Why are blood thinners important?
This article was co-authored by Des Moines University students Michaela Rziha, M.S.P.A.S.’21 and Joseph Thompson, M.S.P.A.S.’21.
Blood thinners are used to prevent blood clots from forming. They do not break up clots that are already present. Most of the time they are prescribed before a person has had any clots – this is known as primary prevention. On average, the CDC reports one American dying from a clot every six minutes. After a person has had one clot, they are more likely to have a second one. If a blood thinner is prescribed after a clotting event has already occurred, this is known as secondary prevention since the medicine is preventing a second clotting event. Three out of ten people who have had a clot will suffer another one within ten years, and patients with cancer have a higher risk for developing recurrent blood clots.
WHO NEEDS TO TAKE A BLOOD THINNER?
While there are many reasons why blood thinners are prescribed, the three most common indications for their use are:
- Prevention of stroke (clot in the brain)
- Prevention and treatment of venous thromboembolism (clot in a vein)
- Prevention of arterial thromboembolism (clot in an artery)
You may be a candidate if you have an inherited or genetic blood disorder such as Factor V Leiden, Protein S/C deficiency or antiphospholipid syndrome (APS), or an acquired condition such as atrial fibrillation, mechanical heart valves, or a history of a clot. Additionally, long hospital stays and recent major surgery can be indications for blood thinner use. Certain cancers also increase your risk of clots, and if you are actively receiving chemo and/or radiation for cancer treatments you may also be put on a blood thinner.
TYPE OF BLOOD THINNERS
The medical word for blood thinner is “anticoagulant.” There are also medications known as “anti-platelet” medications such as aspirin which will not be discussed in this article. Warfarin and the direct oral anticoagulants are the most commonly used blood thinners. Warfarin is less expensive, but requires frequent blood tests to check your INR. While it’s a more expensive option, apixaban (Eliquis) recently became generic, which may make it more affordable.
WHAT ARE THE RISKS OF TAKING BLOOD THINNERS?
The main risk of taking blood thinners is serious bleeding. This is why only some patients need a blood thinner. While taking these medications, there is always some risk of serious bleeding, especially if you are injured or need surgery. Your provider will help analyze your treatment options and the risks and benefits associated with each to determine which blood thinner is right for you.
What can you do to manage your blood thinner safely?
In general, most risks of bleeding can be managed conservatively if your condition is monitored closely by your primary care provider. You can reduce the risks of both bleeding and clotting by doing the following:
- Take your medication at the same time every day.
- If you forget a dose, take it as soon as you remember.
- If it is close to the time for your next dose, skip the missed dose and take the next one on time. Do not take two at the same time.
- Do not stop taking your blood thinner unless a doctor tells you to, as this will increase your risk of strokes and clots.
- Do not run out of your medication.
- If you hit your head, call your doctor even if you feel ok.
- Use a soft toothbrush and an electric razor to avoid cuts.
The amount of Vitamin K you consume affects how warfarin works in your body, so it’s important to eat a stable amount. Green leafy vegetables like kale, spinach, romaine, turnip greens all contain high amounts of Vitamin K, as well as cruciferous vegetables such as brussels sprouts, broccoli, cauliflower and bok choy. These vegetables are excellent for your health, but it’s important to eat them regularly instead of binging some weeks and not having any the next week. Eating a steady, healthy diet will help you and your medical provider manage your blood thinner and prevent both clotting and excessive bleeding.
Some medications and supplements can also interact with your blood thinner. Make sure to tell your doctor about all the medications, vitamins, supplements, or herbal product that you take, even if it’s only from time to time.
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Have questions or want more information? The family medicine providers at Des Moines University Clinic can help. We will walk through your medical history and help you determine which treatment options are right for you. To schedule an appointment, visit the DMU Clinic website or call 515-271-1710.