Hypercoagulation means thickened blood. Research from the late 1990s reveals that many patients with chronic disease may have an underlying coagulation defect contributing to their symptoms. While few doctors are familiar with this condition, understanding the theory behind it can help explain many symptoms. Treatment based on this theory can lead to improvement and even recovery.
David Berg of Hemex Laboratories has been studying the hypercoagulation often found in patients with chronic disease. This list currently includes CFS/FMS, myofascial pain syndrome, osteonecrosis of the jaw, fetal loss, multiple sclerosis, Crohn’s disease, Sjogren’s syndrome, IBS, Lyme disease, autism, gulf war illness and ADD.
Thick blood is the result of fibrin being deposited in the small blood vessels. Fibrin formation is the last step in the clotting process that stops bleeding when blood vessels are cut. Normally, long strands of fibrin weave a mesh around platelets and blood cells to form a clot that plugs the break in the wall of a vessel.
A very complex series of reactions activates the clotting process. The release of thrombin ultimately results in the production of a substance called soluble fibrin monomer (SFM). SFM is a sticky protein that increases blood viscosity (thickness) and results in the deposit of fibrin on the endothelial cells lining the blood vessels. Normally, a single burst of thrombin would generate a large amount of SFM that would produce strands of “cross linked” fibrin, resulting in an actual clot. However, in CFS/FMS and other chronic conditions, continuous generation of low levels of thrombin can occur. The result is hypercoagulation.
There are at least three possible causes or contributing factors:
- Viruses, bacteria, mycoplasmas, and/or parasites activate certain antibodies in the immune system that trigger the production of thrombin, generate SFM and result in fibrin deposits.
- Genetic coagulation defects can lead to hypercoagulation. White people are susceptible to this and black people have a resistance to it.
- Chemical exposure can result in changes that trigger the coagulation process.
The results of this thickened blood are:
- When fibrin coats the walls of the capillaries, nutrient and oxygen delivery to muscle, nerve, bone and organ tissue is compromised.
- The fibrin coating the capillaries and producing thick blood can make virii and bacteria less accessible to treatment.
- Thicker blood is harder to pump.
- By depriving the gut of proper nourishment, hypercoagulation may be a major factor in IBS. If the bowel is deprived of blood, cells will die too rapidly.
- The endothelial cells lining the capillaries are the source of heparans, the body’s natural blood thinners. When fibrin coats these cells, the heparans cannot be released, reducing the body’s ability to dissolve the fibrin.
Hypercoagulation can be detected by Hemex Laboratories’ ISAC (Immune System Activation of Coagulation) test panel. Five substances are measured, and abnormal results on any two are considered a positive test result. Studies show that 79-92% of CFS/FMS patients have a hypercoagulation defect. A standard coagulation work up usually will not detect any abnormalities, since it only assesses the risk of actual clotting. The ISAC panel is 10 to 20 times more sensitive, as well as being more expensive.
In a 1998 study, heparin was given to 7 FMS and 9 CFS patients suffering from hypercoagulation. Of the 7 FMS patients, 1 reported some, 3 moderate, and 3 significant improvement. Of the 9 CFS patients, 4 reported moderate and 5 significant improvement.
Since then, David Berg has learned that the best chance of success involves treating both the hypercoagulation and the underlying pathogen(s). Ideally, a blood thinner such as heparin is prescribed one month before beginning antibiotics for bacteria (for example mycoplasma or chlamydia pneumonia) and/or transfer factor for viruses (such as HHV6, CMV and EBV). The heparin is continued throughout, and then slightly beyond, the course of anti-microbial treatment. It dissolves the fibrin, making the virus and/or bacteria more vulnerable, thus improving the treatment’s effectiveness.
CFS/FMS patients who have been ill for more than ten years may show only one abnormality – or possibly none – on the ISAC test. A trial of heparin, however, especially if accompanied by antibiotics or transfer factor, may change that. Berg suspects that once a pathogen has a large area of fibrin deposits in which to settle, the less active it needs to be. It may therefore stop triggering the coagulation process. As the heparin removes the fibrin and allows a more effective attack against the pathogens, they reactivate and/or become more active, once again triggering the coagulation process. Most patients have more abnormalities on the ISAC test one month into treatment than on their initial test, indicating progress. They often must pass through a time of increased illness when the infection is temporarily activated.
The treatment of this condition is not easy or inexpensive. It requires a doctor who is familiar with the theory, comfortable with the lab testing and willing to individualize treatment.
Conditions that suggest Hypercoagulation (Thickened Blood)
Arrhythmias/Dysrhythmias
In atrial fibrillation, the risk of thickened blood and subsequent stroke is increased. This is the reason why an anticoagulant is so frequently used.
Chronic Fatigue / Fibromyalgia Syndrome
Studies show that 79-92% of CFS/FMS patients have a hypercoagulation defect.
Risk factors for Hypercoagulation (Thickened Blood)
Nephrotic Syndrome (NS)
A hypercoaguable state, in which the blood abnormally overclots, is also seen in some patients with NS. This means that they are at risk for developing a blood clot in the legs or in the renal veins that transport blood from the kidney. Some patients take blood thinners to prevent this complication.
Warfarin/heparin use
The use of anticoagulants suggests that there is an issue with blood clotting, though their administration may be given just to make sure the blood runs thin in order to prevent possible risks in some health conditions.
Hypercoagulation (Thickened Blood) suggests the following may be present
Hypercoagulation (Thickened Blood) can lead to
Chronic Fatigue / Fibromyalgia Syndrome
Studies show that 79-92% of CFS/FMS patients have a hypercoagulation defect.
Recommendations for Hypercoagulation (Thickened Blood)
Heparin
Heparin or another anticoagulant may be used as the primary blood thinner. Each patient must be treated individually.
Fish Oil / Krill
See the link between Hypercoagulation and EPA.
Garlic
Garlic is one of the most researched herbs in America. It has been found repeatedly to have a natural blood thinning effect that is safe and well-tolerated. Its activities are more potent when the garlic is raw. Three cloves of raw garlic per day can have a substantial effect on the functioning of the blood, and will work just as well as conventional blood thinning medications without the side effects.
Kyolic (a standardlized, extracted, aged form of garlic) has numerous research studies demonstrating it’s effectiveness in naturally thinning the blood
H. Kieswetter, M.D., of the University of Saarlandes, Hamburg, Germany, recently found that garlic could help patients suffering from peripheral arterial occlusive disease, characterized by blood clots in the legs. Typically, patients with the condition are asked to walk, because increased blood flow reduces the number of clots. However, they are easily discouraged because peripheral arterial occlusive disease causes extreme pain after walking only a short distance.
Kieswetter gave 32 patients 800 milligrams of garlic powder tablets daily for 12 weeks, while another 32 patients received a placebo. He then measured their “pain-free walking distance.” For the first several weeks, both groups of patients progressed about as they would in a typical walking program. As time went on however, patients taking garlic were able to walk about one-third farther without pain. The researcher also noted that garlic’s benefits, which included decreased blood pressure, could be detected after patients took a single garlic powder capsule. [Clinical Investigator (May 1993;71:pp.383-6)]
Ginger Root (Zingiber officinalis)
Ginger has been shown in research studies to inhibit platelet aggregation thus reducing abnormal clotting of the blood.
EPA (eicosapentanoic acid)
EPA from fish oils (or as a metabolite from omega 3 fatty acid metabolism) can make your blood thinner and less sticky.
Essential Fatty Acids
See the link between Hypercoagulation and EPA.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Fibromyalgia
(FMS): Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.
Multiple Sclerosis
Demyelinating disorder of the central nervous system, causing patches of sclerosis (plaques) in the brain and spinal cord, manifested by loss of normal neurological functions, e.g., muscle weakness, loss of vision, and mood alterations.
Irritable Bowel Syndrome
(IBS) A condition that causes upset intestines for a long period of time. It is very unpleasant to the sufferer but tends to be harmless and usually does not lead to more serious complaints. The symptoms vary from person to person and from day to day. In order to be diagnosed with IBS, a person must have at least three of the following symptoms: pain in the lower abdomen; bloating; constipation; diarrhea or alternating diarrhea and constipation; nausea; loss of appetite; tummy rumbling; flatulence; mucous in stools; indigestion; constant tiredness; frequent urination; low back pain; painful intercourse for women.
Protein
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Virus
Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.
Bacteria
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Parasite
An organism living in or on another organism.
Antibody
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
Immune System
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.
Chlamydia
A sexually-transmitted disease that is often without symptoms. Some females experience a white vaginal discharge that resembles cottage cheese, a burning sensation when urinating, itching, and painful intercourse. A clear watery urethral discharge in the male probably is a chlamydia infection.
Transfer Factor
Protein immunomodulators extracted from colostrum from immunologically stimulated animals that promotes specific immunity to certain antigens such as viruses.
Cytomegalovirus
(CMV): A member of the herpes virus family which may induce the immune-deficient state or cause active illness, such as pneumonia, in a patient already immune-deficient due to chronic illness, such as cancer or organ transplantation therapy.
Epstein Barr virus
(EBV): A virus that causes infectious mononucleosis and that is possibly capable of causing other diseases in immunocompromised hosts.
Stroke
A sudden loss of brain function caused by a blockage or rupture of a blood vessel that supplies the brain, characterized by loss of muscular control, complete or partial loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. The most common manifestation is some degree of paralysis, but small strokes may occur without symptoms. Usually caused by arteriosclerosis, it often results in brain damage.
Anticoagulant
A substance that prevents or delays blood clots (coagulation).