All I have is a low Platelets count...

Hello everyone, I was just wondering if any of you could help me out with an issue that has been making me scratch my head quite frequently since my physical last month.

Last month, my doctor performed routine blood tests me, including a CBC w/differential test, Comprehensive Metabolic Panel, Fasting Test, and what have you. My thyroid test came back a little off, but we ran it again, and we found that the first thyroid test was just a fluke.

From what am I told by medical professionals, and my sister who is practicing nursing, is that aside from my platelet account, my CBC test is phenomenal, and even the CBC we ran a week later to confirm low platelets was just as good (once again, regarding the platelet count). My WBC and RBC are really great, and my hemoglobin level is fantastic. I was also told that my Comprehensive Metabolic Panel concluded very excellent liver and kidney function, and that the lipid panel was also very excellent. To be honest, you probably couldn't have asked for better results.

However, looking back on 3 previous CBC tests, and considering normal platelet counts are above 150, I have not had a normal platelet count since 2006. Here is what they were on the 3 previous tests, and the 2 most recent.

2006: 131 k/uL
2008: 113 k/uL
2010: 141 k/uL
2011: 100 k/uL, and 119 k/uL 1 week later

My doctor who ran the tests in 2006 and 2008 told me that my lab results came back normal, but I think we can conclude that this is not the case. In 2010, I was told nothing regarding my platelets, and maybe that was because they were far too close to the reference range.

On MedHelp, when I search for low platelet count, all I can find is a massive amounts of posts regarding low platelet counts in the Hepatitis C Community, which I find quite odd, since me and my doctor have concluded that this low platelet count is not being caused by any infection (including Hepatitis C), or even cancer for that matter. I would also think that low platelets caused by infection or cancer would be below at least 75 k/uL. I have also heard about something called Idiopathic thrombocytopenic purpura (ITP), which is basically an auto-immune disorder that creates anti-bodies which attack your platelets. However, I think my platelet count would be VERY LOW (less than 50 or even 20) if I had that.

I am on some medications to treat OCD-related anxiety and depression, and ADHD. I treat my ADHD with Concerta, and my OCD related illnesses with Xanax. I was not on any medication in 2010. However, I do recall being on medication to treat my illnesses in 2006 and 2008, and maybe the Ritalin/Concerta caused a decrease? Or maybe it's from the stress and anxiety that is causing me to have high blood pressure? I just can't be sure. I also rare get very fatigued unless I am depressed, until the end of the day when my medication wears off. I also suffer from some anorexia-related features from time to time, and I believe I was going through an episode when I had the test that returned the 100 k/uL platelet count. The most serious illness I have suffered from for almost is decade is the dreaded H1N1 virus, and that was in 2009. I also rarely catch colds, which is quite interesting. I think I have probably had a total of 2 colds in the past 4 years!

Anyone have an idea what this, or know what it could possibly be coming from? It's so confusing when infection or cancer is ruled out. Also, is there a way you can increase these platelet counts without prescription medication?

Thanks!

[Bhupinder Kaur, MD]

Hello,
What you have is called thrombocytopenia. It can be due to decreased production of platelets like vitamin B 12 deficiency, myelodysplastic syndrome, liver causes, increased destruction like in ITP, medications induced or snakebites ( unlikely in your case).

ITP is one cause of thrombocytopenia. The diagnosis of ITP is one of exclusion. One should rule out other causes of blood abnormalities and causes of thrombocytopenia and then move on to confirm the diagnosis of ITP. Confirmatory test for ITP is bone marrow biopsy only. However, I feel that you should take  a second opinion from a hematologist and discuss the various causes of thrombocytopenia before jumping on the conclusion of ITP.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[flow1987]

Wouldn't you say that people who suffer from severe anxiety and major depressive disorder are more suseptiable to Vitamin B12 definiciency? You know, that is kind of funny, I used to take Vitamin B pills on a daily basis, and that was around the time I had a normal platelet count, which is interesting.