Blood clots can affect 900,000 Americans each year, leading to 100,000 deaths. Blood clots like Deep Vein Thrombosis (DVT) or Pulmonary Embolisms (PE) can be a serious consequence of blood clotting disorders. Outside of cancer itself, it is the next leading cause of death for individuals with cancer. With these statistics, it is critical to understand how blood clots occur and what can be done to prevent them. Although blood clotting disorders don't always lead to serious life-threatening issues such as DVTs or PEs, it is crucial to understand how to prevent that from occurring with patients with blood clotting disorders. In this article, we will explore what blood clotting disorders are, the signs of these disorders, the labs to assess the risk, along with the various treatments and management approaches.
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What are Blood Clotting Disorders?
Blood clotting disorders occur when the body has problems with its ability to control how the blood clots. This differs from bleeding disorders in which blood won't form clots to prevent excessive bleeding. Clotting disorders occur when your body produces too much clotting. In a normal response, when your body gets injured, your body will form coagulants or blood clots to stop the bleeding. With clotting disorders, the body may form clots too easily or even without an injury. Sometimes these clotting disorders are called coagulation disorders or thrombophilias. Blood clotting disorders can be inherited or acquired. When these disorders are inherited, this means a person is born with this condition. Some inherited clotting disorders include Factor V Leiden mutation and Factor II mutation. When these disorders are acquired, they occur because of an injury or an illness. Some acquired blood clotting disorders include Antiphospholipid Syndrome (APS), an autoimmune disorder, and Disseminated intravascular coagulation (DIC), usually from sepsis or injury.
Blood clots can result in various health issues, and the symptoms experienced depend on the location of clot formation. Normally, blood clots are seen to form in veins, primarily in the legs or lungs. If they occur in the legs, they can lead to deep vein thrombosis, while in the lungs, they can lead to pulmonary embolism. Arterial blood clot formation is uncommon; however, it can cause severe outcomes such as heart attacks or strokes in rare cases. Treatments discussed later in this article can help your blood from clotting too much. It is important to work with a healthcare practitioner if you suspect that you have a blood clotting disorder or a family history of these disorders.
Signs of a Blood Clotting Disorder
There can be significant health risks with blood clotting disorders that cause excessive clotting. Signs and symptoms may vary depending on the location of the blood clot. For example, symptoms felt in the legs, such as swelling, tenderness, or pain to the touch, can mean a clot obstructing blood flow in the veins of the legs, known as deep vein thrombosis (DVT). Symptoms felt in the chest, such as chest pain or shortness of breath, can signify a pulmonary embolism that happens when a clot travels to the lungs. Other symptoms, such as heart attack or stroke, can also result from blood clots that form in the arteries. If you experience any of those signs or symptoms, it is critical to contact a doctor right away or head to the emergency department.
Possible Causes of Blood Clotting Disorders
When blood clots form more frequently than they should, it results in blood clotting disorders. The normal blood flow in your body is maintained by a balance of molecules called "procoagulant factors" and "anticoagulant factors." Procoagulant factors assist in forming blood clots, while anticoagulant factors prevent them. Any disturbance in this balance of factors can cause a blood clotting disorder.
As mentioned earlier, blood clotting disorders are either inherited (genetic) or acquired (injury, medications, or other conditions). Whether inherited or acquired, this disorder tends to form blood clots or hypercoagulable states. The most common inherited blood clotting disorder is Factor V Leiden occurring in 5% of people of European descent. Another common inherited blood clotting disorder is Factor II, also called Prothrombin gene mutation, occurring in 2% of the population. Other inherited but rare are deficiencies in certain proteins that prevent blood clotting (protein C, protein S, antithrombin) and elevated levels of fibrinogen or dysfunctional fibrinogen.
Acquired blood clotting disorders occur from injury, medications, or other conditions which can increase the risk of forming clotting disorders. The most common cause of acquired blood clotting disorder is cancer. Other acquired causes include medications that treat cancer, trauma, surgery, obesity, pregnancy, hormone therapy as with estrogen birth control pills, decreased activity, nutrient deficiencies such as folate or other B vitamins, infections, and autoimmune disorders.
Functional Medicine Labs to Test for Root Cause of Blood Clotting Disorders
Certain conditions can increase the risk of acquired blood clotting disorders. Outside of a thorough medical and family history, some functional medicine labs can help address and manage blood clotting disorders. Some of these labs include:
Complete Blood Count (CBC)
By analyzing the different components of the blood, CBCs can help doctors diagnose, monitor, and screen for various diseases, conditions, disorders, and infections, which can provide valuable insights into how the person's blood is functioning.
PT-INR
Prothrombin Time is used to monitor treatment, such as anticoagulant therapy for thrombosis and pulmonary embolisms, or to screen for coagulation factor deficiency.
Activated Partial Thromboplastin Time (aPTT)
This prothrombin time and partial thromboplastin time test will measure the time it takes for your blood to clot, which can help assess blood clotting disorders.
Fibrinogen Test
Fibrinogen is a protein needed in the formation of blood clots. This test will measure fibrinogen levels to help assess factors affecting blood clotting.
Homocysteine Test
Homocysteine is an amino acid in your body. B6, B12, and folate will help break down homocysteine levels. Therefore elevated levels of homocysteine indicate a B6, B12, or folate deficiency, which can contribute to blood clotting disorders.
Prothrombin Gene Mutation
This mutation increases the risk for inherited blood clotting disorders. This genetic test can measure G20210A (factor II) gene mutations.
Full Hormone Panel
The hormone panel can assess for elevated hormone levels that may occur with hormone replacement therapy which can increase the risk for clotting disorders.
Additional Labs to Check
Other tests may include Antithrombin activity, Protein C activity, Protein S activity, Antiphospholipid antibody, and Heparin antibodies. All these tests will be run by a specialist in coagulation or hematology. These specialists may be referred to if you are suspected of having a blood clotting disorder. It is important to continue to monitor and manage your blood clotting disorder through these various labs to decrease the risk of DVTs and PEs. Therefore, it is imperative to continue to work with your healthcare provider if you have a blood clotting disorder.
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Conventional Treatment for Blood Clotting Disorders
Just having a blood clotting disorder doesn't necessarily mean you need to be on medications. Your doctor will take a look at your history of blood clots and your current risk factors. With that stated, if a blood clot develops in your vein or artery, you will need to seek treatment for it.
Conventional treatments include blood thinners such as Warfarin or Aspirin, which can be taken orally, or Heparin which can be given as an injection. However, these medications may have certain side effects, such as heavy bleeding, severe headaches, and dizziness. Warfarin can interact with over-the-counter medicines like cold or allergy medications or ibuprofen. You also shouldn't take Warfarin if you are pregnant or planning to become pregnant.
For some people, direct oral anticoagulants (DOACs) might be a good alternative to Warfarin or Aspirin, as they do not require frequent blood testing. However, DOACs may require more doses twice daily compared to once a day for Warfarin. These medications are often used in patients with low-risk, inherited blood clotting disorders, like Factor V Leiden and Prothrombin G20210A.
It's crucial to maintain a balance when taking blood-thinning medication. The doctor will regularly test your blood to ensure the right medicine dosage and proper balance between bleeding and clotting.
Integrative and Functional Medicine Treatments for Blood Clotting Disorders
Blood clotting disorders can be managed conventionally along with integrative and functional medicine approaches. Integrative and functional medicine can offer a holistic approach to some of the underlying factors. By identifying some of the underly factors that can contribute to clotting disorders, functional medicine practitioners can tailor personalized treatment plans to help manage blood clotting disorders. Some considerations include personalized nutrition, clinically relevant supplements, and other integrative therapies.
It's important to note that functional medicine is not a one-size-fits-all approach, and the specific recommendations can vary depending on particular factors such as the type and severity of the blood clotting disorder and any other underlying health conditions.
Nutritional Needs For Patients with Blood Clotting Disorders
The nutritional needs of patients with blood clotting disorders will vary with underlying factors to the disorder and if certain medications are being taken. For instance, if one of the underlying factors is a B vitamin and folate deficiency contributing to the blood clotting disorder, the patient will want to incorporate foods rich in B vitamins and folate. Some of these foods include beef liver, dark leafy greens, asparagus, eggs, legumes, and avocados. These foods should be incorporated on a daily basis if homocysteine levels are high, indicating a deficiency in B vitamins and folate.
The other consideration with blood clotting disorders is the use of medications such as Warfarin. Warfarin is one of the blood-thinning medications to help prevent blood clots. The Warfarin Diet recommends having a consistent daily intake of vitamin K-rich foods such as broccoli, kale, and spinach. Maintaining a consistent daily intake is important so you stay within the daily recommendations, as excessive vitamin K can interfere with Warfarin. The daily recommendations are 120 mcg of vitamin K-rich foods for adult men and 90 mcg for adult women. It is also recommended not to drink cranberry or grapefruit juice (or only drink them in small amounts) or alcohol when taking Warfarin.
Supplements and Herbs for Patients with Blood Clotting Disorders
Many supplements can thin the blood, and integrative practitioners can use them to help manage patients with blood clotting disorders. Any medications must be discussed with the practitioner to ensure that there are no interactions. Here are several supplements that may affect how your blood clots:
Feverfew for Blood Clotting Disorders
Feverfew (Tanacetum) is a botanical and is considered plant medicine. It has been shown to affect how platelets stick together and form clots in some studies. Feverfew is not intended for pregnant or breastfeeding individuals or children under two years old. It can lead to excessive bleeding if taken along with blood-thinning medications like Warfarin.
Omega-3s for Blood Clotting Disorders
Research shows that the omega-3s in fish oil or other sources, such as flaxseed, can affect blood clotting by affecting how platelets stick together. Some research has shown that omega-3 intake can also lower fibrinogen, thrombin, and factor V levels.
B Vitamins/Folate for Blood Clotting Disorders
As mentioned in the previous sections, B6, B12, and folate deficiencies contribute to blood clotting disorders. Deficiencies in these vitamins can lead to elevated homocysteine, which is associated with an increased risk of venous embolism. If this is an underlying cause, taking a supplement or getting these vitamins through food is recommended to help regulate how the blood functions.
Garlic for Blood Clotting Disorders
Garlic has been shown through human studies that it can slow blood clotting. Platelet aggregation can contribute to coronary thrombosis. Garlic at doses of 1200 or 2400 mg has been shown to inhibit platelet aggregation, thus reducing the risk of coronary thrombosis.
Ginkgo for Blood Clotting Disorders
Ginko has also been shown to slow blood clotting and increase bleeding in people who take it alone or with NSAIDs. Gingko works by reducing the "stickiness" of platelets.
Meadowsweet for Blood Clotting Disorders
Meadowsweet is an herb that contains the compound salicylate, which has been shown to affect how well platelets stick together. Meadowsweet's botanical name, Spiraea ulmaria, is where we get the name "Aspirin" since this drug was derived from salicin produced from meadowsweet plants back in 1897. Therefore, this herb has similar antiplatelet properties to Aspirin.
Curcumin for Blood Clotting Disorders
Curcumin is the primary active component of turmeric, and it has many health effects. One of these includes antiplatelet effects, especially in relation to certain pathologies such as inflammatory diseases, atherothrombosis, and thromboembolism.
White Willow for Blood Clotting Disorders
White willow (Salix Alba) contains salicin, which is similar to Aspirin and can keep platelets from sticking together. Research indicates that white willow's antiplatelet effects are less than the effects of Aspirin. However, white willow, in combination with any other herb or medication mentioned in this article, could increase the effect leading to an increased risk of excessive bleeding.
Complementary and Integrative Medicine That Help With Blood Clotting Disorders
There is some exciting research in Traditional Chinese Medicine (TCM) that may help with blood clotting disorders or some of the serious issues that can occur due to blood clotting disorders such as thrombosis or DVTs. A meta-analysis showed that various traditional Chinese herbal medicine of various compounds effectively prevented DVTs after surgery. These herbal concoctions are meant to improve blood circulation to remove obstacles to the channels, according to TCM theory. These herbs have been shown to also have an analgesic and anti-inflammatory effect. Complementary approaches such as TCM can be a safe and effective consideration in managing DVTs after surgery, a serious consequence of blood clotting disorders. However, as with any therapy, further trials are warranted.
Factors contributing to blood clotting disorders also include lifestyle factors and other medical conditions. Therefore, other integrative approaches, including lifestyle modifications, can be beneficial. Some examples of lifestyle modifications include exercise or other forms of body movement, which can improve circulation. This regular body movement can be beneficial for blood clotting disorders. It is imperative to discuss your options with your healthcare provider if you are interested in incorporating functional medicine or integrative approaches to your health.
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Summary
Blood clotting disorders can lead to an increased risk of blood clots that can be life-threatening, such as DVTs or PEs. They can be inherited or acquired. Blood clotting involves a balance between procoagulant and anticoagulant factors. The imbalances of these factors can lead to excessive bleeding or clotting. Understanding these imbalances is key in monitoring, treating, and managing blood clotting disorders. There are both conventional and integrative approaches that have been shown to manage these disorders. Conventional treatment options include blood thinner medications such as Warfarin or DOACs. Functional medicine approaches include supplements such as omega-3s and B vitamins, lifestyle modifications, clinical nutrition, and TCM. A functional medicine or integrative approach can complement conventional treatments to address the underlying factors causing blood clotting disorders. When it comes to these disorders, consulting with a licensed healthcare provider is always recommended.
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