Why are platelets elevated and what to do about it?

Doctors call thrombocythemia, or thrombocytosis, a condition in which the body has an increased level of platelets. It is not always dangerous. But in some cases it can cause serious complications, which are important to know about.

In the “ Yod ” telegram channel we tell you how to take care of your health based on evidence-based medicine.

Why is an elevated platelet level dangerous?

Platelets are blood cells that begin to stick together when they receive a signal about microtrauma in a nearby section of a blood vessel. This is how a thrombus is formed – a clot of coagulated blood that covers the damage. This stops the bleeding and allows the vessel to heal. This is a blood clot in a healthy person.

But if there are too many platelets, there is a risk that they will start to stick together just like that. Tiny clots that form on their own impede blood flow.

Things get much worse if the blood clot reaches a large size or breaks off and enters a smaller vessel with the bloodstream. In this case, it can completely stop the movement of blood in one or another part of the circulatory system. This process is called thromboembolism.

If it occurs in the blood vessels of the brain, the person faces a stroke. In the heart – myocardial infarction . Thromboembolism can affect almost any organ, including the lungs, kidneys, liver, spleen, and spinal cord. As a result, part of the organ that has lost blood quickly dies. And this can lead to disability and even death.

How do you know if your platelet count is high?

Thrombocytosis in most cases occurs without symptoms , so a person may not even realize that he has problems with blood clotting.

If signs of elevated platelet levels do appear, they are not specific. For example, these could be:

• persistent headache;
• dizziness ;
• numbness, tingling, or throbbing pain in the arms and legs (especially the palms and soles);
• feeling of discomfort in the limbs, back, neck;
• vague chest pain;
• nausea felt in the abdominal area;
• bruiseson the skin every now and then ;
• increased bleeding from the nose and gums.

Most often, an elevated platelet level is detected accidentally – during a general blood test (CBC). A referral for a study is issued by a therapist or other doctor to whom a person comes with complaints about well-being.

Why are platelet levels elevated?

The cause cannot always be determined. If it doesn’t work out and doctors only note that the bone marrow is producing too many platelets, they talk about primary (or essential) thrombocythemia. The term “essential thrombocytosis” can also be used, but doctors consider the designation “thrombocythemia” to be preferable in this case.

If the cause of the increase in platelets can be determined, the condition is called reactive thrombocytosis (or secondary thrombocythemia). It is more common than essential thrombocythemia. Typically, a sustained increase in platelet levels is caused by :

• Anemia – iron deficiency or hemolytic.
• Infections or inflammatory processes. For example, connective tissue diseases, all kinds of inflammation of the gastrointestinal tract, tuberculosis, rheumatoid arthritis, sarcoidosis.
• Taking certain medications.
• Surgery to remove the spleen.
• Basically, we are talking about cancer of the lungs, gastrointestinal tract, breast, ovaries, and cells of the lymphatic system. Sometimes an elevated platelet count is the first sign of cancer.

In some situations, the number of these blood cells may increase for a while, but quickly return to normal. This happens , for example:

• for acute infection or inflammation;
• with too much physical activity;
• when recovering from extensive blood loss;
• when recovering from a sharp decrease in platelet count, which was caused by excessive alcohol consumption and a lack of vitamin B12 or folic acid.

What to do if your platelet count is elevated

This is a condition that only a qualified doctor can and should understand. Therefore, you need to contact the specialist who sent you for a general blood test.

The results of a CBC alone are not enough to make a diagnosis . The doctor will definitely conduct an examination, look into your medical history and ask additional questions. Eg:

• What medical procedures have you recently had?
• Have you had a blood transfusion ?
• Have you recently suffered from any infectious disease?
• Perhaps you were vaccinated some time ago? (It doesn’t matter from what.)
• What medications, including over-the-counter medications, do you take?
• How well do you eat?
• Do you have bad habits? Do you abuse alcohol?
• Did any of your close relatives have problems with platelet levels?

A complete blood count may need to be done a second time to ensure that the increase in platelet levels was not (or was) temporary.

Next, the doctor, himself or with the help of a hematologist (this physician specializes in blood conditions and diseases), will try to determine the cause of thrombocytosis. To do this, you may need additional procedures, including blood tests for iron levels , markers of inflammation and cancer (so-called tumor markers). A bone marrow biopsy is also sometimes necessary: ​​during this procedure, a sample of the organ will be taken from you using a thin needle for further research.

When the cause of the increase in platelets is identified, the doctor will prescribe treatment. For example, he will prescribe medications that thin the blood or reduce the level of problem cells in it. People with essential thrombocythemia will have to take these medications for the rest of their lives.

If thrombocytosis has already led to complications such as a stroke, an emergency procedure like dialysis will be needed . A needle will be inserted into a vein and the blood will be pumped through a machine that filters out excess platelets. Then the purified liquid will return to the circulatory system.

In addition, the underlying disease that caused the increased platelet levels will also be treated. If, of course, doctors can detect it.