Anyone else have sporadically low platelets?

Posted by vostie @vostie, Feb 14 12:20pm

I am almost 6 years into Long COVID with initial COVID infection in March 2020. I am now having on and off again low platelet counts (Thrombocytopenia). The platelets have dropped from 146 in Oct 2024 to 33 in Oct 2025 and back up to 149 in Dec 2025. My platelets were up to 209 in 2023. I am not bruising or excessively bleeding when I get cut. Has anyone else seen this occur? I have been on low dose naltrexone about 10 months so am wondering if it is affecting my platelets...or if this is another Long COVID side effect.

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mcchesney | @kathleen1314 | Feb 14 4:07pm

Yes, while rare, low platelet counts (thrombocytopenia) may be a potential side effect of Low-Dose Naltrexone (LDN), according to case reports. Specifically, studies of MS patients on LDN, have suggested a possible link between LDN and immune-mediated thrombocytopenia, where the immune system mistakenly destroys platelets.
It seemed to resolve easily when off LDN so you could check by going off the med.

I sympathize because it takes so long to titer up to the correct dose on LDN that going off it can be a real pain.

vostie | @vostie | Feb 14 5:05pm

In reply to @kathleen1314 "Yes, while rare, low platelet counts (thrombocytopenia) may be a potential side effect of Low-Dose Naltrexone..." + (show)

@kathleen1314 It will be a pain in more than one way...it has cut back my daily pain by about 50%!

mcchesney | @kathleen1314 | Feb 15 7:10am

In reply to @vostie "@kathleen1314 It will be a pain in more than one way...it has cut back my daily..." + (show)

@vostie
Maybe a lower dose would keep the pain down but not attack your platelets?

I am so glad LDN is helping with the pain though and a lower but not dangerous drop in platelets might be worth the day to day relief.

We all come to a time when we balance quality of life issues with dangers of life issues; most of us choose quality of life.

Plus, this seems to tell you that this is an autoimmune issue which means that you might be able to impact for the positive with other interventions.

What kind of pain are you experiencing?

vostie | @vostie | Feb 15 10:09am

In reply to @kathleen1314 "@vostie Maybe a lower dose would keep the pain down but not attack your platelets? I..." + (show)

@kathleen1314 I have tremendous inflammation...so pain everywhere. It was so bad before LDN that I woke up every morning at 4-5 am and could not sleep even on anti inflammatory meds. I have Long COVID so it is causing my immune system to over react and it also made me allergic to most foods now so the littlest bit of gluten, sugar, dairy, etc inflames me more. My doc tried every med possible and nothing helped but LDN. I am going to lower the dose to see if the platelets quite cycling up and down.

bouf1948 | @bouf1948 | Feb 15 4:15pm

Have you been to a hematologist to checked for leukemia or lymphoma? I have CLL, chronic leukemia and lymphoma, and the doctor watches the platelet count. I’m on IViG infusions because my immune system is not working properly. I was diagnosed with thrombocytopenia first. Just a thought. I wish you well.

klf58 | @klf58 | Feb 16 8:13am

Since covid I've had the opposite: thrombocytosis (high platelets) and polycythemia/erythrocytosis (increased volume red blood cells) likely secondary due to SOB from long covid.. Jak2 test was negative, so doctor thinks long covid, not cancer. Constant fatigue. Best of luck to you.

klf58 | @klf58 | Feb 16 8:15am

so sorry for your suffering. I also contacted covid in March of '20. I lived, but have been dying ever since, since I'm not who I was and at this point don't have hope of improving and regaining health

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