Need for Blood Thinners

I have Lone Atrial Fibrillation, and after two cardioversions was started on Flecainide, Atenolol and Pradaxa. This has worded pretty well with only a few brief incidents in the past two years. I had decided to discontinue the daily Pradaxa use, because I understood that blood clots take a day or so to begin to form and If I am in rhythm, there is no need. I take my pulse daily and know if I am out. A few months ago I was out for 2 days and took the Pradaxa for a month. Very recently, I was told that there is recent research showing that blood clots can begin to form in as little as 6 minutes. If this is the case, it seems that daily use of blood thinners is essential to reduce risk of stroke. Since I have the vagal variety and it usually starts while I am asleep, it is likely that I would not know that I was out for much longer than 6 minutes.

Is anyone aware of this research? Is there any research on frequency of strokes for people with afib?

I would greatly appreciate any input relative to these maters.

Reuben

I don't know about any research but if you sleep heavily you could go into AF and not know it. IMO discontinuing Pradaxa on you own is playing with dynamite. Once a clot begins to form anticoagulants are not clot busters so you could be out of luck. DO NOT stop taking Pradaxa unless your prescriber tells you it's safe to do so.

Reuben - There is always a risk for an AF event to go unnoticed...especially during sleep...which obviously increases your risk for clot formation.... especially if your blood tends toward hyperviscosity... or what I usually term, thick, sticky blood. There are several recent posts related to the topic of hyperviscosity and testing of factors that are indicators or markers of blood viscosity...plus various nutritional supplements that help thin blood naturally by reducing inflammatory factors that help promote the "stickiness"... including blood glucose.

Read through these for the general idea and consider having the tests done so if you do decide not to use Pradaxa, then at least focus on keeping your blood flowing smoothly by using natural aids that help. Nattokinase is the natural enzyme that helps prevent clotting or lumbrokinase if you have a soy sensitivity...plus others such as generous doses of Omega 3 fish oil, Pycnogenol or maritime pine bark... proven by studies to lower risk of deep vein thrombosis in long haul flights and also useful for non-travel prevention. These posts offer other aids as well.

Supplementing with magnesium not only helps diminish AF events but also helps keep platelets from sticking together...and always remember to drink plenty of pure water daily.

[www.afibbers.org]
[www.afibbers.org]
[www.afibbers.org]

Be well,
Jackie

Jackie:

I started taking a product called Nattoivita from dr. Brownstein, it has Bromelain, Proteinase, Nattokinase, Papain along with Vit. E, b6, folic acid and vit K2. Natto is derived from soy, I understand that Nato is fermented, so as you know I have a thyroid problem, is this product ok for me?

Liz

Reuben,

What is your CHA2DS2-VASc Score <[www.mdcalc.com] ?

Quote

The CHA2DS2-VASc score has since been validated in multiple cohorts; the accumulated evidence shows that CHA2DS2-VASc is better at identifying ‘truly low-risk’ patients with AF and is as good as, and possibly better than, scores such as CHADS2 in identifying patients who develop stroke and thromboembolism. Amongst patients with CHADS2 score = 0, the 1-year event rates can range between 0.84% (CHA2DS2-VASc score = 0), 1.75% (CHA2DS2-VASc score = 1), 2.69% (CHA2DS2-VASc score = 2), and 3.2% (CHA2DS2-VASc score = 3).38 Also, CHA2DS2-VASc refines stroke risk assessment in ‘low-risk’ AF patients after ablation.

From: <[eurheartj.oxfordjournals.org]

How to proceed depends upon your risk profile.

George

Liz – well certainly if Dr. Brownstein has prescribed it, he must feel it’s safe for you but it's always good to double check.

A question, though.... Since your thyroid is ‘nuked’ (as you say) and rendered nonfunctional, then I don’t understand the soy concern…unless you have a soy sensitivity or a true soy allergy which is another issue entirely.

Typically there is concern over soy consumption if there is a thyroid function problem. However, from the Conference Room Session 40 on Nattokinase… page 2… this notation:

Soy Allergies
The specific form discussed in this post....purified NSK SD – is safe for people with soy sensitivities but people with
extreme soy allergies resulting in anaphylactic shock should NOT take nattokinase.

That said… one of the labels from the recommended original NSK-SD nattokinase indicated this:
"Nattokinase 50 mg NSK-SD™, Allergy Research Group® Soybean oil, soybean lecithin, glycerin fatty acid ester,
beeswax.

And the newer Cardiokinase label indicates this:

Cardiokinase™
Nattokinase (Strain N) 100 mg (25 IU) -
Other Ingredients: Gelatin and Glycerin (Softgel) Soybean oil, Glycerin fatty ester, Bees wax.
Allergen Statement: This product contains soy. No gluten, milk derivatives, or artificial colors or flavors.


So - We’ve always gone with the assumption that small amounts of soy for those without a true allergy to soy can use it without worry. The true allergy would be when exposed, they have an anaphylactic shock reaction; but a sensitivity should not pose a problem for most people although caution should always be the operative word.

I spent some time searching online to see if there were other comments on the soy sensitivity issue. Opinions vary but most say that there is a very small amount of soy and not to be concerned. Still, it makes sense to be aware and very cautious depending on if you have soy sensitivity or a true soy allergy.

Here are some links on thyroid function and soy ... in case you want to investigate more.

[www.mayoclinic.org]
[www.medicinenet.com]
[www.ncbi.nlm.nih.gov]

Hope this helps,
Jackie

Jackie:

Yes, I had my thyroid "nuked", but they try not to completely eliminate the thyroid, I still must have some thyroid function. I take 125 mcg. (synthroid) everyday, I know people that take a much greater amount, so I think my thyroid is not completely eliminated.

I don't know of any soy allergy that I might have, since natto is fermented, doesn't that change the composition of soy?

Thank you for the links, you have had thyroid issues and take natto in your blood thinner med. has it affected your thyroid in any way?

Liz



Edited 1 time(s). Last edit at 08/17/2016 03:30AM by Elizabeth.

OK - Liz - thanks for the explanation.

As you note, I was treated for many years for hypothyroidism. Synthroid didn't work for me and actually facilitated formation of a goiter with nodules. I switched to Armour and that, plus supportive nutrients for both adrenal burnout and the thyroid issues, normalized both issues. I no longer use Armour thyroid, but do still use thyroid support nutrients (including iodine) plus a couple of natural thyroid glandular products advised by my FM MD. The nodules continue to diminish in size or disappear with each annual ultrasound.

I believe it was around 2002 when I learned the nattokinase details from Dr. Holsworth and began taking it. I wasn't worried about thyroid function interference and I don't have a soy allergy so that wasn't an issue, either.

When I began Eliquis, I stopped the nattokinase and many of the other nutrients I used to facilitate thin, slippery blood.
Now, after reducing the Eliquis dose by half, I have begun using small doses again of NK and several of the others I previously used. However, I did not ever lower magnesium doses even though that does help prevent platelet aggregation. I have not had excess or alarming bleeding with cuts.

Jackie

the accepted time from for actual LAA-based (left atrial appendage) clot formation is recognized at 5 hours now. Not 6 minutes, though no doubt one could make an argument for noting at what moment a given clot first started to form out of some 'smoke' or SEC (spontaneous echo contrast) which is turgid stagnant blood flow often in the LAA in the presence of AFIB where even the LA and RA themselves are largely just quivering and not pumping efficiently at all, and the smaller side chamber located in the upper anterior quadrant of the LA called the LAA is where close to 95% of all AFIB related clots/strokes originate. LAA based stroke tend to be very serious due to the typical large size of these LAA clots when they break free from the LAA and 'embolize' or travel to unwanted destinations like the median cerebral artery, carotid artery, causing stroke are as a PE pulmonary embolism etc. And with around 70% of these LAA-based/AFIB related strokes being fatal!

Keep that in mind when assessing your overall risk comfort level and also factor in that taking Oral anticoagulation is not without its own risks as well so with a CHADS2-VASc score of 0 to 1 most often of the risk of anticoagulation can outweigh the risks of stroke in such cases ... all else being equal.

If the person has a very stroke unfriendly LAA morphology and is in frequent or even persistent AFIB .. that will typically override just the CHADs-VASC score alone and most EPs and Cardio's will press you to go on OAC in such cases.

But the rule of thumb now is that while in practice one needs to get cardioverted within 24 to 48 hours after documented start of an arrhythmia,or else has to wait until OAC drug has been on board for a few weeks time to insure any modest clot resolution, there is a very small, but not nil, chance of a smaller clot forming in as little as 5 hours after beginning of an AFIB episode.

Note that the odds of an early clot formation logically also increase, however incrementally, with any added stroke risk variables one may have as found in the CHADS2-VAS2 scoring system.

But for the most part a full blown stroke or TIA worthy clot is still unlikely prior to the 24/48 hour window for getting a cardioversion without necessarily having a TEE to confirm absence of any thrombus in the LA or LAA.

And Eliquis in most cases does a pretty good job of dissolving clots with in several days to several weeks of starting Eliquis in the presence of a documented LAA clot. But in such case, every cardio or EP will require TEE evidence that any prior detected clot is gone before attempting any left sided procedure on your heart.

Shannon