How Do Blood Thinners Work
In general, all blood thinners work by either blocking or inactivating part of the system that forms blood clots. These medications work by binding to proteins that are involved in either the coagulation cascade or to proteins on platelet surfaces.
Anticoagulant medications target the coagulation cascade, whereas antiplatelet medications target platelet activation.
What Are Blood Thinners
Blood thinners are medications that treat and prevent blood clots. Blood clots are semi-solid clumps of red blood cells, platelets, fibrin , and other proteins.
Blood clotting is an extremely important function of the body that prevents bleeding. Without blood clotting, a small cut would cause serious, prolonged bleeding.
What Are Blood Clots
A blood clot is a solid mass of platelet fragments and proteins that forms when blood coagulates and clumps together. Blood clots are a physiological process that helps to stop bleeding when a blood vessel is damaged. However, blood clots can also form in the absence of an injury, and if they occur in the wrong place or at the wrong time, they can be dangerous.
There are two main types of blood clots:
- Arterial clots: These clots form in the arteries, which are the blood vessels that carry oxygenated blood away from the heart to the rest of the body. Arterial clots can obstruct blood flow and cause serious health problems, such as heart attacks and strokes.
- Venous clots: These clots form in the veins, which are the blood vessels that carry oxygen-depleted blood back to the heart. Venous clots can cause deep vein thrombosis , which is a condition that occurs when a blood clot forms in the deep veins of the leg. DVT can be serious because the clot can travel to the lungs and cause a pulmonary embolism .
A variety of factors, including injury, surgery, cancer, pregnancy, and certain medications, can cause blood clots.
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How Low Blood Platelet Counts Develop
Platelets in the blood are constantly renewed by bone marrow, and counts stay normal and consistent through a process of ongoing production and destruction. In healthy people, platelets wind up dying off after about 10 days, at which point theyre replaced by new ones. But in people with low platelets, there are either less platelets being produced, or a faster removal of platelets, which keep counts abnormally low.
Bone marrow is the sponge-like tissue inside the bones, which contains very valuable cells called stem cells. Stem cells mature and develop into various types of blood cells, including red blood cells, white blood cells and platelets. Someone who experiences damage to stem cells inside the bone marrow isnt able to make the necessary blood cells and platelets needed to properly clot blood. People with normal blood platelet counts have between 150,000450,000 platelets per microliter of circulating blood, but those with low counts can have much less.
According to the American Society of Hematology, thrombocytopenia can be caused by genetic/inherited factors or as a side effect of peoples lifestyles, including the medications they take, their diets and their medical histories, which all affect how their spleens and bone marrow function. Genetic mutations can cause thrombocytopenia due to diminished production or shortened life span of platelets related to alterations in transcription factors, cytokines, cell surface receptors and signaling molecules.
What Are The Side Effects Of Blood Thinners
Like all medications, blood thinners can cause side effects. The most common side effects of blood thinners include the following:
- Bleeding: Blood thinners can increase the risk of bleeding, which can range from minor bleeding to more serious bleeding .
- Bruising: Blood thinners can increase the risk of bruising, especially in people who are prone to bruising easily.
- Anemia: Blood thinners can lead to anemia due to blood loss.
- Rash: Some people may develop a rash while taking blood thinners.
- Other: Some blood thinners may cause headaches, nausea, or an allergic reaction.
It is important to note that the side effects of blood thinners can vary from person to person, and not everyone who takes these medications will experience side effects. If you are taking a blood thinner and experiencing any side effects, it is important to discuss them with your healthcare provider. They can help to determine the cause of the side effects and recommend the appropriate treatment.
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What Are Other Treatments For Dvt
When you canât take a blood thinner for DVT, your doctor may suggest:
Thrombectomy. This is a nonsurgical procedure your doctor can do to physically remove a clot from your vein. This may be a good option to treat sudden DVT thatâs causing issues.
A cardiologist, radiologist, or vascular surgeon injects dye into the vein where your clot is. They use X-ray to help them find it. They put a long, thin, flexible tube called a catheter into the vein. Then they guide it closer to where the clot is and pull it out through your vein. Once the clot is gone, your blood will start flowing again right away.
Inferior Vena Cava Filter . This option wonât remove a clot, but it can keep it from traveling to your lungs and triggering a pulmonary embolism. The vena cava is the main vein that carries blood from your lower body to your heart. This might be a good option if you have a DVT in your legs.
Your doctor puts an IVC filter in your vena cava through a small cut in a vein in your groin or neck. The filter catches blood clots and stops them from circulating through your bloodstream. An IVC filter might be a good choice for you if youâre at a high risk of bleeding. But it can actually raise your risk of blood clots in the long term. It also canât stop new blood clots from forming. This treatment is best if youâve had several blood clots travel to your lungs before.
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When To See A Doctor
If you think you may be experiencing symptoms of low platelet count, talk to a healthcare professional especially if youre experiencing serious symptoms, such as wounds or cuts that wont stop bleeding, or blood in your stools or urine.
Its also important to be checked regularly if you are at risk of developing thrombocytopenia due to a medical condition, family history, or medication.
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Low Platelet Count Symptoms
The most common signs and symptoms of a low platelet count include:
- Prolonged bleeding from cuts or wounds
- Easily becoming bruised or developing excessive bruising
- Bleeding under the skin that appears as a rash of small spots , most likely to develop on the legs
- Bleeding gums and gum disease
- Developing an enlarged spleen, which can cause pain in the abdomen and tenderness
- Developing a yellow color of the skin
The most obvious sign or symptom of a low platelet count is bleeding that cannot be stopped using normal interventions, like holding a compress against the wound/cut. Some people with find out they have low platelet counts after getting their annual physical exam results, while others might experience a fall or injury and seek help due to a large amount of bleeding.
Its possible that some people have ITP in their systems and arent aware of it until something triggers bleeding and raises suspicion, leading to them visiting their doctor at which point they receive a diagnoses.
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What Treatment Options Are Available
Treating thrombocytopenia often means treating the condition causing thin blood. For example, if the drug heparin is causing your platelet count to drop too low, your doctor may recommend you switch to a different anti-platelet drug. If alcohol use is a factor, you may be advised to reduce or avoid alcohol consumption entirely.
There are also medications that can help treat thrombocytopenia. Corticosteroids, such as prednisone, can help slow down platelet destruction. Drugs like eltrombopag and romiplostim can actually help your body produce more platelets.
In some cases, your doctor may recommend a platelet transfusion to help restore your levels.
What Did The Fda Approve Brilinta For
Brilinta is approved by the FDA to:
- reduce the chance of a heart attack, stroke or death if you have acute coronary syndrome or a history of heart attack. ACS can result in severe chest pain or a heart attack . This could happen because your heart is not getting enough oxygen. For at least the first 12 months following ACS, it is superior to clopidogrel .
- lower the chance of a blood clot forming in a stent after it is placed in your artery for ACS. Further blockage of your stent could lead to a heart attack or even death.
- reduce the risk of a first heart attack or stroke in patients with coronary artery disease at high risk for such events.
- reduce the risk of stroke in patients with acute ischemic stroke or high-risk transient ischemic attack
Your doctor will usually prescribe a daily dose of aspirin with Brilinta to reduce the chance of a blood clot forming. Using Brilinta and aspirin together is called dual antiplatelet therapy.
Blood clots are formed from red blood cells, platelets, fibrin, and white blood cells. Both anticoagulants and antiplatelets keep these components from clumping together and forming a blood clot.
If you stop taking Brilinta too soon, it may increase your risk of a heart attack, stroke or death.
However, if you are having surgery, your doctor may instruct you to stop taking Brilinta 5 days before your procedure. This will help to lower the chance of bleeding. Follow your doctors directions on when to stop and start taking Brilinta again.
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Low Platelet Count Causes
Wondering what causes the abnormalities described above? According to the National Heart, Lung and Blood Institute, some of the most common underlying reasons for alternations in normal blood platelet counts include:
- Enlarged spleen: The spleen helps fight infections and clean the blood, so illnesses that cause an enlarged spleen can cause too many platelets to become trapped inside while the body tries to fight off bacteria or a virus. In healthy people, around one-third of the bodys platelets are held in the spleen, but conditions like liver disease/cirrhosis prevent scarring, which keep platelets harbored inside.
- Reactions to medications and over-the-counter drugs: Platelet production can be altered due to the use of drugs, including diuretics, NSAID anti-inflammatory drugs and antibiotics, or frequently taking common painkillers like ibuprofen and aspirin.
- Autoimmune diseases: Diseases like lupus and rheumatoid arthritis cause the immune system to mistakenly attack and destroys platelets. This is called immune thrombocytopenia or ITP.
- Alcohol: Alcohol slows the production of platelets and is the biggest problem when its consumed excessively, especially if someones diet is also low in nutrients.
- Toxin exposure from the environment: Chemicals commonly found in the environment, including pesticides, arsenic and benzene, can all slow the production of platelets.
Symptoms Of Low Platelets
A low platelet count can cause a variety of symptoms. Call your doctor if you notice these issues or if they become more frequent or severe:
- Easy bruising, also called purpura
- Petechiae, tiny red spots on your skin
- Excess bleeding after even minor injuries
- Pain in your joints, particularly large joints like the knees and hips
- Frequent nosebleeds
- Vaginal bleeding after menopause or unusually heavy vaginal bleeding
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How To Treat A Low Platelet Count
If you notice that youre developing bruises more easily and bleeding for a long period of time even after only getting a minor cut, talk to your doctor to check your platelet counts. A diagnosis of a low platelet count can be made using several tests: a complete blood count, which measures the levels of all blood cells/platelets in your blood a blood smear, which looks at the actual shape of your platelets or bone marrow tests and blood clotting tests to check for proper production and function of platelets. You might also need an ultrasound to check your spleen to see if its enlarged and possibly tapping platelets inside.
Sometimes thrombocytopenia is only mild and doesnt even need to be treated, since blood can still clot normally enough. Other times if it becomes severe, your doctor might need to prescribe medications to help ensure blood can clot or change the medications you currently take to stop their side effects. Medications and treatments used to stabilize severely low platelet counts can include platelet transfusions, splenectomy , corticosteroids or immunoglobulins, which block effects of the immune system.
Once a diagnosis has been made, you can use the recommendations below to help raise your blood platelet counts, manage symptoms and prevent complications from developing:
1. Improve Your Diet
2. Decrease or Eliminate Alcohol and Sugary Drinks
3. Reduce Exposure to Toxic Chemicals
4. Decrease or Stop Using Painkilling Drugs
How To Identify The Signs And Symptoms
If you have mild thrombocytopenia, you may not have any noticeable symptoms. The condition is often discovered during routine blood work when lab results show low levels of platelets.
The more obvious signs of thrombocytopenia are changes in external bleeding. Platelets help blood clot by clumping together to stop an injury from bleeding too much. If youve ever cut your finger and noticed that it stops bleeding soon and begins to heal, thats healthy blood clotting.
If the same kind of cut bleeds longer than it should, it could be thrombocytopenia. The same is true if brushing or flossing your teeth start to cause bleeding. Other signs of thin blood include nosebleeds and abnormally heavy menstrual flow.
Thin blood can also cause bruises to appear under the skin. A minor bump can cause the tiny blood vessels under the skin to bleed. This can result in purpura, which are small purple, red, or brown bruises. These bruises can develop easily and frequently.
Another sign of thrombocytopenia is petechiae. These are small red or purple spots on the skin.
If youre experiencing internal bleeding, you may notice blood in your urine or stool.
At your appointment, your doctor will review your medical history and your current health and behaviors. You should be prepared for questions about your:
- diet and alcohol intake
- family history of low platelet levels or other blood disorders
- history of blood transfusions and any intravenous drug use
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Blood Thinners: What You Should Know
Blood thinners are medications used to treat and prevent blood clots. Blood travels through blood vessels in a liquid form to bring oxygen and nutrients to tissues throughout the body. When blood clots form in the body, they block normal blood flow from reaching tissues, and can cause tissue death, such as in heart attack, stroke, and pulmonary embolism.
While blood thinners can be lifesaving medications, they carry a risk of bleeding. This article discusses the types of blood thinners, their medical uses, and side effects.
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Normal And Abnormal Platelet Counts
A complete blood count test is a standard panel of bloodwork. The platelet count is one of things this test measures. Here is what various platelet counts mean:
- Normal: Between 150,000 and 450,000 platelets per microliter of blood
- Low: Below 150,000 platelets per microliter
- Mild bleeding risk: Below 50,000 platelets per microliter
- Serious bleeding risk: 10,000 to 20,000 platelets per microliter or lower.
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Bone Marrow Aspiration And Biopsy
A bone marrow test may also be performed. There are two types of bone marrow tests: a biopsy and an aspiration. In some cases, both tests may be performed at the same time.
During a bone marrow aspiration, a small amount of bone marrow is removed from one of your bones.
In a bone marrow biopsy, a sample of your core bone marrow is removed, usually from the hipbone.
The treatment options for a low platelet count can vary. Your doctor or specialist will determine the appropriate treatment for low platelet counts based on the underlying cause and severity of your condition.
If the condition is mild, your doctor may choose to simply monitor you.
If your low platelet count is more severe, you may need medical treatment. Treatment options may include:
- blood or platelet transfusions
- changing medications that are causing a low platelet count
- Prescribing steroids, immune globulin, or other medicines that suppress your immune system
- spleen removal surgery
contact sports that put you at risk for bleeding injuries, or talk to your doctor about safety measures.
If your spleen has been removed, watch for potential signs of infection as the removal of the spleen can increase the risk and seek medical attention if you start to feel ill or have a fever.
Treatment Of Low Platelets
It is important to identify the cause of low platelets. When the cause is clear, treatment can usually help your levels return to normal.
If you are receiving therapies that affect your platelet count, such as cancer treatment, your platelets should return to normal once the treatment ends. Keep in mind that the timeline is different for everyone.
In some cases, a platelet transfusionmay be needed. This is a procedure where you receive platelets from a donor through a vein. A transfusion can help prevent complications from bleeding.
Autoimmune conditions can be treated with drugs that suppress your immune system. This will help stop the destruction of platelets.
When low platelets are caused by medication, the solution is often just switching medications. Your doctor will help you find the right alternative drug.
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