What's the deal with blood clots

Factual Questions
1

I’m super terrified of dying suddenly from a stroke or something due to blocked arteries. I’m equally terrified of blood clots traveling to my lungs or brain.

Whenever I hear anything about blood clotting, I start thinking about my impending, swift death. So when researching the healthiest kinds of lettuce the other day, one measurement was amount of Vitamin K, which helps blood to clot. But is that really helpful? I know it helps stop bleeding when you suffer a cut, but I really don’t like the idea of more clotting than necessary.

Then today I was reading about different fats and got to polyunsaturated fat. This is considered one of the “healthy” fats and also promotes blood clotting. But again, it makes me uneasy.

In both of the above examples, blood clotting was listed as a benefit. But could it lead to harmful blockage? Or is that process something completely different altogether?

Related: is it possible to remove build up once it’s in your arteries? Or do you need surgery and stents put in? Can the buildup disappear over time on its own?

2

I think it’s important that your blood clot when it needs it to clot, but strokes and heart attacks can result from clots in your blood stream causing dangerous blockages. My doctor put me on one baby aspirin a day a long time ago just to keep clotting down, but I am also on a statin for my high cholesterol. If you are truly concerned you should contact your PCP and talk about it, or perhaps bring it up at your next check up. If you have a family history of strokes or circulator issues it’s worth talking to a professional about it.

3

Caveat: I am not a doctor.

First off, don’t undersell the value of blood clotting. You note that blood clotting stops bleeding when you get a cut, but that’s just something that you see externally. Internally, you can suffer much the same bleeding in a variety of places, most notably the GI tract. Clotting helps there too, except that the clotting occurs, the point of bleeding heals, and you’re none the wiser. For small points of trauma, there’s no pain, so it all comes and goes, invisible to you. You might think that having a tiny amount of internal bleeding is no big deal, but remember: it’s slow, but relentless. Having said that, it’s true that I wouldn’t place too much stock in the value of increasing the ability of blood to clot, unless you have a known need to do so. More is not better.

Additionally, many people take a baby aspirin every day to decrease the ability of their blood to clot to avoid strokes and other clot-related problems (deep vein thrombosis, pulmonary embolisms, etc). Aspirin modifies blood platelets such that their ability to clot is decreased (already formed clots are not dissolved, however; that takes a thrombolytic drug, below). When you stop taking aspirin, the resumption of your normal blood clotting ability takes about 10 days, since platelets only last about that long; the effect of the aspirin on the platelets is permanent, so you have to wait for new ones to be made. For this reason, doctors generally ask patients to stop taking their daily aspirin about 10 days before surgery to decrease the risk of hemorrhage.

On the subject of strokes there’s a bit of bad news. Although about 85% of strokes are caused by a thrombus (blood clot) breaking loose and becoming an embolus that becomes lodged in the brain, not all strokes are like that. Hemorrhagic strokes (about 15% of strokes) occur because an artery bursts in the brain. Everything downstream of the break is oxygen starved and dies. Emboli cause brain tissue death through blockage, but hemorrhages cause brain tissue death through leakage. It’s also worth noting that hemorrhagic strokes usually have much more lasting and extensive damage; deaths are also more common. Worse still: it’s not always clear if a stroke is caused by hemorrhage or by an embolism. This is important because embolisms may be treated by clot-buster drugs (thrombolytics), but such drugs will make a hemorrhagic stroke worse since the leakage is prevented from sealing.

Blood clots can dissolve over time; that’s why thrombolytics aren’t always used, particularly if the clot is small. The problem, though, is that damage can occur downstream of the clot in the meanwhile, and there’s always the chance the clot will break loose and wreak more havoc somewhere else (particularly troublesome is a saddle embolism, whereby the embolism rests at the “fork” of a blood vessel, occluding both sides of the fork). As for clogged arteries, there’s more to it than blood clots. Actual damage occurs to the vessel’s wall from plaques formed by cholesterol deposits. This damage is permanent, but progression of the occlusion can be slowed/reversed with cholesterol-lowering drugs (but still, wall damage is permanent). Severe arterial stenosis (narrowing), especially in important areas like coronary arteries, can be treated with stent placement.

BTW, one thing easily checked during a physical is checking the carotid arteries for bruits. A bruit is an abnormal sound heard by placing the stethoscope over the carotid arteries and listening for the characteristic turbulence caused by clogged carotid arteries (bruits can sometimes be heard over other arteries too, e.g., the arteries leading to the kidneys). Next physical, ask the doctor to check.

Take away: more blood clotting is not better, and in many cases may be lessened with drugs to avoid problems related to clots. Cholesterol deposits may be decreased over time with drugs, but underlying blood vessel damage is permanent. Some strokes are caused by clots, and so daily anti-coagulants such as aspirin may help avoid them. Other strokes are caused by vessel leakage and are thus worsened by such drugs. Ask your doctor to listen for clogs.

4

Do you have some condition that gives you a reason to be this scared? If not, anxiety is your problem, rather than blood clots - tackle the anxiety.

5

read up on hemophilia and Idiopathic thrombocytopenic purpura (ITP) to see what happens when you have insufficient clotting.

6

Vitamins don’t work that way. It’s not “the more you have, the more likely a clot will happen”. You just need a certain minimum amount floating around to ensure the system will work properly when needed. The entire cascade is under extremely tight feedback control, and unless you have a genetic defect, it’s really not anything anyone needs to worry about.

7

That anxiety is more dangerous than an objective danger from blood clots.

“Life is a sexuall transmitted disease that always Ends deadly”, as the old joke goes.

No serious medical or biochemist expert will ever tell you “Eat x instead of y and you will be healthy!”. Because that’s not how the human Body works, and how medicine works.

A properly done medical study never states “Eating X makes you healthy, eating Y makes you sick!” (That’s a tabloid Headline). A proper done study will state “In a Group of 100 People observed over 1 year, those who ate X had 20% less incidences of stroke than People in the other Group who didn’t eat X, and 30% less strokes than People in third Group who ate Y”.

There are countless anecdotes of Grandfathers/ Uncles who smoke a cigar / a pack of cigs every day and yet lived to 90+ years of age, but the Young non-Smoking jogger died at age 23 from a heart-attack.

Because all you’re dealing with is probablities, not certainities. There is no Food that will 100% Keep you healthy. There is no behaviour that will you give you 0% Chance of disease. Yes, eating veggies instead of Chips will lower your risk and is good. Yes, doing Sports 3 times a week improves your health.
But you, as individual, can still get lung Cancer as non-smoker, can still get a flu despite eating Vitamin C, can still get stroke despite eating veggies…

So you can either gamble on the Chance that your genetic biochemistry is so good that you defy the Odds, and are one of the exceptions. Or you can go with what the majority recommends. (Or you can look at probablities and say it doesn’t matter because the Chance to die in a car accident/ Shooting is higher than Cancer + heart infarct together). Or you can say “I tried doing Sports twice a week for 6 weeks, and I felt better than before, so I will Keep doing it” “I used to eat McD, but now I have discovered some really well-cooked Mexican Restaurant, and it tastes much better, so I will eat more veggies and less Chips”.

At the Moment, we still don’t know enough about the very complex System of biochemistry as a whole, let alone the differences (genetics) between a dozen People. So we can’t look at your DNA and say “Well you have a high risk of infarct, we recommend These steps… for prevention” or “no matter what you do, your risk for stroke is low (but your risk for lung Cancer is higher than the rest of the Population” We don’t know.

And in the end, everybody dies anyway. :slight_smile:

In General, the human Body can repair a lot of Things with the right behaviour. I remember that there was study, taking photos of lungs, first of smokers (black), then yearly after they stopped. After 5-10 years, the lungs were pink and the function Tests etc were the same as People who had never smoked (and much better than before). So living healthy - Sports, enough sleep, not too much stress/ Frustration, eating healthy - can reverse some damage caused by a non-optimal Lifestyle before.

8

Personal anecdote: My mother (76 years old) had a brain stroke last spring. She was very distraught because she had been vegetarian for years. My father, who is 4 years older, has not had a heart or brain stroke.
But eating meat is not 100% stroke, and eating veggies is not 0% risk of stroke.

On the other Hand, she recovered completly from the paralysis of her left side, and in General recovered around 80% of her previous abilities. Was this because of the good Hospital care and Rehabilitation measures? Or was her Body able to heal better and quicker because she was (for her age) in relativly good shape before? Nobdoy can say with certainity.

9

From my medical perspective: Too much clotting is bad. So is too little clotting. Fortunately most people do it just right. If you have a health condition which requires adjustment of your native clotting abilities, work closely with your doctor. Otherwise, don’t worry about it.

10

My cardiologist put me on a low dosage aspirin a couple years ago.

It’s pretty common with middle aged and older people to avoid strokes and heart attacks.

My father took a daily low dosage aspirin for over 20 years.

Check with your doctor.