Low Platelet Count (Thrombocytopenia): Signs, Causes & Treatment

What is Low Platelet Count?

Platelets are a crucial part of the blood. The small, sticky, colorless, plate-shaped cells help with blood clotting and keep the body from losing too much blood (x). However, sometimes the platelet count in the blood may diminish from genetic conditions, viral diseases or severe infections. Thrombocytopenia is a disorder in which the body’s platelet count is lower than average.

The bone marrow produces platelets along with the blood’s other components (white blood cells, red blood cells and plasma). Platelets travel through the blood vessels and clot together after an injury damages a blood vessel and causes bleeding (x). Without enough platelets in the blood, the patient may experience mild or more severe uncontrolled bleeding, both externally and internally.

In healthy adults, the normal platelet count is between 150,000 and 450,000 platelets per microliter of blood. A count lower than 150,000 platelets per microliter is considered low. However, the patient is typically not at risk for severe bleeding until their platelet count drops between 10,000 and 20,000 platelets per microliter. If it drops lower than 50,000 they may experience mild bleeding (x). There are several different factors that may contribute to thrombocytopenia and the condition may last only a few days or it may last several years, depending on the cause and severity.

Signs of Low Platelet Count 

The main sign of thrombocytopenia is mild to severe bleeding, either internal or external. Mild cases do not usually cause signs and patients usually discover it during routine blood tests. But more serious cases may cause severe bleeding in any part of the body.

Signs of External Bleeding

Normally, external bleeding is the first sign of thrombocytopenia and it may cause petechiae, which are purplish or reddish marks on the skin. The patient may also notice purple, brown and red bruises called purpura. Easy bruising, even from slight trauma, may be a sign of bleeding problems. Patients with low platelet counts may also notice excessive bleeding from the mouth from brushing the teeth or after dental work, frequent nosebleeds, abnormal vaginal bleeding, abnormally heavy menstrual flow, bleeding gums or prolonged bleeding from small cuts and minor injuries (x).

Signs of Internal Bleeding

Internal bleeding can be very serious. Thrombocytopenia may cause patients to bleed heavily into the intestines or the brain. Signs of internal bleeding include rectal bleeding, bloody stool and blood in the urine. If the patient has neurological symptoms, such as headaches, it may indicate bleeding in the brain. Neurological problems from internal bleeding are rare, but still important to discuss with a doctor (x).

Causes of Low Platelet Count 

Patients may inherit genes that increase the risk for thrombocytopenia or they may acquire it from another factor. In some cases, the case may be idiopathic. But typically, the body has a low platelet count for three general reasons. First, the bone marrow may not make enough platelets. In other cases, however, the bone marrow may make enough platelets, but another factor destroys them or uses them up. In other cases, the spleen may hold on to too many platelets and keep them from circulating. Patients may also suffer from a combination of these factors. Each general cause has its own set of factors that causes it.

Decreased Platelet Production

Platelets are made in the bone marrow from stem cells. There are several factors that can damage these stem cells and keep them from developing into healthy cells. For example (x):

Increased Platelet Destruction

If the bone marrow does, in fact, produce enough platelets, the body may destroy them or use up too many and cause a low platelet count. For example, anticoagulant medications are blood-thinning medications that prevent blood clotting (x). Other medications may cause a reaction in the body that destroys platelets. Other conditions that may cause the body to destroy, damage or use up platelets include (x):

In addition, there are some rare but severe conditions that cause the body to use too many platelets when it forms blood clots, including thrombotic thrombocytopenic purpura (TTP) and disseminated intravascular coagulation (DIC). TTP causes blood clots in small vessels and DIC may be a complication of pregnancy, infections or severe injuries. Blood clots develop very suddenly and use too many platelets (x).

Enlarged Spleen

Several disorders may cause an enlarged spleen. Under normal circumstances, the spleen stores up to a third of platelets in the body. However, an enlarged spleen holds onto too many platelets and they cannot circulate through the blood properly. Patients may develop an enlarged spleen from cirrhosis, cancer or from a condition that causes scarring on the bone marrow so that it cannot make blood cells properly (x).

Causes of Low Platelet Count

Treatment for Low Platelet Count 

There are several different options that physicians can use to normalize low platelet counts, but treatment options depend on what causes the condition and how severe it is. Mild thrombocytopenia does not typically require treatment. Physicians may adjust medication dosages or prescribe different medications if thrombocytopenia is a result of a drug interaction. Some patients may have a compromised immune system that causes platelet count to drop. In this case, they may benefit from immunosuppressive medications. However, severe cases with very low platelet counts may require more aggressive treatment (x).


Physicians may prescribe oral or intravenous medicines to raise platelet counts. For example, corticosteroids may keep the body from destroying platelets, intravenous immunoglobulins can block the immune system and drugs like romiplostim can help the bone marrow to make more platelets (x).

Blood Transfusions

If a patient has active bleeding or they are at risk for bleeding, physicians may perform a blood or platelet transfusion. First the surgeon puts an IV line into a blood vessel and then uses it to provide the patient with donated blood with a healthy amount of platelets (x).


If medications fail, a patient may need a splenectomy to surgically remove the spleen. Most of the time, only adults with immune thrombocytopenia need a splenectomy (x).


In addition to medical treatment, patients may also find relief from making healthy dietary choices. Specifically, there are certain vitamins and nutrients that research links to bleeding problems. For example, studies state that vitamin K deficiency may increase a patient’s risk for severe bleeding, even though this is very rare (x). Some leafy greens, like kale, spinach, fenugreek leaves and collard greens are rich in vitamin K. Brussels sprouts are also high in vitamin K (x, x).

Other research studies claim that lack of vitamin B12 and vitamin D may weaken the immune system and potentially increase the risk for thrombocytopenia (x). Animal products like fish, meat, eggs, milk and poultry are good sources of vitamin B12 (x).

Supplements for Low Platelet Count

In addition to medical treatment and possibly dietary choices, patients may also be able to include supplements in their health regimens to regulate platelet count. However, these are not an adequate medical treatment on their own and they are not a substitute for medical advice. Always consult a doctor before taking any supplements.

Papaya Fruit Extract

Papaya fruit is rich in various nutrients, including choline, potassium, magnesium and beta-carotene. Research states that it may be able to reduce the risk of several different types of cancer. In addition, it may also protect cancer patients from negative side effects of radiotherapy (x). It also has antioxidants that can boost the immune system and help the body fight infections and disease (x). As a dietary supplement, the recommended dosage for papaya fruit extract powder is 1,000 mg once or twice a day, or as directed by a physician.

Chlorella Blue-Green Algae

Chlorella is a single-cell algae high in protein, carbohydrates, fats, vitamins and antioxidants. Research shows that it may be able to treat anemia possibly because it contains folate, vitamin B12 and iron (x). It may also help improve circulation in the body and it may also help improve cholesterol, oxygen flow and blood sugar. The recommended dosage for chlorella blue-green algae supplements is 3.2 grams up to three times a day. Consult a doctor before taking this supplement.


Melatonin is a natural hormone that helps normalize the body’s internal clock. The pineal gland in the brain makes this hormone and it travels through the bloodstream with signals to send throughout the body. It is much more abundant at night and the body has receptors that detect it to help induce sleep.

Though patients mainly recognize it for its effect on sleep and mood—such as depression, panic disorders, seasonal affective disorder and anxiety—research also shows that there may be an association between melatonin and platelet count. However, medical professionals need to conduct more research to determine its efficacy (x). The recommended dosage for melatonin powder supplements is between 1 and 3 mg per day before bed. Consult a doctor before taking melatonin supplements.

Folic Acid

Folic acid is the synthetic form of vitamin B9. It is found naturally in foods like oranges, peanuts, kidney beans and black eyed peas. It is 100 percent water soluble and possibly beneficial for maintaining healthy immune, digestive and nervous system function. As a dietary supplement, take between 500 to 1,000 micrograms of folic acid (Vitamin B9) powder a day. Do not exceed 1,000 micrograms under any circumstances and use an accurate microgram scale to measure the dosage. Pregnant patients should only use 300 to 400 micrograms daily. It may not be safe for pregnancy in high doses. Consult a doctor before supplementing with folic acid.

Vitamin C

Researchers believe that daily vitamin C consumption may improve platelet production in the body. According to research, higher doses of vitamin C may prevent platelet damage from free radicals (x). Vitamin C is a powerful antioxidant and a tool that many patients may use to boost the immune system. Research also states that it may help improve iron absorption and possibly prevent anemia. As a dietary supplement, take 1,000 mg of vitamin C / ascorbic acid powder daily, or as recommended by a physician.

The Bottom Line

Low platelet count (thrombocytopenia) is a condition in which there are fewer platelets in the blood than normal (less than 150,000 platelets per microliter of blood). Platelets are components of the blood that form blood clots to stop bleeding and thrombocytopenia can cause abnormal or severe bleeding. In mild cases, the patient may not show any signs or symptoms. However, more severe cases often cause easy and frequent bruising, bleeding in the gums and mouth, nosebleeds and red or purple marks on the skin. It may also cause signs of internal bleeding, such as headaches, bloody urine or bloody stool.

There are three major causes of low platelet counts: decreased platelet production (from viral infections, heavy alcohol use or aplastic anemia), increased platelet destruction (from autoimmune disorders, bacterial blood infections or medications) and an enlarged spleen that holds too many platelets.

Low platelet count is treated according to the cause and severity. For mild thrombocytopenia cases that causes no significant bleeding, treatment may not be necessary. In more severe cases, patients may need treatment. For example, doctors may alter the patient’s prescription if they cause an adverse reaction that destroys platelets. Patients may also need a blood transfusion or splenectomy to surgically remove the spleen. In addition, patients may also try natural supplements that may help boost immunity or improve blood circulation. However, supplements are not a cure for low platelet count or any other medical treatment. Always consult a doctor before taking any supplements.

Author: James D