Low-platelet count concerns reader

DEAR DR. GOTT: I read your column in the Shelby (Ohio) Daily Globe and do appreciate the sage advice you give on health matters.

I’m a 73-year-old female who is in seemingly good health. I’m active and do not take any medications except for an occasional sip of Mylanta when I indulge in spicy foods. I see my VA doctor twice a year for a checkup, and she always orders a blood draw — usually a CBC. Mostly, it is normal and agrees with the ranges. However, my platelet count has run low for years. This month it is 137, and monos (whatever that is) were 9.4, which is on the high side. What does it mean?

My doctor does not seem too concerned about it, and I do not wish to take medication if it can be avoided. I feel great, although I do feel tired at the end of the day after taking care of my house and yard. But isn’t it normal to be tired after a day of activity? My HGB fluctuates from 12.5 to 13.1, and my iron count has been low a time or two, but I’m mostly concerned about the low platelet count that has been going on for years.
I have no problems with bleeding when I cut myself. I try to consume a fair diet without too many sweets and starches. I eat vegetables and salads and love fruit. I do not smoke or drink other than to have an occasional glass of wine with dinner. I don’t eat out much. My weight stays around 120 pounds, and I’m 5 feet tall.

DEAR READER: CBC is an abbreviation of a complete blood count. It can determine the number of white and red blood cells you have, your total hemoglobin (HGB), the fraction of blood that composes red blood cells (your hematocrit or HCT) and a great deal more. While relatively similar, lab values can vary between facilities. For example, you indicate your platelet count has run low for years, with the current reading being 137. At my local hospital lab, the range of “normal” is anything between 130 and 400. If you were tested here, you would be considered on the low side of normal, but normal nonetheless. Your monos (standing for monocytes) are slightly high at 9.4. Monos play many roles in the immune system. Readings can indicate something or nothing at all, although a high count usually indicates infection, a response to stress, inflammation and a great deal more.

Because I don’t have your complete report, I am unable to guess at what, if anything, your physician might be testing you for twice each year, but my guess is that she would follow up vigorously if she suspected anything wrong. Be sure to ask her during your next appointment. In the interim, enjoy your good health, eat well, and keep as active as possible. This regimen has obviously kept you on the right track thus far.

On to your last concern: It’s a big responsibility to care for a home or apartment and normal to feel fatigued at the end of the day. There’s “doggone tired” and there’s a genuine “feel-good tired” from doing a good day’s work. That’s the time to sit back, put your feet up, look around with a sense of genuine satisfaction, and smile. Life is good!