What can cause a low platelet count?

Welcome to Mayo Connect @adnanmuhammad
It sounds like there’s a little mystery surrounding your wife’s low platelet count. Low platelets can be the result of viral infections, medications, autoimmune disorders, bone marrow disorders or liver disease. Your wife’s doctors have already ruled out liver disease which is good. But it’s still not ideal to have lower than normal platelets.

Too few platelets, referred to as thrombocytopenia, can create issues with prolonged bleeding, bruising, frequent nosebleeds, headaches, etc.

I’m posting a couple of links below to give you a better understanding low platelets and low red blood cells:
https://www.mayoclinic.org/diseases-conditions/thrombocytopenia/symptoms-causes/syc-20378293
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https://www.verywellhealth.com/living-with-low-platelets-what-you-need-to-know-2252431
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Has there been a peripheral blood smear? This can be a helpful diagnostic tool. In a smear, platelets (and other blood cells) can be counted and assessed for size, shape which may indication specific disorders. It’s just one of several tests but it may help direct next steps.

Are your wife’s other blood numbers in the normal range? Is she being seen by a hematologist?

@adnanmuhammad

I was first seen for low platelets back in Dec 2025. I have had all the scans, tests for liver, spleen including a bone marrow aspiration/biopsy and genetic test in March. I was down to 70 and after all my test was back up to 92. The tests revealed nothing - no known cause, no symptoms. Just had a 3 month check of blood and now down to 58. So back to once a month check for now. While I am glad I have no symptoms, it would be nice to know why my immune system is attacking my platelets...frustrating. If they go below 50, then the hematologist will talk treatment options. Due to my age (71) they are limited she said. Just know you may never find out the "why" this is happening, and although rare - those of us that have no reason are here to support each other.

I'm a 78 year old male and have had low platelets for at least 10 years (probably longer). They've never been able to determine a cause and my platelets vary anywhere from 48 to 94. Interestingly, if I am injured such as a fall when I get to the emergency room, my platelet count has gone way up. Now I have lost 40 lb in about a year and I'm finally agreeing to a bone marrow biopsy (today). I've given up trying to figure out why and just living with it, because I don't have any other symptoms.

@loribmt we have recently dome peripheral smear and they are saying the platelets count is 212 which is normal, no other issue found in the tests, but she has lost significant weight,now the doctors are saying it can be worms infestation.

Is she doing chemo? Chemo is a killer on platelets, mine were down to 11 so I needed a transfusion. Some of the blood cancers really beat up on the blood counts. I doubt it’s a result of something she did or even didn’t do. It’s really hard to influence your blood counts, I used to try eating liver before labs and there’s no difference! Haha! What can make a difference is the food you eat while on warfarin to prevent blood clots, vitamin K in kale or spinach can really wreck havoc on platelets, again the drug plays the larger part of it all.

I kind of wish drs didn’t give copies of blood labs, for one thing patients typically aren’t qualified to read them and to know what is affected by what. Those blood counts can create a lot of anxiety for patients. I see it in the waiting rooms all the time.
I’ve had cancer over 19 years now, I’ve only kept a few copies of blood labs, what am I going to do with those labs, scrapbook them!! If there’s anything that I really need to know about I know those nurses are definitely going to make some noise. You have to trust your providers a little on some things or you’ll go nuts trying to manage it all.

Hi @adnanmuhammad As I mentioned before there can be any number of reasons for fluctuating platelet counts. If your wife had a peripheral blood smear and the platelets and other blood cells look normal, that’s a good thing to see. Especially since her platelet level is back to normal. But there are infections or inflammatory issues which can also lower platelets and cause weight loss. If her doctors are suspecting a possible intestinal parasite issue, that’s easy to check with a stool cultures and then treated with medication. Just as a precaution, this is best to be done through the assistance of her doctor and not with over the counter remedies.
The weight loss is concerning, of course. So I hope she finds an answer soon. Will you let me know what her next step is?

Dear lori,
Thanks for the helpful insight, for time being after checking the tests results her doctors have recommended for parasite treatment, and if the problem of weight loss is not resolved in few weeks then we will do further treatment. I hope the problem is resolved with this treatment.

Good morning, @adnanmuhammad
I hope the problem of your wife’s unexpected weight loss is solved with this treatment too. I’m sure it’s really troubling to both of you as to why this is happening. The encouraging news is that her blood work isn’t showing anything such as a blood cancer, which are notorious for unintended weight loss. Your wife’s tests were not indicating anything suspicious in that area. So that’s very good.

Will you keep me updated please? I’d like to follow along with her progress.

@steveutnv I had the bone marrow biopsy and aspiration, genetic/hereditary blood work, spleen, kidney. liver, thyroid checked and all good. Mine went from 70 to 92 the day of the bone marrow biopsy and stayed there for 2 months. Next check was 58. There is no cause for mine either which is pretty frustrating. Did they put you on any type of med when it fell before 50? I go back the end of the month and if below 50 that is what the hematologist wants to talk about. I am almost 72 and she said there are not many options, and I won't do steroids. Hope your biopsy was all clear. I am also wondering why they waited so long to do the biopsy - 10 years is a long time!

@chenn I waited so long because my Doc said it was "up to me." However, after I lost 40 lbs, he said it was no longer optional. And no, he's never put me on any med.

I finally got the results and didn't see anything that worried me. I meet with my oncologist the end of July.