Thrombocytopenia

Overview

Melatonin carries the strongest evidence among supplements studied for thrombocytopenia, with medium ratings across six trials. At 20–40 mg daily, starting up to a week before chemotherapy and continuing through several treatment cycles, melatonin appeared to protect against low platelet counts linked to cancer, cancer treatments, and some other conditions.

Berberine and N-Acetyl Cysteine (NAC) carry low ratings. Early berberine data suggest possible platelet increases with bisulfate taken three times daily, but evidence is preliminary. NAC has insufficient evidence for this condition. See the heatmap and evidence reviews below for more detail.

Effect graph

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Relevant supplements

Relevant supplements sorted by DEX Score.


Melatonin	★★★★★	Medium
N-Acetyl Cysteine (NAC)	★★★★★	Low
Berberine	★★★★★	Low

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Studies

Find individual evidence reviews for supplements sorted by DEX Score.

3 supplements for and rated at least stars. All purchase bands. No minimum star filter.

MelatoninView supplement →

Consider purchase★★★★★

How we scored this

Effect SizeMediumEvidenceHighTrustHigh

Evidence Review

Melatonin may help protect against low platelet counts (thrombocytopenia) linked to cancer, cancer treatments, and some other health problems.
In studies, people took 20–40 mg of melatonin daily, starting up to a week before chemotherapy and continuing during treatment for several cycles, and it seemed to improve platelet levels.

Browse 6 studies

Clinical trialChemoneuroendocrine therapy of metastatic breast cancer with persistent thrombocytopenia with weekly low-dose epirubicin plus melatonin: a phase II study1999

A study of 14 metastatic breast cancer patients on weekly epirubicin found adding 20 mg/day melatonin normalized platelet counts in 9 of 12 evaluable patients and produced tumor regression in 41%.

Effect: Benefit
Dose: 20 mg/day
Population: Women

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RCTA randomized study of chemotherapy with cisplatin plus etoposide versus chemoendocrine therapy with cisplatin, etoposide and the pineal hormone melatonin as a first-line treatment of advanced non-small cell lung cancer patients in a poor clinical state1997n=36

In 70 advanced NSCLC patients, cisplatin-etoposide plus melatonin improved tumor response and 1-year survival versus chemotherapy alone in poor-performance patients.

Effect: Benefit
Duration: 3 days
Dose: 20 mg/day
Population: Cancer patients
Participants: 36

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RCTTreatment of cancer chemotherapy-induced toxicity with the pineal hormone melatonin1997n=80

An RCT of 80 metastatic solid tumor patients found 20 mg/day melatonin with chemotherapy reduced thrombocytopenia, malaise, and asthenia vs chemotherapy alone.

Effect: Benefit
Dose: 20 mg/day
Population: Cancer patients
Participants: 80

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Clinical trialThe pineal hormone melatonin in hematology and its potential efficacy in the treatment of thrombocytopenia1996n=14

A pilot study of 14 patients with persistent thrombocytopenia found 20 mg/day melatonin for 2 months normalized platelet counts in 57% and significantly increased mean platelet number.

Effect: Benefit
Duration: 2 months
Dose: 20 mg/day
Population: Patients with thrombocytopenia
Participants: 14

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Clinical trialA biological study on the efficacy of low-dose subcutaneous interleukin-2 plus melatonin in the treatment of cancer-related thrombocytopenia1995

A pilot study of 20 advanced cancer patients on low-dose IL-2 found adding 40 mg/day melatonin normalized platelet counts in 70% of patients.

Effect: Benefit
Duration: 4 weeks
Dose: 40 mg/day
Population: Cancer patients

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RCTPrevention of interleukin-2-induced thrombocytopenia during the immunotherapy of cancer by a concomitant administration of the pineal hormone melatonin1995

An RCT in lung cancer patients found IL-2 plus melatonin prevented IL-2-induced thrombocytopenia (0 of 8 vs 3 of 7 with IL-2 alone) and maintained higher platelet counts.

Effect: Benefit
Population: Lung cancer patients

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BerberineView supplement →

Reconsider purchase★★★★★

How we scored this

Effect SizeLowEvidenceLowTrustLow

Evidence Review

It is unclear if berberine helps increase platelet counts in people with thrombocytopenia.
Early studies suggest that taking berberine bisulfate three times a day for 15 days might raise platelet levels, but more research is needed to confirm this.

Browse 1 study

Effect of berberine bisulfate on platelet hemostasis in thrombocytopenia patients1994

A 15-day study reported berberine bisulfate 5 mg three times daily may raise platelet counts in primary and secondary thrombocytopenia, but available details are limited.

Effect: Benefit
Duration: 15 days
Dose: 5 mg/day
Population: Thrombocytopenia patients

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N-Acetyl Cysteine (NAC)View supplement →

Reconsider purchase★★★★★

How we scored this

Effect SizeLowEvidenceLowTrustLow

Evidence Review

There is not enough evidence to determine if N-acetyl cysteine has any benefit for thrombocytopenia.

Browse 1 study

Clinical trialEvaluation of the Effects of Atorvastatin and N-Acetyl Cysteine on Platelet Counts in Patients with Primary Immune Thrombocytopenia: An Exploratory Clinical Trial2023n=15

In 15 steroid-resistant or relapsed immune thrombocytopenia patients, 1 month of atorvastatin 40 mg/day plus NAC 400 mg every 8 h raised platelet counts versus baseline.

Effect: Benefit
Duration: 1 month
Dose: 40 mg/day
Population: ALL patients
Participants: 15

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Evidence visualised

Same ratings as above, aggregated so you can see coverage and imbalance.

Purchase-guidance distribution

How many supplements fall in each purchase band

Effect-size distribution

How large the reported benefits tend to be

Study distribution across 3 supplements for thrombocytopenia (8 studies total).
Supplement	DEX	Studies	Share
Melatonin	★★★★★68%	6	75%
Berberine	★★★★★40%	1	13%
N-Acetyl Cysteine (NAC)	★★★★★40%	1	13%

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Overview

Effect graph

Relevant supplements

Studies

Evidence visualised

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