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Q #1: High Platelets & Supplementation
My platelets are high -- 377. The reference range that the lab gave is 150-350. What causes this and how can I correct this problem? (October, 2000)
A: Diana Peabody, RD responds:
I have discussed this question with our Infectious Disease specialist. His opinion is that this value is really not abnormally high. In fact at our laboratory the normal range is up to 390. Elevated platelets can occur due to a stress response or inflammatory condition as well as a number of serious medical conditions. These mildly elevated platelets are not likely a nutritional issue and should be discussed with the HIV doctor. Should they continue to rise, further investigations as to the underlying cause of the problem is needed.
There are some nutritional interventions to deal with physiological stress including: 1) Eat well to get a solid foundation of nutrients. 2) Get enough protein (about 0.5 grams protein per pound body weight). 3)Increase antioxidant protection: Some options with good antioxidant activity are fruits and vegetables with lots of color, 400-800 IU vitamin E, 500-1000 mg vitamin C, 30-60 mg coenzyme Q10, 100-200 mcg selenium, 100-600 mg alpha lipoic acid, and 1000-2000 mg n-acetyl cysteine. How many of these to take depends on the pill count and finances. At least take the vitamin C and E to get the basics covered. 4) Whey protein powder is a good way to increase protein intake and may enhance glutathione levels.
Q #2: Low Platelets & Supplementation
My platelet counts have been low for many years now. Recently, with the addition of HU (hydroxyurea) to my HAART regimen, my platelets seem to be getting worse. They are not in the danger zone yet, but I would like to know if any type of supplementation could arrest this decline. Thanks. (November, 1998)
A: Charlie Smigelski, RD responds:
For treatment regarding platelets, I approach the issue in two ways ...
1. I would be certain that a person is on an aggressive antioxidant supplement regimen, so that free radical (stray electron) damage is not causing excessive destruction of platelets. This includes 800IU vitamin E, 1-2 grams vitamin C, 200 mcg selenium, and 10,000+ IU's beta carotene (from foods, like spinach, carrots, broccoli, apricots, and winter squash). Glutamine 5-10 grams a day is good too. (See NAC below).
2. I would look at the supply side....are there plenty of nutrients available for platelet production? In this case, we are looking at adequate levels of protein (1.5 grams protein/kg of ideal weight) and calories (17 calories/lb of ideal weight), and especially adequate levels of B-complex vitamins, including 25-50 mg/day of B6 and 800 micrograms/day of Folate. B12 is important, but should be adequate in the C-complex 25 or complex 50 pill. Len Herzenberg at Stanford once mentioned taking supplemental N-Acetylcysteine(NAC) to restore low platelets, and a while ago I asked a colleague to confirm the dose. I have not yet gotten a response. So far I would recomment 2 grams a day.
3. Drugs like AZT can hinder platelet production as well. Some studies suggest that the 800 IU of vit E should offset some of that damage to bone marrow by AZT. In cancer care, 100mg/day Co-Enzyme Q10 can reduce toxocity of drugs like Adriamycin, given in chemotherapy. I have not yet read about using it for HIV drug toxocity. It has energizing benefits in HIV care, and is an antioxidant as well as an immune cell (PBMC) fuel. One side note, it is PBMC's that can stimulate CD4 cell production, and I wonder about using C0-Q10 in this way for immune reconstruction).
