Natural alternatives to warfarin
Preventing Blood Clots Naturally
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Natural Vs. Prescription: What Are The Risks?

There are some potentially useful natural remedies that have shown some promise in preliminary research regarding blood clot treatment and prevention.  While these treatments may be helpful, it is important to fully understand the risks associated with natural alternatives.  This article is going to cover the dangers of alternative, herbal remedies, the differences between natural and pharmaceutical medications, the types of natural effects that are needed to treat pulmonary embolisms and other clotting problems, and a few of the more common natural remedies that are used in patients with a DVT or pulmonary embolism.  Please remember that this material is not medical advice.  It, like everything on this site, is meant to be used to facilitate discussions between a patient and his or her medical team.

Many people come looking for natural cures with the idea that a natural cure is a chemical-free and safe cure.  The popular view is that if a pharmacy sells the medication it is unsafe and if a natural food store sells it, the cure is safe.  It is very important that we stop looking at the issue in this way.  Natural remedies have potential benefits; however, they are not risk free.  Natural remedies are chemicals that have side effects.

As a society we are being taught that chemicals are bad and plants are good.  The problem with this view is that "herbal remedies" work by using chemicals that are present in a substance.  Plants, minerals, enzymes, and vitamins sound safe because we do not use their chemical names.  Plant chemicals, no matter how gentle they sound, can be dangerous.  One example is Kava Kava.  Kava Kava, Piper methysticum, is used to treat anxiety and sleeplessness.  Xanax sounds far more dangerous than Kava Kava. After all, Xanax needs a prescription and Kava Kava is sold in a drugstore and can be grown in a garden.  Kava Kava may sound safe; it is not.  It is known for causing liver damage.  Any substance, when used as a treatment, is a drug, contains chemicals, and has potential side effects.  It does not matter whether the treatment came from a garden or from a pharmacist, the facts are the same.  Everything that you put into your body is a potential risk.

Medications that are produced as a medication are required by the FDA to publish the possible risks.  Herbs do not have to publish the possible risks.  If you are interested in a natural remedy do not assume it is risk free.  Find an authoritative source and research all drug interactions and possible side effects.  Know what you are putting into your body.  Some remedies are fairly harmless while others can cause fatal reactions.  Label free does not mean risk free.

Please talk with your doctors and pharmacist before adding a natural remedy, no matter how mundane, to your treatment plan.  This is especially important if you are using it for a life threatening condition, in place of another medication, or in addition to other medications.  Also, if you are on warfarin you will need to schedule extra INR checks to see if the natural treatment affects your INR.

What Are The Differences between Natural and Conventional treatments?

There are two major differences between a mass produced pharmaceutical and a natural remedy.  The first difference is that a mass produced medication has been tested.  The risks are known and have been published.  It is much more difficult to find risk information for natural remedies.  This does not mean that the natural formulation is safer than the man made formulation.

The second major difference between natural formulations and man made formulations is that the production of natural remedies is not controlled.  The amounts of active chemicals in a plant can vary from plant to plant.  The FDA does not test natural remedies to ensure that one brand has the same amount of a chemical as another brand.

Blood thinners can be very dangerous in a prescription form.  Keep in mind that natural formulations are still chemicals and still have risks.  The risks are published for warfarin but they will not be published for a natural remedy.  Natural remedy amounts vary from pill to pill and treatment to treatment.  This could have a significant impact on the bleeding risk of any natural treatment.  The FDA requires that warfarin pills all have the same amount of warfarin within a certain measure of error.  Natural remedies do not come with that guaruntee.

What Types Of Natural Treatments Will Help With Blood Clots and Pulmonary Embolisms?

In order to know which supplements and alternative treatments will help heal a pulmonary embolism, you must first know a little about blood clotting.  Pulmonary embolism and deep vein thrombosis are both types of blood clots that form in the veins of an individual. Veins are the blood vessels that return blood to the heart.  Veins have no muscles and rely on the body's movement to assist in moving blood back to the heart.  When the body moves, the movement moves the blood.   When the body is stationary, the blood pools and sits still.  

Thrombin, a glue-like chemical in the blood, begins to set up and form clots when it sits still.  Thrombin is what contributes to pulmonary embolism and deep vein thrombosis.  Some drugs and treatments will work on the thrombin system, these drugs are known as anticoagulants.  They prevent the blood from coagulating.  Warfarin is an example.

Other "blood thinners" work on platelets.  Platelets are the blood cells that help to form the clots.  Platelets are responsible for clots that form in high pressure areas like arteries.  Anti-platelet medications help these types of clots.  An example of this type of medication is aspirin.

Lastly, once blood has formed a clot, thrombolytics are responsible for breaking down the clots and helping the body to reabsorb the materials that made the clot.  The body has natural enzymes that do this process.  Scientists have created drugs that are able to replicate this mechanism as well.  Thrombolytics only work AFTER a clot has formed.

Any alternative or natural remedy that is used to prevent new clots from forming in the veins MUST work on thrombin.  When looking at possible natural treatments it is imperative that the treatment works by affecting thrombin's ability to glue the clots together.  If it works on platelets or already formed clots, the treatment will not help to prevent a pulmonary embolism or DVT.

Natural Treatments That Are Known To Work

There are a few alternative treatments that have a strong track record preventing pulmonary embolism, DVT, and other venous clots.  These treatments are the ones that have had substantial research and are generally accepted by the medical community.  All of these treatments work on thrombin and are good for venous clots.  If you are looking for an established treatment, here are some options to discuss with your doctor:
  • Graduated compression stockings
  • Staying well hydrated, especially with a hydration beverage like Pedialyte or Gatorade
  • Pneumatic leg cuffs during surgery
  • Never sit still for longer than 2 hours without a movement break

These options are typically very safe, compatible with warfarin and other medications, are inexpensive, and are the best methods for lot prevention outside of anticoagulation therapy.  Many people are surprised when they are told that these are some of the best clot prevention options out there.
Another possible treatment is low dose aspirin.  Aspirin is a platelet inhibitor but research is beginning to indicate that it may be useful in venous clots, DVT, and pulmonary embolism.  There is still no general agreement on whether this will or will not work.  It carries the risk of bleeding, especially in people with stomach ulcers.  This treatment is one to watch.  It will be interesting to see what future studies tell us about this possibility.

Natural Treatments Without substantiating Research

There are some other natural treatments that are often discussed in support groups an online.  These treatments include fish oil, nattokinase, vitamin E, and pycnogenol.  Here is a little background on each of these supplement options.  Keep in mind that none of these supplements have substantial (if any) in vitro (in human) testing.  Much of this research was done using test tube blood samples.  Also keep in mind that all of these treatments raise the risk of major bleeding problems.  Talk to your doctor before trying any of them.  The clotting system is a very important part of your body!

FISH OIL
Fish oil really is just fish oil.  It is very high in Omega-3 fatty acids.  The blood thinning effects of fish oil happen in the arterial system.  A tiny amount of research shows that it is possibly effective in preventing strokes due to its ability to decrease platelets.  This effect is not seen in patients already on aspirin.  The studies have been small and conflicting.  More research needs to be done before this can be seen as a large help for stroke prevention.  Strokes happen due to arterial clots.  No research has been done on pulmonary embolism.  Due to its arterial effects, it is unlikely to help in pulmonary embolism or DVT.

NATTOKINASE (NATTO)
Nattokinase is an enzyme that occurs in soybean fermentation.  Nattokinase seems to have thrombolytic properties.  This means that nattokinase breaks down clots that have already happened.  It will not prevent new clots from forming.  There have been no well organized human trials using nattokinase.  All of the testing on nattokinase has been in animals or in test tubes.  One study using a blend of natto and pycnogenol showed that it may prevent clots when taken before a flight.  This study had design flaws and has been thrown into question.  The safety of natto has not been established.  It may raise the risk of bleeding and should be avoided in people who are already taking an anticoagulant or anti-platelet medication.  Natto contains high levels of vitamin K and will affect INR.

PYCOGENOL
Pycogenol is a product derived from pine trees.  Currently there is insufficient evidence to rate its effectiveness on blood clots.  It was used with natto in the one study mentioned above.  This study showed promise but had poor methodology.  No other research has been done on pycogenol.  This means that while it shows promise, we do not know if it is effective or if it has major side effects.

VITAMIN E
Vitamin E has been shown to have blood thinning effects.  In fact, the blood thinning effects make this a dangerous supplement.  It increases the risk of bleeding in people who have a vitamin K deficiency, are on warfarin, are using aspirin, or are on other blood thinning medication.  Multiple studies have shown that it raises the risk of death.

Please see the references page to read more about these supplements.