Understanding How Blood Thinners Work

Blood thinners are medications that prevent blood clots from developing. Blood clots can obstruct the blood flow to the heart. Blood thinners can prevent the formation of new blood clots and also slow down the growth of the existing blood clots. There are many types of blood thinners and they all work in different manners. Understanding how blood thinner works will help you understand how they prevent major heart problems from developing. Read on to find out more about blood thinners.

What are Blood Thinners?

Blood thinners are medications that prevent the formation of blood clots. (1) Blood clots can stop the blood flow to your heart. (2)

Blood thinners can be taken intravenously through a vein or orally for preventing a blood clot. Blood clots can not only stop the blood flow to the heart, but also to the lungs or the brain. This can cause a heart attack or stroke.

You will be advised to take a blood thinner if you are experiencing some type of heart disease, including irregular heartbeats and heart valve disease.

Blood thinners have to be taken exactly as prescribed by your doctor because when you make any changes in the dosage, it might be that it will stop working properly.

Taking too little of the medication will not be effective, and taking too much will lead to severe bleeding. So follow your doctor’s instructions exactly.

Understanding How Blood Thinners Work

There are different types of blood thinners. Some of them thin out the blood to keep blood cells from sticking to each other within the veins and arteries (known as antiplatelet drugs), while others prevent blood clots by increasing the amount of time it takes for clots to form (known as anticoagulant drugs).

Antiplatelet blood thinners work towards preventing blood cells known as platelets from sticking to one another and forming blood clots. Some of the common examples of antiplatelet blood thinners include:

  • Clopidogrel (brand name Plavix)
  • Aspirin
  • Ticlopidine (brand name Ticlid)
  • Dipyridamole (brand name Persantine)

On the other hand, doctors prescribe anticoagulant blood thinners to people who have been diagnosed with some type of heart disease. Coagulate is the medical term to refer to clotting, and these anticoagulant blood thinners work by preventing the formation of blood clots. They do this by increasing the amount of time it takes for your blood to clot. (3)

Anticoagulant medications prevent blood clots from forming, and some of the commonly prescribed anticoagulant blood thinners include:

  1. Heparin
  2. Enoxaparin (brand name Lovenox)
  3. Warfarin (brand names Coumadin and Jantoven)

There are also many newer anticoagulant drugs that are available on the market today that come with a reduced risk of bleeding. These include:

  • Rivaroxaban (brand name Xarelto) (4)
  • Apixaban (brand name Eliquis) (5)
  • Dabigatran (brand name Pradaxa) (6)

When you are on blood thinners, regardless of which type of blood thinner you are taking, your doctor will carefully monitor your dosage of these medications. They may also run a prothrombin test (PT) from time to time to test for some of the medicines. This is a blood test that measures your international normalized ratio or INR. (7)

INR is the rate at which your blood clots, and on average, the INR rate varies from person to person depending on their overall health and medical history. Staying within the range of INR will prevent you from clotting too easily or from bleeding excessively. This is why close monitoring by a doctor while on blood thinners is very important.

What are the Side Effects of Blood Thinners?

Some people may experience possible side effects while taking blood thinners, with excessive bleeding being the most common adverse reaction people have reported. (8)

Excessive bleeding may occur in a variety of ways, such as:

  • Nosebleeds
  • Bleeding gums
  • Heavy periods
  • Discolored or bloody stool or urine
  • Prolonged bleeding from a cut/wound

Some of the other side effects of blood thinners include:

When blood thinners are present in your body, it increases the risk of internal bleeding after an injury. You should immediately go to the nearest hospital or medical center if you experience the above-mentioned side effects after bumping your head or falling, even if you are not having any external bleeding, it could be that there is internal bleeding that needs to be addressed.

Your doctor might even advise you to restrict your participation in contact sports in an effort to decrease your risk of bleeding. However, this does not mean that you cannot lead a normal life or that you cannot exercise. Walking, jogging, and swimming are some excellent forms of exercise that are considered safe for people taking anticoagulant drugs. It is best to discuss which type of activities you can do and which ones to stay away from with your doctor.

If you are taking blood thinners, then you also need to inform your dentist before your regular check-ups and cleanings so that excessive bleeding can be prevented.

It is also important that you are careful and protect yourself while using scissors, knives, yard equipment, or any other item that can potentially injure or cut you.

Drug Interactions with Blood Thinners

There are many types of medications, herbs, and foods that can interfere with blood thinners. These substances can make the medication less or more effective than what the dosage prescribed by your doctor would suggest. However, not all the blood thinners get affected by the same type of substances. This is why it is essential to discuss with your doctor about your diet and what impact it may have on your medication.

Here are some of the known substances with which blood thinners interact.

Vitamin K.

Vitamin K interacts with blood thinners by reducing the effectiveness of anticoagulants such as warfarin. Depending on the specific blood thinner you are taking, you might still continue having foods that have low to moderate levels of vitamin K. However, you need to avoid eating foods that contain mild to high levels of vitamin K, including:

  • Broccoli
  • Asparagus
  • Cabbage
  • Brussels sprouts
  • Endive
  • Lettuce
  • Kale
  • Spinach
  • Collard greens
  • Turnip greens
  • Mustard greens

Herbs.

People who are taking anticoagulant blood thinners need to exercise caution when using herbal supplements and herbal teas. There are many herbs that are also known to interfere with the anti-clotting abilities of blood thinners, and they increase the risk of bleeding as well as the amount of time you bleed for.

This is why you should always consult with your doctor before you use any type of herbal tea or supplements, especially if you are planning to take any of the following:

  • Chamomile
  • Clove
  • Echinacea
  • Evening primrose oil
  • Ginseng
  • Licorice
  • Dong quai
  • Willow bark
  • Goldenseal
  • Gingko Biloba

Also, remember that cranberry juice and alcoholic beverages can be equally harmful when you are using blood thinners, and you should avoid using them as much as possible.

Medications

If you are taking any over-the-counter and prescription drugs, then also you have to consult about using them with your doctor when you are on blood thinners. There are many types of antifungal drugs, antibiotics, pain killers, and acid reducers that increase the risk of bleeding.

Other medications, such as birth control pills, can also reduce the effectiveness of anticoagulants and also boost your risk of developing a blood clot. This is why it is so important to inform your doctor about all the medications you are taking.

Conclusion

Apart from taking prescription blood thinners, there are also certain herbs and foods that act as natural anticoagulants and can help prevent blood clots from forming. However, you should check with your doctor before you start having these foods, especially if you are already taking blood-thinning medications as then these foods could potentially thin out your blood too much. Some of these natural anticoagulants include garlic, aniseed, celery seed, ginger, etc.

You can also think of including foods that are rich in vitamin E as they also act as natural blood thinners. There are also many oils that contain vitamin E, including wheat germ, soybean, corn, and olive oil. Natural anticoagulants can be good for your heart but only consume them after consultation with your doctor.

References:

  1. Sugerman, D.T., 2013. Blood thinners. JAMA, 310(23), pp.2579-2580.
  2. Goldhaber, S.Z. and Grasso-Correnti, N., 2002. Treatment of blood clots. Circulation, 106(20), pp.e138-e140.
  3. Little, S.H. and Massel, D.R., 2003. Antiplatelet and anticoagulation for patients with prosthetic heart valves. Cochrane Database of Systematic Reviews, (4).
  4. Chang, T.W., Arpey, C.J., Baum, C.L., Brewer, J.D., Hochwalt, P.C., Hocker, T.L., Roenigk, R.K. and Otley, C.C., 2015. Complications with new oral anticoagulants dabigatran and rivaroxaban in cutaneous surgery. Dermatologic Surgery, 41(7), pp.784-793.
  5. Agrawal, R., Jain, P. and N Dikshit, S., 2012. Apixaban: a new player in the anticoagulant class. Current drug targets, 13(6), pp.863-875.
  6. Spinler, S.A. and Willey, V.J., 2011. A patient’s guide to taking dabigatran etexilate. Circulation, 124(8), pp.e209-e211.
  7. Turka, J., 2005. Understanding international normalized ratio (INR). Nursing2019, 35(8), pp.18-19.
  8. Somes, J., 2015. Excessive bleeding: case report. Reactions, 1543, pp.36-21.

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