A person with thrombocytopenia has a low platelet count. Platelets, or thrombocytes, are small cell fragments in the blood. When bleeding occurs, the platelets clump together to form a clot.

When someone has an abnormally low level of platelets, the blood does not clot as it should, making it more difficult to stop bleeding when someone sustains an injury. Mild thrombocytopenia may not pose much risk, but more persistent or severe thrombocytopenia can cause serious bleeding.

A range of thrombocytopenia treatments is available, with the cause of the condition determining the options that a doctor will suggest. Some of the medical conditions that can cause low platelet levels include:

  • primary immune thrombocytopenia (ITP), which is an autoimmune disease
  • other autoimmune diseases, such as lupus
  • infections, such as with the hepatitis C virus (HCV), HIV, or the mumps virus
  • certain medications
  • long-term alcohol misuse
  • pregnancy, especially the pregnancy complication HELLP syndrome, which refers to hemolysis, elevated liver enzymes, and low platelets
  • some nutritional deficiencies
  • inherited conditions, although this is more common in children than adults

In this article, we look at the treatment options for thrombocytopenia, including blood and platelet transfusions, medications, surgery, and more.

A machine for separating platelets from blood, with red blood inside the tubes.Share on Pinterest
Travelsouls/Getty Images. A machine for separating platelets from donor blood.

The treatment for thrombocytopenia can vary depending on how low a person’s platelet count becomes. If the platelet count falls within 100,000–150,000 per microliter (μl) of blood, the blood can still clot, meaning that the increase in the risk of bleeding is not significant.

In these cases, a doctor may suggest monitoring the condition rather than treating it. A person may need regular blood tests to monitor the platelet count over time.

When the platelet count falls below 100,000 per μl, a person may develop spontaneous bleeds. This form of thrombocytopenia usually requires immediate treatment that focuses on managing the cause of thrombocytopenia. The treatment may involve:

  • addressing underlying conditions, such as infections or nutritional deficiencies
  • stopping any drugs that could be reducing the platelet count
  • starting medications that stimulate platelet production
  • undergoing blood or platelet transfusions
  • undergoing plasma exchange therapy
  • removing the spleen

If someone develops moderate or severe thrombocytopenia while pregnant, a doctor may admit them to the hospital for monitoring. In some cases, they may recommend early delivery.

When the platelet count is very low, the risk of bleeding is high, especially if a person is about to give birth or have surgery. A doctor may recommend a blood or platelet transfusion to a person who:

  • has very low platelets
  • has a high risk of bleeding
  • currently has a bleed because of a lack of platelets

This treatment replaces the lost platelets by giving someone either whole blood from a donor or just a transfusion of platelets alone. During the procedure, a person receives the donor cells via an IV line in their arm.

The transfusion itself is not painful, but the insertion of the IV line may hurt.

In some cases, medication may be helpful for treating thrombocytopenia. For example, in cases of primary ITP, the immune system mistakenly attacks healthy platelets, resulting in a low platelet count. Other autoimmune conditions can also have this effect.

Drugs that stop the immune system from destroying platelets can help. The first-line treatment for primary ITP is typically glucocorticoids or IV immunoglobulins, which prevent the body from making the antibodies that are damaging platelets.

If these do not help, immunosuppressants are another possibility. These drugs suppress the activity of the immune system overall. Some drugs also stimulate platelet production. Doctors call them thrombopoietin receptor agonists.

Some cases of thrombocytopenia are drug-induced, which means that a medication a person already takes is causing the problem. Examples of drugs that can do this include:

A doctor will advise an individual on what to do if a drug might be causing thrombocytopenia. In many cases, stopping the drug treats the condition.

Surgery is only useful in cases of autoimmune thrombocytopenia. People with primary ITP who do not respond to medications may require a splenectomy to control the condition.

A splenectomy involves removing the spleen, which is the organ that stores platelets, keeping them out of circulation. It is also the place where the body produces the antibodies that destroy platelets in cases of primary ITP. Removing the spleen stops this from happening.

About 50–70% of people who choose this treatment recover from thrombocytopenia. However, predicting how well someone will respond can be difficult, and there is no way to know whether the surgery will work.

Surgery also carries some risks, such as bleeding and infection. It is important to discuss the risks and benefits with a doctor.

A rare disease known as thrombotic thrombocytopenic purpura (TTP) causes platelets to clump together throughout the body, forming small blood clots. This effect lowers the platelet count.

The standard treatment for TTP is plasma exchange. During plasma exchange, a healthcare professional removes a person’s plasma and replaces it with healthy blood plasma, which includes healthy platelets. This procedure works in a similar way to a blood transfusion and requires the insertion of an IV line into a vein.

There is no scientific evidence that lifestyle changes can treat existing thrombocytopenia. The only exception to this is if the condition is due to a nutritional deficiency. A lack of vitamin B12, folate, or copper can sometimes result in a low platelet count.

If a doctor identifies a deficiency as a potential cause of thrombocytopenia, they may advise eating more foods that contain these nutrients. Alternatively, if this is not possible, they may suggest a vitamin or mineral supplement.

People with low platelet levels can also reduce the risk of bleeds. While undergoing treatment, a doctor may advise:

  • refraining from participating in contact sports and other activities that have a high risk of injury
  • wearing gloves while using knives or other sharp objects
  • delaying any surgeries until it is safer to have them
  • avoiding medications that raise the risk of bleeding, such as aspirin

There is no compelling evidence that home remedies can treat thrombocytopenia. However, there is limited evidence that a nutritious, well-balanced diet may reduce someone’s risk of developing the condition.

A 2021 study found that people at risk of cardiovascular disease who followed a Mediterranean diet had a lower chance of developing thrombocytopenia than those following a low fat diet.

Unlike low fat diets, the Mediterranean diet contains sources of healthy fats, such as olive oil and nuts. However, it is unclear whether this is responsible for the reduced risk and how this diet might help. More research is necessary to understand the connection between diet and platelets.

Thrombocytopenia, or a low platelet count, can happen for many reasons. The underlying cause and the severity of the condition determine the best treatment options.

In some cases, treatment may only involve monitoring to see whether the platelet levels remain stable. In other cases, immediate treatment is necessary to bring the platelet levels back up. If the cause is a drug, nutritional deficiency, or infection, addressing this issue may resolve the problem.

In other cases, people have thrombocytopenia because of an autoimmune condition, such as primary ITP. In these cases, medications are generally effective. Sometimes, people with primary ITP undergo surgery to remove the spleen.