Coagulation and Blood Consistency

Définition | Coagulation | Futura Santé

Blood at glance

Blood is a fluid that delivers necessary nutrients and oxygen to the body’s cells and from which retains metabolic waste products that are supposed to be eliminated by the specific organs and body’s systems.

It is composed of blood cells suspended in blood plasma which represents the 55% of blood fluids and is mainly constitute by water, in addition to proteins, glucose, minerals ions and carbon monoxide, result product of the respiration during which oxygen reacts with organic compounds to release water and CO2. The blood cells are mainly red blood cells, or RBCs, or erythrocytes, white cells, or WBCs, or leucocytes, and platelets, or thrombocytes.

The erythrocytes contain hemoglobin the iron-binding protein responsible of the transport of oxygen to the cells in all Vertebrates, carbon monoxide is transported instead outside the cells as bicarbonate ion through the plasma.

Coagulation and Hemostasis

The coagulation is the response to a broken blood vessel and the conversion of blood from a liquid form to a semisolid gel to try to stop the bleeding process. The cells responsible for this process are the platelets and other components like the clot factors or coagulation factors.

Blood is a fluid, but its consistency can vary to an almost solid status of a gel. It can be also defined as a suspension of cells inside a liquid that delivers oxygen and vital nutrients to the cells through the circulatory system.

Coagulation is a cascade of events that leads to hemostasis; there are two different pathways, intrinsic and extrinsic which originate separate but then converge at specific point leading to fibrin activation. The extrinsic pathway is activated by external trauma that causes blood to escape from the vascular system, this pathway involves Factor VII. The intrinsic pathway is activated instead for internal trauma by platelets, it involves Factors VIII, IX, XI, XII, common pathways include Factors I, II, V, X.

Coagulation factors are essential to normal blood clotting, their absence, or decrease can lead to bleeding disorders while the increasing in number to abnormal clots. The body produce a blood clot to stop the bleeding, after the bleeding stops the body breaks down and removes clots.

The coagulation factors are twelve and are indicated with Romans numbers, they function in a cascade series of events which involves other molecules and cofactors.

The Coagulation Factors

Factor I, or Fibrinogen, common coagulation blood marker, is converted into Fibrin through the action of Thrombin, deficiency of this factor causes Afibrinogenemia and Hypofibrinogenemia which manifest, of course with bleeding problems. Factor II, or Prothrombin, is converted in Thrombin in the common coagulation pathway. Factor III, or Thromboplastin, other typical coagulation factor activates factor X. Factor IV represents Calcium which is required in many stages of coagulation. Factor V is in plasma but not in serum, is involved in both intrinsic and extrinsic pathways of coagulation and causes the cleavage of Prothrombin in the active Thrombin, its deficiency is cause of Parahemophilia. Factor VI is not more included in this cascade of factors.

Factor VII, or Proconvertin is a stable factor in serum and plasma which participates in the extrinsic pathway with the activation of Factor X in cooperation with Factor III, its deficiency is involved with vitamin K deficiency and so with hemorrhagic tendency. Factor VIII, or Antihemophilic Factor is a labile factor involved in the intrinsic pathway which behaves as cofactor in the activation of Factor X, its deficiency is associate to an X-linked recessive trait that results in Hemophilia A, the classic Hemophilia. Factor IX, or Plasma Thromboplastin Component, or Antihemophilic B is a stable factor involved with intrinsic coagulation pathway, activates Factor X, its deficiency is involved with Hemophilia B, or Christmas Disease and is treated with purified preparations of the factor from human plasma ore recombinant, or Factor IX Complex.

Factor X, or Stuart-Prower Factor is a labile factor involved in both pathways, activated combines with calcium and phospholipid to activate Factor V to form Prothrombinase which cleaves and activates Prothrombin to Thrombin. Factor XI, or Plasma Thromboplastin Antecedent (PTA), or Antihemophilic Factor C, is stable and involved in the intrinsic pathway to activate Factor IX, its deficiency results in Hemophilia C. Factor XII, or Hageman Factor, is stable and activated by contact with foreign agents, is involved in the intrinsic pathway to activate Factor XI. Factor XIII, or Fibrin-stabilizing Factor, is a factor that polymerizes Fibrin monomers enabling fibrin to form blood clots, deficiency causes Clinical Hemorrhagic Diathesis.  

Causes, Complications and Disease Associated with Abnormal Clotting

Some people get too many clots or their blood clots abnormally. Reasons for blood clotting abnormally, or hypercoagulability are different, like genetic disorders, cancer, atherosclerosis, diabetes, atrial fibrillation, overweight, obesity, dehydration, metabolic syndrome, stroke, some medicines as birth controls pills, or any other type of steroid’s medications, sitting in one position for long time as when driving for long distance or travelling in plane.

Two type of cancers are associate with hypercoagulability, Polycythemia Vera, which is a blood cancer that originate in the bone marrow and that cause the production of too many blood cells, all types, causing blood clotting, and Multiple Myeloma which cause increasing number of white blood cells.

Blood clots can form everywhere in the body, a clot in deep veins is called Deep Vein Thrombosis, or DVTs, symptoms associate are swelling, redness and warmth of the area, leg cramps in calves, if a clot travels through the bloodstream to the lungs it causes Pulmonary Embolism, other complications include, strokes, heart attack and kidney problems, peripheral artery diseases, or PAD, anti-phospholipids syndrome.

Blood clots are also a critical complication of Covid-19, cause of strokes and all other type of consequences that we all know very well now, it looks like based on reports that the most severely ill patients present hypercoagulability and Disseminated Intravascular Coagulation, or (DIC), which is a massive intravascular clot production. Therefore, coagulation tests may be useful to discriminate severe cases of Covid, same as for some of the vaccine’s risks and side effects.

The mechanism of the coagulopathy in regard of the infection from the Coronavirus are not still clear, it is speculated that the dysregulated immune response triggered by the inflammatory cytokines, lymphocytes cells death, hypoxia and endothelial damage are involved.

Factor V Leiden is one of the factors involved in coagulation process, it is a result of a mutation which increases a person risk of blood clots, especially in deep veins, the additional risk is due to its resistance of being deactivated by the protein C that keeps normal Factor V activity under control. Protein C and S deficiency are hereditary deficiency, people with these are at risk of blood clotting.

Prothrombin gene 20210A mutation is another genetic disorder associate, people with this have too much of blood clotting Factor II, or Prothrombin, one of the factors that allows blood to clot properly, with too much of this high risk of blood clots.

Symptoms, Therapies and Natural Remedies

Usually there are not symptoms with blood clots, but occasionally people may experience, blurred vision, headaches, easy bruising, high blood pressure, lack of energy, shortness of brief, menstrual bleeding with clots. Recurrent pregnancy loss are also reasons to be concerned about thick blood.

Therapies for blood clots includes blood thinner, as warfarin or coumadin, or anticoagulants like aspirin, or any other natural remedies with blood thinning properties like fish oil, garlic, ginger, turmeric or curcumin, bromelain and so on, B-vitamins and methylated folates and B-12 vitamins are also useful to lower homocysteine, other cardiovascular associate marker, another supplement suggested is nattokinase, a Japanese product, lemon, pineapple, cinnamon also are elements that support fluidification of blood, and water, of course.

Medications are prescribed only with increased risks, many people with thick blood never experience blood clots and this is the reason why doctors usually only recommend lifestyle changes like, quitting smoke, losing weight, exercise, and avoiding long time in same position.

Blood Consistency or Viscosity

Blood consistency should be not too thin to cause bleeding, but also not too thick to cause clots, this property is defined as viscosity, and represent a measure of a fluid’s resistance to flow; it is important to know the type of blood consistency or viscosity to prevent consequences, to address therapies, lifestyle, and supplementation.

Thick Blood

Thick blood is caused by heavy proteins load or by too much blood in circulation, too many red and white blood cells, and many platelets or thrombocytosis, and from imbalance of the blood clotting system made of clotting factors and other components.

For heart and circulatory system thinner and more watery blood might be better than a thicker or more viscous blood that can cause more risks for heart attack and stroke.

There are more agreements in regard of the fact that watering down our blood can prevent heart disease, a quote from the Harvard Education School states that, “The more viscous the blood is, the harder the heart must work to move it around the body, and it is more likely to clot inside arterial and veins”.   

Viscosity is also associate with high cholesterol and blood pressure, and can be controlled by drinking enough water, more statements in regard of something that looks so obvious and so simple, and the reason why naturopaths keep reminding of drinking enough water, not simply to hydrate but for its multiple function.

How much blood is thin or thick it depends on many factors. The red blood cells have the major influence since they account for half of the volume of total blood. The hematocrit is a measure of the number and size of RBCs, its number in % account for percentage of blood volume occupied by red cells.

Blood fats such as LDL affect viscosity, the more LDL the thicker the blood is, same thing with fibrinogen, soluble protein, coagulation marker that can be transformed into insoluble fibrin, the basis for blood clots. Chronic inflammation also increases the viscosity of blood, so as smoking, high levels of homocysteine, high level of platelets and clotting factors, diabetes, and genetic disorders.

Laboratory’ s studies generally link blood viscosity with cardiovascular markers, and more studies have shown that people with highest viscosity are more prone to develop heart disease and that statins therapy decrease viscosity with long term use, but not all studies convene on this last connection, as we all know there are multiple alternatives today for reducing blood viscosity and the risks related.

To mention an example from conventional medicine point of view a book titled “The blood Thinner Cure” written by a cardiologist, Kenneth R. Kensey talks about “The Sludge Factor” and enlists several steps to thin blood like quitting smoking, eating healthy diet to lower LDL cholesterol, reducing stress, taking low dose aspirin, donating blood, or drawing blood for blood tests, or phlebotomy therapy, drinking 10-12 glasses of water per day.

Thin Blood

Thin blood or thrombocytopenia, due to decreased number of platelets is less common than thick blood. Chronic bleeding and excessive bruising may be caused by overly thin blood.

Hemophilia and Von Willebrand’s disease are two medical conditions due to the missing of clotting factors in the first case, and because blood platelets lack a sticky coating, women with Von Willebrand’s disease may have heavy periods. People with thin blood are given blood thickeners before of a surgery to prevent bleeding complications.

Reasons for decreased platelets production are viral infections, bone marrow disorders, leukemia or lymphoma, disorders of spleen, some autoimmune diseases like RA or SLE, chronic liver disorders, or physiologic factors like aging and pregnancy.

Signs are bleeding gums, nose bleeding, blood in stool, heavy menstrual periods with clots, bruising, causes are those mentioned above, or overuse of aspirin and pain killers.

Therapies for bleeding disorders vary based on site of bleeding and are different and specific for each casualty, for bleeding nose for example there are different remedies and the most are of local application and of pressure and tamponing of nostrils, for other type of bleeding steroids as estrogens and progesterone are suggested, or natural remedies like sugars or salts or herbal elements. Medications for bleeding are not easily prescribed for the risks associated, and side effects.

Thanks For Reading

Mariarosaria M.

Sources:

Harvard Educational School

Medical News Today

Medline Plus

Weber Educational

http://www.insidescience.org

Picture by futura-sciences.com

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