Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

200 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Having rheumatoid arthritis, migraine and hypothyroid. Blood tests showed coagulant issues. Suggest treatment

Answered by
Dr.
Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

default
Posted on Wed, 20 Nov 2013 in Hypertension and Heart Disease
Question: Hi - I am female, premenopausal, with rheumatoid arthritis, monthly migraines, hypothyroid, aged 57 from Australia. I recently had an MRI of brain which showed a couple non-specific T2 hyperintensities throughout white matter likely representing areas of old ischaemic change secondary to small vessel disease. I have also had blood tests recently due to chest compression discomfort, that showed I have 3 coagulant issues - I have Leiden Factor V (heterozygous); APC resistance, Weak Lupus Anticoagulant. I have had not thrombosis 'event'. To treat would you suggest only daily aspirin? Thanks and regards, XXXX
doctor
Answered by Dr. Benard Shehu 4 hours later
Brief Answer:
I would begin anti-coagulation for you

Detailed Answer:
Hi XXXX!

I read carefully your query and would like to say that in your case the decision to initiate anti coagulation should be taken with care.

Although you never had a thrombosis event, the brain MRI result shows some abnormalities due to old ischemic change which may be related with your hypercoagulability disorder.

If i was your treating doctor, I probably will begin the anti coagulation in you.

Hope it helped!

Dr.Benard

p.s. Please write back to me if you have any other concern.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Benard Shehu 29 minutes later
Thanks for that. (Father - triple bypass and atrial fibrillation. Mother - alzheimers.)
By 'anti-coagulant' I presume you mean more than aspirin, so what is good about the new anti-coagulant drugs?
doctor
Answered by Dr. Benard Shehu 37 minutes later
Brief Answer:
Please refer to the following answer...

Detailed Answer:
Hi again!

Yes by "anti-coagulant" i mean more than aspirin. There are available a lot of anti-coagulant drugs. The old anti-coagulants (such as Warfarin) and the new anti-coagulants (such as xarelto).

The new anti-coagulant drugs can be taken at a fix dose, Warfarin doses are variable. Also if you take Xarelto you don't have to monitor INR levels (with warfarin you have to). Another good thing is that Xarelto is a direct inhibitor of coagulation and the effect begin within hours (exactly 4 hours) not days as with old one (warfarin need 2 days to begin it's effect).

Hope it helped!

Dr.Benard

p.s. Please write back to me if you have any other concern.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Benard Shehu 25 minutes later
That's great information thank you. Just one more thing only!! I take naproxen for rheumatoid arthritis flare - I understand it is a blood thinner too. can naproxen be taken with Xarelto?
doctor
Answered by Dr. Benard Shehu 3 hours later
Brief Answer:
naproxen can be taken with xarelto

Detailed Answer:
Hi again!

Yes, naproxen can be taken with xarelto but this combination should be used with care, because the combination of both drugs increase the risk of major bleeding.

I recommend you that before adding xarelto, you explain your cardiologist all the things about all the medications you are taking.

Hope it helped!

Dr.Benard

p.s. Please write back to me if you have any other concern.


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,  
Drug/Medication ,   ,  
Lab Tests

Recent questions on  Aspirin

doctor1 MD

Good afternoon I was told back in Aug 2013 that I have Factor 5 Leiden thrombophilia. The doctor put me on Xarelto for 6 months now and has taken me off and to start using aspirin again. The doctor states that they do not like to keep on medication no longer then 6 months. But I m still on Hydrochlothiazide 25 mg every other day and my ankles are still swollen. I asked the doctor how will I know if I get the blood clots again and his response was I will know. Should I find a hematology & oncology? This scares me!

doctor1 MD

I have always bruised easily and now since being on aspirin therapy since 2007 even more; I have never had a bruise raise on me or get hard.....what could have caused this (I stopped taking ASA for a few days d/t upcoming scope but restarted yesterday d/t cancellation)? Thank you

doctor1 MD

I m a 47 female with a history of anxiety. However, I am a firm believer that my anxiety is a reaction from the pain I expierience and not the other way around. I went to my Cardiologist last December and he performed, Echo, EKG, Blood Test, Ultrasound, and even checked my Carotid Artieries (for stroke)... All negative Today I have been expieriencing the following discomfort: pain in and around the collarbone (both sides), pain in and around both shoulderblades, tightness in front of upper chest, pain under my chin. Any suggestions? I also take an aspirin every morning... is that more harmful than helpful?

doctor1 MD

Cocktail after Ministroke Hate taking Drugs Which are incompatible please?Coversal (High BP) 10 mg Centyl 2.5 mg (5 mg?) Aspirin 60 mg Lipitor 40 mg!!!!!!! Valium 2/4 mg (Sleeping) Paracetemol 0.5g (Pain) Any definitive natural food substitutes? Ron Age 80 Zoologist

doctor1 MD

I have strep throat . I started amoxicillin yesterday, but it seems the swelling in my throat is worse. Is this to be expected? How soon should the medication kick in?

doctor1 MD

I have had a pain under my right shoulder blade for about 8 hours. I've taken aspirin and put heat on it no relief

doctor1 MD

6 days ago my lips swelled up and my eyes swelled shut I had prednisone and it took 40mg to get it down. It came back in about 12 hours and took more prednisone and I had hives on my neck , under arms and in the groin. Went to a doctor and he...