NOSEBLEEDS

POSSIBLE CAUSES

Low platelet count may be the cause of frequent nosebleeds, bruises, trouble stoping cuts or wounds from bleeding or bloody gums.

Vitamin K deficiency

Vitamin C deficiency

– Very high blood pressure can cause  nosebleeds as well as other symptoms including irregular heartbeat, tiredness, chest pains, confusion, headaches, ear buzzing, or vision changes.

 

The lining of your nose contains many tiny blood vessels that lie close to the surface and are easily damaged.

The two most common causes of nosebleeds are:

Dry air — when your nasal membranes dry out, they’re more susceptible to bleeding and infections
Nose picking

Anticoagulant (blood-thinning) medications, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDS) used to treat pain can all cause nosebleeds.

Other causes of nosebleeds include:
Acute sinusitis
Allergies
Aspirin use
Hemophilia (and other bleeding disorders)
Blood thinners (anticoagulants), such as warfarin and heparin
Chemical irritants, such as ammonia
Chronic sinusitis
Cocaine use
Common cold
Deviated septum
Foreign body in the nose
Nasal sprays, such as those used to treat allergies, if used frequently
Nonallergic rhinitis
Trauma to the nose
Less common causes of nosebleeds include:

Alcohol use
Hereditary hemorrhagic telangiectasia
Idiopathic thrombocytopenic purpura (ITP)
Leukemia
Nasal polyps
Nasal surgery
Nasal tumor
Second trimester pregnancy
In general, nosebleeds are not a symptom or result of high blood pressure. It is possible, but rare, that severe high blood pressure may worsen or prolong bleeding if you have a nosebleed.

Liver disease, kidney disease, chronic alcohol consumption, or another underlying health condition can lower your blood’s ability to clot and therefore cause your nose to bleed.

Heart conditions like hypertension (high blood pressure) and congestive heart failure can also cause nosebleeds, as can hypertensive crisis — a sudden, rapid increase in blood pressure that may be accompanied by a severe headache, shortness of breath, and anxiety, according to the American Heart Association (AHA).

 

Colds, allergies, and frequent nose-blowing can also irritate the lining of your nose, resulting in a nosebleed.

Allergic rhinitis: Allergic rhinitis are a group of symptoms that affect the nose, that is, when you inhale something you are allergic to, for example, dust, pollen, dander, or even certain foods. Early symptoms of allergic rhinitis include itchy nose, skin, throat, and eyes; sneezing, watery eyes, runny nose which later develops into stuffy nose. Researchers at University of British Columbia, Canada, found that allergic rhinitis is associated with recurrent nosebleeds in children. These nosebleeds occur due to nasal symptoms plus blood clotting disorders, they suggest.

Barotrauma: When you are flying or driving up the mountains, you may have noticed how your ears starts ‘blocking’. This discomfort is because of difference of pressure between the inside and outside of the ear and is called barotrauma. So, what does this have to do with nosebleeds? Well, if you have a congested nose from allergies, colds, pharyngitis, laryngitis, or other upper respiratory infections, you are more likely to develop barotrauma and hence the nosebleeds. Barotrauma can also occur if you have a swelling in the throat, or if you have congenital blockage of Eustachian tube (connecting the middle ear to the back of the nose and upper throat).

Juvenile angiofibroma: This is a benign (non-cancerous) tumor occurring in the back of the nose or upper throat. It’s a rare type of disorder occurring exclusively in boys aged 7 to 19. The symptoms include frequent and prolonged nose bleeds, easy bruising in nose, difficulty breathing through nose, bloody nasal discharge, and loss of hearing. Surgery may be required if the tumor grows large enough and blocks one’s airways.

Hereditary haemorrhagic telangiectasia: Also called the Osler-Weber-Rendu syndrome, the condition is an inherited disorder in which abnormal blood vessels develop across several areas in the body such as brain, lungs, liver, intestines, etc. When this type of blood vessels develop on the skin it is called telangiectasia. Frequent nose bleeds in children is one of the main symptoms of this syndrome. Other symptoms include port-wine stain (birthmark) and shortness of breath.

Chemical irritants: Exposure to chemicals such as sulphuric acid, ammonia, gasoline and other chemical irritants can sometimes cause nosebleeds. Such type of nosebleeds are common in people who work in chemical factories or work places that use these chemicals. And yes, cigarette smoke is another chemical that may cause nosebleeds not only in the one who smokes but even those inhaling secondhand cigarette smoke.

 

TREATMENT

dry air that contributes to your nosebleeds is to buy a humidifier for your home. You also could try a product called Ayr, a saline nasal gel sold in drug stores; just squirt a little in your nose. Other options are to rub some Vaseline, liquid vitamin E, or aloe gel in your nose. You can also take vitamin C, which decreases the fragility of small blood vessels. The dose is 200 milligrams twice a day. Yet another possibility is grape seed extract or a proprietary pine-bark extract called Pycnogenol; these are sources of anthocyanin pigments that have the same effect. All are worth a try.

Rutin

Bioflavonoids

Frequent nosebleeds may be improved by regularly applying a small amount of raw organic coconut oil to the inside of your nostrils

Vitamin C prevents a condition known as scurvy, a symptom of which is excessive bleeding such as nose bleeds. Vitamin C is also important for strengthening blood vessels, including those on the inside of the nose that can burst to trigger nose bleeds.

The best food sources of vitamin K are leafy green vegetables such as Spinach or Kale. Apart from that also the following are high in this vitamin: Spirulina, Broccoli, Brussels sprouts, Cabbage, Cauliflower, Soybeans, Lettuce, Asparagus, Collard greens, Bok Choy, Green peas, Parsley, Lentils, Split peas

Dandelion Greens: 1 cup raw: 430 mcg, Swiss Chard 1 cup raw: 300 mcg, Spring onions 1 cup: 200 mcg, Brussel Sprouts 1 cup raw: 155 mcg, Turnip Greens, 1 cup: 138 mcg, Spinach 1 cup: 145 mcg, Kale
1 cup raw: 112 mcg, Broccoli 1 cup: 92 mcg.

 

 

Vitamin B12 or folate (vitamin B9) deficiency can both cause mild to moderate low platelet counts. Taking supplements is one way to help resolve this, but the better option is to get enough of these nutrients to begin with. Vitamin B12 deficiency is thought to be one of the leading nutrient deficiencies in the world, and being low in folate puts you at risk for not only having low platelets, but also experiencing pregnancy complications, heart problems and fatigue. Thus, you should consume foods with these vital nutrients:

  • Some of the best sources of vitamin B12 include beef, chicken liver, salmon, tuna, yogurt and turkey.
  • The top folate foods include beans. lentils, spinach, asparagus, avocado and beets.

Aside from making sure to get enough B12 and folate, focus on generally eating an unprocessed, balanced diet to raise immunity against viruses or infections and help your organs detoxify your body of chemicals you encounter. Fresh fruits and vegetables are especially important for meeting your nutrient needs, includin: leafy greens, berries, cruciferous vegetables, fresh herbs and spices.

According to the Platelet Disorder Support Association, about 40 percent of people with low platelet counts reported some improvement in their bleeding symptoms and their platelet counts after following either the macrobiotic diet or the diet recommended in the book “Eat Right for Your Type” by Dr. Peter J. D’Adamo. These recommendations include eating more fresh foods as described above, avoiding packaged/processed foods, and limiting or eliminating dairy, low-quality meat and added sugars. (2)

 

Vitamin K is most well known for being responsible for bone building and blood clotting. Blood would not clot without vitamin K because the vitamin activates the protein that is responsible for forming clots within the blood.

The vitamin K that we are able to absorb from our diet is related to the intestinal bacteria that we have, so your current vitamin K levels can depend greatly on the gut or digestive health. Vitamin K ia also one of the most crucial vitamins for preventing heart disease. Studies have shown that individuals who increase their intake of dietary Vitamin K have a lower risk of cardiovascular mortality. This is why vitamin K deficiency can be so dangerous. However, before supplementing vitamin K there are a few things you should know.

Vitamin K Types

There are two main types of vitamin K that we acquire from our diets: vitamin K1 and vitamin K2. Vitamin K1 is found in vegetables, while vitamin K2 is found in dairy products and is produced by the bacteria in your gut. The best way to get the daily requirement of vitamin K is by eating foods that are rich in the vitamin, like green leafy vegetables, broccoli, cabbage, fish and eggs.

There is also a synthetic version of vitamin K which is called vitamin K3, but I do not recommend getting your required vitamin K this way. Instead, eat plenty of whole foods that are high in vitamin K and other important nutrients too.

 

Vitamin K
When it comes to bleeding, getting enough vitamin K in your diet is important. This vitamin ensures that your blood clots normally; when you experience a deficiency, you may bleed excessively, including nose bleeds. You may be especially at risk of a vitamin K deficiency if you have liver disease, burns or celiac disease. Mostly people get the vitamin K they require from liver and green vegetables, but if you need more to meet your needs, you may take a supplement. Adults require 90 to 120 mg of vitamin K each day.
Potassium
The potassium in your diet regulates the fluids in your body, including the amount of water your body contains. Without enough potassium, you may risk dehydration, and this can cause your body tissues to dry out — including the tissues on the inside of your nose, which can trigger nose bleeds. Your body requires 2,000 mg of potassium each day to combat dehydration. You can take potassium supplements or eat bananas, avocados and tomatoes.

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Vitamin C
Vitamin C plays an important role in decreasing your risk of nose bleeds. Vitamin C prevents a condition known as scurvy, a symptom of which is excessive bleeding such as nose bleeds. Vitamin C is also important for strengthening blood vessels, including those on the inside of the nose that can burst to trigger nose bleeds. Include 75 to 90 mg of vitamin C in your diet each day, whether from vitamin supplements or the foods you eat.
Iron
Get more iron in your diet to prevent nose bleeds. An iron deficiency, sometimes triggered by blood loss, can cause anemia. This condition causes lethargy and easy bruising due to an increased risk of bleeding. This bleeding can also take the form of nose bleeds. While organ meats, red meat, seafood, whole grains and molasses can provide the bulk of the 8 to 18 mg of iron you need each day to prevent anemia and nose bleeds, an iron supplement can ensure you get the amount your body requires.

 

2. Decrease or Eliminate Alcohol and Sugary Drinks

Heavy drinkers are at a higher risk for having low platelet counts since alcohol slows the production of platelets. According to a report in the journal Alcohol, Health and Research World, heavy alcohol consumption can cause generalized suppression of blood cell production and the production of structurally abnormal blood cell precursors that don’t function properly to clot blood. Research shows that a percentage of alcoholics have defective red blood cells that are destroyed prematurely, as well as abnormal levels of white blood cells and higher likelihood to have autoimmune reactions and frequent bacterial infections. Thrombocytopenia affects up to 43 percent of alcoholics who eat normally and up to 80 percent who do not. (3)

Everyone responds to drinking alcohol differently, so you need to consider your unique situation and medical history to know how much alcohol your body can tolerate without complications. A general recommendation for healthy adults is to have no more than one to two drinks per day (one for adult women, two for men), so those with low platelets should have even less. Avoiding sugary, processed drinks is also helpful since these tend to have lots of chemicals that can also disturb normal platelet production, including artificial sweeteners like aspartame, synthetic colors and preservatives.

3. Reduce Exposure to Toxic Chemicals

Chemicals, such as pesticides found in non-organic produce, mercury from certain seafood, arsenic and benzene, can slow the production of platelets. Tips for helping you lower your exposure to these harmful chemicals include:

  • buying mostly organic produce whenever possible
  • using natural cleaning products and beauty products, such as those made with essential oils instead of synthetic ingredients
  • painting your home with low volatile paints
  • growing some of your own food in a garden using organic fertilizers
  • avoiding burning chemical sprays, fragrances or candles
  • using glass or ceramic containers to store leftovers instead of those made with plastic or BPA aluminum toxins, and never heating food up in plastic
  • avoid eating large fish that are high in mercury (like big tuna, shark or swordfish), getting mercury fillings or amalgam fillings in your teeth, or using mercury thermometers

 

 

4. Decrease or Stop Using Painkilling Drugs

Over-the-counter painkillers like aspirin and ibuprofen can thin your blood and affect your platelet levels. While they do reduce pain, they can also raise your risk for bleeding disorders when used too frequently. How much is too much? It depends on the person, but if you rely on taking these almost every day you might experience any number of adverse side effects.

They might not work as quickly, but you can help manage pain naturally by improving your diet and lowering inflammation. Exercise and anti-inflammatory supplements also help, including omega-3 fish oil, turmeric, frankincense/boswellia and peppermint essential oil.

5. Take Helpful Supplements and Herbs

Aside from vitamin B12 and folate described above to help prevent deficiencies, and anti-inflammatories for controlling pain, there’s evidence that people with low platelet counts can also benefit from taking or consuming more of the following: (4)

  • Vitamin D plays a valuable role in the function of hematopoietic stem cells in bone marrow that produce platelets, plus can help manage autoimmune diseases. Vitamin D is best aquired through sunlight and exposure of sunshine on your bare skin.
  • Vitamin K is needed for proper blood clotting, has anti-inflammatory properties and has been shown to help control bleeding disorders, so consume vitamin K-rich foods.
  • Sea vegetables (chlorophyll/algae/seaweed) help bind to heavy metals, can raise immunity and provide many nutrients people tend to be deficient in.

6. Protect Yourself from Injuries and Infections

For people who already have been diagnosed with low platelet counts, avoiding injuries and infections is important, since both can worsen autoimmune reactions, spleen enlargement and trigger excessive bleeding. Be careful to avoid injuries related to sports, work, exercise or operating machinery.

Most experts recommend that people with low platelet counts avoid contact sports, such as boxing, football, skiing or karate, which can cause bleeding. Protect your spleen by avoiding exposure to infections and viruses as much as possible, which means staying away from sick family members or co-workers and keeping children with low platelet counts out of day care facilities.

7. Help Treat Bruises Naturally

If you have low platelet counts that cause bruising or redness on your skin, try this homemade bruise cream made with natural, soothing ingredients like frankincense, shea butter, jojoba oil and coconut oil.


Low Platelet Count vs. High Platelet Count

Here is how platelet counts are normally defined: (5)

  • normal platelet count: between 150,000–450,000 platelets per microliter of circulating blood
  • low platelet count: anything under 150,000 platelets per microliter of circulating blood is considered low (if the platelet count falls below 20,000 per microliter, spontaneous bleeding may occur and is considered life-threatening)
  • high platelet count: above 450,000 platelets per microliter is high — at this point your doctor will likely look for an underlying condition

Having abnormally high platelet counts is referred to as thrombocytosis. An underlying condition of high platelets could be an infection, or it could be due to a blood and bone marrow disease, which makes the causes similar to those of low platelets. Symptoms include headaches, dizziness or lightheadedness, chest pains, and weakness. Both high and low platelet counts are treated similarly and depend on what’s causing them in the first place. Usually changing someone’s medications, diet and nutrient intake can help both conditions, or making sure to identify any underlying infection or autoimmune disorder.


Low Platelet Count Symptoms

The most common signs and symptoms of a low platelet count include: (6)

  • Prolonged bleeding from cuts or wounds
  • Easily becoming bruised or developing excessive bruising (called purpura, which shows up as purple, blue or brown marks under the skin)
  • Bleeding under the skin that appears as a rash of small spots (petechiae), most likely to develop on the legs
  • Bleeding gums and gum disease (this can happen while you brush your teeth or other times)
  • Having nosebleeds
  • Finding blood in urine or stool (stool can appear as red blood or as a dark black-gray color)
  • Having heavy menstrual flows
  • Feeling tired and fatigued often
  • Having frequent headaches
  • Developing an enlarged spleen, which can cause pain in the abdomen and tenderness
  • Developing a yellow color of the skin (jaundice)

The most obvious sign or symptom of a low platelet count is bleeding that cannot be stopped using normal interventions, like holding a compress against the wound/cut. Some people with find out they have low platelet counts after getting their annual physical exam results, while others might experience a fall or injury and seek help due to a large amount of bleeding.

It’s possible that some people have ITP (the type of low platelets that’s an autoimmune disease) in their systems and aren’t aware of it until something triggers bleeding and raises suspicion, leading to them visiting their doctor — at which point they receive a diagnoses.


How Low Blood Platelet Counts Develop

Platelets in the blood are constantly renewed by bone marrow, and counts stay normal and consistent through a process of ongoing production and destruction. In healthy people, platelets wind up dying off after about 10 days, at which point they’re replaced by new ones. But in people with low platelets, there are either less platelets being produced, or a faster removal of platelets, which keep counts abnormally low.

Bone marrow is the sponge-like tissue inside the bones, which contains very valuable cells called stem cells. Stem cells mature and develop into various types of blood cells, including red blood cells, white blood cells and platelets. Someone who experiences damage to stem cells inside the bone marrow isn’t able to make the necessary blood cells and platelets needed to properly clot blood. People with normal blood platelet counts have between 150,000–450,000 platelets per microliter of circulating blood, but those with low counts can have much less.

According to the American Society of Hematology, thrombocytopenia can be caused by genetic/inherited factors or as a side effect of people’s lifestyles, including the medications they take, their diets and their medical histories, which all affect how their spleens and bone marrow function. (7) Genetic mutations can cause thrombocytopenia due to diminished production or shortened life span of platelets related to alterations in transcription factors, cytokines, cell surface receptors and signaling molecules.

In cases where low platelet counts are acquired but not inherited (the person wasn’t born with the condition but later developed it), something in that person’s life causes abnormal changes in how bone marrow and the spleen produce, release and destroy platelets in the blood.

Low platelet counts occur when circulating platelets either:

  • aren’t released by the spleen normally (the spleen can hold on to them or they can become trapped)
  • aren’t produced in high enough amounts by the bone marrow to begin with
  • are produced normally by bone marrow, but then there’s an increased destruction of platelets
  • some combination of these factors above occur

 

 


Low Platelet Count Causes (Thrombocytopenia)

Wondering what causes the abnormalities described above? According to the National Heart, Lung and Blood Institute, some of the most common underlying reasons for alternations in normal blood platelet counts include: (8)

  • Enlarged spleen: The spleen helps fight infections and clean the blood, so illnesses that cause an enlarged spleen can cause too many platelets to become trapped inside while the body tries to fight off bacteria or a virus. In healthy people, around one-third of the body’s platelets are held in the spleen, but conditions like liver disease/cirrhosis prevent scarring, which keep platelets harbored inside.
  • Reactions to medications and over-the-counter drugs: Platelet production can be altered due to the use of drugs, including diuretics, NSAID anti-inflammatory drugs and antibiotics, or frequently taking common painkillers like ibuprofen and aspirin. (9)
  • Autoimmune diseases: Diseases like lupus and rheumatoid arthritis cause the immune system to mistakenly attack and destroys platelets. This is called immune thrombocytopenia or ITP. (10)
  • Alcohol: Alcohol  slows the production of platelets and is the biggest problem when it’s consumed excessively, especially if someone’s diet is also low in nutrients.
  • Poor diet and nutrient deficiencies: Certain nutrients are needed to make enough platelets, including iron, vitamin B12 and folate. Being deficient in these nutrients can change how many are produced and able to survive for normal time periods. The Platelet Information and Blood Testing Labrotory recommends making sure you get enough of these nutrients through your diet in addition to calcium, vitamin K and vitamin D. (11)
  • Infections and viruses: Rarely, severe bacterial infections involving the blood cause a pause in platelet production. Viruses that can change how platelets are renewed include chickenpox, mumps, rubella, hepatitis, HIV/AIDS and certain other rare viruses. Most of the time common viruses only alter blood platelets temporarily, but some serious viruses like AIDS can permanently cause damage.
  • Toxin exposure from the environment: Chemicals commonly found in the environment, including pesticides, arsenic and benzene, can all slow the production of platelets.
  • Pregnancy: Sometimes pregnant women temporarily experience slowed platelet production, but this is usually mild and goes away after the baby is born. Estimates show that around 5 percent of pregnant women develop mild thrombocytopenia at some point during their pregnancies.
  • Genetics: Certain conditions that run in families and are inherited cause low platelet counts, including Wiskott-Aldrich and May-Hegglin syndromes.
  • Cancer: Leukemia or lymphoma directly damage bone marrow and destroy blood stem cells, but also most common cancer treatments (radiation and chemotherapy) destroy stem cell even more. (12)
  • Aplastic anemia: When the bone marrow stops making enough new blood cells, called aplastic anemia, it causes a low platelet count.

Low Platelet Count Takeaways

  • Having a low platelet count — a condition called “thrombocytopenia” — is a problem with normal blood clotting and bruising that results from having low levels of thrombocytes, colorless blood cells produced by bone marrow.
  • Common signs and symptoms of a low platelet count include prolonged bleeding form cuts or wounds, easily becoming bruised or developing excessive bruising, bleeding under the skin that appears as a rash of small spots, bleeding gums and gum disease, nosebleeds, blood in urine or stool, heavy menstrual flows, feeling tired and fatigued often, frequent headaches, enlarged spleen, and jaundice.
  • Low platelet counts occur when circulating platelets either aren’t released by the spleen normally, aren’t produced in high enough amounts by the bone marrow to begin with, are produced normally by bone marrow but then there’s an increased destruction of platelets, or some combination of these factors occurs.
  • Low platelet count causes include an enlarged spleen, reactions to medications and over-the-counter drugs, autoimmune diseases, alcohol, poot diet and nutrient deficiencies, infections and viruses, toxin exposure, pregnancy, genetics, cancer, and aplastic anemia.
  • Once a diagnosis has been made, you can use the following recommendations to help raise your blood platelet counts, manage symptoms and prevent complications from developing: improve your diet, decrease or eliminate alcohol and sugary drinks, reduce exposure to toxic chemicals, decrease or stop using painkillers, take helpful supplements and herbs, protect yourself from injuries and infections, and help treat bruises naturally.

 

 

 

Self-care steps for occasional nosebleeds include:
Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach.
Gently blow your nose to clear out any clotted blood. Spray a nasal decongestant in the nose.
Pinch your nose. Use your thumb and index finger to pinch both nostrils shut, even if only one side is bleeding. Breathe through your mouth. Continue to pinch for five to 10 minutes. This maneuver puts pressure on the bleeding point on the nasal septum and often stops the flow of blood.
Repeat. If the bleeding doesn’t stop, repeat these steps for up to a total of 15 minutes.
After the bleeding has stopped, to keep it from starting again, don’t pick or blow your nose and don’t bend down for several hours. Keep your head higher than the level of your heart.

Tips to help prevent nosebleeds include:
Keeping the lining of the nose moist. Especially during colder months when air is dry, apply a thin, light coating of petroleum jelly (Vaseline) or antibiotic ointment (bacitracin, Neosporin) with a cotton swab three times a day. Saline nasal spray also can help moisten dry nasal membranes.
Trimming your child’s fingernails. Keeping fingernails short helps discourage nose picking.
Using a humidifier. A humidifier will counteract the effects of dry air by adding moisture to the air.