Hemorrhagic deaths related to Coumadin

Hi everybody:
With all the fear of Coumadin and hemorrhage, has anyone ever seen stats on the risk percentage? Subdural hematomas, intercranial episodes of hemorrhagic CVAs? I'm going to try to research and someone else can try too? Pisan??

Pam

Here's what I have found so far:

Coumadin® is not a safe drug, since it can cause bleeding:

0.5 % of patients on coumadin® die every year due to bleeding;

1 % of patients will have a life-threatening or fatal bleed per year;
4-5 % of patients on coumadin® will have a serious bleed per year (leading to hospital admission or transfusion);

younger patients probably have a lower bleeding risk, and if a patient has not bled during the first year of coumadin® treatment, the risk is also lower;

poorly controlled INRs lead to a higher risk of bleeding





I would have rather seen #1 be 0.05%, but, I'm still looking. I'm sure there are many in this studay falling into the last catagory.

Pam

Pam,

The latest numbers I have are from a study involving 7500 California Medicaid patients. These patients all had AF with accompanying conditions (hypertension, congestive heart failure, prior stroke or heart attack, diabetes,etc.). During the follow-up period 514 strokes were observed.

The incidence of stroke was 3.4 %/year among patients treated with warfarin and 4.1%/year among patients receiving no anticoagulation. This gives an absolute risk reduction of 0.7 %/year. Of course, the drug sales person and most likely the doctor would quote the risk reduction as 17% (relative risk reduction).

During the same period internal bleeding serious enough to require hospitalization occurred at a rate of 3.0 %/year in warfarin-treated patients and at a rate of 2.2%/year in patients receiving no anticoagulation. Absolute increase in risk 0.8% (relative risk increase 36%/year).

So from this data it appears that warfarin reduces the stroke risk (in seriously ill afibbers) by 0.7 %/year while increasing serious bleeding risk by 0.8 %/year. Not terribly impressive really :~)

Hans

Hans:
Thanks for your post. None of this applies to me since with the prosthetic valve, I believe that staying on Coumadin is a must for me. I'm just curious, don't you have some stats for people without underlying heart disease?
So, are you saying that the bleeding risk is 0.1% higher than the stroke risk?
Also, what is the difference between "absolute" risk and "relative" risk"?

In sites I have found speaking of other forms of anticoagulation (homeopathic), there is no documentation of the efficacy or bleeding risks as compared with Coumadin. Right? I found one site that really knocks Coumadin and claims pharmaceutical hype that makes people feel that their safety they HAVE to take it. I'll try to find it again and post it.

Lastly, do you take any anticoagulation?

Pam

Hi everybody. Here's the site I was looking for:

Gordon Research Institute
Garry F. Gordon, MD, DO, MD(H), President
708 East Highway 260, Suite C-1F, Payson, AZ 85541
OFFICE: (928) 472-4263 FAX: (928) 474-3819
www.gordonresearch.com ggordon@gordonresearch.com


Dr. Gordon,
I saw your website and wanted your advice on Coumadin. My grandfather, who is in his late 60s, was just prescribed Coumadin. He has undergone an angioplasty in the past, but his health was ok until last week when he was running fevers and was not responding to antibiotics prescribed for his severe cold.

A doctor advised my mother to bring him to the hospital, and he was checked in since he was running a high fever. The doctors ran all kinds of tests and determined that it is most likely a virus. He remained in the hospital during the testing, and it was discovered that he was having irregular heartbeats. His cardiologist, afraid that the irregular heart beats could lead to a stroke, prescribed Coumadin as a preventative measure. So my grandfather is still in the hospital, as the doctors want to make sure he is regularized.

My mother and myself feel that this might be a mistake as we are reading all the risks associated with this medication. Furthermore, while the doctor said it's only for a month, if it takes this long to regularize on the medication, I imagine that discontinuing it must be difficult as well. Is it? My other concern is that it is possible that the only reason he was having the irregular heartbeats is because he was running a fever at the time.

I would like to know when is the quickest that we could possibly discontinue this medicine? What are the alternatives? and what is your opinion of the situation I described?

Any guidance would be much appreciated.
G. R.

Answer from Dr. Gordon:
The response to all blood thinning substances whether natural or drugs is HIGHLY variable since there are so many factors impacting our likelihood of having a clot or bleeding to death, from cigarettes and hormones to diet and stress, all on top of genetics and chronic infections of our vascular tissues that we all have.

Thus, the poor doctor prescribing Coumadin for your grandfather is merely protecting himself because the powerful drug interests have managed to make this unfortunate practice of using DRUGS and avoiding natural clot busters like Nattokinase, the current STANDARD of MEDICAL PRACTICE.

This means the practicing doctor carries some LIABILITY if he does not try to PUSH his patients into taking Coumadin when they have anything that may increase the risk of a blood clot, and certainly they believe that irregular heart beats is one such risk factor. Unfortunately the powers that be make sure that he knows nothing about natural substances that could do the job far better without any risk to the patient!

If the doctor, however, believed in the doctrine of informed consent he would also HAVE to tell you about the number of SERIOUS bleeding complications that REGULARLY occur with Coumadin. This bleeding can be into the eye (losing vision) or into the spinal cord with resulting loss of function of a part of the patient's body. This warning would help set you free to do your own research and find protocols such as that which I am advocating to you and others on my web site.

The skimpy evidence that the drug company was able to come up with to force doctors in this predicament shows that they have to treat 14 patients for a full year with the toxic substance (it is what we use for rat poison) in order to have ONE less thromboembolic event than would have otherwise occurred. That means 14 patients are placed at considerable risk for a full year, and incur a lot of inconvenience and expense in order to have avoided ONE less heart attack or stroke between them all. And guess what? That is their BEST study and when repeated, by the luck associated with the selection of patients for another study, the so-called benefit may not even be seen again!

Yes, you are right, there are many reasons for temporary existence of skipped beats, particularly fever and stress, and certainly the hospital and the fever you describe qualifies as serious stress. But, the drug companies have lots of money to push their products into the poor consumer through the doctor. With grants and stock options they buy the approval of some big medical heart specialists, who then become the AUTHORITIES and the doctors without the experience are hard pressed to challenge these well-funded pseudo authorities. These authorities then make sure that lots of prescriptions are written by setting up artificial standards so that your doctor is afraid to ignore this Coumadin recommendation. In fact, the drug company makes sure that hospital charts are reviewed to see how many more patients could have been pushed into taking their drug, (under the so called guidelines for good medical practice they push through the system) and the doctors cannot stand up to this PEER PRESSURE.

You have a way out and that is to use your right to freedom of choice and even though you are not an expert in blood clots, you do have common sense and know how to use a computer and the Internet. If it is clear that natural products are no better, then why not do your own research and see what kind of a safe program with proven benefits you can find that does not carry all of these tremendous risks. Start with something as simple as Omega-3 (Salmon) oil, which can do better than aspirin in studies on preventing blood clots. The recent past president of the American Heart Association, writing as editor for the 40 year study on WHY heart patients DIE, concluded that aspirin only gets 1 of the 3 pathways involved in producing these fatal blood clots.

Remember, it is hard for you to know how they manipulate the statistics so it is hard for you to understand just how small the actual proven benefits with Coumadin are. Suffice to say, since experts worldwide now agree that we could avoid at least 70% of all heart attacks and strokes if we did not get these fatal blood clots, then why are we not adding Coumadin to everyone's diet? It is because the harm they know they would do far exceeds the tiny benefit they deliver, and to get that tiny benefit they had to select just those patients at greatest risk of serious clot formation.

This is like the scandal over excessive open-heart surgery that continues to this day even though most of us are aware that MOST of the bypass surgery is now known to be unnecessary. However, they still manage to SELL this unjustified approach to 500,000 each year but the Internet providing alternative information will finally pop that balloon and more and more patients are refusing that surgery and choosing far less toxic approaches.

This Coumadin decision then is something that you as a family can also decide to take your own course of action and thank the doctor for his recommendation but politely decide not to follow it. You can even relieve the doctor of the liability he fears by saying that you as a family, having looked into the benefits and the risks, you have decided NOT TO GO ALONG WITH THE COUMADIN. After all, you read Dr. Foster's report for the American Heart association in his Vulnerable Plaque book that many new drugs are being developed, clearly showing that all experts see the severe limitations to the Coumadin approach. You may learn from a book entitled Antithrombotic Therapy by R. Becker, MD, D. Fintel MD and D. Green MD, PhD, second edition from Professional Communications Inc published in 2002. Purchase it from www.pcibooks.com or call 1-800- 337-9838 to learn all the details about newer drug alternatives to Coumadin.

This book gives you the "success" rate with each study and as you look at it carefully you will see the risks with drugs that manipulate our bodies' clotting mechanisms are gigantic and frightening and the benefits minuscule. I believe that without a doubt anyone doing their homework will find that 98% of the time you will beat the odds published in this book hands down with my oral program as outlined here. When you want to identify that rare case where some drug, usually Heparin, needs to be added to my program, you will send the patient's blood to www.thrombocare.com and do the largest number of tests you can get your doctor to order, as the costs are from $3-4,000. and insurance generally pays.

Go to that website to learn that with proper testing and treatment more than 1 million lives would be saved each year. I believe that I have a non- toxic approach that exceeds those figures because my approach works with the body. There is one report of excessive bleeding apparently associated with the use of high levels of with fish oils (Omega-3) and the patient had hemorrhagic strokes, but there is no proof that this would not have happened anyway.

It is, however, important for the drug industry to try to find any possible risk with anything that is natural, as their drugs are now proven to be the 3rd or 4th leading cause of death in our country, so anyone who knows that would obviously use natural approaches first. Thus, you will see a big effort to try to find someone harmed by some vitamin in an effort to keep the population confused enough that they keep swallowing the expensive drugs that are killing them!

The good news is that there are tremendously effective alternative approaches such as Nattokinase, which is found in a world famous formula Wobenzym, now reformulated specifically for this blood clot prevention need and called ENDOZYM and many other nutritional based blood thinners from Garlic and Omega-3 oils to Vitamin E and Ginkgo Biloba as well as just drinking enough water to stay adequately hydrated at all times.

But, with today's knowledge about how many die of blood clots, I routinely advise an even more aggressive program using things like Nattokinase and oral enzymes and anti-inflammatory products and in selected cases having the patients take intravenous oxidative therapies to lower the body's total burden of microbes (Pathogens) living in the plaque on our vessels. These additional measures are particularly beneficial for those with known risk factors such as your grandfather had.

Regarding my now world recognized oral chelator, ESSENTIAL DAILY DEFENSE, I worked with Dr. Lester Morrison to develop this, starting in 1983. He had focused on the blood-clotting problem using only nutritional approaches for over 10 years as Director of the Arteriosclerosis Research Institute and had spent over $10 million coming up with what was then called the Institute Formula. There are 3 books on his important research. It had become so successful that he documented, using just his early formula, which I was able to help significantly improve when we added oral EDTA, a 91 % PREVENTION of heart attacks. Today this has evolved into the program that I am advocating and explaining here; I virtually do not hear of anyone having a heart attack or stroke. If someone does get a blood clot, as to the lung, which has happened once in 10 years, I found that the patient had serious underlying genetic propensity to developing a blood clot.

Depending on the abnormality, and the patients desires, I may rarely agree that the best approach in those serious cases may be to combine my approach with the drugs in low doses (usually heparin). Using low doses avoids most of the dangers of the Antithrombotic drugs. Furthermore, since my approach emphasizes trying to avoid blood clots first with things like Garlic and Ginkgo and Vitamin E and only when still confronted with a problem, do we carefully add some drug to my preferred regime. This approach then ends the nonsense that if you are on the drugs you must not take anything natural to help lower the likelihood of blood clots.

If you read about the very poor record at really lowering the number of deaths from blood clots published in the drug studies, you would agree that to bet your life on just the drug approach is a truly uninformed approach! The experts admit everywhere that none of the drugs to prevent blood clots are very effective, but due to their toxicity, they have been reluctant to combine the drugs to try and get a broader spectrum of blood thinning benefits, which I can safely do with my approach as explained here.

Much of that blood thinning benefit in Essential Daily Defense is from the unique form of Mucopolysaccarides from Red Algae, which is significantly enhanced because of the presence of EDTA, which also increases blood flow by simply getting out lead that inhibits the production of NITRIC OXIDE (the body's NATURAL blood vessel dilator)!

When I began to work with Dr Morrison, his formula was as hard to take as Metamucil and you had to take huge quantities of it, which was so hard to get down that the only patients that would religiously take it had to be documented heart attack patients unresponsive to standard medications of that time. I helped him improve his formula so it could be conveniently taken in capsules (recommended 1 capsule per 10 # of body weight for high risk patients), by simply incorporating the patented concept from Riker Pharmaceuticals that EDTA in the presence of certain sulfated polysaccharides produces a safe, gentle, heparin-like effect.

The result was produced in 1985 and initially sold to doctors under the name Cardioguard. That product has been improved and reformulated by me over the years and is now sold as Essential Daily Defense. This product incorporates natural heparin/Coumadin like action along with orally effective chelation so that patients get detoxified safely while helping to prevent the blood clots that your grandfather's doctor is rightfully concerned about. It also has organic garlic, which is also a safe, natural blood thinner and major detoxifier for everything including mercury from our body and brain.

With mercury in dental fillings, the mercury released into the environment by coal burning power production facilities, and mercury that comes into our diet from everything we eat, particularly fish such as Tuna, unless you are protected everyday by consuming my Essential Daily Defense (EDD), you will become mercury toxic and develop serious health problems from Chronic Fatigue to headaches, depression and even things like Cancer and Autism, which have been linked to excessive mercury in our bodies. Anyone on adequate levels of my oral chelator not only avoids unsafe excessive clotting tendencies but EDD will also safely lower your toxic metal load, including lead and mercury.

We all, of course, will see quicker and even stronger benefits if we can also afford to see a chelation doctor and receive some more aggressive detoxification and possibly also some oxidative therapy (such as H202, Ozone or UVB or HBO), which only trained chelation/oxidative doctors can provide. It would be ideal if everyone could take at least 30 IV Calcium EDTA by IV push initially, depending on the severity of the problem; this can be as little as once weekly, and later, given monthly, ideally for life. These intravenous therapies are necessary for maximum benefits and are what I tell everyone to obtain who is not seeing rapid enough benefits from aggressive oral programs.

There is no question that rapidly administered intravenous Calcium EDTA, provides a deeper and more rapid detoxification effect; in fact, this is true even if the patient has already had over 100 of the standard slow 3-hour infusions of EDTA. There have been over 1 million patients treated with the slow intravenous infusions of EDTA that I initially advocated when I wrote the protocol over 30 years ago for safe intravenous chelation for patients with vascular disease problems.

We find that, although over 1 million patients have been significantly helped with that program, when you follow my current protocol for rapid IV chelation, to enjoy the full potential detoxification benefits, it MUST be accompanied with ORAL CHELATION (preferably at least 10 capsules of EDD in the 4-6 hours before the IV is given). Virtually every patient treated with this new detoxification focused protocol will see several times more lead etc removed in the 6 hour provocative urine test than was coming out when we used the slower infusion rate. The older protocol was before we had proof that there is no safe level of lead, and that getting the lead out first is the most cost effective approach to dealing with virtually any chronic health problem seen today.

Therefore, with the understanding that the lining of the blood vessels called endothelium can be lead toxic, we are finding that the patient's results are more rapid and more predictable if we focus on keeping the blood thinner, lower in viscosity, more like wine and less like honey. Part of the thickness of blood is due to genetics and part is due to the body's response to the chronic infections in the vascular tissues that we all carry like CMV, Herpes, Epstein Barr, Chlamydia, etc. Thus, my new approach, which is working even on patients where the old chelation protocol is not working, is based on treating ENDOTHELIAL DYSFUNCTION.

Now the doctors see that we do the far more effective heavy metal detoxification because we focus on the proven connection between toxic metals like lead and healthy blood flow and not primarily on the calcium that in many cases is taking care of itself once we have detoxified the body effectively for the first time, which the old protocol is provably failing to do. Anyone disputing that statement just has to check the heavy metal yield in the 6 hour provoked specimens from a reliable lab such as Doctors Data with the old protocol. Then repeat the test following fully my new protocol, with at least 10 Oral EDD, Beyond C 1 tsp twice the day of the test, and alpha Lipoic acid, 200 mg twice daily and add the HEEL Detox Kit taking 30 drops in 8-16 ounces of good water, preferably either PENTA or NARIWA. The water protocol with my oral and the rapid IV chelation shows that the now detoxified Endothelium is able to deal much more efficiently with its major function of supporting healthy blood flow!

Thus, since none of us are adequately detoxified today, even if you eat organically and even if you have had over 100 of the useful slow form of chelation, I recommend that everyone interested in optimizing health and vitality (and achieving their maximum intended lifespan) should detoxify continuously everyday with something. A very affordable adjunct is for everyone to simply add proven, effective, homeopathic detoxification products (See HEEL in Albuquerque NM for their DETOX kit and or go to www.Shelton.com).

However, some of us are so Mercury toxic today that it may be justified to even add, when necessary, small amounts of oral DMSA or DMPS and/or Penicillamine, to hasten the excretion so that the benefits of heavy metal detoxification can be enjoyed more rapidly. Other detoxification for metals includes Alpha Lipoic Acid, I prefer the fat and water soluble form called Thio Gel, and extra intakes of Vitamin C, preferably the most advanced formula in existence anywhere today, the Beyond C because the Ribose, Bioperine, MSM and TMG included in this trend-setting formula provide unparalleled enhancement of the detoxification benefits of Vitamin C. Today we all need detoxification as we all have at least 90 provable dangerous immune suppressing cancer causing, neurotoxic chemicals in our bloodstream at all times, making optimal health impossible for anyone not detoxifying continuously!

If you believe in aspirin, realize that the reason they say to use a baby dose is because aspirin does harm to the body, including hurt the gastrointestinal track, so that people bleed and get rushed to the hospital and many die. But it works by depressing the enzyme cyclo-oxygenase that we need if we are to convert efficiently the healthy oils that I recommend to things like prostacyclin that keep the arteries slippery. This is why eating Salmon regularly reduces heart attacks by up to 40%. I prefer to take the extra omega 3 oils and even take some cod liver oil daily and 1 tablespoon of freshly ground flax seed as a drink each morning.

Only those choosing not to deal with all the causes of abnormal blood clotting rely on aspirin. Yet, there are many that will choose to take some aspirin and perhaps some Coumadin AND my program as described here. That is your free choice as everything I have attempted to do here is to provide information to help educate so that YOU may make a more informed decision as to what to do with yourself and or your grandfather. Those who discontinue Coumadin must read my website under Coumadin and see that I force the patient to make this decision on their own since in our litigious society I cannot make that recommendation except for those who have had the panel of tests done with Thrombocare so we KNOW what we are dealing with and who I have personally evaluated.

Garry F. Gordon MD, DO, MD(H)


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For complex medical questions, we advise a personal recorded telephonic consultation with me at $300 per hour. We mail you an audiotape of the consultation.

Garry F Gordon MD DO MD(H)
Gordon Research Institute
708 E. Hwy 260 Bldg. C-1 , Payson, AZ 85541
Ph: (928) 472-4263 Fax: (928) 474-3819
All contents © 2003 GRI. All rights reserved.

Pam,

I think, overall, the stroke and bleeding risk with Coumadin pretty well cancels each other out. The problem is that all the numbers bandied about by the manufacturer and pro-warfarin physicians are based on very carefully controlled CLINICAL TRIALS. It is now becoming quite clear that the results in real life (CLINICAL PRACTICE) are far less impressive. One major problem is the lack of INR control in real-life situations.

ABSOLUTE risk is what really matters. RELATIVE risk is what is quoted to sell the product. If you have 100 people on warfarin and 3 experience a stroke and you have another 100 patients NOT on warfarin, of which 4 experience a stroke, then the ABSOLUTE risk reduction is 1%. However, the relative risk reduction is 100 x (4-3) divided by 4 = 25%. Guess what number is quoted!

I use a stroke prevention regimen of vitamin E, ginkgo biloba, vitamin C, and fish oils plus aspirin when I actually am experiencing an afib episode.

Hans

Keeping INR between 2.0 and 3.0 at all times by intelligent, careful people is not easy, due to many, many variables. I suspect that the majority of coumadin users are not very good at keeping their INR at the proper levels, due to lack of intelligence, understanding, or being careful.

I suspect that many bleeding episodes are caused by INR levels above 3.0. If this is true, the statistics would show that coumadin is more dangerous than it actually would be if INR was kept at proper levels.

Newman