Living Your Best with Blood Thinners

September 14, 2017 Kyler Barkley, MD


A few added precautions will help make your treatment work

Each year, nearly 2 million Americans are prescribed blood thinners to prevent blood clots. It’s one of the treatments for warding off stroke and has proven remarkably successful.

“These medications are highly effective at keeping people healthy,” says Kyler Barkley, MD, an interventional cardiologist at Covenant Health. “However, they are complex drugs, and some of them require regular monitoring, important lifestyle changes, and frequent dose adjustments to help reduce your risk of bleeding too much.”

If you’re taking blood thinners, you’re not alone. Just use them as your doctor prescribes and take heed of some important information:

First, the name “blood thinner” is misleading because they don’t actually “thin” your blood. These drugs simply change the clot formation process in one of two ways. Anticoagulants interfere with the body’s chemical reactions, so it takes longer for a clot to form. Typical anticoagulant medications include warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis). Antiplatelet drugs prevent platelets from clumping together and eventually forming a clot. These medications include aspirin, clopidogrel (Plavix), prasugrel (Effient), and ticagrelor (Brilinta). Either way, when you take these drugs, there’s increased risk of bleeding.

“We always try to weigh the benefit versus risk for these medicines at each appointment,” says Dr. Barkley. “The benefit is that they can decrease your risk of having a stroke or heart attack. Unfortunately, they also increase your risk for bleeding, so you may notice that you will bruise easier or bleed longer if you cut yourself.” That said, you need to watch out for activities where you risk cutting yourself.

For your own protection, try simple precautions for certain every day activities. For example, wear gloves when handling scissors, knives and other sharp objects. Put on shoes whenever possible, especially when outside and walking in tall grass. Also, switch to an electric razor and use a soft toothbrush and waxed dental floss to clean your teeth.

If you do get injured, get emergency help or call your doctor. This is a precaution even if there's no blood. A bruise on your body means you're bleeding somewhere beneath the skin, which can be just as serious.

There are also certain lifestyle changes that you need to consider. For one thing, put off that giant sailboat tattoo you were considering. If you’ve got an all-day tattooing session booked, the potentially large amount of blood that you could lose could cause dangerous side effects and extensive blood loss.

Also check in with your doctor about drinking alcohol. It's not recommended while on blood thinners, especially if you’ve had any liver damage. Normally, the liver contributes to blood clotting, so if you’re taking blood thinners with a compromised liver, you could have a deadly situation.

When it comes to diet, if you’re taking the blood thinner warfarin, be mindful of consuming too much vitamin K, which reverses the drug’s effectiveness. Typical vitamin K-rich foods include asparagus, broccoli, brussels sprouts, cabbage, collards, turnips, mustard greens, endives, green onions, kale, lettuce, parsley, soybeans and spinach. Avoid cranberries and cranberry products too, because they can also interact with your medicine and make it easier for you to bleed.

Newer blood thinners don’t require you to watch your diet the way you have to with warfarin. 

Finally, be careful with your medication. Not taking medication as directed by your health care provider can put you at risk of serious problems at worst or bleeding that is not life-threatening but still difficult to control. Also, don’t double up on doses. Ask your doctor what you should do if you accidentally miss a dose of your blood thinner. And, don't take over-the-counter medicines, vitamins or supplements unless you check with your doctor. Your blood thinner may not interact well with them. For example, aspirin and ibuprofen can make you bleed more. Even products like Pepto-Bismol may cause problems.

The bottom line is that blood thinners save lives. You may just have to adjust certain aspects of your current lifestyle to ensure your treatment is successful.



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