TOPIC:

Hi guys, I'm new here. I'm 35/F/non-smoker and I have not had an alcoholic drink in over 3 months. I did enjoy a few too many beers before that - probably about 2-3 drinks a day. I realized that was a bit much, so I stopped for a while to see if my health improved. It has not. I'm generally pretty active (a runner) but have been completely quarantined during covid because I have a family member who is immuno-compromised.

I had some bloodwork done by my endocrinologist recently (I have hypothyroidism and pre-diabetes). My platelets came back low at 115,000 (range 150,000-400,000). This is the second time I've gotten a low result (I believe it was 130,000 a couple of years ago). I also have pretty widespread petichiae which I have always had. I bruise super easily and I have always had issues with serotonin/insomnia, etc. I was shocked to learn that serotonin is carried by platelets, which would explain my ongoing issues with that. The only other abnormal results I got were high LDL cholesterol and a1c of 6%, which I have been working on. I'm currently on Synthroid for my thyroid and Zoloft (generic) for my insomnia.

Since you guys are experts, do you think this warrants a visit to a specialist? My endo recommended I see one or my pcp, but I'm wondering if 115,000 is low enough to warrant a doctors visit and further tests. I should also add that auto-immune issues tend to run in my family and I have blood work to check for lupus and RA among other things here coming up.

The cut off point was changed from 150 to 100 about 10 years ago, labs just haven’t changed their parameters. I would just get it checked every so often. Treatment rarely starts until a count is below 30. A watch and wait approach is adopted above 30 unless there are serious symptoms such as active bleeding.

I don't think you would be considered having ITP at this point. I'd make sure my PCP knows what my platelet count is and then just check it every now and then. When my count was going between about 80k & 125k I only checked once a year - then had a crash so now keeping a closer eye on things.

mrsb - I have not heard/read/seen the low was changed to 100k, I have seen 140k as the low range - I just did a very quick search and didn't see anything on that. Interesting.

Mel
I was told when I was diagnosed it used to be 150 but it is now 100
UK ITP Association states "anyone with a count less than 100 would be considered thrombocytopenic".
GP notebook states "Thrombocytopaenia is a decrease in the number of platelets in the blood - it reduces the ability of the blood to clot and is thus a bleeding diathesis. It is defined as a platelet count less than 100 x 10⁹/L (<100,000 per cubic mm)"
I don't think you will be able to access either of them unfortunately as they are UK log in only sites but you should be able to access the following 2 papers

:- ashpublications.org/blood/article/117/16/4190/20799/The-American-Society-of-Hematology-2011-evidence
"An International Working Group (IWG) consensus panel of both adult and pediatric experts in ITP recently provided guidance on terminology, definitions, and outcome criteria for this disorder. Primary ITP was defined by the IWG as a platelet count less than100 × 10⁹/L in the absence of other causes or disorders that may be associated with thrombocytopenia. The IWG based its recommendations for the use of an upper-threshold platelet count of 100 × 10⁹/L on 3 considerations: a study demonstrating that patients presenting with a platelet count between 100 and 150 × 10⁹/L have only a 6.9% chance of developing a persistent platelet count of less than 100 × 10⁹/L over 10 years of follow-up; recognition that in non-Western ethnicities normal values in healthy individuals may be between 100 and 150 × 10⁹/L; and the hypothesis that a cut off value of 100 × 10⁹/L would reduce concern over the mild “physiologic” thrombocytopenia associated with pregnancy"

:- www.ncbi.nlm.nih.gov/pmc/articles/PMC3410635/
"ITP is defined as a platelet count of less than 100 × 10⁹/L (100,000/μL) with no evidence of leukopenia or anemia. This cutoff point is new: in the past, ITP was defined as a platelet count of less than 150 × 10⁹/L, which is the threshold for a normal platelet count in most laboratories."