From the Research
High platelets in anemia, known as thrombocytosis, can occur as a reactive response to the underlying anemia, and the primary treatment approach should focus on addressing the underlying anemia rather than directly targeting the elevated platelet count. When anemia develops, particularly iron deficiency anemia, the body may increase platelet production as a compensatory mechanism. This reactive thrombocytosis typically resolves once the anemia is treated effectively.
Key Considerations
- For iron deficiency anemia, oral iron supplements such as ferrous sulfate 325mg taken once or twice daily with vitamin C to enhance absorption is recommended 1.
- Treatment should continue for 3-6 months even after hemoglobin normalizes to replenish iron stores.
- For other types of anemia, treatment depends on the specific cause - B12 deficiency requires B12 supplementation, while hemolytic anemia may need steroids or other interventions.
- Regular monitoring of complete blood counts during treatment is essential to track both hemoglobin and platelet levels.
Mechanism and Rationale
The elevated platelets typically normalize gradually as the anemia improves. This relationship exists because the body's response to anemia includes increased production of erythropoietin and other cytokines, which can stimulate megakaryocytes in the bone marrow to produce more platelets alongside efforts to increase red blood cell production 2.
Clinical Approach
It is crucial to identify and treat the underlying cause of anemia, as this will also address the associated thrombocytosis. The most recent and highest quality study 1 supports the use of oral iron supplements for iron deficiency anemia, and this approach should be prioritized in clinical practice.