Have you been hearing more about blood clots in the news lately? Anytime we cut ourselves, we’re certainly grateful for our ability to clot and stop bleeding. However, if clotting happens in a healthy, non-traumatized vein, the result is a potentially life-threatening pathology called venous thromboembolisms (VTEs) or blood clots. Blood clots are the end result from coagulation, when platelets aggregate or stick together to make a fibrin-mesh plug. When pieces of these clots break off (becoming embolisms), they can travel to capillaries in the brain, heart, kidney, lungs, or limbs, which can result in stroke, heart attack, or pulmonary embolism. The Center of Disease Control has reported that as many as 900,000 Americans each year are affected by VTE.
When a blood clot forms in the deep veins of the pelvis, lower leg, or thigh, they are called Deep Vein Thrombosis (DVT). The ominous signs of a DVT are swelling, pain, and redness of usually one leg. Medical care should be sought immediately if you even suspect this; imaging and treatment measures to be sought urgently.
Risk factors for clots include being immobile (long car or plane rides) or overweight, smoking, taking oral birth control pills, not exercising, having cancer, and enduring a long surgery. Once you have had one VTE, you are at a higher risk for forming these again. Other than the lower leg signs, relatively few symptoms or signs exist for letting you know about VTEs. Diseases like atherosclerosis (hardening of the vessels), cardiac arrhythmias, and blood clotting disorders like Factor V Leiden and antiphospholipid syndrome also put you at a higher risk for VTEs.
Fortunately, a simple, inexpensive blood test exists that can help you track VTEs – the D-Dimer. When a blood clot begins to dissolve, D-Dimer (a protein) is released. It is named for the two “D” shaped fragments that make up its structure. The presence of the D-Dimer confirms that thrombin and plasmin formation has occurred and a clot exists.(1) If you have increased risk factors, using the D-Dimer test is a vital tool.
A normal D-Dimer is less than 0.4 mcg/mL or 250 ug/L. Most labs will report the mcg/mL, but watch those units or you can misinterpret the results. Due to molecular structure, there are few ways a D-Dimers can be false positive – for example, rheumatoid factor (a blood test that confirms rheumatoid arthritis), CA-125 (a tumor marker for ovarian cancer), various estrogen therapies and even the estrogen elevations in pregnancy may give a false positive D-Dimer. A D-Dimer will also often be positive after a surgery or trauma, just due to the normal healing of tissues from those events.(2)
D-Dimers can be run at any medical doctor’s office or lab center. At Peoples Rx, we partner with various labs to offer low-cost options for testing. The test costs around $50 (not counting the draw fee). If you have a positive D-Dimer and any risk factors, it is vital that you seek medical attention for imaging and treatment due to the potential for stroke and heart attack.
However, if life-threatening circumstances have been ruled out by your healthcare provider, supportive measures exist to help dissolve the clot.
- First, move. Exercise promotes circulation and this will support the body’s natural progression for dissolving the clot in a balanced way. People often get concerned about moving because they think that will break the clot loose and cause an embolism event; that really isn’t the case. When the clot gets too big, it is more likely to break off due to the size. Exercise will promote circulation (provided there is no trauma) and will actually dissolve the clot. (3)
- In addition to exercise, a few supplements have been reported to be supportive for dissolving blood clots. Grape Seed Extract has been studied in respect to coagulation time, clot formation, and clot firmness and shown to be “a promising nutraceutical in the prevention of cardiovascular thrombotic events caused by different mechanisms.”(4)
- Bromelain is an enzyme from pineapples that breaks down blood clots and reduces clot formation. It also has anti-inflammatory properties that improve blood viscosity (making it less sticky).(5) However, if someone has a pineapple allergy, bromelain may create inflammation, so this has to be watched.
- Two very powerful and promising enzymes that have surfaced in the last few years show great results for dissolving blood clots – Nattokinase and Lumbrokinase. Nattokinase comes from nattō, fermented soybean common in Japanese foods. This enzyme can degrade fibrin and plasmin, proteins involved in clot formation. Nattokinase also decreases the activity of clot-forming components in the blood (plasminogen activator inhibitors) and increases the level of elements that dissolve clots (plasminogen activators).(6)Lumbrokinase is even more effective than nattokinase. Lumbrokinase is a fibrinolytic enzyme (it breaks down fibrin) isolated from earthworms. Bulouke is the brand name of the lumbrokinase. Because it targets only fibrinogen and fibrin (blood clot components), it will work well in conjunction with medications like Coumadin or heparin.(7)
Lumbrokinase is even more effective than nattokinase. Lumbrokinase is a fibrinolytic enzyme (it breaks down fibrin) isolated from earthworms. Bulouke is the brand name of the lumbrokinase. Because it targets only fibrinogen and fibrin (blood clot components), it will work well in conjunction with medications like Coumadin or heparin.(8)
Balancing out the clotting cascade to stop VTEs can be done effectively by supplementation and working with your healthcare provider. The beauty of Grape Seed Extract, Bromelain, Nattokinase and Lumbrokinase is that they pose less of a risk for increasing bleeding times, meaning if you cut yourself, you won’t bleed excessively while taking these supplements. Contact us at Peoples Rx for more information regarding these therapies.
By: AMY NELSON, ND*
Amy Nelson, ND* received her Naturopathic Doctorate from the National College of Natural Medicine in Portland, OR where she studied nutrition, homeopathy, herbal and functional medicine. In addition, Dr. Nelson was the Associate at The IBS Treatment Center in Santa Monica where she treated irritable bowel syndrome and complex food allergies. Dr. Nelson utilizes her experience in natural medicine to address female and male hormonal imbalances, mental health, and digestive disorders. Amy is available for consultation at Peoples North.
*Although licensed in other states, Naturopathic Doctors are not currently licensed in Texas.
If you have comments and/or questions about this blog, email us at firstname.lastname@example.org.
(1) Bounds EJ, Kok SJ. D Dimer. [Updated 2021 Jul 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431064/
(2) Fischbach FT, Dunning MB. A Manual of Laboratory and Diagnostic Tests. 8th ed. Philadelphia, NY: Williams & Wilkins; 2004.
(3) American Heart Association’s 4th Annual Conference on Arteriosclerosis, Thrombosis and Vascular Biology, Washington, D.C., May 8-10, 2003. News release, American Heart Association.
(4) Bijak M, Sut A, Kosiorek A, Saluk-Bijak J, Golanski J. Dual Anticoagulant/Antiplatelet Activity of Polyphenolic Grape Seeds Extract. Nutrients. 2019;11(1):93. Published 2019 Jan 5. doi:10.3390/nu11010093
(5) Pavan R, Jain S, Shraddha, Kumar A. Properties and therapeutic application of bromelain: a review. Biotechnol Res Int. 2012;2012:976203.doi:10.1155/2012/976203
(6) Weng Y, Yao J, Sparks S, Wang KY. Nattokinase: An Oral Antithrombotic Agent for the Prevention of Cardiovascular Disease. Int J Mol Sci. 2017;18(3):523. Published 2017 Feb 28. doi:10.3390/ijms18030523
(7) Jiang G, Zhang W, Peng M, Yan W. [Effect of lumbrokinase on patients with acute and moderate risk pulmonary thromboembolism]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Oct 28;42(10):1156-1162. Chinese. doi: 10.11817/j.issn.1672-7347.2017.10.005. PMID: 29093246.
(8) Jiang G, Zhang W, Peng M, Yan W. [Effect of lumbrokinase on patients with acute and moderate risk pulmonary thromboembolism]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Oct 28;42(10):1156-1162. Chinese. doi: 10.11817/j.issn.1672-7347.2017.10.005. PMID: 29093246.