Q: My wife is on Coumadin to reduce blood clotting. Coumadin inhibits vitamin action, but with long-term side effects. I am encouraged by Dr. Wright’s suggested alternative of using cod liver oil. I hope my wife can gradually move off of Coumadin and on to cod liver oil. Can this be done safely with INR tests as a measure? Can we look forward to a day when she is only using cod liver oil, and INR tests indicate that her clotting times are within an acceptable range?
Dr. Wright: While it is very possible to both prevent and guard against blood clots without the use of Coumadin® or other patent medications, please make sure to be working with a physician skilled and knowledgeable in natural and nutritional medicine if you decide to do so!
Did you know that it’s possible to take so much fish oil that if you cut yourself you won’t stop bleeding? That should be a clue to the fact that fish oil can be an effective anti-coagulant. But even if you’re bleeding nearly to death it won’t be reflected by the INR test, which tests only for the very specific effect of Coumadin® on the “clotting cascade.”
If your doctor feels better if he or she can use a specific test, have him (or her) look for a local laboratory which uses a platelet aggregometer, lab equipment which measures how long it takes platelets to start forming clumps, an aspect of the clotting process not affected by Coumadin®, but definitely affected by larger quantities of fish oil. An “extra-long” platelet aggregation time indicates inhibition of blood clotting.
For adults, 1½ tablespoons of fish oil twice daily is almost always enough to lengthen platelet aggregation time and partially–although not completely–inhibit blood clotting. However, never take extra fish oil without additional vitamin E in the form of “mixed tocopherols.”
Vitamin E prevents extra fish oil (or any other polyunsaturated oil) from causing lipid peroxidation, oxidative damage to cell membranes. Your best bet is 600 IU of mixed tocopherols twice daily (or three of the 400 IU capsules) with this amount of fish oil.
Yes, this is a lot of fish oil, and can cause burping or belching or, in a few cases, loose bowels. This can almost always be stopped by taking a high-lipase digestive enzyme (ask your natural food store, compounding pharmacy, or the Tahoma Dispensary) with the fish oil each time.
More importantly, in the long run, all this omega-3 fatty acid consumption from fish oil, while helpful in protecting against clots, can also cause an imbalance with important omega-6 fatty acids. This is one of many reasons why it’s important to work with a physician skilled and knowledgeable in natural and nutritional medicine who can help you measure your balance of fatty acids.
And yes, to achieve the anti-coagulant effect, your fatty acid test will always show your omega-3 fatty acids higher than the “population normals” which are used as indication of normal ranges. Remember, those “population normals” are for people who are almost never taking that much fish oil as an anti-coagulant tool! To stay in balance at the high levels resulting from taking considerable extra fish oil, it’ll likely be necessary to also take extra omega-6 fatty acids such as GLA (gamma-linolenic acid).