Question: Hi there,
I had a few questions I'm curious about.
As a 34 year old male whose father died early of heart disease and who has had some blood pressure readings higher than I'd like (in the prehypertensive range). I've been working with my doctor and have gotten my blood pressure in the generally good range (exercise and supplement changes). I also (working with my doc) take some supplements that help, including a multivitamin, fish oil (~2g), garlic (1,200mg), grape seed extract (300mg), as well as smaller amounts of CoQ10, cayenne, celery seed, and cinnamon). I'm also considering adding reishi mushroom to this regimen, but haven't yet.

A few questions:
1.) My doctor mentioned that in addition to these (which surprised me since they thin the blood a bit), I could start on low-dose aspirin therapy, but at 34, and already taking some of the above compounds, I'm not quite comfortable with that. I've also read some alarming things about aspirin being linked to gastric bleeding, cerebral microbleeds, and glaucoma risks. While I realize not everything is understood re more natural supplements, is it generally thought that things like garlic or reishi mushroom would have these same risks as the aspirin (I'm particularly concerned re cerebral microbleeds)?
2.) I'm not having surgery anytime soon, but I've read that you should stop certain supplements a week or two prior to surgery if it increases bleeding risk. I've also read, though, that things like aspirin can have a rebound effect, and suddenly stopping could actually trigger a cardiovascular event. Would the same be true with the alternative supplements I listed instead of aspirin?

Thanks much for your time/expertise!

Dr. Shehu,

Thanks so much for your thorough reply!

It is good to note there is less chance of undesirable side effects with natural supplements and foods.

I also understand re surgery it is a good idea to stop the supplements before surgery, and should I need it in the future, I will discuss with my doctor my regimen.

I also understand we don't know as far as rebound effect with supplements.

A few followups:
- I've often read that blood thinners can increase your chance of things like hemorrhages, but I've never understood why. I can understand that blood thinners would make an existing bleed worse, but not how it could actually cause a hemorrhage to happen in an otherwise healthy person. Can you shed any light on this? And does your previous information stand that the natural things like garlic supplements, fish oil, and reishi are less likely to do this than something like aspirin (or warfarin)?

- If my blood ever became too thin, would there be warning signs such as nosebleeds or excess bruising?

- Are the tests you mentioned (prothrombine time, INR, and coagulation time) a good thing to have as part of my checkup under my supplementation to make sure everything is happening appropriately?

Thanks!

Hi and thanks for getting back to me! A followup if you don't mind (at your convenience) just to get this clear in my head:

1. So in the case of these natural blood thinners (foods and herbs), does this mean they don't actually *cause* situations like brain bleeds/hemorrhages and they can simply make them worse if they were to happen (a bit like increased bleeding time during surgery)? Or can they actually be a cause of serious conditions?

This is one of the things I haven't quite understood when reviewing information. I want to get the benefits of the lowered blood pressure and healthy lipid profile I've been experiencing, etc., but I don't want to risk a hemorrhage either. [Though I know these are still much safer than something like warfarin in that regard.] I'm also aware some of these compounds (Garlic and CoQ10, for example) have been shown in studies to help reduce/prevent atherosclerosis, provide antioxidants, and some other good things that could improve long-term health and reduce chances of problems later.

I haven't had any noticeable bleeding issues whatsoever, so that's good, and my next doctor's appointment I'll see about getting those blood clotting tests you mentioned.

Thanks again for your help!

It is good to know that these shouldn't cause additional risk for aneurysm/hemorrhage.