dehydration - update

[Carthe]

I note on my fbc readings my hct is higher end too which can mean dehydration…. So any thoughts on deyhdration and raised platelets? Can being mildly dehydrated, or in short not drinking enough H2O cause a higher platelet reading? Thank you

[Mirror368]

All I know is if taking Hydroxyurea you are advised to drink a minimum of 64 ounces of fluids daily.

[Carthe in reply to Mirror368]

Thanks for the reply. I’m not on any medication so I suppose my question comes from that perspective…..

[hunter5582]

Platelets count for less than 1% of your total blood volume. RBCs and plasma each comprise a bit less than 50% each of the rest of the volume. Dehydration (severe) does affect plasma levels and possibly hematocrit. Impact on PLT levels would be more minor; however, good hydration is very important when managing a MPN. Everyone should get at least 64oz/day of water. Your kidneys will thank you.

[Carthe]

Thanks Hunter - minor as in 10’s of numbers ?

[hunter5582 in reply to Carthe]

I do not know of a way to calculate exactly how much. Too many different factors. PLTs could go up to some degree but could also go down. Apparently, dehydration can also cause PLT to go down. Here is one reference to this en.wikipedia.org/wiki/Throm... .

Suggest that the best approach is to not find out what impact dehydration is having on your blood cell counts. Do not let yourself become dehydrated. It is bad for your body even if you do not have a MPN. When managing a MPN, good hydration is all the more important.

[Carthe in reply to hunter5582]

However it also says the below for high platelets

Reactive thrombocythemia is the most common cause of a high platelet count. It accounts for 88% to 97% of thrombocythemia cases in adults, and near 100% in children. In adults, acute infection, tissue damage, chronic inflammation and malignancy are the common causes of reactive thrombocythemia. Usually, one or more of these conditions is present in more than 75% of the cases with reactive thrombocythemia. Causes for reactive thrombocythemia in children are similar to adults. In addition, hemolytic anemia and thalassemia are often present in children living in the Middle East. Other causes of reactive thrombocythemia include: post surgery, iron deficiency, drugs, and rebound effect after bone marrow suppression.[

I have been testef for mpns and I have none of them present and have been through various other tests and all negative so I am left in no man’s land!?? Platelets slights raised 450 ish since 2017 on and off sometimes below 400 last test in March 436

[hunter5582 in reply to Carthe]

If you have ruled out all potential causes of reactive thrombocytosis, then that would leave a several explanations: a low-grade triple-negative ET, hereditary thrombocytosis. or perhaps you just naturally run at the high end of platelet levels without it being a diagnosable condition.

It is worth noting that some people just naturally run higher on their baseline platelet levels. It is normal for PLT to cycle by as much a 100K based on what is happening in the body. If someone just naturally rides at the ceiling of the normal platelet count, then something minor could trigger PLT above 450K.

Hereditary Thrombocytosis is a condition that some people have. I do not know much about it other than that it exists. I have no way to know if this is even relevant for you. Here are a couple of references.

onlinelibrary.wiley.com/doi...

ashpublications.org/blood/a...

You are likely already aware of triple negative MPNs. There is plenty of information on this in the literature and a number of others here on the forum with who have a triple-negative MPN.

Please do let us know what you learn as you move forward on the diagnostic process. We can all benefit from your experience. Wishing you all the best.

[Carthe in reply to hunter5582]

Thanks Hunter can I confirm though don’t you numbers have to continue to rise in order for an MPN to be considered . My have remains relatively stable since 2017 around upper 300 to mid 400’s highest recorded being 476 lowest 362/

[hunter5582 in reply to Carthe]

The presence of thrombocytosis (PLT > 450K) is one of the diagnostic criteria for ET.

The WHO diagnostic criteria for ET are as follows. The diagnosis is made if all 4 major criteria are met or the first 3 major criteria and the minor ones are satisfied.

MAJOR CRITERIA

1. Platelet count greater than or equal to 450,000/microliter.

2. The bone marrow biopsy shows proliferation, mainly of the megakaryocytic lineage, with an increase in the number of enlarged, mature megakaryocytes with hyper loculated nuclei. No significant increase or left shift in neutrophil granulopoiesis or erythropoiesis is present, and there is very rarely a minor increase in reticulin fibers.

3. The presentation does not meet WHO criteria for BCR-ABL1 + CML, PCV, myelofibrosis, MDS, or other myeloid neoplasms.

4. + JAK2, CALR, or MPL.

MINOR CRITERIA;

There is a presence of a clonal marker or absence of evidence of reactive thrombocytosis.

Hope you get your diagnosis sorted soo.

[Carthe in reply to hunter5582]

Thanks I’ve seen this but that is it I don’t have a diagnosis and heam isn’t keen on doing a biopsy. He thinks an MPN is unlikely so I’m trying to figure why it’s higher..

[hunter5582 in reply to Carthe]

It would be nice to have an explanation, but sometimes it is just a mystery. Given your profile, it is not surprising that the doc does not recommend a BMB. In the absence of any concerning symptoms, suggest not sweating it too much. It may be that you are just one of those people who naturally rides at the top of the reference range for platelets.

If you get an explanation - great. If not, then it would be best to not stress out about it. Focus on taking good care of your overall health and carry on with enjoying life to its fullest.

[Wyebird]

I think you are right there. I was really really poorly due to ET fatigue. Too tired to get off the sofa and get a drink ( not understanding my condition I phoned for a paramedic ) Something on blood results made me query. I think I was told that not drinking enough can increase platelet count. Everything in the blood becomes more concentrated.

[Wyebird]

Aaagghhh I’ve just googled, it’s not platelets that increase as I just stated, its haemoglobin! That’s what I queried because I’m always anaemic but the haemoglobin was normal which was unusual for me. Sorry

[Carthe in reply to Wyebird]

see attached

Extract from website to show feedback from a dr

[Carthe]

you see I’ve read that dehydration can cause platelets to increase …. It’s confusing

[Carthe]

kjcls.org/journal/view.html...

[ainslie]

Yes it can, dehydration will increase all the counts on your CBC that have L after them. This excludes MCV etc

[Carthe in reply to ainslie]

Have a l after them? What do you mean?

[ainslie in reply to Carthe]

for example on my CBC the range of Haemoglobin is 130-180 g/L the L refers to per litre.

[Carthe in reply to ainslie]

Oh are platelets the same? With a L I mean?

[ainslie]

yes hence sensitive to hydration, if dehydrated your platelets will be higher

[Carthe in reply to ainslie]

Do you notice this with your readings?

[ainslie in reply to Carthe]

yes hydration can make a difference but the thing remember platelets can jump around for other reasons or apparently no reason, up or down a 100 is common and some 200 depending on what the original level was, eg if your platelets are 200 they are unlikely to jump to 400 for no reason but if platelets are 900 a jump to 1100 is fairly common, its always best to follow the trend over say 3 blood tests. They can also go up for MPN progressing a bit , before going on meds mine went from around 300 to 600 over 10 years, now on Rux 200. If its still concerning you , perhaps check with your haem for their view.

[Carthe in reply to ainslie]

ok so for example my numbers are around late 300s to 470 ish could mild dehydration cause this type of increase…

[ainslie in reply to Carthe]

if its say 380 to 470 it is normalish, and 470 is just over normal , good counts if you have a MPN and no meds, most haems wont treat platelets under 1 million unless other risks or symptoms, a variation in platelets can also be for many reasons other than hydration or MPN , best try to not worry about it and keep an eye on trend and if in doubt chat to haem, I doubt he or she will bat an eyelid with those numbers

[Carthe in reply to ainslie]

Sorry I’m probably not being clear I mean platelets are late 300s to 470’s…. I haven’t got an MPN as have been tested and no genes showing I just need to understand why the platelets are raised - hence the question around platelets / dehydration….

[ainslie in reply to Carthe]

I see, I didnt realise your MPN, lucky you, the hydration part applies to anyone , I dont know why your platelets may be raised, I wouldnt assume its anything to be concerned with but one for your docs really

[Carthe in reply to ainslie]

Well I’ve had the blood tests no bmb he doesn’t want to - has signed me back to gp really and now I feel in limbo. Last test in March was 436 so not sure if I should do anything / worry etc….l suppose that’s why im reaching out - what would you do?

[ainslie in reply to Carthe]

what would I do is always a tricky question because I am not you and I dont know your history. from what you have told me I would say get another blood test if last one was March and retest every so often depending on what the result of this one is. In other words monitor it , if they are rising bring it to attention of your GP or haem but in the meantime try not to waste valuable life time worrying about it as there may be absolutely nothing wrong.

[katiewalsh]

Yes, dehydration affects platelet counts & it doesn’t have to be severe dehydration in my experience.

[Carthe in reply to katiewalsh]

Hi Katie thanks for coming back do you know by how much yours are impact?

[katiewalsh in reply to Carthe]

I’ve never been really dehydrated. But just a little dehydrated raises them 10-20 points. If you’re worried they might be willing to run another blood test & you could be well hydrated to see. If you’re on steroids it really raises platelets too.

[Carthe in reply to katiewalsh]

Ok not on steroids but that helps thank you xx

[GSD23]

Platelets being raised can be a sign of raised inflammation. Mine see a significant raise when my RA is flaring.