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Platelets: High & Low Count + Normal Range

Written by Helen Quach, BS (Biochemistry) | Reviewed by Biljana Novkovic, PhD | Last updated:
Jonathan Ritter
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology) | Written by Helen Quach, BS (Biochemistry) | Reviewed by Biljana Novkovic, PhD | Last updated:

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Platelets are vital for blood clotting and wound healing. However, having either too few or too many platelets can cause serious health issues. Keep reading to learn more about high and low platelet counts and things you can do to improve them.

What are Platelets?

Platelets, also called thrombocytes, are small blood cells that help blood to clot. When a blood vessel gets damaged, platelets gather at the damaged site and make a plug (clot). Clotting helps slow down and stop bleeding and helps wounds heal [1].

Apart from wound healing, platelets are also involved in immune system defense, inflammation, and tumor growth. When there are too many or too few platelets, you can experience problems with blood clots or wound healing [2].

Normal Range

Platelet count normally ranges from 150 – 400 thousand cells/uL (thousand cells per microliter) [3]. This range may vary slightly depending on the laboratory.

Low Platelet Count (Thrombocytopenia)

Low platelet count is also known as thrombocytopenia. When there are not enough platelets, the blood doesn’t clot well, which can cause excessive bleeding and prevent wounds from healing properly. Extremely low levels can be life-threatening [4].

Platelets can be low for two main reasons: either when there are issues with making platelets, or when they are destroyed faster than normal. This is most often caused by drugs or an underlying health disorder [3].

Symptoms of a low platelet count include:

  • Excessive bleeding from wounds, or during menstrual cycle [4]
  • Nosebleeds [4]
  • Bruising (from unknown causes) [5]

Causes of Low Platelet Count

The most common causes of low platelet counts are disorders that impair bone marrow function.

1) Autoimmune Disorders

Autoimmune disorders can impair bone marrow function and decrease platelet production [6, 7].

In an observational study of 230 people, lupus was associated with a low platelet count [8].

2) Nutrient Deficiencies

Various nutrient deficiencies can decrease your platelet count. They include:

3) Alcoholism

Excessive alcohol consumption can have toxic effects on platelet function and production. However, abstaining from alcohol for 2 – 5 days will lead to a rise in platelet count [12].

4) Infections

Bacterial and viral infections can cause a low platelet count. Examples include Helicobacter pylori infection, hepatitis, and HIV [7, 13, 14, 15].

People with sepsis, a condition caused by infections that can cause tissue and organ damage, also have an increased risk of having low platelets. In an observational study of 304 sepsis patients, the ones with low platelet counts had more instances of bleeding, kidney injury, and a longer ICU stay [16].

5) Cancer

Various cancers, such as ones that spread to the bone marrow like leukemia and lymphoma, can cause low platelet levels. The severity of thrombocytopenia (low platelets) depends on the type, stage, and malignancy of the cancer [17, 18, 19, 20].

Radiation therapy and chemotherapy for cancer may also decrease platelet counts [21, 22].

6) Drugs

Certain drugs can decrease your platelet count, such as [23, 24]:

  • Aspirin [25]
  • Ibuprofen [26]
  • Medication that reduces or prevents blood clotting (anticoagulants), such as heparin [27, 28]
  • Some antibiotics, such as trimethoprim (Proloprim, Monotrim, Triprim), amoxicillin, and penicillin [29]
  • Quinine, a medication used to treat malaria and babesiosis [30]
  • Chemotherapy [22]

7) Toxin Exposure

Exposure to toxic chemicals can decrease your platelet count [31].

A study showed that 34 workers exposed to toluene had lower platelet counts compared to non-exposed people [32].

8) Genetics

Sometimes a low platelet count may be due to your genes [33, 34, 35].

Ways to Increase Your Platelet Count

1) Eat a Balanced Diet

Make sure that you are getting enough nutrients:

  • If you are iron-deficient, increase your consumption of iron-containing foods. Good sources of iron include animal liver, organ meats, fish, poultry, beans, and green leafy vegetables, such as broccoli, kale, and spinach. Iron-fortified cereals, flours, and bread can also contribute to your daily dietary iron requirement [36, 37].
  • If you are vitamin B12-deficient, increase vitamin B12 containing foods such as clams, oysters, beef, milk, chicken, and cheese [38].
  • If folate-deficient, increase folate-containing foods such as dark green leafy vegetables, beets, broccoli, asparagus, cabbage, cauliflower, kidney beans, and lima beans [39].

2) Get More Sun

If your vitamin D levels are low, spend more time outdoors and getting more sun [40].

3) Avoid/Treat Infections

Having good hygiene and a healthy lifestyle to protect against bacterial and viral infections will help prevent disorders that can decrease your platelet count [13].

4) Avoid Alcohol

Reducing alcohol intake will help prevent your platelet levels from being too low [12].

5) Discuss Your Drug Regimen With Your Doctor

Some drugs, such as antibiotics, aspirin, and ibuprofen can cause your platelet levels to become too low. Consult your doctor for possible alternatives [23].

High Platelet Count (Thrombocytosis)

High platelet count is also known as thrombocytosis. There are 3 main types [41]:

  • Spurious or “false” thrombocytosis is very rare and occurs when blood tests falsely recognize bacteria as platelets
  • Reactive thrombocytosis can be caused by infections and inflammatory disorders
  • Clonal thrombocytosis occurs when there is abnormal platelet production

If your platelets are high, they may falsely elevate blood potassium and phosphorus levels [42].

Causes of High Platelet Count

1) Inflammation

Inflammatory disorders, such as rheumatoid arthritis or IBD, are the most common causes of increased platelet counts [43, 44, 45].

2) Infections

Infectious diseases can increase your platelet count. They are most often soft tissue (Staphylococcus, Streptococcus), lung (tuberculosis), and stomach/gut infections [46, 47].

3) Iron-deficiency Anemia

High platelet count is often found in iron-deficiency anemia. In an observational study, 31% of the studied 140 people with iron-deficiency anemia had elevated platelet counts [48].

4) Spleen Removal

Having your spleen removed (splenectomy) can significantly increase your platelet count [49, 50].

5) Cancer

Various types of cancer can increase platelet counts (e.g. lymphoma, breast, lung, ovarian and stomach/gut cancer) [51, 52, 53, 54, 55, 56].

6) Exercise/physical exhaustion

Exercise and physical exhaustion can temporarily increase your platelet count [57, 58].

7) Alcohol Withdrawal

Drinking alcohol initially decreases your platelet count. However, when the alcohol is gone from your system the body overcompensates leading to a rebound effect and thrombocytosis (high platelet count) [59, 60, 61].

This rebound effect is associated with heavy alcohol drinking and is not observed with moderate red wine consumption, for example [62].

8) Recovery from Blood Loss

Recovery from blood loss after surgery or injury can increase platelet counts [63, 64].

Ways to Decrease Platelet Count

1) Correct Any Potential Iron Deficiency

Iron deficiency can cause both decreased or elevated platelet counts [48]. If your iron is low, increase iron-rich foods in your diet. Good examples of iron-rich foods are animal liver, meat, fish, eggs, beans, tofu, nuts, whole grains, and dried fruit.

Vitamin C may also help, as it increases iron absorption. Sprinkle some lemon juice on your steak or salad [65].

2) Don’t Overdo Alcohol

As mentioned above, heavy alcohol drinking causes fluctuations in your platelet count. First platelets will decrease, then after withdrawal, they will increase above the normal range [59, 60, 61].

3) Treat/Resolve Infections

If your platelets are high in response to infection or inflammation, which is most often the cause, addressing the underlying cause will help decrease platelets back to normal.

Irregular Platelet Levels?

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About the Author

Helen Quach

BS (Biochemistry)

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