Blood Thinners And Mini Strokes: What's The Link?

Blood thinners are medications that prevent harmful blood clots from forming and travelling to the brain, causing a stroke. While blood thinners are commonly prescribed to prevent strokes, they can also increase the risk of bleeding in the brain, which is a cause of hemorrhagic stroke. This means that it is possible to have a stroke while on blood thinners. However, the benefits of taking blood thinners are believed to outweigh the risks.

Can blood thinners cause strokes?

Blood thinners, also known as anticoagulants, are medications that prevent harmful blood clots from forming. They are often prescribed to people who have had strokes or are at risk of having strokes to prevent blood clots from forming or re-forming. However, as with all medications, blood thinners have side effects. While they reduce the ability of the blood to clot, they also increase the chance of bleeding in some people. Usually, this bleeding is minor, such as bruising more easily, having a nosebleed, or a cut taking longer to stop bleeding. However, in rare cases, serious bleeding can occur, which can be life-threatening.

Blood thinners are effective in reducing the risk of ischaemic strokes, which are caused by blood clots. By preventing blood clots, blood thinners help to maintain regular blood flow to the brain and reduce the risk of ischaemic strokes. Ischaemic strokes account for about 62% of all stroke cases, making them the most common type.

However, blood thinners can also increase the risk of haemorrhagic strokes, which are caused by bleeding in the brain. While taking blood thinners, there is a higher risk of bleeding in the brain, which can lead to a haemorrhagic stroke. This is because blood thinners interfere with the blood's natural ability to clot, making patients more prone to bleeding. Therefore, it is crucial for patients taking blood thinners to make lifestyle adjustments to prevent injury and excessive bleeding.

Additionally, it is important to be aware of potential drug interactions. Blood thinners may interact with other medications, supplements, or even certain foods, reducing their effectiveness or leading to dangerous side effects. For example, a recent study found an increased risk of bleeding associated with Non-Vitamin K Oral Anticoagulants (NOACs) when taken with commonly prescribed medications.

In conclusion, while blood thinners are effective in reducing the risk of clot-related strokes, they can also increase the risk of strokes related to bleeding and blood vessel rupture. The benefits and risks of taking blood thinners should be carefully considered and discussed with a healthcare professional. Patients taking blood thinners should be well-informed about the potential risks and make the necessary lifestyle adjustments to minimise the chances of adverse effects.

What are the side effects of blood thinners?

Blood thinners, or anticoagulants, are medicines that prevent blood clots from forming. They do not break up clots that you already have, but they can stop those clots from getting bigger. Blood clots can cause heart attacks, strokes, and blockages, so blood thinners are used to treat and prevent these life-threatening conditions.

The most common side effect of blood thinners is bleeding. They can also cause an upset stomach, nausea, and diarrhoea. Other possible side effects depend on the type of blood thinner being taken.

Side effects of specific blood thinners

Warfarin

Warfarin has a much higher risk of causing bleeding because the dosage must be precise. It also has several other side effects and risks, including:

• Skin necrosis: a rare complication where clots form in the blood vessels in the arms and legs, or in surface fatty tissue like breasts, buttocks, or thighs.
• Blue or purple toes: a colour change in the toes and feet, sometimes painful, that usually happens within the first two months of taking warfarin.
• Congenital disabilities or miscarriages: warfarin can damage an embryo or foetus, so it should not be taken during pregnancy.
• Complications in patients with lupus: people with lupus are usually prescribed a higher dose of warfarin and often need to stop taking it before a medical procedure to avoid bleeding problems.

Heparin and its derivatives

Heparin can affect other components of the blood and bones, with side effects ranging from mild to severe. One possible complication is heparin-induced thrombocytopenia (HIT), which causes a decrease in platelets. There are two types:

• Type I: a slight decrease in platelets that is more common and usually goes away within a week of stopping heparin.
• Type II: a rare but dangerous response where platelets are activated, causing widespread clotting in the body.

Direct oral anticoagulants

Direct oral anticoagulants can sometimes cause indigestion or bleeding in the gastrointestinal tract.

Reducing the risk of side effects

To avoid severe bleeding while taking blood thinners, it is important to talk with a healthcare provider about any lifestyle adjustments that may be necessary. For example, alcohol can increase the risk of bleeding, so it is recommended to drink less than eight alcoholic drinks per week. It is also important to inform any medical professionals that you are taking a blood thinner before undergoing surgery or any other medical treatment.

What are the benefits of taking blood thinners?

Blood thinners, or anticoagulants, are medicines that help prevent blood clots from forming. They do not break up clots that already exist, but they can stop those clots from getting bigger. Blood clots can block blood vessels and stop blood flow to organs such as the brain, heart, or lungs, which can cause strokes and heart attacks.

There are several benefits to taking blood thinners:

• They can help prevent heart attacks and strokes in people who tend to form blood clots easily.
• They can reduce the risk of clots forming in your blood, which is the leading cause of strokes.
• They can be used as a long-term treatment to reduce the risk of having another stroke.
• They can be used to treat people with certain heart or blood vessel diseases, abnormal heart rhythms (atrial fibrillation), heart valve replacements, a risk of blood clots after surgery, or congenital heart defects.
• They can be used to prevent deep vein thrombosis (DVT) after surgery, which can be life-threatening.
• They can be used to prevent pulmonary embolism, which is when a blood clot breaks off your blood vessel and travels to your lungs.
• They can be used to treat people with blood clotting disorders, reducing their risk of complications such as deep vein thrombosis.

While blood thinners have many benefits, it is important to note that they can also increase the risk of bleeding and may require lifestyle adjustments to prevent injury and excessive bleeding.

What are the risks of taking blood thinners?

Blood thinners are medicines that help your blood flow smoothly through your veins and arteries by preventing blood clots from forming or getting bigger. While blood clots are important to stop bleeding when you cut yourself, blood clots inside the blood vessels or in the heart can travel to the brain and cause a stroke or transient ischaemic attack (TIA). Blood thinners are therefore prescribed to prevent strokes and heart attacks.

However, as blood thinners prevent blood clotting, they can cause excessive bleeding. This can be dangerous, for example, if you fall and hit your head, you may have internal bleeding even if there is no external sign of injury. Bleeding in the brain or stomach can be life-threatening. Other signs of unusual bleeding to look out for include heavier-than-normal menstrual periods, blood in your urine or faeces, bleeding from your gums or nose, and vomiting or coughing up blood.

Additionally, blood thinners can make you feel unwell, causing side effects such as nausea and low blood cell counts, which can lead to fatigue, weakness, dizziness and shortness of breath.

It is also important to note that blood thinners can interact with other medications and supplements, including over-the-counter painkillers, and increase the risk of bleeding. Alcohol consumption can also increase the level of blood thinners in your blood and the risk of bleeding.

Therefore, it is crucial to inform all your healthcare providers, including your dentist, that you are taking blood thinners, and to consult your doctor before taking any new medications or supplements.

What are the alternatives to blood thinners?

While blood thinners are effective in minimising the risk of strokes, they also come with their own set of risks. They can increase the risk of a stroke caused by bleeding and blood vessel rupture. Therefore, patients may need to make lifestyle adjustments to prevent unwanted complications.

Some alternatives to blood thinners include:

• Left Atrial Appendage Closure: A permanent device is implanted with a catheter inserted through a vein in the leg. Over the next few months, tissue will grow over the device, permanently sealing off the left atrial appendage to prevent blood from reaching that area. This procedure has been shown to significantly reduce the risk of AFib-related strokes and provides a promising alternative to blood thinners for many patients.
• Catheter Ablation: A minimally invasive procedure that can stabilise the heart and offers an alternative to medication.
• The Watchman Device: This is an FDA-approved implant that fits just inside the small left atrial appendage (LAA) pocket. It is umbrella-shaped and designed to plug the mouth of the LAA. It is also porous, which encourages skin cells to grow over the device, creating a physical block to ensure blood clots cannot leave the LAA and travel to the brain.
• Natural Blood Thinners: Some natural substances, such as ginger, turmeric, cinnamon, and ginkgo biloba, may help reduce the risk of clotting. However, they are unlikely to be as effective as prescription medication, and they will not dissolve a blood clot. It is essential to speak with a doctor before trying natural remedies, as they may not work as well as medication and may interfere with some prescription drugs.

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