Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Fluctuating Hemoglobin Levels?
Question: My Wife is undergoing treatment for PCOS. A Couple of years back she was diagnosed with ITP too after an episode of Dengue. Her Platelet counts then used to be in the range of 95K to 125K. We consulted a Hematologist and after a series of tests came out with the conclusion of ITP. In the meanwhile, her Haemoglobin count too used to go up and down. At one point it went to 8.5 and her Gynaec started Iron Supplements. Regular Blood Counts had been advised for ITP and also one for haemoglobin. We did a blood count four months back. The Haemoglobin levels came back upto 11.5 but the platelet count was at 55K. Post this, we did three Blood Count, once every month and it was 82K, 80K and the most recent one was 58K. My wife is worried considering that the platelet count in decreasing over a period of time. No medication as of yet have been taken for the Platelet count boosting.
Brief Answer:
No treatment is required right now for ITP.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us with your health concern.
I think your main issue right now is the platelet count.
See, your wife has ITP - idiopathic thrombocytopenic purpura.
In this condition, there is no real cause, hence the term ' idiopathic ' which means - cause unknown.
Generally women are likely to develop this condition after an infection, such as dengue, which happened in her case.
Most adults are not treated for ITP unless they have symptoms of bleeding and bruising.
That is not the case with her.
She is asymptomatic.
For such patients, treatment consists of observation, follow up and regular blood counts.
Treatment options include steroids , immunoglobulin injections and surgery ( removal of the spleen ) for very severe cases.
But that is required only if she has severe symptoms of bleeding .
The problem with medication is that once she stops them, the condition might relapse, and one cannot go on taking steroids indefinitely.
So right now the correct thing is being done - observation and follow up.
Please continue that and do not worry, as she is symptom free.
Just remain in constant touch with the Hematologist.
All the best
Please feel free to discuss further.
No treatment is required right now for ITP.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us with your health concern.
I think your main issue right now is the platelet count.
See, your wife has ITP - idiopathic thrombocytopenic purpura.
In this condition, there is no real cause, hence the term ' idiopathic ' which means - cause unknown.
Generally women are likely to develop this condition after an infection, such as dengue, which happened in her case.
Most adults are not treated for ITP unless they have symptoms of bleeding and bruising.
That is not the case with her.
She is asymptomatic.
For such patients, treatment consists of observation, follow up and regular blood counts.
Treatment options include steroids , immunoglobulin injections and surgery ( removal of the spleen ) for very severe cases.
But that is required only if she has severe symptoms of bleeding .
The problem with medication is that once she stops them, the condition might relapse, and one cannot go on taking steroids indefinitely.
So right now the correct thing is being done - observation and follow up.
Please continue that and do not worry, as she is symptom free.
Just remain in constant touch with the Hematologist.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the response. A few questions that come to my mind which if you can answer would be very useful:
1. Even in ITP, can the platelet cont drop from the previous regular range of 100K+ platelet count 2 years back to the 55K to 80K now. Basically my wife is worried looking at the current trend of decreased platelet count as compared to two years back.
2. Can external factors such a Work Pressure, Mental Stress or Physical exertion and those sorts have any effect on ITP?
3. Would any of the PCOS treatment medications such as Diane-35 or Metformin have any effect on the platelet count? Or is this just a coincidence that both these things are happening at the same time.
1. Even in ITP, can the platelet cont drop from the previous regular range of 100K+ platelet count 2 years back to the 55K to 80K now. Basically my wife is worried looking at the current trend of decreased platelet count as compared to two years back.
2. Can external factors such a Work Pressure, Mental Stress or Physical exertion and those sorts have any effect on ITP?
3. Would any of the PCOS treatment medications such as Diane-35 or Metformin have any effect on the platelet count? Or is this just a coincidence that both these things are happening at the same time.
Brief Answer:
As below
Detailed Answer:
Hello again.
1. In ITP, characteristically, the platelet count fluctuates and can vary . So the values that you mention are all due the inherent changes that happen as part and parcel of ITP.
2. Yes, stress can definitely worsen this condition.
Mental stress, tension at work or in personal life can aggravate the scenario.
Physical exertion of moderate degree generally does not have any impact on the platelet count.
3. No, Diane - 35 or Metformin have no impact on the platelet count. It is just random chance.
Hope this clears your doubts.
Take care.
You can contact me directly anytime, using the following link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
As below
Detailed Answer:
Hello again.
1. In ITP, characteristically, the platelet count fluctuates and can vary . So the values that you mention are all due the inherent changes that happen as part and parcel of ITP.
2. Yes, stress can definitely worsen this condition.
Mental stress, tension at work or in personal life can aggravate the scenario.
Physical exertion of moderate degree generally does not have any impact on the platelet count.
3. No, Diane - 35 or Metformin have no impact on the platelet count. It is just random chance.
Hope this clears your doubts.
Take care.
You can contact me directly anytime, using the following link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
