Platelets (or thrombocytes) are colorless blood cells that help blood clot by clumping and forming plugs to stop bleeding during an injury. The normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood. However, a platelet count below the normal range is a health condition called thrombocytopenia, which makes it difficult to stop bleeding under the skin, from the skin’s surface, or inside the body when injured.

Symptoms
Uncontrolled bleeding is usually the key trigger for all symptoms of thrombocytopenia. So, common signs include:

• Bleeding that lasts longer to stop after suffering even minor injuries
• Nosebleeds or bleeding from the gums
• Small, flat red spots (petechiae) develop under the skin due to blood leaking from the vessels
• Bleeding in the skin (purpura) causing red, purple, or brownish-yellow spots
• Blood in the urine or stool that gives it red or a dark, tar-like color
• Heavy menstrual bleeding

The symptoms may develop suddenly or over time. Mild thrombocytopenia usually causes no symptoms and is often detected during a routine blood test.

Causes and risk factors
Under normal circumstances, a platelet lives only for about 10 days, and the body continually replenishes the supply by producing new platelets in the bone marrow. However, thrombocytopenia leads to an inadequate supply of platelets, i.e., fewer than 150,000 platelets per microliter of circulating blood. According to experts, the condition might be inherited, which means the parent passes it on to their children. Thrombocytopenia might also be acquired, where one develops it later in life due to various conditions. Sometimes, it is difficult to determine the precise cause of the disease. However, here are a few reasons for the development of the condition:

• The bone marrow may not produce enough platelets.
• The bone marrow makes enough platelets, but the body eliminates or utilizes them quickly.
• The spleen, an organ responsible for storing about one-third of the body’s platelets and helping fight infections, may hold onto several platelets, lowering the platelet count.

Additionally, the following factors may increase the risk of a low platelet count:

• Exposure to harmful chemicals, such as arsenic, benzene, and pesticides, may slow the production of platelets.
• Unhealthy lifestyle choices may cause the platelet count to drop for a short period.
• Certain prescriptions are known to slow down platelet production. Additionally, reaction to treatment options may confuse the body and cause it to eliminate its platelets.
• Health conditions like aplastic anemia, autoimmune diseases, cancer, infections, and an enlarged spleen might also trigger thrombocytopenia.
• Some pregnant women may develop mild thrombocytopenia closer to the delivery. The exact cause of this issue is not known.
• Those who undergo surgery may experience a low platelet count. This may occur as platelets may get destroyed as they pass through artificial heart valves, blood vessel grafts, or machine tubing used for blood transfusion or bypass surgery.

Management options
The treatment for thrombocytopenia depends on the causes and severity of symptoms. Those with a mild form of the condition might not require treatment, as a fully normal platelet count is not necessary to prevent serious bleeds, even in the case of major injuries. 

Prescription options: Those with severe bleeding episodes or a high risk of bleeding-related complications may require prescriptions to manage the condition and underlying causes.  Those undergoing treatment for other conditions may have to look for alternative management options if the current prescription ends up lowering the platelet count. Here, most people recover after the initial treatment is halted. Further, if the immune system is responsible for a low platelet count, one may have to seek prescriptions to suppress the immune system. 

Procedures: If prescriptions do not work, one might undergo procedures to manage bleeds. For instance, a blood or platelet transfusion could help manage heavy bleeding and associated complications. A surgical procedure might also be required to remove the spleen to help increase platelet count in the blood.

Lifestyle changes: Apart from treatments, one can adopt a healthier lifestyle and some home remedies to manage and improve platelet count. A few ways to tackle the complications of thrombocytopenia include:

• If at risk of thrombocytopenia, one should avoid activities that could cause injury. One can speak to a healthcare provider about safe activities. Contact sports like boxing, football, and martial arts carry a high risk of injury and should be avoided.
• Adding healthier foods, like leafy vegetables, fatty fish, and citrus fruits, to daily meals can help increase the platelet count. Foods rich in iron and folate may also help here.
• Scheduling regular appointments with a healthcare professional can help one identify potential complications and address them at the earliest.