Examples of Blood Thinners
Coumarins: warfarin (Coumadin, Jantoven), anisindione (Miradon)
Heparins: enoxaparin (Lovenox), dalteparin (Fragmin)
Thienopyridine derivatives: clopidogrel (Plavix), ticlopidine (Ticlid)
What Do They Do in the Body? They are known as anticoagulants or blood thinners, and although their actions are complicated, in essence they thin the blood, reduce its stickiness, and reduce its tendency to clot.
What Are They Prescribed For? To reduce the risk of stroke or blood clots, for treatment after a stroke or heart attack; they are sometimes prescribed during or after surgery. Anticoagulants have been in the news because of overdoses of heparin given to premature infants prescribed anticoagulants to flush out IV catheters, and because a tainted batch of heparin from China was linked to multiple deaths and hundreds of allergic reactions.
What Are the Possible Side Effects? The major risk in taking the anticoagulants is that they will work too well and not allow the blood to clot when it needs to, causing a hemorrhage or uncontrolled bleeding. This can happen internally or externally. The anticoagulants are also affected by a wide range of other drugs, making dangerous drug interactions common. Easy bruising, nosebleeds, dark urine, and tarry or red stools may be the first signs of too high a dose or uncontrolled bleeding. People with bleeding ulcers can die if given anticoagulants.
A study published in the New England Journal of Medicine that compared patients taking aspirin and esomeprazole (Nexium, which blocks stomach acid) with those taking clopidogrel (Plavix) and esomeprazole found significantly more bleeding ulcers in the patients taking the clopidogrel.
Think Twice About Taking These Drugs If . . .
• You have a bleeding ulcer.
• You have adrenal insufficiency.
• You have heavy bleeding during menstruation.
• You have liver or kidney problems.
• You have diarrhea.
Women and the elderly are more sensitive to these drugs.
What Are the Interactions with Other Drugs? If you are taking anticoagulants, do not take any new drug, even over-the-counter drugs, or supplements of any kind without checking first with your physician or pharmacist. Especially avoid NSAIDs (nonsteroidal anti-inflammatory drugs), which can cause gastrointestinal bleeding that can quickly spiral out of control under the influence of anticoagulants. Any product that contains salicylates should be used only with the supervision of your doctor, including aspirin, Pepto-Bismol, arthritis rubs that contain wintergreen oil (methyl salicylate), and wine. Specific supplements that may interact dangerously with anticoagulants include St. John’s wort, gingko biloba, feverfew, fenugreek, chitosan, and nattokinase.
Vitamin K can also increase the effect of these drugs, and some doctors will warn patients to be careful about foods that contain vitamin K, especially dark, leafy greens such as kale, spinach, collards, and beet greens. This is backward! You should be encouraged to eat these foods, and the drug dose should be lowered.
The list of specific over-the-counter and prescription drugs that can interact dangerously with anticoagulants is pages long. The bottom line is that if you’re taking an anticoagulant, make sure all health care professionals you’re working with are reminded of this fact when they recommend you take any medicine, herb, vitamin, or other supplement.
What Are the Interactions with Food? Alcohol can increase the time it takes to clear anticoagulants from the body, increasing the risk of bleeding. Over time, the opposite can happen: the drug may be cleared out faster than usual.
Cooking oils that contain silicone additives, such as sprays, may bind with these drugs and decrease their absorption. Eating a lot of foods very high in vitamin K could theoretically block the actions of these drugs. Foods high in vitamin K include dark, leafy green vegetables, lettuces, potatoes, fish and fish oils, fruits (especially citrus fruits), egg yolks, dairy products, and the cruciferous family of vegetables, including broccoli, cauliflower, cabbage, and brussels sprouts. Onions, garlic, and soy foods may increase the action of anticoagulants. If you eat lots of vegetables, don’t stop just because you’re taking this drug! Have your physician adjust the drug levels accordingly.
Don’t drink tonic water if you are taking an anticoagulant. It contains an ingredient called quinine that can enhance the action of anticoagulants.
What Nutrients Do They Throw out of Balance or Interact With? Anticoagulants may attach to the metals in mineral supplements and not be absorbed. Take them separately from mineral supplements. Vitamin C interferes with the action of these drugs, reducing their effects. Vitamin E, which by itself “thins” the blood, may increase the effects of anticoagulants, although to date no studies have shown that it’s harmful to combine vitamin E and anticoagulants.
Natural Alternatives to Drugs for Treating Strokes and Blood Clots
Your foundation for preventing strokes and blood clots is to follow the Six Core Principles for Optimal Health and the guidelines expostulated in other posts for a healthy heart. Especially important are getting plenty of exercise, drinking plenty of water, avoiding “bad” fats and oils, and keeping blood pressure moderate.
A stroke can be caused by either a blood vessel breaking or a blood clot blocking a blood vessel. Estrogens, including those used in birth control pills and for HRT, greatly increase the risk of some types of strokes.
Garlic, onions, berries, and fish are foods that keep the blood and blood vessels healthy. The most important supplements for strong blood vessels are the bioflavonoids, including grapeseed extract, rutin, hesperidin, ginkgo biloba, green tea, and bilberry. Supplements important for healthy, “slippery” blood (follow dosage recommendations for daily vitamins in this book) include magnesium, vitamin B6, folic acid, vitamin B12, vitamin E, selenium, N-acetyl cysteine, lysine, and garlic.
If you have high levels of vitamin C, your risk of dying from a stroke may be half that of those with lower levels. This is according to a major study published in the British Medical Journal that tracked 730 elderly men and women for twenty years. Low levels of vitamin C were a strong predictor of death from stroke.
Some Drugs Delay Stroke Recovery
A stroke causes damage to the brain that can often be reversed with time and physical therapy. But it can be a long, slow, difficult road to healing, and those who are on that journey should be given every advantage. That’s why you should know that some drugs can actually slow recovery after a stroke. The brain is particularly vulnerable after a stroke, and a recovering stroke patient shouldn’t be given any drugs that aren’t absolutely necessary.
According to a study done at North Carolina’s Duke University that analyzed 96 stroke patients, 37 of them who were taking drugs such as benzodiazepines (Valium, Serax, Ativan, Xanax, etc.) took significantly longer to recover. In fact, even one dose of a drug such as the dopamine antagonist haloperidol (Haldol) can delay recovery by as much as two weeks. These human studies were a follow-up to animal studies that demonstrated the same result. Other drugs that appeared to delay recovery included prochlorperazine (another dopamine antagonist), antihypertension drugs such as clonidine and prazosin, and anticonvulsant drugs such as phenytoin and phenobarbital.
Having a stroke can be a very frightening and disorienting experience, but sedatives should not be used unless it’s absolutely necessary. Before you resort to prescription drug sedatives, try some of the natural antianxiety remedies such as kava and St. John’s wort.
Your first attempts at reassuring and calming a stroke victim should be the best sedatives of all: loving, supportive family and friends, gentle massage, humor, beautiful music, a good view out the window, good nutrition, and competent medical care and physical therapy.
Prescription Alternatives: Hundreds of Free, Natural, Prescription-Free Remedies to Restore & Maintain Your Health, by Earl L. Mindell, R.Ph, Ph. D, & Virginia Hopkins, M.A. Published by McGraw-Hill.