Low platelet count of around 120,000: What should be looked at?

I have low platelets. My “normal” is around 68,000. I was diagnosed with ITP. It’s an autoimmune disorder where my body attacks my platelets. I was also diagnosed from a bone marrow biopsy with MDS. MDS can cause low platelets as well. It was determined my low platelets are ITP because when they dropped to 7,000 I did respond briefly to steroids. They finally gave me Rituxamab in 2018 and my platelets are staying in the mid 60s. They won’t treat until they drop to 20s. So your numbers are great but you should find out the cause. By the way, a bone marrow biopsy isn’t bad and that’s coming from a person who hates/panics with any invasive procedures. Check into your levels of B vitamins and copper. Unfortunately a hematologist or oncologist won’t do it. Seems their protocol is CBC and CMP.

Welcome to Connect, @guenthg2575. A normal platelet range can change based on a person’s age. It tends to decline the older we get. However, a platelet count of less than 150,000 is considered lower than normal and referred to as thrombocytopenia. If this is a ‘one-off’ event it may not be anything significant. But if it’s a trend in your repeated blood results, then your doctor would want to do some further investigating to find the cause.

There can be number of causes for a decrease in platelets including autoimmune diseases, viral infections, vitamin deficiencies, underlying medical conditions, etc..
Here’s a link to a good article about thrombocytopenia from Verywellhealth.com

https://www.verywellhealth.com/living-with-low-platelets-what-you-need-to-know-2252431
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You mentioned being on several prescriptions daily. There are some meds which can cause a drop in platelet levels. You may have already seen this but here’s an article which discusses some of the meds which can cause this decrease.
https://www.healthline.com/health/drug-induced-thrombocytopenia#causes\

I know you’re concerned about your decrease in platelets. Was this something that was discovered recently? How was the rest of your blood work? Some follow up tests could be to check for autoimmune diseases, hepatitis C, viruses such as EBV, CMV, HIV, anemia, vitamin deficiencies. Have you noticed any unexpected bleeding if you get a cut or more bruising than usual?

Dear @memesedona
Hoe you are doing now?
I saw your comment how diagnosed with MDS? From when? what was your abnormal things in your cbc test??

I am stressed. I don’t like the “watch and wait”. I now get blood checked monthly. Use to be every six months, then 3 months. I am eating healthy and taking supplements. 2014 I went to a functional medicine doctor who saw my wbc and platelets were low. They have been low for years prior and other doctors wanted me to have a bone marrow biopsy done. Since I felt fine and the thought of a biopsy scared me I always declined. Anyway i finally said yes. The diagnosis came back MDS. In 2018 my platelets dropped drastically to 7000. I had huge bruises on my arm and legs, blood blisters in my mouth. Pretty scary. I had platelets transfusions which only helped temporarily. Then they tried high doses of steroids which didn’t work. I went to Mayo for a second opinion. Mayo dr thought my low platelets were from ITP, not MDS. I had four rounds of infusions, once a week for a month. That finally worked. Infusion was Rituxan. Now my cbc, rbc, hemoglobin, neutrophils, platelets are in the low range. No treatment at the present, hence watch and wait. So that is why I’m trying to find other avenues to improve my numbers. Oncologists don’t think like that. I asked to have an appointment with a nutritionist and integrative dr. Hope you are okay.

Guenthg2575, I understand your concern and am glad you are investigating, but want to share that sometimes low platelets aren't always an indicator of serious disease. My husband of 54 years has had low palettes for decades, at least 52 years that we're aware of. It was brought up in the Air Force as an advanced jet pilot and later as an airline pilot. He was never grounded for it. The lowest it has ever been is 68,000, today a bit better at 110,000. It fluctuates some without explanation, but it has never been in the normal range. His other blood counts are normal except for high Triglycerides which he has always had and the doctors say is hereditary. He doesn't have high blood pressure and has a strong heart. He's heathy at age 76, almost 77, rarely gets a cold and heals normally if he does get sick. He's never had Covid. He does have thin skin as a redhead, and bleeds easily if cut or scrapped but it clots in a normal amount of time The doctor's say it's just normal for him.