Dr. Roach: ‘Super platelet donor’ concerned about high platelet count

Dear Dr. Roach: I am a 58-year-old female in reasonably good health. When I was young, I donated blood several times and would have continued to do so, had I not become ineligible due to living in England during the mad cow disease outbreak. I happened upon something recently stating that this particular disqualifier has been lifted — so much to my delight that I made a blood donation.

The American Red Cross was delighted, too! My blood type is AB negative, and I learned that it is the universal donor type for platelets. The Red Cross reached out to me by phone, text and email to encourage me to make a platelet donation, which I did.

After my donation, I was able to track where my platelets and plasma went. (Very cool!) I also received a card in the mail telling me that I was a “super platelet donor” because I had a high platelet count (no specifics mentioned). At first, I thought that must be a good thing, but researching “a high platelet count” made me think: “Oh, no!”

My last two complete blood count tests had my platelet count at 265,000 and 278,000 (the oldest was done in 2023), which was middle-of-the-road, according to the normal range given. I have two concerns: Should I see my doctor right away about this? Are there any health risks to donating platelets? The Red Cross wants me to do it quite frequently. 

— Anon.

Dear Anon.: People with any blood type are encouraged to come donate blood or blood products, such as platelets and plasma. But you are right that you, like only 3% of the population, are the ideal platelet and plasma donor.

Most people know that O negative is the universal blood donor. They don’t have the A, B or D (formerly called Rh) antigens in their red blood cells, so their cells can be given to anyone. In the case of platelets and plasma, what the blood bank is trying to avoid are antibodies. People with an AB blood type (both AB positive and AB negative) have no A or B antibodies, so their plasma and platelets are the safest. AB positive is the best of the best, but as you saw, they are very happy to have an AB-negative donor like you.

I think there was a miscommunication about what a “super platelet donor” means. It means you are doing a great job donating platelets, not that there is anything abnormal about your platelet count.

There’s no rush to see your doctor. I confirmed with the Red Cross today that if your platelet count were abnormally high, they would let you know. The normal platelet count in adults is 150,000 to 350,000. (That’s thousands of platelets in a microliter of blood.) A single platelet donation is then about 3.5 billion platelets!

Many repeated platelet donations can cause a small and temporary decrease in blood platelet counts. For this reason, the Food and Drug Administration limits platelet donations to no more than 24 times in any 12 months. 

Readers may email questions to ToYourGoodHealth@med.cornell.edu.