The COVID era has confirmed our thinking that we should all know where our biochemistry is taking us. We are all N of 1 citizen scientists living at “the tip of the spear” or, as Tamara likes to say, “You are the experiment.”
D-Dimer
In the B.C. (Before COVID) era, D-Dimer, an important cardiovascular marker, was used to help assess risks for blood clots and inflammation. There are many studies linking it to poor cardiovascular outcomes and also to an increase in mortality and cancer risk. D-Dimer is a marker of hypercoagulability or sticky blood. It can be non-specific and increased by inflammation or infections but its continued presence is linked to important health problems from heart health to cancer and increased mortality risk.
For example, in this study:
D-Dimer Predicts Long-Term Cause-Specific Mortality, Cardiovascular Events, and Cancer in Patients With Stable Coronary Heart Disease
A high D-dimer level is an important independent risk factor for a wide range of vascular events, cancer events, and multiple cause-specific mortalities in the long term (16 years).
D-dimer level predicts risks of cardiovascular disease and all-cause mortality independently and, in addition to known traditional risk factors and biomarkers, should be considered in future risk nomograms and clinical decisions.
D-Dimer and COVID
During the early days of COVID, forward-thinking physicians led by Virginia’s own Dr. Paul Marik saw that blood clots posed a unique problem and that measuring clotting risks and treating them with blood thinners was an essential factor in improving outcomes. This spurred us on early to start using medicines like Aspirin and Eliquis but also natural ingredients like nattokinase and proteolytic enzymes to good effect. Subsequent research confirmed that an increased D-Dimer correlates to poor hospital outcomes and current thinking has finally acknowledged the importance of anticoagulation therapy in treating COVID patients.
We continue to test and recommend the D-Dimer test and closely follow trends. We found that many patients have increased D-Dimer levels, especially in those who are vaccinated and also many who are slow to recover after a COVID infection. Research seems to confirm our interest and suspicion that the D-Dimer marker is not only important but can persist for some time.
Elevated D-dimer levels common months after COVID-19 diagnosis
Impact of persistent D-dimer elevation following recovery from COVID-19 – PMC
A Case of Adverse Reaction to Booster Dose of COVID-19 Vaccination: Could D-Dimer Elevation Suggest Increased Clotting Risk
We report the clinical case of a 40-year-old Italian woman, who soon after her booster vaccination with mRNA-1273 after the two previous vaccinations with BNT162b2, developed severe headache, high fever, and Musculo-skeletal pain. She went to the emergency department, where computerized tomography (CT) scans of chest and brain were performed, resulting in both negative for pathologic findings. On the contrary, white blood count was strongly lowered and D-dimer severely elevated. She improved after treatment with enoxaparin and the blood analyses returned in the normal range after ten days. This case supports the hypothesis that COVID-19 vaccines could increase blood clotting in some predisposed subjects. Therefore, we believe that robust and well-designed clinical trials, considering the evaluation of D-dimer levels, should be performed to eliminate any doubts on this issue.
Blood Clots After COVID-19 Vaccination Linked to Immune Response: UK Report
Now more than ever we need to have a nuanced and personalized approach to our health and assess one’s biochemistry and river of life. Our current healthcare system led by our sclerotic public health sector with its reliance on Big Pharma unfortunately strives for a one size fits all model and thus should not be the last word in your health research. All should make sure that D-Dimer levels are checked in addition to other inflammation markers.
What to do about an elevated D-Dimer?
There are some good resources we recommend. The excellent organization Life Extension Foundation has a helpful research protocol about blood clots and how to minimize your risk:
What Dietary and Lifestyle Changes Can Help Prevent Blood Clots?
- Eat a plant-based unprocessed diet rich in fruits, vegetables, and unsaturated fats, such as a Mediterranean style or DASH diet
- Exercise regularly
- Manage stress
What Nutrients May Help Prevent Blood Clots?
- Fish oil. Fish oil and its omega-3 fatty acids lower the risk of thrombotic events such as heart attack and stroke, as well as deep vein thrombosis.
- Ginkgo. Ginkgo may improve platelet and blood vessel function, and has been shown in preclinical studies to inhibit platelet activation and aggregation and promote the breakdown of blood clots.
- Garlic. Garlic has been shown to promote cardiovascular health in many human studies. One of the observed benefits is garlic’s ability to reduce platelet aggregation, which may help protect against excessive blood clotting.
- Cocoa flavanols. Cocoa intake is correlated with cardiovascular health and lower risk of conditions that raise thrombosis risk. Clinical trials show cocoa flavanols can reduce platelet aggregation.
- Coenzyme Q10. Clinical trials have shown coenzyme Q10 supplementation can lower levels of markers of thrombotic risk, improve blood vessel function, and reduce cardiovascular risk.
- Pycnogenol. Pycnogenol, extracted from French maritime pine bark, has been shown to reduce fluid build-up and blood clots in people with a history of venous thrombosis.
- Probiotics. Certain probiotic bacteria, especially the Lactobacillus reuteri NCIMB 30242 strain, have been found to improve markers of thrombosis risk.
- Nattokinase. Nattokinase has demonstrated the ability to increase the breakdown of blood clots. Together with pycnogenol, nattokinase was found to reduce leg edema and venous blood clots in long-haul air travelers.
- B vitamins. Vitamin B12 and folic acid deficiencies cause high homocysteine levels, which have been associated with increased atherosclerosis, stroke, arterial clots, and venous thrombosis risk. Vitamin B3 (niacin) may also reduce thrombosis risk by inhibiting platelet aggregation and supporting blood clot breakdown.
- Other natural interventions that may help prevent blood clots and improve cardiovascular health include green tea extract, pomegranate, saffron, quercetin, ginger, and guavirova.
A more detailed and specific resource for D-Dimer is from the excellent pharmacist Suzy Cohen:
Understanding D-Dimer and 10 Strategies to Reduce It
1.Grape seed extract.
Among the most famous heart-loving and blood-thinning agents we have grapes! You have all heard that a glass of red wine is good for the heart. I don’t exactly believe that myself, nor do I advocate it, but the seeds of grapes do have merit. So at the top of my list is grape seed extract. These are edible and delicious. There are supplements that offer a concentrated dose of the antioxidants that are known to support blood health and the entire cardiovascular system. Grape derived polyphenols lower LDL oxidation, and that’s good because it helps atherosclerosis. It has proteolytic activity and prolongs plasma clotting time and in short, I think it could help towards reducing D-dimer.
2. Bromelain.
The pineapple extract is like Pac-Man® and will digest proteins which is good because fibrin is a protein. It acts like a drug and inhibits platelet formation. Know what else does that? Aspirin… aspirin blocks platelet formation to some degree too.
Bromelain is an enzyme has important constituents like glucosidase, peroxidase, cellulase, escharase and other protease inhibitors. It’s a well-documented fact that bromelain has fibrinolytic activity, and is also anti-thrombotic. Amazingly, you can eat pineapple, or take supplements and all the goodness gets past your stomach acid! This is why bromelain has so many post-surgical therapeutic benefits. It’s often prescribed by natural-minded physicians for bronchitis, sinusitis, wound debridement and various clotting and cardiovascular disorders.
3. Ginkgo biloba.
This herb comes from a beautiful tree and everyone knows it is a natural blood thinner! It’s often used to improve circulation of blood around the body, and to protect the brain by improving blood flow to that region. It blocks plaquing around the arteries and reduces risk of arterial clots. There have been studies on venous thrombosis and ginkgo supplementation led to improved vascular health. Not only does ginkgo help support the vascular system and reduce risk of thrombosis, evidence suggests it may improve lipid ratios. Finding teas of ginkgo, and supplements are easy. Find this at any health food store and online.
4. Garlic.
If you’re not allergic to garlic, and you like it, use it as often as you can. There are also supplements of aged garlic made by Kyolic® brand that are odorless. While no medical claims can be made about supplements in the USA, I can talk about the food’s nutritional benefits here. Cooking with garlic may help lower thrombosis risk while also inhibiting the clumping of platelets. Garlic reduces fibrinogen levels, and remember, that’s a good thing. Garlic will speed the breakdown of clots too. There are many compounds that are responsible for the anti-thrombotic properties of garlic, and one of them is called ajoene. Eating garlic should be okay with warfarin therapy, but of course do as your physician says.
5. Nattokinase.
Nattokinase is an enzyme, but we don’t make it. Found in a cheese-like food called natto, this is popular in Japan, South Korea and China. Of all the dietary supplements used for breaking down blood clots, nattokinase is probably the most studied. According to this ARTICLE published in 2017,
“Nattokinase (NK) can break down blood clots by directly hydrolyzing fibrin and plasmin substrate, converts endogenous prourokinase to urokinase (uPA), degrades PAI-1 (plasminogen activator inhibitor-1), and increases tissue plasminogen activator (t-PA) which supports fibrinolytic activity. Unlike common fibrinolytic proteases, such as t-PA and uPA, which can produce various side effects such as bleeding, NK exhibits little to no side effects. Studies also indicate that an oral administration of NK can be absorbed by the intestinal tract. NK exhibits strong fibrinolytic activity after intraduodenal absorption. These characteristics make NK a versatile and potent fibrinolytic enzyme that can be used to combat blood clots.”
Put simply, nattokinase has well-documented anti-thrombolytic activity makes it a good adjunctive treatment for some people. Sold over-the-counter, nationwide in health food stores, ask your doctor if it’s right for you. You can eat natto as well. By the way, natto is produced by fermenting soybeans. After taking a pill of this, it may take 2 to 8 hours to even begin working. Some experts worry about a theoretical problem where a clot dislodges. This is an interesting consideration, but it’s only theoretical. Nevertheless, I advise caution with this, and ALL supplements here. If you have an existing problem, such as DVT, you should be under physician’s care, and should NOT be self-treating with these supplements.
6. Lumbrokinase.
Lumbrokinase is the word that names an enzyme which comes from earthworms! After the obvious “eeew” factor, consider the medical (and potential life-saving) benefits. You’ve got to get out of your head when you take these capsules, because the clean, purified supplements like Boluoke® aren’t selling earthworms, they’re selling a clean, purified, proprietary standardized enzyme of lumbrokinase. With some other brands (not all), you might be just getting earthworms. You just never know. So insist on high-quality brands, my favorite is Boluoke® because they are the leaders.
Boluoke® is a fully researched oral fibrinolytic supplement that publishes in vitro studies, animal studies, toxicity studies, and pharmacokinetic studies. According to the makers, Boluoke® does not affect INR or aPTT, thus is compatible with Coumadin® or heparin. There’s an interesting STUDY that you can read about regarding lumbrokinase in combination with LMWH (and subsequent warfarin), which should benefit.
Again, I like this brand name, I trust them. Their product works by reducing fibrinogen and fibrin, and it does not interfere with the natural coagulation cascade. It also contains 20mg lumbrokinase per capsule, and they verify that. Finally, if you have a hypercoagulable blood condition (whether that’s from a respiratory illness, or from taking IVIg, take birth control pills, or other), this is a good product because it seeks to prevent clots. Infections as well as those medications I’ve just listed increasehypercoagulability of blood.
7. Water.
Does water lower D-dimer? No, it does not. But becoming dehydrated lowers blood volume, and this makes your blood ‘thicker’ raising your risk for blood clots if you are predisposed. So water is listed here as an important reminder to drink pure, filtered water each day. It doesn’t cost anything to drink a bit more and as a perk, it improves constipation, migraines and immunity. If your lips are cracked or dry, or your urine is potent and concentrated dark yellow or amber color, it’s a sign you’ve waited too long.
8. CoQ10 and Selenium.
This duo is interesting and was studied by researchers in Sweden. The paper was published in Nutrients 2021. The objective of the study was to find out how a combination of selenium and coenzyme Q10 would impact the D-dimer levels of people who had heart disease. D-dimer was measured in 213 individuals at the start and after 4 years of a well-designed double blind placebo-controlled trial, they found that it helped! A significantly lower D-dimer concentration was seen in the group treated with these supplements. They used 200 mcg selenium and 200 mg CoQ10 which are both available nationwide. Ask your doctor if they’re right for you.
9. Green Tea or Matcha.
There are some studies that suggest green tea is as good as aspirin in terms of inhibiting clot formation, however, the compounds in green tea leaves work differently than aspirin, so the consensus is that you would continue to take your baby aspirin even if you drink green tea.
However, it should be noted that aspirin has some anti-thrombotic effects that differ from green tea, so if you are taking low-dose aspirin to prevent a heart attack or stroke, you should continue doing so even if you also drink green tea.
Compounds in green tea decrease levels of fibrinogen, a protein that helps clot blood. Green tea also prevents the oxidation of fatty acids, which can lead to thinner blood consistency.
10. Ginger.
Inhibits platelets from sticking together similar to aspirin. There are many studies, this is a well-documented effect of zingiber officinale (ginger). In September, 2019, this STUDY on rodents confirmed yet again, ginger’s pronounced anti-thrombotic effect on the blood. Here’s one of my other articles you will like, Why You Should Eat More Ginger. One other impressive benefit of ginger is its ability to help with coughs. I talked about that in my other article entitled, 9 Amazing Cough Suppressants to Shut You Up.
As a bonus, I’ll mention one more, CHAMOMILE. It’s easy to find supplements and teas of chamomile which is best known for its relaxation benefits. If you’d like to read how Chamomile acts as a platelet-inhibitor, CLICK HERE to read my article entitled, Chamomile Helps Arthritis, Blood Thinning and Oral Pain. Also, I have a recipe for a sleep tea called Lavender Rose Tea, and this contains some chamomile in it. This is great to drink at night, and it has broad spectrum anti-microbial activity, blood-thinning benefits and immune-boosting properties.
Proteolytic enzymes for inflammation/ D-Dimer, and other health benefits like artery health and joint support
Proteolytic enzymes, such as bromelain, papain, pancreatin, trypsin, chymotrypsin, and rutin, are essential regulators and modulators of the inflammatory response.
Among their important actions is a seven- to ten-fold increase in the “appetite” of macrophages and in the potency of natural killer (NK) cells. Proteolytic (protein-destroying) enzymes also degrade pathogenic complexes that can inhibit normal immune function.
These immune complexes, which consist of an antigen bound to an antibody, are a normal part of the immune response. But when immune complexes occur in excess, they are a principal cause of certain kidney diseases, nerve inflammations, and a number of rheumatologic diseases, including rheumatoid arthritis.
Evidence suggests that trypsin, papain, and other proteolytic enzymes can break up existing pathogenic immune complexes and even prevent their formation in the first place, enhancing lymphatic drainage.
The bottom line of these actions is a regulatory or stimulatory effect on the immune system.Proteolytic enzymes modulate the inflammatory process by a variety of mechanisms, including reducing the swelling of mucous membranes, decreasing capillary permeability, and dissolving blood clot-forming fibrin deposits and microthrombi.
By reducing the viscosity (thickness) of the blood, enzymes improve circulation. This consequently increases the supply of oxygen and nutrients to and the transport of harmful waste products away from traumatized tissue.
Proteolytic enzymes also help break down plasma proteins and cellular debris at the site of an injury into smaller fragments. This greatly facilitates their passage through the lymphatic system, resulting in more rapid resolution of swelling, with the consequent relief of pain and discomfort.
Other helpful resources and information:
Proteolytic Enzymes: How They Work, Benefits and Sources
Proteolytic Enzymes Benefits, Sources, Supplements and More
Helpful products
Trying most of the above is safe and easy.
We are a big fan of natto-kinase, but is contraindicated if on any blood thinners such as Eliquis.
We recommend:
Natto-Serrazime by Designs for Health
Pulmonary Revive by Designs for Health
(with bromelain and ginger)
Sinatrol by Ortho Molecular Products
(it has ingredients that help lower inflammation and the COVID spike)
Vascuzyme by Ortho Molecular Products
Inflammatone by Designs for Health
Systemic Enzyme Complex by PURE Encapsulations
Citranox by Ortho Molecular Products
CoQ10-300mg by Ortho Molecular Products
Kyolic One Per Day by Wakunaga
