Mangosteen
And Coumadin
Are There Any Side Effects With Blood Thinners?
What
is Coumadin?
Warfarin, sold in the drugstores under the
brand name Coumadin, is a prescription drug that prevents the formation
of blood clots, which belong to a class otherwise known as blood
thinners.
How Are Blood Clots Formed?
A
process known as hemostasis prevents or stops blood loss from an
injured blood vessel. There are four steps involved in this process.
- Constriction of blood vessels : special
cells known as endothelial cells stick to one another (like a stack of
coins) at the site of injury initially stopping bleeding
- Platelet plug formation: special
cells known as platelets replace the endothelial cells to form another
plug to stop the bleeding which occurs just seconds after the injury.
- Fibrin formation: fibrin clot is
created
- Fibrinolysis: breakdown of the
fibrin clot and replaced by a connective tissue as the injured vessel
wall is healed. Some of these blood clots may travel into the blood
stream, form a blockage which subsequently reduces blood flow resulting
in conditions like cerebral embolism (block in vessels leading to a
part of the brain).
The liver produces
substances, known as clotting factors, which are part of the clot
formation. To be able to produce these clotting factors, vitamin K is
needed.
What About Vitamin K?
Vitamin K is one of the fat-soluble vitamins,
absorbed in the small intestine and stored in the liver, which is
important in controlling bleeding. It is a component in the coagulation
process.
How Does Coumadin Prevent Formation Of Blood Clots?
Coumadin blocks the transformation of the
inactive form of vitamin K to its active form causing disruption in the
steps for clot formation resulting in longer time for the blood to clot.
What Are The Beneficial
Effects Of Coumadin In The Body?
It slows down clot formation and
prevents the recurrence of blockage in the distant veins and in the
lungs. If there is an existing clot, it stops it from growing larger.
In people with artificial heart valves and those who had a heart
attack, it likewise prevents the formation of blood clots.
What Are The Harmful Effects Of Coumadin In The Body?
In pregnancy, it causes spontaneous
abortion, stillbirth, neonatal death, preterm birth, birth defects like
abnormal bone formation, and seizures.
Since it
stops the coagulation process, it can cause excessive bleeding or
hemorrhage in the event of injuries or surgery.
Within
the bones it causes osteoporosis or “brittle bone. On the skin, it
creates dark red or black lesions.
What To Watch Out For?
1. nosebleeding
2. dark stools
3. dark urine
4. coughing
up or vomiting of blood
5. joint
pains
6. bruising
without any injury
7. presence
of rashes on the skin
What Are The
Drugs That Interact With
Coumadin?
Drugs that increase anticoagulant effect and risk of bleeding
1. Aspirin
2. Metronidazole
3. Cephalosporins
4. Cimetidine
5. Miconazole
6. Trimethoprim-sulfamethoxazole
7. Heparin
8. Amiodarone
9. Ibuprofen (example. Advil)
Drugs that decrease anticoagulant effect and risk of bleeding
1. Vitamin K
2. Rifampin
3. Barbiturates (example.
Phenobarbital)
4. Cholestyramine
Other factors that
interact with Coumadin
1. Liver
disease
2. Hyperthyroidism
3. Hereditary resistance
4. Intake of foods like
cranberry juice, spinach, broccoli, mangosteen
What About Mangosteen?
Mangosteen, a fruit native to Southeast Asian
countries like Thailand, Indonesia, and Philippines, is known for its
high medicinal value and antioxidant content.
What Are Antioxidants?
Antioxidants are molecules which can safely interact with
free radicals and thus prevent body cell damage. It is known
to help maintain the immune system which makes our body fight diseases
like common colds caused by viruses. It also acts as an
anti-inflammatory agent which helps alleviate symptoms of arthritis.
Antioxidants
present in Mangosteen are:
Xanthones:
known not only for is antioxidant property but also for
its immune system booster and anti-inflammatory properties. Helps heal
cells damaged by free radicals,
Catechins
Polyphenols: fights
oxidative stress that causing both neurodegenerative and cardiovascular
diseases.
Proanthocyanidins:
Strong anti-oxidant
Sterols:
helps in the reduction in the amount of blood plasma cholesterol in the
body
Choosing
Mangosteen
Supplements
Between
the juice and pill form, the latter has far more advantage in bringing
you the maximum health benefits. It contains 100% mangosteen, while the
juice form uses other fruit extracts to improve its taste, and
preservatives to prolong its shelf life. It leaves little
percentage of mangosteen in the bottle supposedly marketed as
mangosteen juice.
The
manufacturing process of the juice form involves processes such as
pasteurization
and reconstitution which destroy the natural medicinal properties
of mangosteen.
The
whole fruit is utilized in the manufacturing of the juice. For the
whole fruit to be transported to the United States for processing, it
is required by the law to undergo irradiation to kill pests, bacteria
and viruses. The radiation effects to your food may be passed on to
your body, putting you at risk for cancer.
The pill
form does not have to go through the same harmful procedures. It uses
only the pericarp or rind of the mangosteen, where
the xanthones are highly concentrated. After being freeze-dried, it is
transported for processing without the need for irradiation.
Mangosteen
and Coumadin
Mangosteen
does not have vitamin K that may exert an opposite effect against blood
thinners. In laboratory studies, mangosteen was found to increase the
risk of bleeding.
Anti-inflammatory
drugs like Coumadin block blood clot formation by preventing the
platelets to stick to one another. It stops the production of
Thromboxane A2, a substance that makes the platelets change shape and
stick to one another. Bleeding is therefore prolonged.
This is
believed to be the mechanism of action of mangosteen that reduces
clotting. It means that if a person is on “blood thinners” like
Coumadin, should be educated and informed that mangosteen may double
the effect of Coumadin.
In
the case of injury or the need for surgery, it may be difficult to stop
bleeding if both mangosteen and coumadin are taken, which may lead to
blood loss. However, there has been no documented case to date, of
mangosteen causing problems on patients taking Coumadin
despite what laboratory findings on animals suggest.
If you are on any supplements, it would be wise to inform
your physician what you are regularly taking, so that he or she will be
informed of the possible interactions of the drugs to be prescribed and
the supplements that you are religiously taking. This will prevent any
complications in the future.
