Luca and all,
I don't have a definite answer yet, but I'm making changes and my counts are improving, so I'll share the data I have.
It's important to understand that, while I've been doing an analysis on my own ITP for a while, and I feel confident that I've narrowed the cause to a particular range of activators, there has is no way been a single smoking gun which, when removed from my environment, provided spectacular results.
Basically, what I've been able to determine is that my ITP is allergy related. I think, like most of the time in the outside world, in order to have a comprehensive failure of a well thought out system (i.e. commercial airplane crash, etc.), an unlikely confluence of events is to blame. This is to say that the answer is not just one thing; multiple failures have to occur simultaneously which overpower the system's built-in redundancies designed to cope with emergency situations. The human body works the same way.
In order to accurately analyze data you need solid, reliable data points to gain a purchase on. In my case consistent seasonal fluctuations provide this. Consistency is the key. A reliable pattern must be present and visible. You can't be trying to read tea leaves. It is only one set of data points, but it's perhaps one more than most people get. Or see.
It means something. It clearly means one of two things; either the cause of my ITP is less present in the period from October to January, or something is present that allows my body to more effectively to defend against ITP.
When I meditate on all of the things that are different in this timeframe from the rest of the year, the obvious (obvious meaning that it sticks out, not necessarily that it's correct) answer is that my exposure to air conditioning in significantly reduced. We live in Orlando, FL so unlike the rest of the country we almost never heat our homes and after September our air conditioning usage drops considerably.
So, as I explained in earlier posts we examined the central air unit for the section of the house we sleep in and discovered greater than normal mold issues and proceeded to remediate them.
I had hoped, agreeably naively, for a magic bullet solution, but it didn't happen.
For sure, things improved. My average platelet count, year round has increased (though there is no possibility of definitely correlating the AC repair as the cause), but my platelets are still in the 55-65 range through the parts of the year we use AC. Up, but nowhere near normal.
This was frustrating because I really thought I was onto something, and not just an answer for myself. I was hoping that if I was right that the specific steps we took could help a lot of people.
This led me to take a step back and think about the nature of system failure and it occurred to me at once that the only time a well thought out system (commercial airplane, human body, etc.) fails from one cause is when the failure is premeditated or otherwise intentional (missile, bomb, bullet, poison, etc) and that accidental failures, almost exclusively, have multiple causes simultaneously.
This is so, precisely because the system exists in a harsh environment and is engineered or adapted to anticipate isolated component failure.
I use the commercial airliner analogy because though many man made systems are complex and robust, very few are engineered to protect life and even fewer are engineered to protect 400 people moving together at 500 miles per hour. The cost of failure for an airliner is immense for all parties involved, and so very few things in the world are designed with the same system redundancies.
It's easier for me to logically consider a mechanical object than a human body, perhaps for some abstract and person reasons, so the commercial airliner analogy has proven invaluable to a reasonable point.
The nature of system failure, in my analysis, suggested a high probability of multiple causes. However, it seemed unlikely to me that the causes would be totally unrelated (such as mold and emotional stress or mold and physical trauma) because systematic failure is usually caused by the interaction of two or more problems, not simply the fact that two or more problems occurred at the same time, and to have interaction there has to be a conduit for that interaction, which is to say a clear way for one problem to exacerbate the other.
So, hypothetically if I was getting 'gassed' by my mold in my AC system, what else is happening?
Well, mold, except in cases where it's universally toxic (black mold, etc.), is an allergen. I have well documented, and occasionally comic, food and environmental allergies. Green peas, lentil beans cause and an anaphylactic response, while cats, dust, etc. cause common symptoms.
My next step was to start removing certain foods from my diet, one at a time. While this may sound odd to some people, I didn't get my platelets checked after every experiment to objectively evaluate their efficacy because it was impractical to demand bloodwork twice a week and I didn't want to put my veins through that.
However, like a lot of people with ITP I've become extremely sensitive to my body and how it's running; by considering my energy level, my digestion, my sleep quality, my ability to focus, and several other factors I can get a general idea if improvements are occurring and at that point I've sought out a blood test for confirmation.
I'm not running out of time, but I'll try to wrap this up quickly so I don't leave anyone hanging until I get back to my computer.
Right now, Wheat is looking like the most likely co-allergen to mold. I recognize it's the food villain du jour, but it's pop culture status may well be deserved.
As I've mentioned in previous posts I've had digestive tract issues for most of my life and once I eliminated wheat, gluten, and pretty much all bread, from my diet (very difficult to do this, btw) my energy levels have become consistent. This won't be remarkable to people without ITP, but a lot of ITP sufferers have energy crashes, brain fog, and fatigue.
It all went away.
My year round platelet average has been rising, though I'm still not close to normal, and most of the symptoms of ITP are a memory at this point.
I am on no medication, save sublingual allergy drops for environmental allergies.
It is very important to note that I DID NOT test positive for Celiac on any of the five or six different tests I took from various doctors. I did test positive for a wheat allergy with an ENT/Otolaryngologist, but even that reaction was not profound.
To summarize, the combination of reducing/eliminating mold exposure from our AC system and the elimination of wheat/gluten/bread from my diet has occurred concurrently with a rise in platelet count (though not to normal levels) and a nearly absolute cessation of ITP symptoms in the absence of any ITP medication.
My opinion, while I continue my evaluation, is that the proximate cause of ITP in my instance is likely to be an allergic response to the interaction of two or more stimuli.
This is as much as I believe I know as of June 2013, though I did run out of time to provide additional corroborating information, which I will try to do as soon as it's convenient.