Supplemental Anticoagulants

            According to Dr. Andrew Weil, there are natural substances which can thin the blood. Among these are “garlic, ginger, ginko biloba, dong quai, feverfiew, fish oil, vitamin E” and a mushroom found in Chinese grocery stores called “tree ear mushrooms.” (Q&A 2010) Taking each by turns, beginning with garlic, I’ll describe interesting factors about each supplement. In Latin, garlic is called Allium sativum.  (National Standard) The entire plant is edible, but the bulb is what’s used to create a powdered pill form, but the diet may include an equal amount to the supplemental forms. The effects after consumption appear temporary and it is believed that a chemical in garlic called allicin is what creates the pharmacologic effect, but the mechanism is unproven. (National Standard) As this is a fairly commonly used culinary plant, I will finish this description by saying only that the recommended daily dosage for an adult to maintain the efficacy of the pharmacologic effect is 2-7 grams, taken in divided doses daily. Its shelf life is, therefore, relatively short and its blood thinning effects are likely to only be sustained for a short time after meals. (National Standard)

            Ginger, also called Zingiber officinale, is taken in the form of fresh or dried root and may be ingested in the form of tablets, capsules, liquid extract, tincture and tea form, as well as in foods. Amounts up to 4 grams a day are considered safe. (National Standard)  In high doses it is theoretically possible to cause arrhythmias. (National Standard) Some few studies have shown it to decrease platelet counts and to effect thromboxane. (National Standard) National Standard suggests that patients using anticoagulants and antiplatelet medications should avoid ingesting 

ginger, but if it is a favorite, ginger should at least be used cautiously prior to surgery because of increased risk of bleeding. (2013)

            Vitamin E, is listed as another source of blood thinning, according to Dr. Andrew Weil, and is obviously a common constituent in vitamin supplements and in Vitamin E rich foods. (Q&A Library) According to Natural Standard, Vitamin E is an antioxidant and it’s most active form for humans is Alpha-tocopherol. (2013) According to the Office of Dietary Supplements, this vitamin is taken up by the liver via the hepatic alpha-tocopherol transfer protein. After metabolism, the other forms of Vitamin E are excreted by the liver for use in the body (2011). The daily allowance for this vitamin is 15 mg for adults and is tolerated up to 1000 mg (or 1,500 IU) in adults. (Dietary Supplements) The dietary sources are wheat germ, sunflower seeds, safflower, hazelnuts, peanuts, corn, spinach, broccoli, soy, kiwi, mango and tomato. Generally, these are listed as raw or dried. (Dietary Supplements) According to the National Institutes of Health Office of Dietary Supplements,

“Vitamin E can inhibit platelet aggregation and antagonize vitamin K-dependent clotting factors. As a result, taking large doses with anticoagulant or antiplatelet medications such as Coumadin can increase the risk of bleeding, especially in conjunction with a low Vitamin K intake. The amounts of supplemental vitamin E needed to produce clinically significant effects are unknown but probably exceed 400 IU/day.” (Daily Allowances )

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