Nutrition Diet: What supplements should I avoid if my platelets are low?

October 11, 2025 •

4 min read

According to the Platelet Disorder Support Association (PDSA), several supplements have been reported to interfere with platelet levels in individuals with immune thrombocytopenia (ITP). For anyone managing thrombocytopenia, understanding what supplements should I avoid if my platelets are low is a critical step in preventing further complications and maintaining optimal health.

Quick Summary

A low platelet count, or thrombocytopenia, requires caution when choosing dietary supplements. Numerous herbal remedies and some vitamins can have anticoagulant or antiplatelet effects that worsen the condition. Consulting a healthcare provider before adding or removing any supplement is essential to ensure safety and prevent adverse health outcomes.

Key Points

Avoid High-Risk Herbs: Supplements like Ginkgo Biloba, Ginseng, and Feverfew can thin the blood and inhibit platelet function, increasing bleeding risk.
Be Cautious with Vitamins: Supplemental forms of Vitamin E and Niacin can negatively impact platelet levels and should be avoided unless medically advised.
Watch Out for Omega-3s: Very large supplemental doses of Omega-3 fatty acids can have antiplatelet effects, so moderate intake is essential.
Consult a Professional: Always discuss supplements with a healthcare provider, as some can interfere with medications or have negative side effects for those with low platelets.
Consider Dietary Factors: Beyond supplements, avoid or limit alcohol, quinine (in tonic water), aspartame, and cranberry juice, as they can also affect platelet counts.
Support Platelet-Friendly Nutrients: Focus on a diet rich in iron, folate (B9), and Vitamin B12, but consult a doctor for appropriate supplementation.

Understanding Thrombocytopenia and Supplement Risks

Thrombocytopenia, or a low platelet count, is a condition where the blood contains fewer platelets than normal. Platelets are tiny blood cells that help the body form clots to stop bleeding. For individuals with low platelet counts, anything that further inhibits the function or production of platelets can increase the risk of excessive bleeding, bruising, and other complications. Many over-the-counter supplements and herbal remedies, often perceived as harmless, can have unintended and negative impacts on platelet levels and function. It is crucial to be aware of these risks and to discuss all supplements, vitamins, and herbal products with a healthcare provider.

Herbal Supplements to Approach with Caution

Several popular herbal supplements are known for their anticoagulant or antiplatelet properties, which can pose a significant risk for those with thrombocytopenia. The following list includes some of the most commonly cited herbs to be cautious with:

Ginkgo Biloba: This herb is often used for memory and cognitive function but is known to thin the blood and can interfere with platelet function.
Ginseng: Widely used as a vitality booster, certain types of ginseng can inhibit platelet aggregation and may increase bleeding risk.
Feverfew: Primarily used for migraine prevention, feverfew contains compounds that can interfere with platelet activity.
Ginger and Turmeric (in supplemental forms): While small amounts in food are generally fine, supplemental forms of these anti-inflammatory spices can have blood-thinning effects.
Garlic (in supplemental forms): Similar to ginger, supplemental forms of garlic contain compounds that can affect platelet production and aggregation.
Echinacea: This immune-boosting herb is another that has been reported to potentially interfere with platelet levels.
St. John's Wort: This popular antidepressant herb can interact with numerous medications and may affect platelet counts.
Kava and Valerian: These are often used for anxiety and sleep but are also listed among supplements that may interfere with platelets.
Guarana and Pycnogenol (Pine Bark Extract): Both have been cited for potential interference with normal platelet function.

Vitamins and Minerals to Monitor

Beyond herbs, certain vitamins can also be problematic in supplemental forms, especially when taken in large amounts:

Vitamin E: Supplemental Vitamin E can have a blood-thinning effect and interfere with the body's ability to clot blood.
Supplemental Niacin (Vitamin B3): Excessive supplemental intake of niacin can cause a decrease in platelet levels and should be monitored closely.
Vitamin D: Some studies suggest that Vitamin D replacement therapy in deficient individuals can lead to a reduction in platelet counts, a finding that may be beneficial for those with high platelet counts but requires careful consideration in cases of thrombocytopenia.
Omega-3 Fatty Acids (in supplemental forms): While beneficial in moderation, very large supplemental forms of fish oil can have antiplatelet effects and can increase bleeding time.

Comparison of Supplements: Avoid vs. Consider

It can be difficult to distinguish between beneficial supplements and those that pose a risk. The following table provides a clear comparison to help guide discussions with a healthcare provider.


Feature	Supplements to Avoid	Nutrients to Discuss with a Doctor
Primary Effect	Antiplatelet / Anticoagulant	Supports Blood Cell Production
Examples	Ginkgo Biloba, Ginseng, Feverfew, supplemental Ginger, supplemental Garlic, supplemental Vitamin E, supplemental Niacin, supplemental Omega-3s	Vitamin B12, Folate (Vitamin B9), Iron, Vitamin C, Vitamin K
Reason to Avoid	Inhibit platelet function or production, increasing bleeding risk.	Deficiencies can lead to low platelets; supplementation may help under medical guidance.
Potential Interaction	Can interact with prescription medications and worsen thrombocytopenia symptoms.	Crucial for blood cell formation, but supplementation must be supervised, especially for B12 and folate to avoid masking deficiencies.

The Importance of Medical Supervision

Self-prescribing supplements is particularly dangerous when dealing with a condition like thrombocytopenia. A qualified medical professional can help identify the root cause of the low platelet count and recommend the safest and most effective course of action. This may involve adjusting prescription medications or addressing underlying deficiencies. For instance, a Vitamin B12 or folate deficiency can directly cause a low platelet count, and targeted supplementation under a doctor's care would be appropriate. Conversely, simply taking a generic multivitamin with potentially problematic nutrients could be detrimental.

Beyond Supplements: Other Dietary Factors

Dietary choices play a significant role in managing a low platelet count. In addition to avoiding certain supplements, individuals should consider limiting or avoiding:

Alcohol: Excessive alcohol consumption can suppress bone marrow function and reduce platelet count.
Quinine: Found in tonic water and some medications, quinine has been linked to decreased platelet levels.
Artificial Sweeteners (Aspartame): Some reports have linked consumption of aspartame to a lower platelet count.
Cranberry Juice: Certain compounds in cranberries may interfere with platelet aggregation.

Conversely, a balanced diet rich in iron, folate, and vitamin B12 can help support healthy blood cell production. Examples include leafy greens, lean meats, eggs, and fortified cereals.

Conclusion

Managing a low platelet count is a complex medical issue that requires a comprehensive and cautious approach. Knowing what supplements should I avoid if my platelets are low is crucial for preventing serious complications. Individuals with thrombocytopenia should avoid herbal supplements with known antiplatelet effects, such as ginkgo biloba, ginseng, and feverfew, as well as supplemental forms of vitamins like E and niacin. Always consult with a healthcare professional before starting or stopping any supplement or making significant dietary changes. A tailored approach, guided by a medical expert, ensures that any nutritional support aids, rather than hinders, a healthy platelet level and overall well-being. For more information, the Platelet Disorder Support Association provides valuable resources on diet and lifestyle for ITP patients.

Note: The information provided here is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional for diagnosis and treatment of any medical condition.

Frequently Asked Questions

Some supplements, particularly certain herbs like ginkgo biloba and ginseng, have natural anticoagulant or antiplatelet properties. This means they can prevent platelets from clumping together and forming clots, which is dangerous for individuals who already have low platelet counts.

It is best to discuss your multivitamin with a doctor. Some multivitamins may contain certain nutrients, like Vitamin E or Niacin (B3), which can interfere with platelet function. A doctor can help determine if the multivitamin is suitable for your condition.

The primary risk is an increased likelihood of excessive bleeding and bruising. With an already low platelet count, further inhibiting your body's ability to clot can lead to uncontrolled bleeding from minor injuries or even internal bleeding.

Yes. Beyond supplements, you should consider avoiding excessive alcohol, cranberry juice, quinine (found in tonic water), and aspartame. These have all been reported to potentially interfere with platelet levels or function.

You should inform your doctor immediately about any supplements you are taking. Do not abruptly stop taking any medication or supplement without consulting your healthcare provider first, as they can advise on a safe approach if necessary.

No. In fact, deficiencies in certain vitamins like B12 and folate can cause low platelet counts. However, this does not mean all vitamins are safe to take in supplemental forms. For instance, supplemental Vitamin E and Niacin can be problematic.

Generally, yes. The amount of ginger and turmeric used for cooking is typically not enough to cause concern. The issue arises with concentrated supplements that contain much larger quantities of the active compounds.