Platelets, The Whole Story

Platelets, low platelets, ITP, low platelet count, low platelets, platelets low, ITP disease, immune system disease, living with itp, blood disorder, Chronic itp, platelets,

Feature image from JCWILSON Archive

Platelets.  We have heard that word a thousand times.  We know what they are and we know what they do. Right?  Platelets are just those tiny little things that float around in your blood that magically ‘plug up’ leaks when you need them.  Wrong.  Here’s the whole story, about how platelets are made, what they actually do and how they go about doing it.

What is a Normal platelet count?

A ‘Normal’ platelet count has a very wide range.  Anywhere between 150 and 450 billion platelets per litre of blood is considered normal.  Men and women often differ slightly in ‘normal’ ranges, but not consistently enough for it to be documented.  Any higher than 450 billion platelets and you are in trouble.  Any lower than 150 billion platelets and you have a very different set of problems.

TP, low platelet count, low platelets, platelets low, ITP disease, immune system disease, living with itp, blood disorder, Chronic itp, platelets,

Where do platelets come from?

Platelets are created by a larger cell in the body called a Megakarycytes.  Pictured.  No, I have never said that word out aloud.  Megakaryocytes are created from steam cells in the bone marrow.

 ITP, low platelet count, low platelets, platelets low, ITP disease, immune system disease, living with itp, blood disorder, Chronic itp, platelets,As a MEGAKARYOCYTES matures it begins to fragment into platelets that are released into the blood.  This fragmentation of the megakaryocytes is very important because it is triggered by the hormone THROMBOPOIETIN.

The hormone, thrombopoietin, is secreted by the kidneys and liver.  The kidneys and liver are crucial in the life cycle of a platelet.  Liver failure can cause thrombocytopenia, for without the liver producing this hormone, the megakaryocytes don’t fragment into platelets.

These small young platelets survive in the blood stream from between 7 to 10 days.  Platelets circulate the blood steam before being stored in the spleen for about 36 hours.  When the body is injured it goes into repair mode, the spleen contracts and releases the platelets back into the blood stream to head off and save the day.  These platelets become ‘activated’.

What do Activated Platelets do?

When a platelet is activated, it grows little sticky arms that adhere to each other and the injury site.  I have often wondered how a platelet becomes ACTIVATED.  One way that a platelet becomes activated is that is responses to the presence of collagen.  Collagen is found in almost every part of the body accept the blood vessels.  Which means that for a platelet to come into contact with collagen, the blood vessel must be broken in some way.

When platelets are young, they absorb seretonin into their plasma.  Seretonin is a vasodilator.  This hormone remains in the plasma of the platelet until the platelets are activated at the onset of an injury.  Once the activated platelet releases the seretonin from it’s plasma – the blood vessels around the injury dilate.

Old platelets, more than 10 days old which are never activated are removed from the body through the liver.  And the liver secretes more thrombopoietin to trigger the megakaryocytes to fragment into more platelets.  The life cycle is complete.

What does a low platelet count feel like?  

One cannot always feel a low platelet count.  A lot of the time a patient may never feel anything.  However a patient with a bleeding disorder will certainly feel the symptoms of a low platelet count.

Most people can guess at the most common symptoms of a low platelet count, you bruise easily and you bleed a lot.  You also may have frequent nose bleeds, PETACHE rash or bleeding gums.  These symptoms are grose.  They may also hurt and cause discomfort and pain.  You may feel embarrassed because your bleeding disorder is hard to hide.

Lesser known symptoms of a low platelet count is pain in your joints.  This can make you fee weaker, unable to recover, and more likely to stop partaking in physical exercise.  Redness or blood in the corner of your eyes and dark circles like bruises under your eyes may also cause embarrassment, and loss of self confidence.  How many times have people told you ‘You look tired!’

Did you know that headaches are also a symptom of low platelets?  Yikes!  Having a low platelet count can make you feel fragile, or weaker then you once were.  It might make you feel different, at the changes it has caused in your life.

Then again, you might not feel any different.  As your immune system kills off platelets in your blood stream, the platelets that you do have are often the young ones, that function the best.  Some people don’t feel a low platelet count at all.

Taking care of the whole Platelet System

To properly take care of your platelets, you need to make sure you are taking care of your bones, your kidney’s, your liver and your spleen (if you still have one)  Drink plenty of water to help your liver and kidney’s function.  Make sure you are getting enough CALCIUM and VITAMIN D for your bones.  Ensure you do as much exercise as you can, to ensure you’re fit and healthy and your lymphatic system is moving that Lymph around your body.

by Meg

Meghan Brewster is a writer and blogger. She is an ITP patient and launched ITP&Me in 2011. She is a coffee lover and a try hard dancer. @meghan_brewster

6 thoughts on “Platelets, The Whole Story

    Carl says:

    I had my first encounter with ITP at my dermatologist’s office. She removed a growth from my thumb and ask the resident to cauterize the wound while she went to the lab. The bleeding didn’t stop and little red dots started to appear on my wrists. When the doctor returned from the lab, I asked her what the little red dots meant. She quickly looked at my ankles then told me I had to go to the lab immediately (the bleeding was stopped before they let me go). By the time I got home from the lab–less than 35 minutes–I had a call from the on-call doctor telling me to go the local hospital. He had called them about my condition telling them to stabilize me, them transfer me to the university hospital. He told me my platelet count was 8,000. Then he asked me if I was starting to bleed from my sinuses or gums. Yes, I was now bleeding from sinuses.

    I ended up being hospitalized for a total of 13 days. I was initially treated via IVIG which raised my platelet count to 25,000. At that time, I was released from the hospital. I was given a single large dose of prednisone to take the following day. I called my primary care doctor to let him know what happened and asked him if he wanted to see me since I had what they called a “classic case” of ITP. (I was added to grand rounds at the university hospital since they didn’t get to see many cases like mine.) Since I was feeling funny, I asked my doctor if he would order a blood test at the lab, which he did. Well, an hour later he called and said to go back to the university hospital since my platelets had fallen below 20,000. They had a bed waiting for me on the fourth floor of the East Wing.

    They started me again with IVIG. After four back-to-back units of IVIG, my platelets still remained between 8-12,000. The hematologist decided to give me a the largest dose of prednisone allowable at bed time to see if I responded favorably. Instead, my platelets dropped below 2,000 and caused internal bleeding to occur (very painful). I lapsed into a semi-comatose state. When I came too, I knew I was in trouble when the doctor asked me if I would like him to call the hospital chaplain. In the meantime, they re-started me on IVIG.

    Fortunately, my platelet count started climbing. This time, they kept me in the hospital until my platelet count reached 50,000. That’s when we realized that the first prednisone dose had caused my platelet to crash and that I was allergic to the drug. (They listed my reaction in the hospital report as a “severe reaction to medication”.)

    My hematologist treated with Rituximab after leaving the hospital the following week. After one series of four doses, my platelets climbed to 400,000. Over the course of the next five years, my count ranged from 220, 000 to 300,000, averaging 235,000. Then it dropped suddenly to 12,000. (I was having my platelet levels checked monthly.) My Primary Carl Physician (PCP) called me within 35 minutes after I had my blood drawn and told me they had a bed waiting for me at the hospital. Fortunately, I just happened to be working on our medical campus on a retirement call-back bases for the school of medicine. I spent 6 days this time after a series of IVIG treatments. Being in a teaching hospital, they asked me if it was okay to be included in grand rounds. I saw a total of 20 doctors — residents and fellows, not counting my attending.

    After my release, I was sent to an immunologist. That’s when he determined I was missing IgA and IgM. My IgG levels were very low too. He then challenged my immune system by injecting me a TDAP vaccine. Well, I developed a titer which according to the doctor I shouldn’t have been able to do.

    Currently, my platelet levels are still up but are starting to vary widely between monthly checks. Up until six months ago, I had been staying between 225-250,000 based on an expected normal range of 130,000 to 400,000. The counts are now fluctuating between 180,000 and 265,000.

    Well, that’s my life’s adventure with ITP. And yes, I do believe in miracles. During my first hosptial stay, and unknowingly by me, a youth group prayed for me to be healed. I found out a few weeks later about their prayers on my behalf.

      Stephen says:

      I hope this finds you and finds you well. I would very much appreciate additional information regarding your treatment for ITP. Regarding challenging your immune system with a TDAP vaccine, were you also given another course of Rituxan infusions? Were your B-cell levels and/or anti-platelet antibody titers also followed? It would also be helpful to know your treatment since your last post, March 3, 2015.

  2. Pingback: The N Plate Article

    ronisha says:

    I’m going through the same thing can you help me my platelets will not stay up it happens to me after I had my baby an they won’t stay up by them self an ive gain a lot of weight from taking prednisone for over a year

Leave a Reply

Your email address will not be published. Required fields are marked *