Worried about slightly elevated platelet count

Posted by torcia @torcia, Oct 2 10:44pm

My platelets have been at the high end of normal (394 to 399) since 2016. A few weeks ago, they were 401. The doctor retested two weeks later and they were 404. How concerned should I be about these numbers? Can some people just run on the higher side? I don't appear to be anemic. Autoimmune diseases run in my family and I have Hashimoto's that is controlled with levothyroxine. Multiple tests for inflammation came back normal. The only other abnormal result is a slightly low RDW (11.8%). Recent colonoscopy, endoscopy, and mammogram were all normal. I'm 54 years old and otherwise healthy and active. My doctor suggested the JAK2 test, which really scared me. Does this seem premature? Can stress lead to platelet levels as high as mine? I would greatly appreciate any suggestions anyone can offer. Thank you!

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I, too, am interested in what feedback others have. My platelets are in the 500s and my hemoglobin is around 11.7 g. The hem/ onc doctor ordered a JAK2 test which showed the mutation. Now, I’m labeled as having Polycythemia Vera. Since I have never had an elevated red count it makes no sense to me. It makes me wonder what’s coming.


Hi Cindy and Torcia,
I am sorry to hear you have this condition. I was diagnosed with Poly Vera in late 2021 with JAK 2 mutation at 70 years old. My haematacrit was 52%. In January 2022 I began venesections beginning with fortnightly, then 3 monthly and I am now at 4 monthly intervals. It has been kept in check and is down below 45% now. I was worried because my platelet count has been slowly rising and is now at 560. My haematologist has said it is not a concern so I am not thinking about it. I feel fine, just still get the original symptoms e.g. high blood pressure, restless legs, a bit anaemic. I know that if it gets too high drugs like hydoxyurea will be prescribed. I hope you can stabilise and not stress too much. I think stress has a great impact on all of this. I had a very stressful 2019.
Best wishes,
Cheryl from Australia


Knowledge is everything. Listen to your Dr. Myself, I would rather know what I’m up against and how much it progresses.If you have a bone marrow biopsy, take it with sedation, it makes it uneventful.


Torcia, stress does not elevate your platelets…did you have the JAK2 test yet? It is the next step in a proper diagnosis. If that test is positive, then likely youshould be referred to a hematologist for further treatment. You are very lucky to have medical help paying such close attention. It is best to catch things early. Best wishes!


Thank you for the responses. My doctor at Kaiser ordered the JAK2 test, but I freaked out and asked him to remove it (which was probably a mistake). I am worried about the implications of testing positive for my future insurance and medical care. I'm self employed and have to purchase my own insurance. If the affordable care act gets overturned, it may be impossible to get coverage with one of these blood disorders diagnosed. I'm 11 years away from Medicare. Is there an advantage to knowing you are JAK2 positive when the platelets are just barely over normal? Is there anything they can do other than keep watching the platelet numbers? I guess if it comes back negative, maybe they would do other testing for things like other forms of cancer to see if they can explain the high numbers. My hematocrit, white blood cell differentials, red blood cells, etc. are all well within normal.

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