~Thrombosis Prevention, Part 4 - Summary
The Life Extension Foundation recommends a comprehensive approach to preventing thrombosis with a full assessment of cardiovascular health (including the presence of hypertension and atherosclerosis) and levels of homocysteine, fibrinogen, and cholesterol. A thrombosis prevention protocol fits well with an overall approach to wellness including a healthy diet and regular exercise. Smoking is a well-known risk factor for chronic disease and should be avoided.
Thrombosis prevention involves several diverse mechanisms. Several laboratory tests are recommended to assess the cardiovascular system and guide appropriate treatment, including cholesterol and triglyceride levels, homocysteine, template bleeding time, fibrinogen, and CRP (see the protocols on Medical Testing, Cardiovascular Disease, Stroke, and Diabetes for specific recommendations).
The following supplements have demonstrated antithrombotic action by lowering cholesterol, fibrinogen, and homocysteine; suppressing inflammation; and by inhibiting platelet aggregation.
1. Low-dose aspirin is widely recommended to help prevent abnormal platelet aggregation, thus reducing heart attack and stroke risk. The Life Extension Foundation recommends Healthprin, which contains 81 mg of enterically coated aspirin. One tablet daily is recommended for its anticlotting and anti-inflammatory effects. Some people may require more than 81 mg of aspirin daily, which can be determined by a TBT.
2. Garlic inhibits thrombosis by multiple mechanisms. Garlic is available in supplement form as Kyolic one-per-day caplets that supply 1000 mg of odorless garlic. One to two caplets daily is suggested. Another form of garlic is Pure-Gar Caps (900 mg garlic powder) or Pure-Gar with EDTA (a chelating agent). Two to four of these garlic capsules are recommended daily.
3. Essential fatty acids GLA (from borage oil), DHA and EPA (from fish oil). The most efficient way of obtaining all three of these antithrombotic fatty acids is to take 6 capsules a day of a supplement called Super GLA/DHA.
4. Vitamin E is an antioxidant and platelet aggregation inhibitor. The recommended dose for most people is 400 IU of alpha tocopheryl succinate, 200 mg of gamma tocopherol, and at least 50 mg of tocotrienols. Vitamin E with gamma tocopherol is essential when taking arginine, nitroglycerin, iso-sorbide mononitrate, or other nitrate medications.
5. Homocysteine can also be lowered by vitamins B6 and B12 and folic acid. For vitamin B6, 100-750 mg daily is recommended. Folic acid should only be taken in the dose of 800-2400 mcg with at least 1000 mcg of vitamin B12 to prevent masking a B12 deficiency. Trimethylglycine also lowers homocysteine levels (see the Cardiovascular Disease protocol for more information). TMG tablets contain 500 mg of trimethylglycine. One to five tablets daily are recommended. TMG Powder is also available. One scoop contains 500 mg of trimethylglycine. Two to five scoops daily are recommended.
6. Fibrinogen levels may be lowered by taking at least 2000 mg of vitamin C; 1000 mg of niacin; and 2000 mg of bromelain or by using a fish oil supplement that provides 5600 mg of EPA and 3200 mg of DHA.
7. Curcumin is well known for its anti-inflammatory action. It has also been shown to inhibit platelet aggregation. One 900-mg capsule with 5 mg of bioperine daily is recommended for healthy people. Curcumin should be used with caution in patients with biliary tract obstruction because it stimulates secretion of cholesterol bile acids from the liver through the bile duct into the intestines. High doses of curcumin on an empty stomach may contribute to stomach ulcers or gastric irritation.
8. DHEA has been shown to suppress certain inflammatory cytokines that cause elevated levels of CRP. Typical dosing for men and women is 25-50 mg daily. Refer to DHEA Replacement Therapy protocol for information and precautions.
9. Nettle leaf extract reduces inflammatory cyto-kines, which increase platelet aggregation that can lead to thrombosis. A dose of at least 1000 mg daily is suggested.
10. Quercetin is an antiplatelet agent. About 100-500 mg daily of highly absorbable water-soluble quercetin is suggested.
11. Green tea inhibits several factors involved in abnormal platelet aggregation. Green tea extract is available in 350-mg capsules and in 300-mg decaffeinated capsules for persons who are sensitive to caffeine. Two to four capsules daily is recommended for healthy people. Higher amounts may be taken to further reduce thrombotic risk. Green tea is best taken with meals. Green tea is also available in bulk leaf or in tea bags for those who want to brew and drink the tea.
12. Tomatoes have been shown to inhibit platelet aggregation. Lycopene, the main constituent of tomatoes, is a powerful antioxidant. Lycopene is available in supplement form: 10-30 mg a day is suggested.
13. Policosanol has been shown to lower cholesterol, inhibit platelet aggregation, and prevent thrombosis. Policosanol Tabs usually contain 10 mg of policosanol. To achieve optimal cholesterol levels, the normal dose is usually 10-20 mg taken daily at bedtime. Monitor cholesterol levels regularly because levels below 150-180 can be dangerous.
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