Understanding High Platelet Count: Causes, Symptoms, and Treatment Options

So you've had your bloods taken recently, and they show that your platelet count is high. You might be wondering what this means, and if you are, then you've come to the right place. In this post, I'll be explaining key things that you need to know about a high platelet count, which is medically known as thrombocytosis.

First of all, what are platelets, and what does having too many mean? Platelets are blood cells that stop bleeding by sticking together to form a clot. Too many platelets, however, can cause your blood to become too sticky, and this is known as thrombocytosis. In severe cases, thrombocytosis can cause dangerous clots in your blood vessels, increasing your risk of a stroke or a heart attack.

There are two types of thrombocytosis: essential and reactive thrombocytosis. The first of these, called essential thrombocytosis or primary thrombocytosis, is a rare blood disorder in which your bone marrow makes too many platelets during the production of blood cells. It's usually due to an underlying genetic issue. The second reason is reactive thrombocytosis or secondary thrombocytosis. This type is more common and happens when your platelets increase because your body is reacting to something else, such as another condition like anemia or cancer, an injury like a broken bone or wound, an infection, or surgery. Your body could even be reacting to a medication. This reason for high platelets is more common and is often temporary.

So what are the symptoms of a high platelet count? Many individuals with a high platelet count don't initially have symptoms. However, those with reactive thrombocytosis might have symptoms linked to the underlying condition that's causing the high platelet count. For example, if your high platelet count is because of an infection, then you might have a fever. When symptoms do arise, they typically involve issues related to unusual bleeding and clotting. These symptoms can include headaches, easy bruising, feelings of weakness, dizziness or lightheadedness, and bleeding from the nose, mouth, and gums. There might also be bleeding in the stomach or the intestines.

People with essential thrombocythemia, which is usually caused by an underlying genetic issue, might suffer from pain, swelling, and redness in the hands and feet, along with possible numbness and tingling. In more extreme instances, high platelet counts can lead to rare blood clots in the abdomen called Budd-Chiari syndrome, which elevates the risk of a stroke or a heart attack.

Now that we know some of the underlying causes and potential symptoms, how is a high platelet count diagnosed? Because it doesn't typically cause symptoms, the first sign is often a high platelet count that shows up on a routine blood test called a full blood count. A high platelet count is generally considered as having more than 450,000 platelets per microliter of blood. If you've got elevated levels, your health provider will likely order a follow-up blood test a few weeks later to see if your levels remain high. Levels that are momentarily high but then return to normal aren't usually concerning, but levels that remain elevated may signal an underlying condition that your health provider will look into.

Identifying the underlying condition, such as an iron deficiency anemia, cancer, or even an infection, will help health providers diagnose and manage the reason for your high platelet count. If your provider can't find a cause, then they'll likely run tests to see if you've got essential or primary thrombocythemia.

So now let's explore how a high platelet count can be treated. If you don't have any symptoms, you may only need routine checkups. If you've got raised platelets secondary to another condition, levels usually return to normal after the underlying condition resolves. For example, if you've recently had an injury and your platelet count is raised, this will normally fall back to normal once you've recovered from your injury.

On the other hand, if you've got a high platelet count due to an underlying genetic mutation and you're experiencing symptoms, your health provider might recommend a few different treatment options. These might include taking a daily low-dose aspirin to prevent blood clots. The low dose doesn't usually cause stomach upset or bleeding, but be sure to check with your health provider before taking aspirin regularly. In some cases, they might recommend taking more specialist medicines that lower platelet levels. Finally, if your platelets are so high that they're putting you at risk of life-threatening blood clots, your provider may recommend plateletpheresis. This procedure uses a machine to filter excess platelets from your blood.

So now let's take a look at what the outlook is like for people who do have a high platelet count. High platelets aren't life-threatening, but the complications that can result from the condition, such as blood clots or severe bleeding, can be. The most common causes of high platelets are short-lived, and they don't usually put you at risk of serious blood clots. The risk for this is greater with essential thrombocytosis. Still, your health provider will monitor you closely, prescribe medicines if needed, and perform necessary procedures to prevent harmful blood clots if this is the case. After many years of having the disease, however, bone marrow scarring can develop, and a small percentage of people with essential thrombocythemia can develop leukemia.

Finally, what are five useful questions to ask your health provider if you do have a high platelet count? The first is, should I be concerned that my platelet levels are high? Secondly, will I need follow-up tests to check my platelets again? Thirdly, what tests do I need to determine what's causing my high platelets, if any? Fourth, what treatments do you recommend? And fifth, what lifestyle changes can I make to manage my condition?

In conclusion, try not to be alarmed if your blood test results show high platelet levels. Your platelets might be elevated for various reasons, and many cases and causes of high platelets don't require treatment. But if your levels remain high and you're experiencing symptoms, your health provider will work with you to determine the underlying cause. Careful monitoring and medications can usually prevent the most concerning complications associated with high platelets.

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