Hi XXXXXXX.

Thanks for posting your query.

After going through your history, I would like to comment the following:

1. You are a diagnosed case of ITP since 3 years of age and are currently on prednisolone (short course) and calcium which is a conventional treatment of your condition.

2. Sexual intercourse will not affect your platelet count. If however your platelet counts are low at times then the risk of local bruises following intercourse are increased.

3. Coming to dietary suggestions in ITP:
A. Here is a short list of the foods to avoid:
Avoid all greasy foods
Avoid margarine and mayonnaise
Avoid all fried foods
Avoid all types of fast foods
Avoid too much protein
Avoid high sugar content foods and refined starches
Avoid alcoholic beverages which can damage bone marrow. Reduce the amount of blueberries, red/purple grape products, garlic, onions, ginger, ginseng, and tomatoes. These foods can interfere with blood clotting.
Avoid canned and frozen foods and leftovers. The nutritional value of food deteriorates with time. A wide variety of food assures your body gets the variety of nutrients it needs.

B. Foods that will help increase platelets:
Fresh fruits and vegetables.
Wild salmon, flax seed oil, cod liver oil (all contain omega 3 fatty acids)
Diet XXXXXXX in vitamin B12 and folic acid such as spirulina, milk, pulses, amaranth, drumstick leaves may be helpfull in platelet production.

However remember no formal scientific study has been reported on diet and platelet counts till date.

4. Regarding the insomnia, it seems to be a side effect of short term wysolone.
For this you first need to follow sleep hygiene habits- going to bed on time, no drinking caffeine or tea at bed time, using your sleeping bed exclusively for sleeping and not for other purposes like watching tv or reading and so on. Most importantly you need to be relaxed and stress free. If inspite of these habits you are having insomnia then you may take a sedative anxiolytic medication under prescription from your physician.

I hope I have answered your query. I will be glad to answer any follow up queries.
Please accept my answer if you have no follow up queries.

Take care.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

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Hi,

Thanks for the follow up.

After going through your follow up history , I would like to comment the following:

1. Adults with platelet counts >50,000/mm3 seldom require treatment. Treatment is indicated for adults with counts < 50,000/mm3 with significant mucous membrane bleeding. Treatment also is indicated for those adults with risk factors for bleeding (eg, hypertension, peptic ulcer disease, vigorous lifestyle) and in patients with a platelet count < 20,000-30,000/mm3. Thus as correctly mentioned by your physician any count above 0000/mm3 should not worry you.

2. You need to regularly follow-up with your physician in order to assess for a potentially reduced platelet count.Also because of the increased risk of bleeding, you should avoid aspirin products.

3. Follow a healthy life style. Do not neglect any physical symptom if it develops especially easy bruisability, gum bleeding. Do monitor your BP regularly.

I hope I have answered your query. I will be glad to answer any follow up queries.
Please accept my answer if you have no follow up queries.

Take care.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

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