8 Things That Elevate Your Platelet Count

1
What Elevates Your Platelet Count?

Blood specimen tubes on form for ordering lab tests
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In general, a platelet count more than 450,000 cells per microliter is considered elevated; this is known as thrombocytosis. There are numerous causes of thrombocytosis and fortunately the majority are benign and transient. Let's will review some of the most common causes.  

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Myleoproliferative Disorders

Blood cells
Blood cells. National Cancer Institute/Science Photo Library/Getty Images

Chronic myleoproliferative disorders (a disorder where the bone marrow makes too many blood cells) can cause thrombocytosis. These include polycythemia vera, essential thrombocythemia (ET), and primary myelofibrosis.

In ET, for example, the bone marrow makes too many megakaryocytes, the cells that make platelets, resulting in thrombocytosis. With these conditions, the excessive numbers of platelets cause the blood to be thick and flow more slowly which may result in blood clots.  Treatment is aimed at reducing the platelet count to reduce this risk.  

3
Infection

Young man holding thermometer
Young man holding thermometer. Emma Innocenti/Stone/Getty Images

In both children and adults, infections are the most common cause of an elevated platelet count. This elevation can be extreme, with platelet counts greater than one million cells per microliter.

The majority of people who experience this are asymptomatic but a small group of patients with other risk factors may develop blood clots. Platelet counts generally return to normal after resolution of the infection, but this may take several weeks. In some patients, thrombocytosis may be a rebound effect after having thrombocytopenia (low platelets) during initial infection.  

4
Iron Deficiency Anemia

Blood work
Blood work. TEK IMAGE/SCIENCE PHOTO LIBRARY/Getty Images

Although a low hemoglobin and small red blood cells are the typical laboratory values associated with iron deficiency anemia, elevation of the platelet count is not uncommon. At this time, it is unknown what exactly causes this thrombocytosis. In general, it is well tolerated and resolves with appropriate iron supplementation treatment.

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Not Having a Spleen

Liver, Gallbladder, Pancreas, Spleen
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A certain amount of platelets are housed in our spleen at any given time. If the spleen is removed surgically (splenectomy) or stops functioning properly (functional asplenia) as in sickle cell disease, thrombocytosis results. This thrombocytosis is usually mild to moderate and well tolerated.

Immediately after splenectomy, the thrombocytosis may be severe and may trigger the formation of a blood clot. This post-splenectomy complication occurs in about 5 percent of patients. In general, the risk is greatest in the month after splenectomy.  

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Inflammatory Conditions

Crohn's Disease
Crohn's Disease. JUAN GARTNER/Science Photo Library/Getty Images

Conditions with inflammation like rheumatologic disorders, inflammatory bowel disease, and vasculitides can have thrombocytosis. The elevated platelet count occurs in response to cytokines (small proteins released from cells that signal other cells to do something). In particular, the cytokines interleukin-6 and thrombopoietin stimulate platelet production.

7
Mixed Cryoglobulinemia

Liver
Liver. SEBASTIAN KAULITZKI/Science Photo Library/Getty Images

Mixed cryoglobulinemia can cause a false elevation in the platelet count. In this condition, cryoglobulins (proteins) in the blood stick together when exposed to cold temperatures (like the hands and feet). These particles may be falsely counted as platelets by the machine performing the complete blood count. This condition is associated with hepatitis C infection, systemic lupus erythematous, and rheumatoid arthritis. 

8
Hemolytic Anemia

Red blood cell
Red blood cell. SEBASTIAN KAULITZKI/Science Photo Library/Getty Images

If the hemolytic anemia (anemia secondary to red blood cell fragmentation) results in the formation of very small red blood cells, these red blood cells may be inaccurately counted as platelets by the machine that performs the complete blood count. This can be diagnosed by reviewing a peripheral blood smear (a microscope slide of blood). A visual count of the platelets will be lower with many small red blood cells seen.  

9
Malignancy

White Blood Cells
White Blood Cells. Science Photo Library - DR GOPAL MURTI/Brand X/Getty Images

Thromocytosis can be a secondary effect of some malignancies (cancer). This is known as paraneoplastic thrombocytosis. This is more common in solid tumors like lung cancer, hepatocellular (liver) carcinoma, ovarian cancer, and colorectal cancer.  Elevated platelet count can also be seen in chronic myelogenous leukemia (CML).

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