Your doctor may use the following tests and procedures to determine whether you have thrombocytopenia:
- Blood test. A complete blood count determines the number of blood cells, including platelets, in a sample of your blood. In adults, normal platelet count is 150,000 to 450,000 platelets per microliter of blood. If the complete blood count finds you have fewer than 150,000 platelets, you have thrombocytopenia.
- Physical exam, including a complete medical history. Your doctor will look for signs of bleeding under your skin and feel your abdomen to see if your spleen is enlarged. He or she will also ask you about illnesses you've had and the types of medications and supplements you've recently taken.
Your doctor may suggest that you undergo other tests and procedures to determine the cause of your condition, depending on your signs and symptoms.
People with mild thrombocytopenia may not need treatment. For example, they may not have symptoms or the condition clears up on its own.
Some people develop severe or long-term (chronic) thrombocytopenia. Depending on what's causing your low platelet count, treatments may include:
Treating the underlying cause of thrombocytopenia. If your doctor can identify a condition or a medication that's causing your thrombocytopenia, addressing that cause may clear up your thrombocytopenia
For example, if you have heparin-induced thrombocytopenia, your doctor will direct you to stop using heparin and prescribe a different blood-thinning drug. Your thrombocytopenia may persist for a week or more despite stopping all heparin therapy.
- 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. If your condition is related to an immune system problem, your doctor may prescribe drugs to boost your platelet count. The first-choice drug may be a corticosteroid. If that doesn't work, he or she may try stronger medications to suppress your immune system.
- Surgery. If other treatment options don't help, your doctor may recommend surgery to remove your spleen (splenectomy).
- Plasma exchange. Thrombotic thrombocytopenic purpura can result in a medical emergency requiring plasma exchange.
Lifestyle and home remedies
If you have thrombocytopenia, try to:
- Avoid activities that could cause injury. Ask your doctor which activities are safe for you. Contact sports, such as boxing, martial arts and football, carry a high risk of injury.
- Drink alcohol in moderation, if at all. Alcohol slows the production of platelets in your body. Ask your doctor whether it's OK for you to drink alcohol.
- Use caution with over-the-counter medications. Over-the-counter pain medications, such as aspirin and ibuprofen (Advil, Motrin IB, others) can impair platelet function.
Preparing for your appointment
Start by seeing your primary care doctor if you have any signs or symptoms that worry you. Most cases of thrombocytopenia can be managed by your doctor. In certain situations, he or she may recommend that you see a specialist in blood diseases (hematologist).
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared for your appointment. Here's some information to help you get ready and what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
- List the warning signs you've noticed, such as any unusual bruising or bleeding or any rashes. Include any signs that may seem unrelated to the reason for which you scheduled the appointment.
- List key personal information, including any recent illnesses or medical procedures such as a blood transfusion, major stresses or recent life changes.
- Make a list of all medications, vitamins and supplements that you're taking.
- Take along a family member or friend. It can be difficult to remember all the information provided during an appointment. The person who accompanies you may remember something that you forgot or missed.
- List questions to ask your doctor. List your questions from most important to least important, in case time runs out.
For thrombocytopenia, some questions you may want to ask include:
- How many platelets do I have in my blood?
- Is my platelet count dangerously low?
- What is causing my thrombocytopenia?
- Do I need more tests?
- Is my condition likely temporary or chronic?
- What are my treatment options?
- What will happen if I do nothing?
- What are the possible side effects of the treatments you're suggesting?
- Are there any restrictions that I need to follow?
- Is there a generic alternative to the medicine you're prescribing?
- Do you have any brochures or other printed material that I can take with me?
- What websites do you recommend?