More ways to understand low platelets

How low do platelet counts need to go before treatment is necessary?

The answer to this question, in most cases, depends on whether the patient is having bleeding problems, because most doctors will treat the symptoms rather than looking only at the platelet count. A normal platelet count is between 150,000 and 450,000 per cubic millimeter, but most people won't experience serious bleeding problems until their platelet count drops below 50,000, and some will function fine with a platelet count lower than that. "Doctors try not to treat to a number because everyone is different and reacts differently," says Andrew Putnam, director of the Palliative Care program at Lombardi Comprehensive Cancer Center and Georgetown University. "If you aren't having problems with bleeding, then the doctor will probably let it go lower and see if the counts recover."

What symptoms of low platelet count should I watch for?

Bruising and bleeding that won't stop are the two main signs of a low platelet count. A patient may have frequent nosebleeds or a nosebleed that won't stop. Women who are still menstruating need to watch out for heavy flow that seems like it won't let up. Less common symptoms of a low platelet count are blood in the stool or black, tarlike stools; blood in the urine; or a skin rash of pinprick-size red dots.

If there haven't been any problems with excessive bruising or bleeding, the doctor will probably wait to treat it, but there are still protective steps you should take.