bleeding

[Birdlady2021]

Hi all I was taking clopidrell blood thinners from few years then I sadly kept heavy nose bleeds so I been taking 75 mg Asprin daily and I notice I have now bleeding gums ! Also got to repeat blood test for Gp I have low folate and low B12 so seeing Gp Thursday ! I have an app coming up for heamatology re ET mpn had since 2015

Many thanks if you can advice

[hunter5582]

Sorry to hear about the issues with bleeding. The increased risk of hemorrhage is as aspect of ET that is intrinsic to the condition. It is a bit of a paradox that people with thrombocytosis experience a risk of both thrombosis and hemorrhage. Aspirin and clopidogrel come with an intrinsic risk of hemorrhage as well. Add to this that as we age our response to aspirin and clopidogrel changes and we are at increased risk for bleeding events.

It may be that you need a dose adjustment for the antiplatelet medication to find a better balance of preventing thrombosis without increased bleeding risk. I used to experience increased bleeding/bruising when my platelet levels were higher and I was taking 81mg aspirin. The MPN specialist took me off aspirin for a time. Unfortunately, I started to experience erythromelalgia. I went back on aspirin but took 1/2 of a chewable 81mg aspirin tab. This worked worked for me for a time. Later, when my PLTs were under better control, I went back to 81mg. It has not been a problem since.

Suggest that you review your situation with your hematologist. Hopefully, you are already seeing a MPN Specialist. This is particularly important when you may need an alteration the the standard ET treatment protocol. Not all docs have the experience to individualize MPN care.

Your plan to follow up with the GP about the low Vit B/folate is good. This deficiency can have significant health impact, including neurologic and hematologic issues. Your hematologist will need to know about the issue as well.

Please do let us know how you get on.

[Birdlady2021 in reply to hunter5582]

Hi HU Hunter , thank you for all your knowledge on my post , I only take 75mg of Asprin and HU for platelets the readings are good at the minute so I’m okay with this drug so far ! Been on it 9 years I’m now 72

[hunter5582 in reply to Birdlady2021]

If the HU has the PLTs in a good range then it is unlikely that is the issue. More likely that it is the aspirin that is the issue. Aging changes how we respond to aspirin and other antiplatelet medications. As my Mother used to say, "Aging is not for sissies."

Hopefully your MPN care team can come up with a better plan to control risk of thrombosis without undue levels of bleeding.

[Itchy-Scratchy]

Hi, on half a 75mg Aspirin for years plus B12 and so far bloods good. I'm 64 this summer.

[william-Indo]

You need to adjust the dose of aspirin.Tray half tablet or one each 2 days.

Do not stop without consult to your doc, as he/she must know every drugs you take to avoid any interaction of your treatment.

Cheers

[Birdlady2021 in reply to william-Indo]

Thank you I speak to my heam on Tuesday morning and will tell her thanks for advise !