Aa
Low Platelets
Hello,
I was diagnosed with end stage cirrhosis back in March 2010. My last lab test revealed my platelet count is down to 60k. I have concerns since I read I could be heading for real trouble at around 20k. I have splenomegaly (enlarged spleen) which I think is directly responsible for the low platelet count. Any suggestions I would sure appreciate.
Thx
Randy
I was diagnosed with end stage cirrhosis back in March 2010. My last lab test revealed my platelet count is down to 60k. I have concerns since I read I could be heading for real trouble at around 20k. I have splenomegaly (enlarged spleen) which I think is directly responsible for the low platelet count. Any suggestions I would sure appreciate.
Thx
Randy
COMMUNITY LEADER
Thank you Diana and welcome to our new group!
Vitamin C surely isn't for everyone with cirrhosis but in my personal circumstance I think it fits pretty well. I didn't know that about garlic so I did some looking around and found this little artice:
Garlic, a pungent spice used to enliven many food dishes, has a long history of medicinal use to treat everything from the common cold to cancer. Garlic may also play a part in protecting against heart disease by its effect on platelets, irregularly shaped cell fragments that are the smallest of the blood cells, according to the University of Oklahoma Health Sciences Center. Platelets clump together at the site of injury to help stop bleeding. Taking garlic doesn't produce more platelets, but it does decrease platelet aggregation, the ability to stick together.
Read more: http://www.livestrong.com/article/528281-does-garlic-help-raise-platelet-count/#ixzz1zC88jLbN
Thank you for passing along the info, diet plays a huge role in our recovery so everything ingested should be carefully considered.
Vitamin C surely isn't for everyone with cirrhosis but in my personal circumstance I think it fits pretty well. I didn't know that about garlic so I did some looking around and found this little artice:
Garlic, a pungent spice used to enliven many food dishes, has a long history of medicinal use to treat everything from the common cold to cancer. Garlic may also play a part in protecting against heart disease by its effect on platelets, irregularly shaped cell fragments that are the smallest of the blood cells, according to the University of Oklahoma Health Sciences Center. Platelets clump together at the site of injury to help stop bleeding. Taking garlic doesn't produce more platelets, but it does decrease platelet aggregation, the ability to stick together.
Read more: http://www.livestrong.com/article/528281-does-garlic-help-raise-platelet-count/#ixzz1zC88jLbN
Thank you for passing along the info, diet plays a huge role in our recovery so everything ingested should be carefully considered.
Glad for the new forum. I've been a little lost dealing with bleedout and bandings since I finished triple. My platelets have not gotten above 70 since pre tx. Hopefully liver is regenerating and spleen will calm down and quit hoarding. haha!
Karen :)
Karen :)
COMMUNITY LEADER
Since this is a forum for all people with cirrhosis regardless the cause of their liver disease, it seems impudent to promote the use of Vitamin C (IV in particular) when a person with cirrhosis due to Hemochromatosis can be injured by its use.
What Is Hemochromatosis?
Hemochromatosis occurs when the body absorbs too much iron from foods (and other sources such as vitamins containing iron). This disease causes extra iron to gradually build up in the body's tissues and organs, a term called iron overload. If this iron buildup is untreated, it can, over many years, damage the body's organs.
Tips for Living Well with Hemochromatosis
There is much you can do to make sure your life is as normal and healthy as possible.
Check-ups: Have the amount of iron in your blood checked regularly.
Phlebotomy: Make sure to get phlebotomies when you need them.
Phlebotomy is the best treatment for hemochromatosis. Hemochromatosis cannot be treated by changing your diet alone.
Iron pills: Don't take iron pills, supplements, or multivitamin supplements that have iron in them. Eating foods that contain iron is fine.
Vitamin C: Vitamin C increases the amount of iron your body absorbs. Avoid taking pills with more than 500 mg of vitamin C per day. Eating foods with vitamin C (such as oranges) is fine.
http://www.cdc.gov/Features/Hemochromatosis/
----------------------------------------------------------------------------
Raising a person platelet count has no advantage for most cirrhotic patients. It doesn't improve their illness in any way. Besides platelet counts vary all the time as do all blood levels. The only time platelet count is a problem is when it goes lower than 20,000. Platelet count is caused by cirrhosis. Unless the cirrhosis is eliminated, platelet counts will always be below normal values.
Why cirrhotics have low platelet counts -
Blood flows from the spleen...through the portal vein...then through the liver.
Scar tissue in the liver (cirrhosis) can interfere with that blood flow, causing pressure to build up in the portal vein (portal hypertension), and the spleen to enlarge (splenomegaly).
As the spleen enlarges, it traps platelets. (The amount of platelets in the bloodstream is reduced because the spleen is busy trapping them).
So usually---people with cirrhosis end up having a problem with portal hypertension and an enlarged spleen, and a reduced platelet count in the bloodstream. As time goes by, the liver may try to repair itself by growing new cells. If there is a lot of scar tissue already present--- the new cells grow between scar tissue (and result in abnormal nodules). (The nodules and scar tissue can further interfere with blood flow through the liver). So over time people with advanced cirrhosis can end up having a problem with more and more abnormal nodules and scar tissue forming...which interferes even more with blood flow through the liver.....which makes the spleen continue to enlarge....and the platelet count continue to drop.
Hector
What Is Hemochromatosis?
Hemochromatosis occurs when the body absorbs too much iron from foods (and other sources such as vitamins containing iron). This disease causes extra iron to gradually build up in the body's tissues and organs, a term called iron overload. If this iron buildup is untreated, it can, over many years, damage the body's organs.
Tips for Living Well with Hemochromatosis
There is much you can do to make sure your life is as normal and healthy as possible.
Check-ups: Have the amount of iron in your blood checked regularly.
Phlebotomy: Make sure to get phlebotomies when you need them.
Phlebotomy is the best treatment for hemochromatosis. Hemochromatosis cannot be treated by changing your diet alone.
Iron pills: Don't take iron pills, supplements, or multivitamin supplements that have iron in them. Eating foods that contain iron is fine.
Vitamin C: Vitamin C increases the amount of iron your body absorbs. Avoid taking pills with more than 500 mg of vitamin C per day. Eating foods with vitamin C (such as oranges) is fine.
http://www.cdc.gov/Features/Hemochromatosis/
----------------------------------------------------------------------------
Raising a person platelet count has no advantage for most cirrhotic patients. It doesn't improve their illness in any way. Besides platelet counts vary all the time as do all blood levels. The only time platelet count is a problem is when it goes lower than 20,000. Platelet count is caused by cirrhosis. Unless the cirrhosis is eliminated, platelet counts will always be below normal values.
Why cirrhotics have low platelet counts -
Blood flows from the spleen...through the portal vein...then through the liver.
Scar tissue in the liver (cirrhosis) can interfere with that blood flow, causing pressure to build up in the portal vein (portal hypertension), and the spleen to enlarge (splenomegaly).
As the spleen enlarges, it traps platelets. (The amount of platelets in the bloodstream is reduced because the spleen is busy trapping them).
So usually---people with cirrhosis end up having a problem with portal hypertension and an enlarged spleen, and a reduced platelet count in the bloodstream. As time goes by, the liver may try to repair itself by growing new cells. If there is a lot of scar tissue already present--- the new cells grow between scar tissue (and result in abnormal nodules). (The nodules and scar tissue can further interfere with blood flow through the liver). So over time people with advanced cirrhosis can end up having a problem with more and more abnormal nodules and scar tissue forming...which interferes even more with blood flow through the liver.....which makes the spleen continue to enlarge....and the platelet count continue to drop.
Hector
COMMUNITY LEADER
New lab results taken 07/10/12 show a 20 point increase bringing my platelet count to 80k from the 60k I was tested at on 03/28/10! I know this can change quickly in my next lab test yet still nice to see the difference I can make with diet.
My new doctor has sent the required information for evaluation by Vanderbilt transplant center. It's weird.. I hope to be accepted for reason of possibly better medical treatment and guidance yet I also hope not to be bad enough to be accepted.
I hope everything is going well on your end, Keep taking care!
Randy
My new doctor has sent the required information for evaluation by Vanderbilt transplant center. It's weird.. I hope to be accepted for reason of possibly better medical treatment and guidance yet I also hope not to be bad enough to be accepted.
I hope everything is going well on your end, Keep taking care!
Randy
Hi,
My mother has just been diagnosed with HEP C & also with Liver cirrhosis.
I got shocked after getting this to know as I was not aware about these disease earlier.
I kept on getting the blood tests done as prescribed by doctors for my Mother.
After checking LFT doctor asked to get the Hepatitis checking done & she got detected with HEP C. After further diagnosis, she detected with Genotype 1 with the HCV viral Load of 220,351 & log value 5.34.
The treatment for Interferon & Ribavirin is so costly & therefore now I have taken her to Government Hospital for treatment. Now they have collected the blood for getting different tests done. I am waiting for the reports.
They have also conducted Liver Fibrosis test the result of which is Stiffness (KPa) 12.2 & some more details given on the report.
As of now she is not vomiting, getting a good sleep at night, due to tiredness she sleeps for sometime at day & again starts working as and when she feels comfortable.
Now I am really worried about her as I do not know at what stage her liver disease is & what is going to happen next.
Can anyone please comment with your expertise knowledge.
Regards,
Kiran
My mother has just been diagnosed with HEP C & also with Liver cirrhosis.
I got shocked after getting this to know as I was not aware about these disease earlier.
I kept on getting the blood tests done as prescribed by doctors for my Mother.
After checking LFT doctor asked to get the Hepatitis checking done & she got detected with HEP C. After further diagnosis, she detected with Genotype 1 with the HCV viral Load of 220,351 & log value 5.34.
The treatment for Interferon & Ribavirin is so costly & therefore now I have taken her to Government Hospital for treatment. Now they have collected the blood for getting different tests done. I am waiting for the reports.
They have also conducted Liver Fibrosis test the result of which is Stiffness (KPa) 12.2 & some more details given on the report.
As of now she is not vomiting, getting a good sleep at night, due to tiredness she sleeps for sometime at day & again starts working as and when she feels comfortable.
Now I am really worried about her as I do not know at what stage her liver disease is & what is going to happen next.
Can anyone please comment with your expertise knowledge.
Regards,
Kiran
COMMUNITY LEADER
I am not real familiar with Hepatitis since I have alcoholic cirrhosis. As you may already know there can be many causes for cirrhosis. I can tell you that I think the next step would be to diagnose what stage liver disease she has. This is done one of two ways, Ct Scan or Liver Biopsy, although biopsy seems to be the most common and accurate procedure used.
Here is a link to a video that can assist to educate you about said procedure:
http://youtu.be/ug3n7bvq2Wg
There are many different types of liver biopsies, such as the percutaneous, transjugular, laparoscopic, fine-needle aspiration and open surgery liver biopsy.
You should also know that symptoms of cirrhosis are normally not present until the person has reached decompensated cirrhosis. (End stage cirrhosis)
---------------------------------------------------------------------------------------------------
What are the symptoms of hepatitis C?
Many people infected with hepatitis C have no symptoms. When symptoms are present, they can range from mild to severe. The most common early symptoms are mild fever, headache, muscle aches, fatigue, loss of appetite, nausea, vomiting and diarrhea. Later symptoms may include dark coffee-colored rather than dark yellow urine, clay-colored stools, abdominal pain, and yellowing of the skin and/or whites of the eyes (jaundice).
----------------------------------------------------------------------------------------------------
How is hepatitis C treated?
There are no specific treatments for the symptoms of acute hepatitis C. Doctors recommend bed rest, preventing dehydration, a healthy diet and avoidance of alcoholic beverages. Most patients with mild to severe hepatitis C begin to feel better in two to three weeks and recover completely from their symptoms within four to eight weeks.
Synthetic forms of the protein interferon are used to treat some people with chronic hepatitis C. This can improve liver function in some people with hepatitis and diminishes symptoms, although it may cause side effects such as headache, fever and other flu-like symptoms. Sometimes this drug is used in combination with another drug, ribavirin. Treatment is effective in 10 percent to 40 percent of patients.
Many chronic carriers remain symptom free or develop only a mild condition, chronic persistent hepatitis. However, approximately 50 percent go on to develop the most serious complications of viral hepatitis: cirrhosis of the liver and liver cancer.
Keep posting as you find out more information, myself and others will do our best to communicate our experiences and knowledge. There is much to learn about the symptoms of cirrhosis and the best way to protect the liver from any increase cirrhotic advancement. Take care and I hope the best for you and your mom.
Randy
Here is a link to a video that can assist to educate you about said procedure:
http://youtu.be/ug3n7bvq2Wg
There are many different types of liver biopsies, such as the percutaneous, transjugular, laparoscopic, fine-needle aspiration and open surgery liver biopsy.
You should also know that symptoms of cirrhosis are normally not present until the person has reached decompensated cirrhosis. (End stage cirrhosis)
---------------------------------------------------------------------------------------------------
What are the symptoms of hepatitis C?
Many people infected with hepatitis C have no symptoms. When symptoms are present, they can range from mild to severe. The most common early symptoms are mild fever, headache, muscle aches, fatigue, loss of appetite, nausea, vomiting and diarrhea. Later symptoms may include dark coffee-colored rather than dark yellow urine, clay-colored stools, abdominal pain, and yellowing of the skin and/or whites of the eyes (jaundice).
----------------------------------------------------------------------------------------------------
How is hepatitis C treated?
There are no specific treatments for the symptoms of acute hepatitis C. Doctors recommend bed rest, preventing dehydration, a healthy diet and avoidance of alcoholic beverages. Most patients with mild to severe hepatitis C begin to feel better in two to three weeks and recover completely from their symptoms within four to eight weeks.
Synthetic forms of the protein interferon are used to treat some people with chronic hepatitis C. This can improve liver function in some people with hepatitis and diminishes symptoms, although it may cause side effects such as headache, fever and other flu-like symptoms. Sometimes this drug is used in combination with another drug, ribavirin. Treatment is effective in 10 percent to 40 percent of patients.
Many chronic carriers remain symptom free or develop only a mild condition, chronic persistent hepatitis. However, approximately 50 percent go on to develop the most serious complications of viral hepatitis: cirrhosis of the liver and liver cancer.
Keep posting as you find out more information, myself and others will do our best to communicate our experiences and knowledge. There is much to learn about the symptoms of cirrhosis and the best way to protect the liver from any increase cirrhotic advancement. Take care and I hope the best for you and your mom.
Randy
Have an Answer?
You are reading content posted in the Cirrhosis of the Liver Community
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
I wanted to mention the standard treatment to prevent variceal bleeding.
All quotes are from the AASLD Practice Guideline for for managing Varices.
'Prevention and Management of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis'
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/Prevention%20and%20Management%20of%20Gastro%20Varices%20and%20Hemorrhage.pdf
Recommendations
8. In patients with medium/large varices that have not bled but have a high risk of hemorrhage (Child B/C or variceal red wale markings on endoscopy),
nonselective -blockers (propranolol or nadolol) or EVL may be recommended for the prevention of first variceal hemorrhage (Class I, Level A).
9. In patients with medium/large varices that have not bled and are not at the highest risk of hemorrhage (Child A patients and no red signs), nonselective -blockers (propranolol, nadolol) are preferred and EVL (banding) should be considered in patients with contraindications or intolerance or non-compliance to -blockers (Class I, Level A).
10. If a patient is placed on a nonselective -blocker, it should be adjusted to the maximal tolerated dose; follow-up surveillance EGD is unnecessary. If a patient is treated with EVL, it should be repeated every 1-2 weeks until obliteration with the first surveillance EGD performed 1-3 months after
obliteration and then every 6-12 months to check for variceal recurrence (Class I, Level C).
11. Nitrates (either alone or in combination with -blockers), shunt therapy, or sclerotherapy should not be used in the primary prophylaxis of variceal
hemorrhage (Class III, Level A).
What this is saying is that all patients with varices should be taking a beta-blocker to prevent the first bleed. It reduces the portal hypertension that we with scared livers have. Why is this important and basic treatment for all cirrhotics? Because once we bleed the chances of future bleeds goes way up. All pretransplant patients that I know use them. I have been taking Nadolol for 3-4 years now and have no bleeds. It is the only proven way to prevent bleeds other than banding which is the next thing to be done before bleeding. Bleeding from varices is a potentially life-threatening complication of cirrhosis. You can actually lose most of the body's blood during a bleed.
'Patients who survive an episode of acute variceal hemorrhage have a very high risk of rebleeding and death. The median rebleeding rate in untreated individuals is around 60% within 1-2 years of the index hemorrhage, with a
mortality of 33%.'
'Nonselective -blockers have no role in the prevention of the development of esophagogastric varices but are the gold standard in the prevention of first variceal hemorrhage in patients with medium/large varices. Endoscopic variceal ligation (banding) has been established as an alternative to nonselective -blockers for the prevention of initial variceal hemorrhage.'
----------------------------------------------------------------------------------
I am glad you are in Memphis where you will be able to see a hepatologist.
Methodist is where Steve Jobs had his liver transplant.
Maybe you can get a referral from your current doctor to have the transplant center do an evaluation so you know what options are available to you.
Methodist University Hospital Transplant Institute
1265 Union Ave.
Memphis, TN 38104
http://www.methodisthealth.org/healthcare-services/transplant-institute/organ-transplant-outpatient-clinic/
Transplant Outpatient Clinic
Pre-Transplant Evaluation
A good candidate for a transplant is determined by a full medical evaluation and input from several medical professionals. The transplant team performs this evaluation in the Pre-Clinic. This team is composed of the transplant surgeon, hepatologist/nephrologist, pre-coordinator nurse, financial case manager, and social worker.
Evaluation Process
The evaluation process begins with a referral from a potential candidate's primary care physician. The candidate then answers a variety of health and lifestyle questions. This information helps the transplant team decide the eligibility of the transplant candidate.
During an initial visit, a transplant candidate will meet with a financial coordinator and a social worker and receive detailed information about the transplant process. For those who are identified as potential candidates, a complete medical evaluation is performed. The medical evaluation is a series of tests dependent upon the specifics of each case. The surgeon reviews the results of this medical examination to further determine eligibility. If the evaluation indicates the candidate is appropriate for transplantation, staff members work with the patient to finalize financial arrangements.
The candidate will receive written confirmation and be listed with the United Network for Organ Sharing (UNOS), a non-profit scientific and educational organization that administers the only national patient waiting list. Once listed with UNOS, patient evaluations must be performed at regular intervals to determine continual eligibility for transplantation. Should an organ become available, it is offered to a patient on the list based on a defined set of criteria established by UNOS.
------------------------------------------------------------------------------------------
Local Support Group
Get the support you need with Living Kindly, monthly support group sponsored by Methodist Healthcare. The group is open to caregivers, family members, transplant candidates, donors and those who have had a transplant. You will have access to knowledgeable speakers discussing a variety of subjects, such as medication side effects, living donation, financial concerns, blood donation and maintaining a healthy lifestyle.
Methodist University Hospital Transplant Institute staff is on hand at each meeting to offer support, share their knowledge and answer any questions you might have. More importantly, other transplant donors and recipients are available to share their transplant experiences or provide mutual peer support to you and your family.
Not a joiner? That's okay. You are welcome to attend and listen. Living Kindly is designed to give donors and recipients access to as much information as possible to assist with their transplantation journey.
The group currently meets the second Thursday of each month in Stratton Auditorium, which is located at Methodist University Hospital (1265 Union Avenue). The class starts at 3:30 p.m., with a medication education session beginning at 3 p.m.
Food and beverages are served and parking is free.
-------------------------------------------------------------------------------
I would highly recommend you meet others who are waiting for transplants. It is a good way to learn a lot and you will see that many others are going through what you are going through.
Cheers!
Hector