Pumping Marvellous

A blood clot that forms on the outside of the body over a wound is a good thing. It stops the bleeding if you cut yourself. But a blood clot that forms inside a blood vessel can cut off blood flow to vital organs like the brain or heart. This results in a stroke or heart attack. A clot can also block circulation in the legs or lungs.

If taken properly, blood thinners can help prevent dangerous clots but still allow normal clotting to take place and stop blood flow from an injury.

Examples of blood thinners are:

• Anticoagulants such as warfarin and heparin
• Antiplatelet drugs such as aspirin and clopidogrel

A newer drug called Pradaxa may also be an option to prevent stroke in some people with atrial fibrillation. Regular blood test monitoring is not required with Pradaxa as it is with warfarin.

To make sure your blood thinner medication is both safe and effective, follow these steps.

1. Timing is important

• Take your blood thinner at the same time each day.
• Never skip a dose or take more than your prescribed dose.
• If you miss a dose, take the medicine as soon as you remember.
• If you don’t remember until the next day, call your doctor or anti coag clinic for instructions before taking that day’s dose.

You may find it easier to take your medicine if you use a pill organizer with compartments for each day of the week.

2. Watch for signs of bleeding
A nose bleed or bleeding from a cut are obvious. But more serious bleeding can occur in the brain or digestive track hidden from view.

A head injury can result in bleeding within the brain. This can cause a severe headache or other signs of a stroke. If you hit your head hard then we would suggest you go to Accident and Emergency for a check up or call the Emergency Services.

Call the emergency services if you are on a blood thinner and you have:

• A severe headache
• A fall or injury to the head
• Confusion, numbness, weakness
• Cough up large amounts of bright red blood
• Vomited blood
• Passed a lot of blood in the stool

Bleeding from the digestive track can occur gradually over time and may not cause pain. Seek immediate medical help if you have any of the following:

• Bright red blood in the stool
• Very dark or black stool
• Blood in the urine
• Bleeding that does not stop
• Bleeding in the mouth after a dental procedure (make sure your dentist is aware you are taking blood thinners before any surgery)

3. Use caution
Be careful with:

• New prescription medicine. Any doctor you see should know that you are taking a blood thinner. Warfarin and other blood thinners can interact with many types of medicine.
• Over-the-counter products. Check with your doctor or pharmacist before taking any non-prescription product, including aspirin, herbal medicine, or vitamins.
• Alcohol. Alcohol increases the effect of blood thinners and raises the risk of bleeding.
• Foods containing vitamin K. Foods that contain vitamin K can interfere with blood thinners. They make warfarin less effective and raise the risk of a blood clot. Vitamin K is found in green and leafy vegetables such as broccoli, lettuce, and spinach. You don’t have to avoid these foods, but keep the amount of vitamin K you eat consistent from day to day.
• Dental visits. Tell your dentist that you are taking a blood-thinning medicine as well as about all your other medicines. He or she may modify certain dental procedures to limit bleeding. Avoid eating hard foods or foods with sharp surfaces for 2 days after a dental procedure.

4. Keep your lab appointments
Doctor and Anti Coagulant Clinic visits for blood tests or lab visits are important when you are on certain blood thinners such as warfarin. Frequent testing is often needed to make adjustments to this medicine.

While taking warfarin, a blood test is used to measure the time it takes blood to clot. It’s called the prothombin time, or “protime.” The result is reported as the INR, which stands for the International Normalized Ratio. The INR is what your doctor uses to monitor the effects of the drug. The goal is to take enough blood thinner to keep the INR in the therapeutic range, which is higher than normal so that clotting is delayed but not prevented.

• When the INR is too low, the risk of a dangerous blood clot is increased.
• When it is too high, the risk of bleeding is increased.

It often takes some time to get the INR into the therapeutic range. INR monitoring may be necessary twice a week or more at first, and then less frequently.

Image via Wikipedia

Interaction between Vitamin K and Warfarin

I think this is a great article on Vitamin K and Warfarin and how it all works. It is taken from a blog on the site Xtend-life.com which is an excellent site where I buy my supplements, namely Total Balance Men and Omega 3 QH Ultra.

It is a conversation between a customer of theirs and Jo their Medical Nutritionsist you gave me this link and it takes you through what you need to know. Ok it talks about there products but this is a conversation between customer and company so you would expect that oh and by the way it is worth looking at their products and probably the most refined you can get.

Michael: asks…

Hi, I just read about your new Multi-Xtra vitamin/mineral supplement. I would like to know if it is safe to take with blood thinners (Warfarin). I saw it has some vitamin K-2 and Green Tea in it. I believe these could interact with Warfarin but I don’t know if the levels are sufficient to do so or if any of the other ingredients are a problem. I already understand that the Total Balance Premium could interact with Warfarin because of some of the ingredients. Please advise. Thanks

Joanna: responds

It is true that you should recognize that there is a relationship between Warfarin and vitamin K, but often the relationship between Warfarin and vitamin K is misunderstood.

First, you should know that your liver needs and uses vitamin K to make blood clotting proteins. In doing so, vitamin K plays a role in your body’s natural clotting process. Warfarin of course works against vitamin K.

Specifically, Warfarin reduces your liver’s ability to use vitamin K to produce normally functioning forms of the blood clotting proteins. By reducing the liver’s ability to use vitamin K to produce normally functioning forms of the blood clotting proteins, Warfarin reduces your risk of forming a blood clot.

It is a common misconception that people on Warfarin should avoid vitamin K. Reducing your vitamin K intake can cause your INR (your International Normalized Ratio) to increase and may make it more difficult to control. Rather than avoiding vitamin K, you should maintain a consistent intake of vitamin K by maintaining a consistent diet and supplement regime. In other words, from week to week, you should eat the same types of foods and take the same dose of your supplement. If your vitamin K intake is consistent then you won’t have any problems with your Warfarin interaction.

A significant change in your intake of vitamin K is what can result in a significant, and potentially dangerous, change in your INR, not your intake of vitamin K alone. For example, if you reduce your amount of vitamin K, your INR will increase, making it more difficult to manage your Warfarin therapy (patients who have a low intake of vitamin K have been found to have more fluctuation in their INR).

So why would a diet LOW in vitamin K make your INR more difficult to manage? Well, suppose you have a diet that is extremely low in vitamin K. Now suppose you eat a spinach salad at dinner one night for example. Spinach salad is high in vitamin K, so you have just increased your vitamin K intake, which represents a huge change in your dietary vitamin K. The result of this will be a significant drop in your INR. Any changes to your vitamin K intake represent fluctuations in your INR.

In order to maintain a consistent intake of vitamin K, keep to a good consistent diet, and the normal regular dosage of your supplement. Remember that the critical consideration in managing Warfarin and vitamin K is keeping the levels of vitamin K constant so your doctor doesn’t have to constantly change your dosage. People and their livers vary in their responses to Warfarin and vitamin K. The key is consistency. If your doctor gives you odd doses of Warfarin, such as 5 mg on Tuesday and Thursday and 2.5 mg on Friday for example, then that is what’s needed to keep your clotting factors constant. So, don’t adjust your vitamin K to your Warfarin.

Now, if you are on Warfarin and only just thinking of taking Total Balance or Multi Xtra, then my advice would be to consult your doctor about your wish to take this supplement simply so that he can then adjust your Warfarin dose accordingly. This is actually a good thing as it is a potential to perhaps lower your Warfarin dose, and discuss with your doctor other more long-term and natural approaches. For example, depending on your exact condition and health status of course, I would highly recommend discussing with your doctor the possibility of looking at not only Total Balance, but also Omega 3/DHAs (high dose fish oil can have a similar blood thinning effect) at 4-6 per day of our brand, plus our Cardio-Klenz supplement which has many cardiovascular benefits as well as helping blood consistency. These would be very beneficial for you and may, along with a good diet, help you to lessen your need for Warfarin at the same time.

If you decided to look at such a regime, and are currently on a normal dosage of Warfarin, my advice would be to start at a lower dose of Total Balance initially:

Total Balance 4-5 per day Premium (3 per day Standard; or 2 of Multi Xtra). Note: If you were not on warfarin you are strongly advised to take the full daily recommended dose right from the outset.

Omega 3/DHAs at 2-3 per day;

Cardio-Klenz at 4 per day.

Then gradually increase these dosages up to the recommended daily dose levels as your Warfarin decreases, if your condition warrants this.

Finally, regarding the other ingredients in Total Balance, such as ginkgo, policosanol, n-acetyl-glucosamine. It is true that, like vitamin K, attention needs to be paid to the dosages. However, again the dosages in Total Balance are all low compared to what would cause interaction. Only excesses in vitamin K, or any of these other ingredients, may potentially cause problems. In the low dosages in Total Balance, and careful dosing of both your medication and supplementation, as suggested above, whilst still on Warfarin, there is no indication of interaction.

I just want to make clear these are the opinions of Xtend-Life and no before you ask I am not in the pay of them, I just think this is a cracking blog post.