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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 44395
Experience:  Experienced Oncology Physician trained in New York City. I'm ready to help.
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I am a 34 years old woman, and I am very afraid I may have a

Customer Question

Hello, I am a 34 years old woman, and I am very afraid I may have a serious health problem.For the last 9 months, I got regular platelet count by blood tests. In all the results, the platelets counts are lower than the minimal required number (which is 140 in Quebec, Canada). My number of platelets have varied in this way : on Febuary 19, 134; on April 22, 96; on June 16, 150; on October 11, 138; on October 26, 115, and on November 9, 129. Before having my daughter (3 years ago), the platelets counts were around 200. When I was pregnant of her, the lowest platelet count I had was of 165. Since the blood tests when I was pregnant until Febuary 19, 2016, I haven't been monitored on platelet count.As of medication, I was taking Zoloft (sertraline) at 50mg dose for a year, but I stopped taking it at the month of April.Before the actual situation, I had some periodical pains in my joints, particularly in my hands. I did not have any other specific symptoms. The only thing that can be worth telling you is that I always had more ecchymoses easily than most of people do.On november 7, I have seen a generalist doctor in a private clinic, and she gave me a prescription to go see a hematologist. She did check me out. She checked on my lymph nodes, and she has not felt any difference. She also ckecked my abdomen, and all seemed fine.Since that day, I got a lot more symptoms. I feel that my lymph nodes are swollen, and I feel that they are painful (particularly on right armpit and right neck). I have a loss of appetite, a loss of weight (6 pounds over the last month), and I also have a diarrhea .I am a person who is anxious about my health, that is the reason why I was taking sertraline.Here are my questions :
In your opnion, with the information I gave you, what can be the cause of my symptoms? Can it be cancer ( leukaemia, myeloma or lymphoma) ???
If it is not cancer, can it be an auto-immune disease (but negative ana)?I am joining you the blood tests results I was talking about, except for the ones of November 9. I don't have the results at home.Thank you
Submitted: 4 months ago.
Category: Oncology
Expert:  Dr. David replied 4 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 4 months ago.

I am a cancer doctor.

thanks for uploading your blood tests.

I am not worried about you having cancer.

platelet levels you are having are not in the dangerous or cancerous range.

why did you stop the sertraline? you may need to go back on it if you have bad anxiety symptoms

your testing does not point to cancer or leukemia or myeloma or lymphoma.

your platelet levels are 100% normal and not dangerous.

let me know if you have questions.

Customer: replied 4 months ago.
Hello again;As what I have seen on my results, 96 to 135 of platelet count is considered as below normal (normal starting at 140 in my reports and in litterature). Why do you say that it is normal ? I am really worried about the possiblity of cancer because of those results.Why does the testing do not point to cancer/leukemia/myeloma/lymphoma ?I am also worried about autoimmune disease that are linked to a low platelet count (ex: lupus). Is it a possibility even if my AntiNuclear Antibodies are being tested as negative ?Before my daughter, I had 2 miscarriages. Is it possible that it can be due to the Antiphospholipid Syndrome ?Finally, do you think that the lasts symptoms that occured may be caused by somatization (diarrhea, swollen lymph nodes, loss of appetite, loss of weight) ?Thank you again
Expert:  Dr. David replied 4 months ago.

that "normal" range is a general guidelines

you can be below 140 and still be 100% normal.

leukemia would show up much higher WBC counts of 30-50,000 range WBC or higher.

myeloma would cause overgrowth of plasma cells in your bone marrow and cause very low WBC counts and low hemoglobin

lymphoma would cause enlarged lymph nodes like 3-4cm in size or larger.

Antiphospholipid Syndrome causes blood clots. you haven't had any blood clots.

Customer: replied 4 months ago.
I am also worried about autoimmune disease that are linked to a low platelet count (ex: lupus). Is it a possibility even if my AntiNuclear Antibodies are being tested as negative ? Particularly for the Lupus, I had some more hair loss than the usual (to 150 hair per day) since April 2016. Also, I have some pain (particularly at my hand joints) that comes and goes, but when it's there, it is really painful.Do you think that the lasts symptoms that occured may be caused by somatization (diarrhea, swollen lymph nodes, loss of appetite, loss of weight) ?Finally, before my pregnancy to have my daughter 3 years ago, my platelet count was over 160, and even more when I was younger. If you do not think that the lowering of platelet count is not due to cancer or autoimmune disease, what could cause this ?Thank you very much
Expert:  Dr. David replied 4 months ago.

your platelet levels are not low enough to worry about autoimmune disorders.

your ANA is negative.

you can have more blood tests, but it will not show autoimmune disorder.

severe anxiety can cause diarrhea, loss of appetite and weight loss.

lymph nodes are normal to feel between 1-2cm in size.

it is normal for your platelet levels to vary between 100-450k range.

let me know if you have other questions.

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Customer: replied 4 months ago.
Hello;As of what I have read about Lupus, there is 11 criterias that are markers to say that you have Lupus, and if you have 4 of them, you have high chances to have a lupus. Actually, the first cirteria that I have is to have once a platelet count below 100. The second criteria that I have are the joint pains. With this statement, do you think it is possible that my body is going in direction of a lupus ?And could it be another form of cancer ? At which problem do you associate the pain in the neck and the armpit ?Can the sertraline lower the platelet count of the body ?Thank you
Expert:  Dr. David replied 4 months ago.

you don't have a platelet count below 100.

no, I don't think you are moving into the direction of lupus

your symptoms are not pointing to cancer.

you are probably feeling into your arm pit too much and causing the pain yourself.

sertraline would not lower your body's platelet count.

you are not taking sertraline now.