Immune Thrombocytopenia (ITP)


Immune thrombocytopenia (ITP) is an autoimmune condition affecting the blood. The immune system attacks normal platelets, decreasing the number of functional platelets circulating in the bloodstream. This disorder increases the risk of bleeding and bruising, which lead to purpura, among other symptoms of ITP.1 

Dietary Recommendations for People with ITP

No scientific evidence shows that any particular foods or diet increase platelet count; however, certain foods are recommended to ease the symptoms of ITP.

The Platelet Disorder Support Association (PDSA) conducted a survey about nontraditional treatments for ITP. The survey results indicated that 40% of patients with ITP reported improvements in bleeding symptoms and platelet counts following the consumption of a macrobiotic diet or the specific diet recommended in Eat Right for Your Type by Peter J. D’Adamo, ND, MIFHI. In contrast, people with ITP demonstrated less success with diets such as the Atkins and Zone diets.2

PDSA recommendations include2:

  • Higher intake of fresh, whole foods, such as fruits, vegetables, nuts, legumes, and whole grains
  • Higher intake of leafy green vegetables, such as collard greens, spinach, kale, and seaweed, which contain high amounts of vitamin K, calcium, and other minerals to support clotting and potentially reduce fatigue
  • Healthy fats, such as olive and canola oils in cooking and baking
  • Organic foods that are not treated with chemicals like pesticides, herbicides, or insecticides, which are associated with exacerbations of autoimmune diseases and reduced platelet levels

Avoidance of certain foods may also decrease or prevent worsening of ITP symptoms. PDSA recommendations for foods and beverages to avoid include2:

  • Additives and preservatives that increase free radical production
  • Canned, frozen, and leftover foods with decreased nutritional value
  • Highly processed foods, such as white flour, white rice, and certain processed grains
  • Sugar, dairy products, fried foods, and hydrogenated, partially hydrogenated, or trans fats that increase free radical damage
  • Alcohol, which can lead to bone marrow damage
  • Foods that impair blood clotting, such as blueberries, ginger, red/purple grapes, ginseng, tomatoes, garlic, and onions
  • Quinine, as it may decrease platelet counts

Read more about ITP care team

The Macrobiotic Diet

George Ohsawa, a Japanese philosopher, formulated the macrobiotic diet in the 1920s, attesting that following a simple, healthy diet can reduce serious illness and cancers, although as yet, no research has studied this theory.3 

People following the macrobiotic diet avoid foods containing toxins, such as processed foods, foods with artificial colors, preservatives, or flavors, and any vitamin or mineral supplements. Avoidance of caffeinated beverages and flavored water or teas is also recommended.3

The bulk of the macrobiotic diet comes from organic whole grains (50% of intake), locally grown organic fruits and vegetables (up to 25% of intake), and soups containing seaweed, beans, lentils, fermented soy, and fresh vegetables (up to 25% of intake). Small servings of nuts, seeds, pickled vegetables, and organic fish and meats also may be consumed.3 

Many followers of the macrobiotic diet become vegan, avoiding dairy and meat products, while others consume small amounts of organic fish and meat. The macrobiotic diet is viewed as a complementary treatment.3

Food preparation is also important. Microwaves and cooking with electricity should be avoided. All food products should be cooked, eaten, and stored using wood, glass, china, or stainless-steel pots, utensils, or containers. Water used for drinking and cooking should be purified.3

Read more about ITP treatment

Studies on ITP Diet and Nutrition

Recently published results from a randomized controlled trial showed that a Mediterranean diet allowed people to maintain platelet counts at normal levels. This was evidenced by a decreased incidence of thrombocytopenia in the study participants on the Mediterranean diet compared to those consuming the control diet. Additionally, this study found that risk of mortality related to thrombocytopenia decreased in those on the Mediterranean diet.4

Another study indicated that food allergies, intolerances, and sensitivities mediated by immunoglobulin (Ig) E and IgG responses did not contribute to ITP development. Researchers compared 50 patients diagnosed with primary ITP between the ages of 18 and 65 years with 50 healthy, age-matched volunteers. Neither those with primary ITP nor the healthy volunteers demonstrated any significant or substantial changes in platelet counts following dietary modifications made to reduce reactions from food sensitivities or intolerances.5

A third study on model mice with ITP showed that the mice who consumed an energy-restricted diet (approximately 32% less energy) demonstrated longer lifespans than the mice on a free-access diet, suggesting that dietary adjuncts in addition to standard therapeutic treatments may be beneficial for patients with ITP.6

Read more about ITP clinical trials

References

  1. Kessler CM. Immune thrombocytopenia (ITP). Medscape. Updated January 7, 2021. Accessed October 13, 2022.
  2. Diet & lifestyle. Platelet Disorders Support Association (PDSA). Accessed October 13, 2022.
  3. Macrobiotic diet and cancer. Cancer Research UK. Accessed October 13, 2022. 
  4. Hernáez Á, Lassale C, Castro-Barquero S, et al. Mediterranean diet maintained platelet count within a healthy range and decreased thrombocytopenia-related mortality risk: a randomized controlled trial. Nutrients. 2021;13(2):559. doi:10.3390/nu13020559
  5. Batty CA, Hunter JO, Woolner J, Baglin T, Turner C. Is food intolerance a factor underlying chronic immune thrombocytopenia (ITP)? Br J Haematol. 2018;183(4):683-686. doi:10.1111/bjh.15014
  6. Mizutani H, Engelman RW, Kurata Y, Ikehara S, Good RA. Energy restriction prevents and reverses immune thrombocytopenic purpura (ITP) and increases life span of ITP-prone (NZW × BXSB) F1 mice. Journal Nutr. 1994;124(10):2016-2023. doi:10.1093/jn/124.10.2016

Reviewed by Kyle Habet, MD, on 10/27/2022.

READ MORE ON ITP