to eliminate foods that may affect your platelet count. These foods include alcohol and sugary drinks , which are known to cause fluctuations in the platelet levels.
People at risk of low platelet counts should avoid activities that can cause even a mild injury (football, boxing, karate etc.). Additionally, certain chemical products can affect the composition of blood including platelet levels. Furthermore, mercury, arsenic and benzene are agents that can retard the production of platelets by the bone marrow. Lifestyle changes must be made in such a way that exposure from these harmful chemicals is minimized.
Additionally, using natural, organic products at home, avoiding mercury fillings and reducing the use of plastic can all help keep your platelet levels in check.
In addition to food, you may choose to consume non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen and aspirin have an anti-coagulant action. These drugs, although useful, can thin the blood and affect the levels of circulating platelets.
According to the severity, different treatment approaches are made by a clinician. Ultimately, the goal of treating abnormal platelet levels is to correct the underlying disease causing it.
Certain drugs are also prescribed to combat decreasing platelet levels. Furthermore, in most cases, the first-line drug is usually a corticosteroid. However, if levels are too low, it could be a medical emergency and immediate whole blood or platelet transfusions are given. Surgical removal of the spleen and plasma exchange is also performed as a last resort in cases of thrombotic thrombocytopenic purpura (TTP).
In cases of high platelet counts, or thrombocytopenia, cytoreductive therapy is performed and medications like hydroxyurea and busulfan are usually given.
When to See a Doctor
If you notice any signs and symptoms of platelet count abnormalities, you should check in with your doctor. However, if symptoms persist and begin to worry you, it is important to seek medical care. Your doctor will recommend you take a CBC test or may refer you to a hematologist for further investigation
The sooner the condition is diagnosed, the easier it will be to treat it.
Additional Diagnostic Tests
Along with a complete blood test (CBC), platelet disorders can be diagnosed through a comprehensive patient history and a general physical examination. As a result, your doctor may ask you questions related to your diet, family history of the disease and any medications that you are currently taking. A physical exam will also help the physician look for apparent signs of platelet disorders such as pinpoint bruises on the skin or an enlarged spleen.
Lab tests include CBC, blood smear and bone marrow biopsy. Additionally, these tests can give a solid confirmation whether platelet levels are normal and in appropriate quantities.
Other tests that are not routinely performed but can be helpful in diagnosis are noting the prothrombin (PT) time and the partial thromboplastin time (PTT). Additionally, an ultrasound of an enlarged spleen can also be of a diagnostic value.
Mild fluctuations in the platelet count are usually easy to rectify. In cases of severe abnormalities, the number of platelets in your blood can take a toll on your overall health. Thus, it is important to address the clinical signs of thrombocytopenia and thrombocytosis as early as possible to prevent untoward consequences.
If you want to find out more about managing a vitamin B12 deficiency and how you can balance your platelet count, take a look at our lifestyle article here!
Interested in other biomarkers, check out the rest of The Biomarker Handbook.
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