Natural Blood Thinners: Any research comparing them with doc-prescribed blood thinners?

Searching pubmed abstracts, I have found some encouraging results for individual foods and supplements that improve cardiovascular conditions (i.e., thins the blood or reduces the tendency of blood platelets to coagulate) - in particular for fish oils, nattokinase, garlic (fresh only, 1 to several cloves daily), and bromelain (fibrinolytic, antithrombolic; up to 12 grams daily).

One source outside of the pubmed sphere, the M@@@@@@ website, featured Dr. S@@@@@@, who recommends all the above supplements plus Vitamin E (he recommends the garlic as dried form in capsules; however, I found a study that shows the dried form was ineffective). My searches of pubmed reveals vitamin E as not really having any effect in more than one study, and having a negative effect in other studies, because it overkills (needed) oxidative processes in moderate (800 IU) daily doses over a long time, which made cardiovascular conditions worse! (One 2010 study revealed that vitamin E increased haemorrhagic stoke by 22% while only decreasing ischaemic stroke by 10%.)

In addition to the above boldfaced supplements in my first paragraph is the very interesting practice of "earthing" or "grounding," which involves walking, standing, or sitting on any surface that is grounded to the earth that allows free electrons from the earth to enter (and leave) one's body - a phenomenon that is claimed to have a blood thinning effect "after the 85 minutes it takes for the electrons to enter one's bloodstream" (but no scientific proof has been offered anywhere, to my knowledge). Going barefoot is recommended, and when not, one should wear leather soled shoes, and avoid rubber sole shoes. Dr. S@@@@@@ says that gounding is so great that it would cause an increased risk of bleeding to do it (grounding) if one is also taking potent blood thinners!

Questions:
1a) Is there any scientific study that compares the blood thinning ability of a concerted combination of natural blood thinning supplements (as listed above) plus healthy practices (e.g., grounding, daily exercise, diet) to doctor-prescribed blood thinners? 1b) For example, has any health professional or clinical scientist taken the time and effort to do a controlled study that measured the clotting times, platelet aggregation, and simulated bleeding times of subjects who have been consuming the natural blood thinners listed above over an extended time? 1c) If so, how have these compared to the same measurements of subjects who were taking the standard doctor-prescribed blood thinners?
2) How confident could a lone afibber be if he chose to rely only on these natural blood thinners?
3) How confident could he be with this life choice, if his CHADS₂ Score was a 3 (at a level at which doctors are obligated to prescribe him a "potent" blood thinner)?

Regarding the use of "diet" as mentioned above, from my online searches, a menu of fish, whole grains,vegetables, and fruit is recommended; and also recommended are only sparing amounts of fatty foods, including olive oil and coconut oil, which have been dangerously over-promoted.

You can check some of these past posts that discuss this topic. When I posted the "sticky, thick blood" post a while back, I was emphasizing the importance of doing the tests that determine elements that contribute to sticky, thick blood which can be influenced by the various nutrients mentioned in that post.
[www.afibbers.org]

The grounding or Earthing practice that Dr. Sinatra and the EMF groups discusses as beneficial does have some testing to back up the claims that it reduces the platelet aggregation tendency. I sleep with a grounding pad and also take the NOAC, Eliquis, and have not had abnormal problems with bleeding. Optimal intra-cellular magnesium levels are also known to help reduce platelet aggregation tendency as well.

My favorite cluster of natural nutrients that I used successfully for 8 years prior to the first ablation and 11 years until the second procedure....so for a total of 19 years... was based on my test results of those underlying factors addressed in the sticky, thick blood post... with strong emphasis on Omega 3 fish oil, Nattokinase, magnesium and others to address and keep each influencing factor in the low-normal range.

Three months after my first ablation and after I had stopped taking coumadin and had resumed nattokinase and the other natural blood thinners, I had a brief bout of AF that required cardioversion. The next week, I had a CT scan of the heart which revealed a clot had formed in the LAA. However, I wasn't informed of that and I didn't learn about it until about six weeks later when I received a copy of the report. I've used that evidence as support that the right type of Nattokinase and other natural anticoag-type nutrients do work... since I lived to tell about it.

I have always followed the advice to use the healthy fats approach as well and eat my own version of a 'modified Paleo diet'.

Jackie

I have completely unnoticeable by me AFIB. A long sequence of regular beats and occasional short skipped beat.

I take low dose Eliquis 2 1/2 mg twice a day. That's my only medication.

I wonder about taking cardiokinase and if so how many. Same with Gingko Biloba etc.

The problem is there is no test certainly none in Australia of measuring blood stickiness so is a quandary of too much or not enough of said to be blood thinners and knowing some kind of rating of where a person is at.

Any suggestions?

Thanks

Alex

Hi Jackie,


Thanks for your comprehensive reply to my questions. It has taken me awhile to absorb its content since you cover several different phases of your experience over many years. I am going to take another look at the details you report about those underlying factors that determined how much or those supplements in your favorite cluster you took. That approach might be the only way for any one to figure out at least a rough approximation of optimum doses of supplements that are not backed up by randomized controlled clinical trials!

I am impatient and would like to check my blood's tendency for clotting, or at least get a baseline, since I have been taking a cluster of supplements for a few weeks now. Although my GP thinks it would be meaningless, he has relented and has ordered a PT-INR for me even though I am not taking any prescribed blood thinner; it won't be reliable as a test of the efficacy or safety of my cluster of supplements (nattokinase, fish oils, MK-7, bromelain, COQ10, vitamin D3, Vitamin E, curcumin phytosome, low-dose aspirin, selenium, hot green tea, etc), because the INR is mainly geared for patients who are taking warfarin or other vitamin K antagonists. I just want to see if the data reveal an elevated INR; my online searches say that a person not on any blood thinner would not have an INR value higher than a 1.0, which indicates he is not protected by a pharmacological or therapeutic level of blood thinner. The INR value for a person on an effective blood thinner (like warfarin) would be between 2.0 and 3.0.

Since you are now on a NOAC, I guess you are not still taking that cluster of supplements, right? It is not clear to me what you are doing about them because in your first paragraph you don't say you are taking them currently. (Almost all medical advice I can find is against taking any supplements that could affect blood quality, if one is also taking a potent blood thinner, including any NOAC).

My doctor is concerned that I am not taking the Pradaxa the cardiologist he referred me to prescribed for me; so he is going to call me and discuss the issue with me later today. I am not sure what he is going to say, but I'm pretty sure it will include a repeat of his warnings that I have a significant stoke risk and all the supplements I am taking are just not enough to protect me. I have paroxysmal afib (only one symptomatic episode that corrected itself) plus an episode of temporary blindness (amaurosis fugax) in one eye (classified as a TIA) that lasted 20 seconds.

Bye for now. Thanks again for your generous supply of information! .

Jackie,
Interesting. In my case, even though I am in SNR with Flec, now that I am turning 70 with controlled BP via Lisinopril, the Dr wants to put me on either warafin or Ellipsis.
I prefer warafin since I was on it in 2007 when my afib first struck. Any advice? Hope all good with you....Joe

Hello Alex,

Apparently (even though you are asymptomatic now), your doc put you on a potent blood thinner because you are at significant risk of stroke or heart attack. Since Eliquis is comparable to warfarin in effectiveness, and since users of warfarin are advised to avoid taking supplements such as cardiokinase (a brand of nattokinase) and any other natural blood thinners, I suggest that you avoid taking them as long as you are taking Eliquis, or until you get clearance for using blood thinning supplements from your doctor.

I believe you can find more of the information you are looking for by viewing the hour-length presentation (for the layperson) given by afib electrophysiologist, Dr. Gregory Marcus (UCSF), at: [www.youtube.com].

Good luck,
aka NoNOACster

Response to both Tibbar and Alex.... Now... my disclaimer:

Although the medical precautions for Eliquis and Coumadin, warn not to use the natural thinners along with the Rx, and since I know my body well and have used the fibrinolytic enzyme (nattokinase) and the proteolytic enzyme, (serrapeptase) long before the Eliquis was required, once my dose of Eliquis was lowered to 2.5 mg twice a day, I started using again some of the natural thinners I have always relied upon but at much lower doses. I have had minor cuts and scrapes that bled, but did not have an extended time to form a clot so I feel comfortable in doing that. I have resumed use of Omega 3 fish oil as well, but at a lower dosage. I am continuing on with that protocol until I hear the results of the last TEE after ablation #3. I also use Ginkgo biloba, pycnogenol and other anti-inflammatories but at lower doses and some, every other day.

Being off all my natural anti-inflamatories and fibrinolytics, revved up some of the muscle pain and sensitivities that prompted my use in the first place, so I was elated - even only if was the half-dose because my experience is, all that I use, helps in my particular situation.

However, please note: This is not an instruction to you to do the same.

That said... As we age, we become a statistic with CHAD2s Vasc Risk scoring. Certainly being female and age 80 give me points of which physicians (out of medico/legal necessity) must be aware, so we can expect the push to be on some sort of Rx blood thinner.

You probably recall my story of the clot in my Left Atrial Appendage ... probably caused by the breakthrough AF and ECV required at 103 days after my first ablation (2003) and when I had also discontinued the coumadin at 90 days. I didn't learn about the clot until six weeks after the scan since it wasn't flagged and no one caught it until I read the report mailed to me. We all remarked at the time... Good thing the nattokinase works!!!!

When I stopped the coumadin, I immediately resumed my hefty dose of nattokinase I formerly used prior to scheduling the ablation with the requisite coumadin. I've always referenced my experience as anecdotal testimony that nattokinase does, indeed, work.... and I'm alive to tell about it. You just have to use enough of it and a well-known, reliable brand. That and I always used at least 4 grams of Omega 3 fish oil daily.

I don't do well with drugs and chemicals so I was pleased to learn about Nattokinase long ago from the leading NK expert in the US, Ralph Holsworth, DO, who shared many details on the reliability and efficacy of proper dosing of a reliable nattokinase - ie, Cardiokinase.

Jackie

Jackie:

So do you use Cardiokinase? And when you say you just have to "use enough of it," can you put a number to that? Specifically, how much were you taking of it every day?

Thanks,

Travis

Hi Travis,

Regarding the amount of NK you are asking about, to make it useful to you, you would actually have to also know Jackie's body weight - so you could calculate her effective dose as mass in milligrams per kg (or pounds) of body weight. That way, you could calculate your effective dosage, using Jackie's "proper dosing" as a reliable reference.

The generally accepted dosing seems to be 100 to 300 mg per day, on an empty stomach. The NOWFoods brand suggests that you take 100 mg twice a day. Doctor's Best Inc suggests 100 mg between 1 and 3 times a day. The latter manufacturer's product is mixed with another enzyme, serrapeptase, which appears to give support to the immune system.

I contacted Doctor's Best and asked how much of nattokinase actually made it into the blood. I received a quick reply saying that it "has gastric stability," which they say is why "it is not common for it to be coated." Hmm, maybe we really don't have to take it on an empty stomach, right? But just to be more sure, I take it between meals if I can, and if I can't, I take it 5 minutes before dining or just at the beginning of meals to give it a head start. (When one is taking a lot of vitamins, minerals, and enzymes it doesn't seem to be an easy task to plan the best schedule for all of them!)

Doctor's Best also gave me the following additional information:

"Below is a study you may find helpful:

[j-nattokinase.org]
TOPICS – Intestinal absorption of Nattokinase in animal experiments
It is confirmed that Nattokinase got absorbed by bowel and the absorbed Nattokinase degraded plasma fibrinogen.
?Reference?
Fujita M , Hong K, Ito Y, Misawa S, Takeuchi N, Kariya K, et al. ?
Transport of nattokinase across the rat intestinal tract.
Biol. Pharm. Bull. 1995;18(9):1194-6?
Intraduodenal administration of nattokinase (NK) at a dose of 80 mg/kg, resulted in the degradation of fibrinogen in plasma suggesting transport of NK across the intestinal tract in normal rats. The action of NK on the cleavage of fibrinogen in the plasma from blood samples drawn at intervals after intraduodenal administration of the enzyme was investigated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting analysis with an anti-fibrinogen γchain antibody. The 270 kDa fragment carrying antigenic sites for the binding of the anti-fibrinogen γchain antibody appeared within 0.5 h and was then degraded gradually to a 105 kDa fragment via a 200 kDa fragment. This suggests that fibrinogen was degraded to a 105 kDa fragment via several intermediates (270 and 200 kDa). In parallel with the degradation process, plasma recalcification times were remarkably prolonged. NK was also detected in the plasma from blood samples drawn 3 and 5 h after administration of the enzyme by SDS-PAGE and Western blotting analysis with an anti-NK antibody. The results indicate that NK is absorbed from the rat intestinal tract and that NK cleaves fibrinogen in plasma after inraduodenal administration of the enzyme."

By the way, weeks ago, I sent a message to the "leading NK expert in the US, Ralph Holsworth, DO," asking about proper dosing for NK in general, but unfortunately, I never received a reply. (Maybe the contact information I found on the web for him was outdated; since I can't find a record of an email to him in my email account, I guess I sent that inquiry through his patient office service, which was probably not appreciated. He seems to be unreachable by the general public!)

Hi Travis - sorry I didn't see this new entry on page 3. I should learn to check more than the first page.

Yes. Cardiokinase. If you look through the two reports on Nattokinase in CR 39 and 40, you'll see that the importance of using a reliably sourced enzyme is critical. There are numerous products claiming to be a true nattokinase enzyme but don't measure up. This is one area where it's important to be sure that what you take.... works. Preventing a clot is obviously critical. Personally, I would not risk taking anything that Dr. Holsworth doesn’t endorse. (you recall my story about the clot in the LAA back in 2003). I’m sold.

Initially, the preferred NK enzyme had the designation NSK-SD... and now in Cardiokinase, the enzyme is listed as Nattokinase Strain N - 25 IU delivered in 3 softgels (100 mg) … whereas the previous dose strength was fibrinolytic units or F.U. Note that for Cardiokinase, it says to take another capsule at bedtime.

Award Winning Cardiokinase contains a new kind of Nattokinase even more potent than the original. Cardiokinase incorporates a new strain (“strain N”) of Bacilius Substilisin that produces higher activity than all other nattokinase strains. This new nattokinase is the absolute strongest nattokinase available. This nattokinase has the additional health benefit of being 100% Non-GMO. No other nattokinase can make these claims.

To answer your question, initially and all through my afib years starting in 2002, I took the NSK-SD…dosing equal to 3,000 FUs daily. And continued that dose after my first Natale ablation in 2003 right up until the time in 2014 when I went on Eliquis for Ablations 2 and 3. Now that I am on half-dose of Eliquis, I’m adding Cardiokinase back in -- just 2 capsules a day with always one of those at bedtime. I also use other supplements to ensure I meet all the proper test levels for contributors to thin, slippery blood.

I don’t ever recall being reminded to gauge dosage by the weight of the person…. in the literature, my vast collection of reports from Dr. Holsworth, and various studies of lab animals and with patients…regarding the properties of clot lysing with regard to speed and efficacy.

Let me know if this helps.

Jackie

PS

Be sure to read through the Cardiokinase report at this link. [www.pureprescriptions.com]

Here’s an important observation written by Dr. Holsworth from the website on Cardiokinase. Be sure to note the chart above the text.
[www.cardiokinase.com]


Other Brands in this comparison chart are considered to be any proteolytic enzyme (bromelain, papain, fungal enzymes). These brands are based upon a false identification of FUs activity and are not nattokinase. (See note below from Dr. Holsworth explaining this in detail)

Since my introduction of nattokinase as a safe and effective therapeutic modality into the clinical and hospital setting in 2002, I have been searching for a standardization of nattokinase that will allow health professionals to determine two important facts concerning the use of nattokinase;

1. Biochemical validation that the substance is nattokinase, specificity

2. Accurate determination of fibrinolytic activity in vitro, sensitivity

The previous standardization of nattokinase identified activity in fibrinolytic degradation units (FUs). Unfortunately, the test does not validate whether the enzyme is in fact, nattokinase. Any proteolytic enzyme (bromelain, papain, fungal enzymes) tested using this test would erroneously report fibrinolytic activity or the ability to degrade cross-linked fibrin. Many companies manufactured, produced and falsely identified their bulk and/or finished retail products as “nattokinase” based upon a false identification of FUs activity. Can you imagine a physician prescribing insulin that was not truly insulin or the units of the insulin were incorrect? Many patients’ lives depend upon securing a valid form of nattokinase and accurate determination of its activity because they do not have a pharmaceutical drug such as an anti-coagulant that they can tolerate and/or is effective in the prevention of their condition of inadvertent blood formation.

In addition, the substrate utilized in the previously standardization for determining the activity was not soluble so activity determinations were inaccurate and not reproducible.

Dr. Hiroyuki Sumi, Ph.D., a medical researcher in thrombolytics who discovered nattokinase in the 1980's, has developed and published a new standardization method that validates not only the biochemical identification of the enzyme as nattokinase but also the activity or ability of nattokinase to degrade or lyse cross-linked fibrin in International Units. Now, physicians and patients are insured that they are receiving authentic nattokinase in a stable and quantified amount of activity to address various medical indications.

-Dr. Ralph Holsworth
Nattokinase Pioneer & Researcher

Jackie:

3,000 FUs...what does that translate to in terms of Cardiokinase capsules? The only measurement on the Cardiokinase label is 25 IU per capsule. I'm assuming FUs are not the same as IUs.

Thanks,

Travis

Travis... from the Pure Prescriptions weblink on Cardiokinase... the slide presentation...

b]What is the Difference between Fibrin Units (FU) and International Units (IU)?[/b]

* A Fibrin Unit is an old standard of measurement that used to be associated with nattokinase, but is not currently endorsed by Dr. Sumi

* Cardiokinase features the more widely accepted International Units

* Comparative testing has confirmed that 25 IU (100 mg) of Cardiokinase is equal 2500 FU of the old nattokinase which was only 2000 FU per 100 mg, making Cardiokinase much more potent


Why is Fibrinolytic Activity Important?

Fibrin is a protein that naturally forms in the blood after trauma or injury. The body can also produce fibrin when there is no trauma or injury. When this type of unhealthy formation occurs, there are major implications for cardiovascular and cerebrovascular health. The fibrinolytic activity of Cardiokinase™ can help to:
• Minimize the formation of an inadvertent blood clot
• Decrease blood sluggishness (anti-viscogenic)
• Improve circulation (release of tissue-plasminogen activator—t-PA)
• Maintain healthy effects on blood pressure
• Establish blood cells that are less likely to stick to vessel walls, especially veins, decreasing the development of unhealthy clots
Source: [www.pureprescriptions.com]

Hope this helps.

Tibbar -

Hi Joe - All is good here. Thanks for asking.

Doctors are rightfully cautious about 'seniors' and clotting tendencies as they advance in age and of course when they are afibbers. If you have a choice, then certainly, if you got along well with coumadin, then continue... as there is at least peace of mind with coumadin...knowing there is an "easy" antidote should you need one. However, you are still bound to the INR testing... correct? So if you don't mind that, then use warfarin.

The one thing that could totally wreck the rest of your life is a stroke or MI so it's smart to give this full attention.

While I absolutely hate blood thinners, I have to say that the NOACs... like Eliquis are certainly less of a hassle... as long as you can get past the knowledge that if you have a severe trauma with bleeding, you are likely not to survive. But...that said, that could also happen with coumadin if you didn't get the reversal agent quickly enough.

I managed to get that dark thought out of my mind and only had some minor inconveniences with excess bleeding from minor traumas such as aborted insertions of IV ports that didn't go well... or removal of same without proper care to apply pressure to the site once the port was removed. Otherwise, and in addition to Eliquis side effects that I noticed, it was a lot more convenient.

I'm glad you are holding so well in NSR with your current meds. That's good news. Let me know what you decide to do.

Best to you,
Jackie

Hi Jackie (and others),

I found a description of another nattokinase product (LifeExtension) that seems to have well-documented properties. The associated webpages (see the two links below) also have comprehensive information on various supplements relevant to afibbers. Click on the "Life Extension suggestions" and "quick menu" for even more information.
See below for more details that came to me in response to my email inquiry:

"We are sorry to hear that you have atrial fibrillation, but we are happy to provide you with information on the nattokinase we use in our product, which is NSK-SD Nattokinase. Please note that due to strict Food and Drug Administration (FDA) regulations, we are restricted from claiming that a supplement can dissolve a blood clot. We understand that information that we send to you may be posted and shared with other readers.

NSK-SD is an identical strain to that of Dr. Sumi's nattokinase (Dr. Sumi discovered and researched nattokinase). Subsequently, all Dr. Sumi's research validates NSK-SD efficacy. Also, this form provides the highest activity of >20,000 fibrin units per gram. There is no detectable presence of vitamin K, and thus this eliminates any potential adverse drug interaction with medications that interact with vitamin K. The manufacturing process is patented and protected by trade secrets in purification. We consider this to be the only superior form of nattokinase clinically and scientifically proven and validated. It is used clinically in U.S. hospitals. It is the only nattokinase with self-GRAS affirmation and medical food clearance. Over $1 million has been spent to assure safety in toxicological data specifically on NSK-SD using animal and human studies. Also, the Japan Nattokinase Research Association only recognizes fibrin units (FU), not international units (IU).

For additional information and suggestions, here is a link to our protocol on arrhythmias as well as a link to our blood clot prevention protocol:

[www.lifeextension.com]

[www.lifeextension.com]

If there is anything else that we can help you with, please e-mail us or call the wellness specialist helpline at (800) 226-2370; international customers dial 001-954-202-7660. We will be glad to assist you.

Thank you for choosing Life Extension as your source of health information.

Life Extension
Health Advisors
(800) 226-2370"

Yes - I'm very aware of Life Extension and several other NSK-SD products as well. My history shows that that form served me very well in lysing the clot that formed in my LAA...back then.

I later switched to this upgraded formula because of my history with Dr. Holsworth and his experience...thinking that a more 'efficient' version is an improvement, but certainly, the original did work well. I understand why LEF claims theirs is better... as do most bottlers.

I just rely on the Cardiokinase info:

* 20% more Fibrin Units (FU) per capsule than NSK-SD; Exceeds all current standards

* 10% better lymphatic absorption than NSK-SD

I also use a separate vitamin K2 MK7 product ... (in fact by LEF) to help manage that issue as well.

As I commented previously, I don't rely solely on nattokinase to prevent platelet aggregation. Managing the inflammation that leads to the stickiness is paramount...so those appropriate tests are what needs to be done so one knows where the focus needs to be IN ADDITION to the NK to help prevent a clot calamity.

Jackie

Hi Jackie,

Thank you for responding so quickly. I am especially appreciative, because you are a very successful afibber with much experience with supplements. My main interest in posting my last message was to add to your previous message about Cardiokinase. From reading it I got the impression that any other brand of nattokinase was not reliable, or would probably be improperly labeled due to inaccurate analysis. That news was important to me because I have been using other brands that I thought were trustworthy, even though they don't have the extra high potency as Cardiokinase. Out of the five vitamin companies I emailed (NOWFOODS, LifePriority, Doctor's Best, LifeExtension, I forgot) for more information on their product's analysis, LifeExtension was the first company to reply. Of the rest, only NOWFOODs replied but was much less informative.

LifeExtension did not make any claims of superiority, but they assured me that their product (NSK-SD) was reliably analyzed and labeled. Their information stated that 100 mg of its nattokinase had 2000 FU, which reveals that it is 20% less potent than Cardiokinase. However, their product information at their ordering webpage indicates that it is specially formulated to provide very good delivery to targeted tissues.

I thought it would also be of interest that the Japan Nattokinase Research Association only recognizes fibrin units (FU), not international units (IU) (according to LifeExtension's recent email to me) - despite the fact that FU is not endorsed by Dr. Sumi.

I also appreciate you reminding me about other ways to prevent platelet aggregation. The last sentence of your last paragraph of your July 31 (12:29 PM) message responding to my previous post was this:
"Managing the inflammation that leads to the stickiness is paramount...so those appropriate tests are what needs to be done so one knows where the focus needs to be IN ADDITION to the NK to help prevent a clot calamity."

Would you please summarize, within this topic, what these appropriate tests are?

Aaron
(aka NoNOACster)

Hi Aaron - Thanks. I appreciate your sharing the information you have gleaned. If I've learned one thing about various bottlers of supplements, it can be difficult to uncover accurate details from some, but not all. I'm not posting this to throw stones at any in particular but have learned to trust some more than others...and find often the wording is skillfully manipulated. That said, I agree that LEF is a reliable source and would trust what they state. I (personally) think it makes sense to stick with the Fibrinolytic Unit designation.

In any event, the importance of what enough NK can do for us is the true issue. Do check the current thread that is running at this link as well for more detail. [www.afibbers.org]

Following is the post with the tests that help determine if one has blood that tends to be 'thick and sticky' leading to easy clot formation, titled Sticky, thick blood - risk of stroke and MI at this link... [www.afibbers.org]. An advanced search on the topic brings up an abundance of posts on various facets of this topic. .. Go here: [www.afibbers.org]

Now... Here's that post...on what tests monitor factors that influence the 'thick, sticky blood'...

Jackie [ PM ]
Sticky, thick blood - risk of stroke or MI
September 06, 2012

For new readers or for those who may have not been reading regularly and may have missed the many discussions about inflammation and sticky, thick blood leading to risk of stroke or heart attack, this is a reminder to become very knowledgeable on the key risk factors which can be identified by specific highly-sensitive tests.

Preventive medical care should be high priority and these tests should be routine, but apparently, there is more money to be made from having to stent or do bypass surgery. What other reason could there possibly be for not screening everyone with tests that truly are preventive indicators? Typically, unless you see a doctor who practices integrative/functional medicine, you’ll have to ask for these special tests and often pay out of pocket. It makes no sense that this is the case, but that’s the way it is. (Medicare pays for some but not all.) You can call the lab that routinely does your blood draws and ask which of these tests are covered by insurance and the cost if not covered. If you have to pay out of pocket, try to get as many as possible and eventually, all of them.

Afibbers, especially, should be screened routinely and if any numbers are out of range, then immediately take corrective measures to normalize the levels. Don’t rely that your cardiologist or internist is routinely checking. You have to be the one to make sure you know your numbers.

Overly sticky, thick, inflamed blood has a tendency for adverse clotting. Test, don’t guess.

INR measurements while on warfarin/Coumadin only indicate that specific number and as we know, warfarin does not protect us 100% from the risk of adverse clotting. If one or several these risk markers are out of the safe range, you can still have complications.

This is the list for essential testing
Homocysteine
Fibrinogen
Ferritin
High Sensitivity or Cardiac C-reactive protein
Hemoglobin A1C
Lipoprotein (a)
Interleukin – 6
Oxidized LDL

Elevated homocysteine, above all, is a very important marker. Everyone should read about and understand the role that elevated homocysteine plays as this is a serious influence. Many past posts on homocysteine have been offered. The Internet is loaded with information… specific reference would be the book by Kilmer McCully, MD… The Homocysteine Revolution. Start here with this link – 2 part report plus others
[www.spacedoc.com]

(also)
Refer to the original post describing these marker tests.

Red Flags to Beat the Odds
PREDICTING YOUR RISK FOR HEART ATTACK OR STROKE –THE SILENT SYMPTOMS
[www.afibbers.org]
(Interleukin is not on this post… it’s an important measurement to rule out inflammation).


Integrative Cardiologist Stephen Sinatra says:
Interleukin-6 is important because it stimulates the liver to produce CRP. And, in addition to heart disease, we are learning that this cytokine has a strong association with asthma (asthma is the result of airways swelling and constricting, so it makes sense that an inflammatory agent is behind the curtains here as well). The Iowa 65+ Rural Health Study demonstrated that elevations of interleukin-6 and CRP were associated with increased risk of both heart disease and general mortality in healthy older people.

I’m convinced that interleukin-6 may be an even better marker for inflammation than CRP because these “precursor” levels rise earlier. Therefore you should ask your doctor to conduct an interleukin-6 test.
----------------------------

So Aaron, for each of the tests in that list, you can Google to read more at Lab websites that offer those tests.
Lab Corp may do most. Metametrix will do all, I believe, and probably many other specialty labs in various locations such as Meridian Valley in Kent, WA offer as well. Life Extension offers tests at fairly reasonable rates as well.

Insurance covers most of them. I'm retired and on Medicare and Lab Corp covers most of them for me. My Functional Medicine MD likes to do them at least once a year if not twice... or more, especially if one or more are significantly out of range.

Hope this helps. My focus has always been that I had enough woe from AF, I didn't need yet another complication to cause even more problems. Fortunately, I've been in a positive holding pattern.

Let me know if I can help more.

Jackie

Thank you, Jackie,

Thanks for your comprehensive reply! I've noted your list of risk markers and their acceptable ranges; I was aware of the homocysteine and the CRP, but not the others. So now I have a good guide for re-examining and evaluating my most recent lab tests ordered by my primary care physician. They were all in their "normal" ranges according to my doc, but I have never been satisfied with the official normal ranges of anything.

My doc is concerned that I am not taking any of the prescribed blood thinners (NOACs) relevant to my chads2-vasc score, but has not been pushy. I am grateful for that, since I value his perspective as a sort of reality check. He has entered all my self-prescribed supplements (including my ancient Chinese herbal meds which contain 10 to 20 extracts each) into his medical center's patient-friendly official database. He has told me that none of my supplements (for example, fish oil, nattokinase, vitamin k2, etc) have been scientifically proven to be effective and safe (in preventing strokes), individually or in any combination.

My very cautious doc (an Internal Medicine physician, MD/MPH, whose special interest is in preventing medical errors) knows that I have found many studies online (via pubmed, google searchers, etc) that indicate that these supplements provide control over some of the associated risk factors, but he points out that most of the studies (if not all of them) aimed at proving an effect on stroke are too weak or inconclusive. So far, unfortunately, I have to agree, because almost all of the randomized controlled trials (RCTs) I have found on any of my supplements seem to possess a lot of bias (poorly designed) and/or were done using participants who were: very ill; taking drugs concurrently; had lifestyles or supplement histories that were not clearly defined; in a trial that was plagued by poor adherence to the stated intervention.

Even though this is a large forum with many members, only one member (you) has actually addressed my original question regarding research comparing natural blood thinners to doc-prescribed blood thinners. Answers to my question might be in some of the other posts, but I have not noticed any addressing the problem of effective stroke prevention in persons who have declined taking doc-prescribed blood thinners. Dr. Larsen did attempt a self-designed program of using supplements, but it was mainly aimed at alleviating his persistent, severe afib symptoms, not at preventing stroke for which atrial fibrillation, for some persons, is a significant risk.

It seems that the chances of finding a strong RCT that uses a supplement as an intervention are very slim, because there is really no incentive for drug companies, medical research organizations, or medical centers to invest big bucks in them. The results would not return a profit.

It would be ideal to be using a set of supplements whose efficacy and safety have been confirmed by a well designed RCT, but a pretty darn good alternative is the collective practical advice of members of this forum.

Meanwhile I continue to strive to conduct my own one-participant RCT, using my own medical records and my carefully selected combination of supplements. Documentation is very important in setting up a good RCT. In accordance to that objective, I have joined a very large prospective or longitudinal study being conducted by three principal investigators through UCSF: See here for more information: [www.health-eheartstudy.org]. I am hoping some cohorts relevant to afibbers' interests will be developed and organized out of their massive and rapidly growing global-scope database.

It'd be welcome to me if one or more afibbers, who have declined taking NOACs or coumadin, would identify themselves and join me in this endeavor.

Take care,

Aaron

Hi Aaron - Thanks for your very detailed reply. I appreciate your in-depth examination of this topic as it certainly is both relevant and important.

For obvious reasons regarding medico/legal liability, the information provided here is just that… “informational” and not intended as absolutes or medical directives. As you probably know, it’s typically against FDA rules to allow a supplement to claim a “cure” or benefit unless fully approved by the FDA. For many supplements, there are studies that “prove” beneficial effects for a variety of uses. Keep in mind that unlike allopathic medicine, often, it’s the tracking of the various pathways to the end result… that is… knowing that the markers listed in that report measure factors such as inflammation and viscosity that tend to promote hyperviscosity (as demonstrated in hemorheology analyses) so could lead to hypotheses that various nutrient properties support lowering blood viscosity by various means.

Nattokinase has some published studies. See some of the references at this link [www.smart-publications.com] plus those two CR sessions. And, various other studies have shown lowering of blood viscosity by Omega 3 Essential Fatty acids. Various other studies on herbals such as turmeric and bromelain (and others) show anti-inflammatory properties and so on. You have to link by association. There is the 2003 study on maritime pine bark or pycnogenol preventing deep vein thrombosis on long-haul flights that remains a viable, natural herbal treatment for clot prevention. [www.ncbi.nlm.nih.gov]

My 21 years of in dealing with arrhythmia and researching natural approaches that would keep me safe but yet avoid (for me) the side effects of anticoagulants is behind my constant focus on what patients can do to help prevent adverse clotting if not using a formal Rx anticoagulant.

My situation with low platelets plus multiple chemical sensitivities (MCS) is limiting; yet I want safety, obviously. Back then, warfarin was the only option. I didn’t do well with that so choose not to use and opted for supplements that offered anti-platelet aggregation benefits, including the nattokinase which I used before and after ablation #1. My events were often very lengthy – 24 – 27 hours of …4 hours in NSR and then back for another long session.

Thankfully, the nattokinase, magnesium, Omega 3’s, pycnogenol, ginkgo, and all of the other natural thinners and anti-inflammatories kept me me clot-free. For ablation #1, I was required to be on warfarin a month prior and 3 months after the ablation. Then I went back to the natural ‘healthy maintenance’ approach until 11 years later for ablations 2 and then 3, the following year – Eliquis was required and I remain on half dose. I currently use a combo of lower doses and the half-dose of Eliquis.

Over the years, I have consulted with many highly-regarded and well-credentialed physicians in cardiology and other specialties – all of whom confirmed the position that there were no options to Rx drugs. With the initial onset of Afib, I began branching out and consulting with the ‘holistic’ MDs available and began to learn about natural healing options. Today, they are recognized as Functional, Integrative and Restorative Medicine physicians. I’ve been in the care of a board-certified Family Practice Functional Medicine MD for 15 years along with a D.O. as my primary care physician. They manage health challenges differently from allopathic physicians who choose drugs or surgery as the first choice and are typically not receptive to alternatives since nutritional approaches to healing are not part of their education. That’s common, although now the trend is changing. Witness the recent addition by behemoth, Cleveland Clinic Foundation, adding the Center for Functional Medicine headed by Mark Hyman, MD. There is hope.

So… the Functional approach to hemorheology looks at the various influences or test markers that offer clues to what underlying factors (besides the obvious arrhythmia) contribute to adverse clotting in the first place (whether or not there is arrhythmia) and then working to normalize those influences so patients are healthier and have less overall risk. Take lectins in one’s diet, for instance. Doctor’s don’t typically mention to patients that lectins (glycoproteins) in food can cause inflammation and play havoc in the arteries.

As an example… Louis Cordain, PhD author of The Paleo Diet, wrote in his March 2008 Paleo Diet Newsletter… about "Whole Wheat Heart Attack Part 2: The Role of Dietary Lectins," how dietary lectins found in wheat, promote the formation of fatty streaks and mature atherosclerotic plaque in the arteries.”

He elaborates:
“ Common dietary lectins are potent stimulators of inflammatory cytokines in white blood cell cultures20,21. In Figure 3 you can see that lectins from lentils, kidney beans, peas and wheat potently increase the production of inflammatory cytokines (IL-12, IL-2, and INFγ). Wheat lectin (WGA) also stimulates production of two other inflammatory cytokines (TNFα and IL-1β)21 that promote the atherosclerotic process. Consequently, if dietary lectins reach circulation intact, which previous human and animal studies demonstrate1-5, they have a high probability of causing glycocalyx shedding, thereby increasing entry of monocytes into the intima and contributing to the formation of the fatty streak. Because of their potent inflammatory nature, dietary lectins have the potential to promote and accelerate atherosclerosis at all steps of this disease where inflammatory cytokines are operative. You will recall that one of the deadly steps involved in atherosclerosis is the rupturing of the fibrous cap and the formation of a blood clot. Enzymes called matrix metalloproteinases (MMPs), secreted by white blood cells and other cells within the plaque, are known to cause collagen and elastic tissue within the fibrous cap to disintegrate.

Consequently, any dietary or environmental factor which facilitates synthesis of MMPs is not a good thing for cardiovascular disease patients. Well guess what? Lectins from wheat, WGA22, and lectins from kidney beans, PHA23, cause tissue cultures of white blood cells to increase their production of MMP."
(Source: [deflame.com])

Bottom line is: While it’s easier and definitely standard of care to take a blood thinner to avoid clotting, what about the rest of the body and why isn’t it critical also to determine the source of the thick, sticky blood? This is important for everyone and not just afibbers. However, with the risk of poor clearance in the heart as with AF, one has to be aware and take proper precautions. No one wants to risk a stroke or MI.

Def: hemorheology – The scientific study of the deformation and flow properties of cellular and plasmatic components of blood in macroscopic, microscopic and sub-microscopic dimensions and the rheological properties of vessel structure with which the blood comes in direct contact. Dorland’s Medical Dictionary

Be well,
Jackie



PS By the way, these are the only details I have, but a friend asked me for Dr. Natale’s contact info for a new afibber living in Texas. Apparently they were Facebook 'friends' and the Texas guy (age 50) was concerned about his afib but didn't want anticoags. By the time my friend emailed me and I returned email, the afibber had died. That’s all we know. Could have been something else, but could have been a case of thick, sticky blood combined with arrhythmia.

Hi Jackie,

Thanks for your additional information! That's a lot of content to consider and weave into my own situation. I have also found studies for the supplements you mention; some of them seem very familiar to me. For example, the use of pycnogenol, which, if I am recalling it correctly was used along with nattokinase, making the trial results unclear for the benefits for either one of the two supplements.

When you say "lower doses" of the combinations of anti-inflammatory supplements, do you mean half the dose as shown on product labels?

Referring to our discussion about studies of supplements, I think I might have found a rare, well designed and generously funded RCT for one of them! The supplement is the complete full spectrum "tocotrienols (TCTs)," less known members of the vitamin E (tocopherols) family. Studies have indicated that tocotrienols support arteriogenesis and protects against ischemic stroke. The two types are incompatible, since the tocopherols suppress levels of the TCTs; so take them hours apart. I have begun taking the TCTs before bedtime a few hours after my last meal and long after my morning dose of regular vitamin E. The full source of clinical trial data may be found at [clinicaltrials.gov]. I classify this study as "rare" because it is unusual for this kind of support and follow through to be lavished on a natural supplement. The reason for its success to date is its funding, at least in part, by another government besides the United States: Malaysia! Through its government's Palm Oil Board. And because of its connection with the principal investigator, a longtime researcher at the Ohio State University Medical Center (Columbus). This study will not be complete until December 2016.

I am also interested in your use of Functional, Integrative and Restorative Medicine physicians. I believe I should follow your example! I am in Houston, Texas and have only begun a list of DO's in the area. Do you know of any physicians in my area that practice Functional, Integrative, and Restorative medicine?

One more topic
I have just now noticed the existence of a method that could be used to fine-tune one's use of natural blood thinners. A device called the AliveCor Monitor (Kardia app). For more details, see:
[www.eplabdigest.com] AND
[www.pennmedicine.org]
What do you think about it?

Hi Aaron - I apologize for the delay in response.

Answering your questions. I took the pycnogenol years before I developed AF and as I recall, I had actually forgotten about using it. When I began using nattokinase, I was not using pyc.

The lower dosing on antiinflammatories... I typically alternate days and times. Take the full dose, but for some, only on alternate day; others I do take every day. I realize that's vague for your use... so you could start by using either half dosing.. or as I do, only every other day... or just on MWF of the week.

As for the two types of vitamin E. I use the Mixed tocopherols in the morning... and separate out the Tocotrienol for the evening dose... as directed by the Tocotrienol expert, Barry Tan, PhD. You can google him.. .he has an interview with Richard Passwater MD and also a YouTube presentation.

I always take the fat soluble vitamins... A, D, E and K, with my Omega 3 fish oil doses and some coconut oil to assist with assimilation.

If you send me a PM I'll help you check to see the availability of FM type practitioners in your area.

On the AliveCor monitoring device.... I'm sure it's the very best way to monitor. I was offered the opportunity to have the device implanted during my second ablation but declined for a number of reasons.

Hope this helps.

Jackie

Gentlefolk,

Is there any independent reliable blood stickiness test on the horizon ?

It would make life a lot easier !

Thanks

Alex