Having a low platelet count can affect your blood’s ability to clot. This can result in uncontrolled bleeding, which can sometimes require immediate medical attention.

Blood is made up of several types of cells which float in a liquid called plasma. The types of blood cells are:

  • red blood cells
  • white blood cells
  • platelets (also called thrombocytes)

When your skin is injured or broken, your platelets clump together and form clots to stop the bleeding. When you don’t have enough platelets in your blood supply, your body can’t form clots.

A low platelet count is called thrombocytopenia. This condition can range from mild to severe, depending on its underlying cause. Some people with thrombocytopenia may not experience any symptoms; for more severe cases, uncontrollable bleeding can result in death.

Thrombocytopenia can be caused by a range of factors such as pregnancy, medical conditions such as leukemia, or certain medications (such as blood thinners). As a result, there are multiple treatment options for thrombocytopenia which may differ depending on the root cause of the condition.

Whether or not you experience symptoms of thrombocytopenia may depend on how low your platelet count is.

If you have a low platelet count, you may experience:

In more severe cases, you may bleed internally. Symptoms include:

If you experience any signs of internal bleeding, seek immediate medical attention.

In rare cases, thrombocytopenia may lead to bleeding in your brain. Talk to a healthcare professional if you have a low platelet count and experience headaches or neurological problems.

Bone marrow issues

Your bone marrow is the spongy tissue inside the bone where all the components of blood, including platelets, are produced. There are multiple reasons why a person’s bone marrow may not create enough platelets, such as:

Platelet destruction

Platelets live about 7-10 days in people without thrombocytopenia. A low platelet count can be a result of the body destroying too many platelets too quickly. Some reasons a body might destroy its platelets include:

If you think you may be experiencing symptoms of low platelet count, talk to a healthcare professional — especially if you’re experiencing serious symptoms, such as wounds or cuts that won’t stop bleeding, or blood in your stools or urine.

It’s also important to be checked regularly if you are at risk of developing thrombocytopenia due to a medical condition, family history, or medication.

Physical examination

If your doctor suspects a low platelet count, they will first do a physical exam. Your doctor will check your body for unusual bruising or evidence of petechiae (small red and purple dots), which is a sign of capillary bleeding that often accompanies a low platelet count.

Your doctor may also feel your abdomen to check for an enlarged spleen or liver.

Medical history

Your doctor may also ask about the following:

  • if you have a family history of bleeding disorders
  • medications that you take
  • herbal supplements that you take
  • your eating patterns
  • alcohol intake and IV drug use
  • current sex protection methods

If you are diagnosed with low platelet count, this information can help your healthcare professional treat your condition effectively.

Tests

There are multiple blood, bone marrow, and ultrasound tests that can help your doctor diagnose this condition and determine the underlying cause.

Blood tests

To diagnose low platelet count, your doctor will need to do a complete blood count (CBC) test. This test is often performed with a simple blood draw in your arm.

A CBC test looks at the number of blood cells in your blood. It will tell your doctor if your platelet count is lower than it should be. A typical platelet count will range between 150,000 and 450,000 platelets per milliliter of blood.

Your doctor may also choose to perform a blood smear test, which looks at your blood under a microscope to see how the platelets look.

You blood may also be tested for platelet antibodies. These are proteins that destroy platelets. Platelet antibodies can be produced as a side effect of certain drugs, such as heparin, or for unknown reasons.

Blood-clotting tests, including partial thromboplastin time and prothrombin time, may also be ordered. These tests require a sample of your blood. Certain chemicals are added to the sample to determine how long it takes your blood to clot.

Ultrasound

If your doctor suspects that your spleen is enlarged, they may order an ultrasound. This test uses sound waves to make a picture of your spleen.

Bone marrow aspiration and biopsy

A bone marrow test may also be performed. There are two types of bone marrow tests: a biopsy and an aspiration. In some cases, both tests may be performed at the same time.

During a bone marrow aspiration, a small amount of bone marrow is removed from one of your bones.

In a bone marrow biopsy, a sample of your core bone marrow is removed, usually from the hipbone.

The treatment options for a low platelet count can vary. Your doctor or specialist will determine the appropriate treatment for low platelet counts based on the underlying cause and severity of your condition.

If the condition is mild, your doctor may choose to simply monitor you.

If your low platelet count is more severe, you may need medical treatment. Treatment options may include:

  • blood or platelet transfusions
  • changing medications that are causing a low platelet count
  • Prescribing steroids, immune globulin, or other medicines that suppress your immune system
  • spleen removal surgery

If you are at risk of developing a low platelet count, scheduling regular doctor’s visits will help you pay attention to potential signs and symptoms.

Let your doctor know about any supplements or medications you take. Also, be aware that certain over-the-counter pain medications like ibuprofen and aspirin can thin your blood.

When possible, avoid activities like contact sports that put you at risk for bleeding injuries, or talk to your doctor about safety measures.

If your spleen has been removed, watch for potential signs of infection — as the removal of the spleen can increase the risk — and seek medical attention if you start to feel ill or have a fever.

There are many reasons that your doctor may screen for low platelet count. In some cases, a routine blood test may indicate that your levels are low.

If you are at risk of developing a low platelet count due to an underlying condition or medical history, your healthcare professional may recommend that you take prevention measures. These may include:

  • avoiding activities with a high risk of bleeding or bruising (i.e., contact sports)
  • limiting alcohol consumption
  • making dietary changes
  • stopping or switching medications that affect platelets, including aspirin and ibuprofen
  • getting certain types of vaccinations
  • avoiding toxic chemicals

If left untreated, a low platelet count can be very serious because it can cause internal bleeding of the brain or the intestines.

In the worst cases, this may even cause death. That is why it is essential to seek medical care if you think you might be at risk.

While a low platelet count may sound scary, there is much that can be done to prevent and treat the condition. In some cases, the only recommended treatment is to simply monitor it.

However, some individuals with low platelet counts will require treatment. In most cases, the low platelet count is resolved by treating the underlying cause.

If you have a low platelet count or are at risk of developing one, your healthcare professional can work with you to create a prevention or treatment plan.