high-normal platelet count but bruising and bleeding easily?

July 13, 2017 10:25 PM

For the past few years I've been bruising and bleeding very easily. However, recent blood tests show I actually have a high-normal platelet count (409k at a lab that considers 400k to be the top end of normal). Easy bruising is apparently a symptom of aplastic anemia, but mine is iron-deficient (at least based on my ferritin which is... 4). Shouldn't a higher platelet count mean my blood clots very quickly? I guess easy bruising is subjective, but I got a cut recently that bled for more than 48 hours. How does this work?

I do have a doctor, we're working on getting my iron up. I'd just like to understand the platelet/clotting relationship.

posted by mrmurbles to Health & Fitness (4 answers total)

Along with your platelets, there are a whole host of enzymes involved in clotting - your doctor will probably order a simple coagulation screen to begin with, to check that you are not deficient and that you haven't developed antibodies that prevent them from working. Also, it's possible to have plenty of platelets that just don't function very well - your doc might order a platelet function test.
posted by Naanwhal at 11:36 PM on July 13, 2017

Platelets are like a patch in the dike. They are a good first step to plug a hole in a blood vessel, but they are only temporary, buying time until your coagulation factors can actually repair the damage.

You may have a slightly high platelet count because they aren't functioning 100%, as Naanwhal says. Various reasons for this -- medications can affect platelet function, as can many infections, and sometimes it's genetics. Your bone marrow realizes this (sorry for the anthropomorphism) and is pumping out more platelets in response. So your count is a little up, but not super high.

Here is a pretty good overview of how platelets (and coagulation in general) works.
posted by basalganglia at 3:47 AM on July 14, 2017

IANYhematologist but higher platelets can be associated with iron deficiency anemia, among many other things. Platelets can be high due to inflammation as well. There are also intrinsic, qualitative factors that keep platelets from working properly, regardless of numbers, and other alterations in the molecular process involved in blood clotting (independent of platelet count and quality) that can cause oozing and longer bleeding time.

Glad you're seeing a doctor about the iron issue - would ask if it may be reasonable to have other testing done if you have longer-than-normal bleeding and oozing from cuts and sores.
posted by honeybee413 at 6:33 AM on July 14, 2017

The bruising at least could very well be from the (very) low ferritin.
posted by Amy93 at 6:01 PM on July 15, 2017