Reasons for Low Platelet Count and Ways to Manage it During Cancer

When you have cancer or receive treatment for cancer, your levels of specific blood cells can decrease below normal levels. Platelets are one among them. Having low platelets is known as thrombocytopenia in medical terms.

Platelets help stop bleeding when needed. For example, platelets make the blood cells clump together or clot if you cut yourself. This blocks off the cut blood vessels so they can heal.

The most common mode to increase platelet count during chemotherapy is to either delay the next dose of chemotherapy or to have a platelet transfusion administered by your doctor.

Drugs that increase platelets are available, but these are only approved for low platelet levels due to an autoimmune condition and are rarely used for chemo-induced low platelet levels. The most commonly used drug is Neumaga (oprelvekin), Nplate (romiplostim) and Promacta (eltrombopag).

Also Read: How to Naturally Increase Platelet Count during Cancer Treatment?

What is a platelet transfusion?

A platelet transfusion is used to stop ongoing bleeding in people with poor platelet function or low platelet count. It is the most common way to treat thrombocytopenia, especially short-term thrombocytopenia that occurs due to chemotherapy drugs. The most common side effect of thrombocytopenia is a temporary fever. Rare side effects such as transfusion reactions, infections, or transmission of hepatitis can also occur.

Reason for low platelet count

Chemotherapy: Some cancer medicines, including chemotherapy, destroy bone marrow. This tissue is found inside your bones, where your body makes platelets. A low platelet count during chemotherapy is usually temporary. Chemotherapy does not damage bone marrow cells permanently.

Radiation therapy:Generally, radiation therapy does not cause a low platelet count. But if you receive a large amount of radiation therapy to your pelvis or if you have radiation therapy and chemotherapy at the same time, your platelet levels may go down.

Antibodies:Your body makes proteins called antibodies. They destroy harmful substances such as bacteria and viruses in your body. But sometimes, the body produces antibodies that destroy healthy platelets.

Specific types of cancer:Certain cancers, such as leukemia or lymphoma can decrease your platelet count. The abnormal cells in these cancers can crowd out healthy cells in the bone marrow, where platelets are made.

Less common causes of a low platelet count include:

The cancer spreads to the bone. Some cancers that spread to the bone may cause a low platelet count. The cancer cells in the bones can make it difficult for the bone marrow inside bones to make platelets.

Cancer in the spleen. Your spleen is an organ in your body. It has several functions, including storing extra platelets. Cancer can make the spleen larger, so it may hold more platelets than usual. This means fewer platelets in your blood where they are needed.

Signs of a low platelet count

If you have any of these signs and symptoms, talk to your doctor immediately:

More bumps, or worse bumps than usual

Small red or purple dots under your skin

Nosebleeds or bleeding gums

Black or bloody-looking bowel movements

Red or pink urine

Blood in vomiting

An unusual menstruation

High headaches

Pain in muscles and joints

Feeling very weak or dizziness

If you have a low platelet count, your body will find it difficult to stop bleeding from a nosebleed or a cut.

Managing a low platelet count and other cancer side effects is essential for your treatment.

Natural way to increase platelet levels

There are some minerals and vitamins to help increase a persons platelet count naturally, although these are best obtained by eating foods naturally rich in them rather than by taking supplements. It includes:

Folate-rich foods:

• Green leafy vegetables, beans, peanuts, liver, and seafood

• Foods rich in vitamins B-12, C, D, and K, such as beef, liver, chicken, fish, seafood, citrus, tomatoes, potatoes, egg yolks, and cereals

• Iron-rich foods such as red meat, pork, and poultry.

• Fortified breakfast cereals and dairy alternatives

• Rice
• Yeast

Vitamin B-12-rich foods

• Vitamin B-12 is necessary for the formation of red blood cells.

• Low levels of B-12 in the body may also contribute to low platelet counts.

People aged 14 and over require 2.4 mcg of vitamin B-12 daily. Pregnant and breastfeeding women require up to 2.8 mcg. Vitamin B-12 is present in animal-based products, including:

• Beef and beef liver
• Eggs
• Fish, including clams, trout, salmon, and tuna

Dairy products also contain vitamin B-12, but some research suggests that cows milk can affect the production of platelets.

Vegetarians and vegans can get vitamin B-12 from:

• Fortified cereals

• Fortified dairy alternatives, such as almond milk or soy milk

• Supplements

Vitamin C-rich foods

It plays a vital role in the immune function. Vitamin C also helps the platelets work correctly and enhances the bodys ability to absorb iron, which is another essential nutrient for platelets.

Many fruits and vegetables contain vitamin C, including:

• Broccoli
• Brussels sprouts
• Citrus fruits, such as oranges and grapefruits
• Kiwifruit
• Red and green bell peppers
• Strawberries

Heat destroys vitamin C, so for the best result, it is advisable to eat vitamin C-rich foods raw when possible.

Vitamin D-rich foods

Vitamin D contributes to the proper functioning of the bones, muscles, nerves, and immune system.

The body can produce vitamin D from sun exposure, but not everybody receives enough sunlight each day, especially if they live in colder climates or northern regions. Adults aged 19 to 70 require 15 mcg of vitamin D daily.

• Food sources of vitamin D include:
• Egg yolk
• Fatty fish, such as salmon, tuna, and mackerel
• Fish liver oils
• Fortified milk and yogurt
• Strict vegetarians and vegans can get vitamin D from:
• Fortified breakfast cereals
• Orange juice (Fortified)
• Fortified dairy alternatives, such as soy milk and soy yogurt
• Supplements
• UV-exposed mushrooms
• Iron-rich foods

Males over 18 and females over 50 require 8 milligrams (mg) of iron daily, while females aged 19 to 50 need 18 mg. Women need 27 mg per day during pregnancy.

Iron-rich foods include:

• Beef liver
• Fortified breakfast cereals
• White beans and kidney beans
• Dark chocolate
• Lentils
• Tofu

Also Read: Blood Cancer And Its Complications And Ways To Manage It

Do any foods or supplements decrease platelet levels?

Some foods and supplements have been shown to reduce the number of platelets and these should be avoided. They include:

• Alcohol
• Aspartame (NutraSweet)
• Cranberry Juice
• Erucic acid (in Lorenzo's oil, some rapeseed and mustard oil)
• Jui (a Chinese medicinal herbal tea)
• L-tryptophan
• Lupinus termis bean (cultivated in Egypt, a food protein supplement that contains quinolizidine alkaloids)
• Niacin (can cause liver damage with long-term use)
• Tahini (pulped sesame seeds)

Conclusion

People with a low platelet count may be able to improve their condition by eating specific foods and taking supplements. It can also be helpful to avoid alcohol, aspartame, and other foods that decrease platelet levels. However, always seek medical advice first, as diet alone may not be enough to restore normal platelet counts.

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Reference:

1. Kuter DJ. Treatment of chemotherapy-induced thrombocytopenia in patients with non-hematologic malignancies. Haematologica. 2022 Jun 1;107(6):1243-1263. doi: 10.3324/haematol.2021.279512. PMID: 35642485; PMCID: PMC9152964.