Blood 'thinners'

[Lorna058]

Please could BobD volunteer explain to me again the difference between blood thinners and anticoagulants!

[BobD Volunteer]

"Blood thinners" is in my opinion a term dreamed up by condescending doctors who think that we mere patients can not understand the word anticoagulant. The viscosity of blood seldom changes although aspirin is known as an anti-platelet and can be described as reducing the stickiness of the blood so could perhaps be called a blood thinner.

Anticoagulants work on parts of the clotting process in the body. They slow down the rate at which clots are formed which means that any blood pooled in the heart during AF is less likely to form a clot or thrombus which may later be ejected and find its way into the brain causing a stroke.

The down side of anticoagulants is that any cut or injury will bleed for longer than normal. INR number describes how much longer so for example if your INR is 2 you take twice as long to clot. NOACs work on a different area of the process to warfarin but have no ongoing measurement protocol. I have always felt that for non technical people the term blood thinner may give them the impression that blood may spontaneously start to leak out which is totally untrue.

To bleed you need either a breakdown in tissue or an injury. Intestinal bleeds can be caused by digestive disorders breaking down the lining of the stomach or gut resulting in tissue damage and in a brain bleed or haemorrhagic stroke a small blood vessel needs to burst either due to perhaps an injury or excess blood pressure over time. In neither case is the viscosity of the blood relevant.

Hope that helps Lorna.

[SRMGrandma Volunteer]

Another way to look at it is that your hematocrit measures the ratio of the solid components of the blood to the liquid components. That is not something that AF changes....it does not make your blood thick, therefore, we don't need medications to thin it. I have a friend with a blood disorder where her solid components of the blood take over and she really does need a blood "thinner", which is NOT warfarin or a NOAC, but a chemotherapeutic agent. She is at risk of a stroke because her blood is like sludge, but not because of the same issues that we with AF have.

[Pdotg]

This raises an interesting question. I am filling in online medical questionnaires for travel insurance. One question they all ask is "are you taking a blood thinner?" I know they're asking about warfarin etc so I say Yes. Technically speaking, am I telling a lie? It would save money to tell the truth and say No!

[Hidden in reply to Pdotg]

I have asked about that and was told tHe term blood thinners does mean Warfarin etc. Even though wrong, anticoagulants are referred to as blood thinners, including by doctors and the NHS. I've heard an EP at Patients Day use the term as well. Maybe it's referring to the thickness of the blood at the time of bleeding, i.e. It keeps your blood thinner (normal) for longer???

[BobD Volunteer in reply to Hidden]

I stand by my opinion. A leading EP once told me that when doctors don't want patients to understand something they give it a Greek or Latin name. hence Tachycardia, Cardiomyopathy etc.. being condescending was their way of keeping us mere patients in the dark and under control so we didn't waste their time asking questions.

Blood thinners is their attempt to engage with us but fails wholesale by being so obviously condescending. Anybody with half a brain knows they aren't but sadly the term has stuck.

Climbing down from high horse now.

[Hidden in reply to BobD]

Sorry Bob, misunderstanding, I did not explain myself well. I also stand by and completely agree with your comments. Anticoagulants do NOT thin the blood, it is plastered all over the web for anyone who cares to Google it.

But, my health insurers at least, and also a lot of doctors and the NHS do (incorrectly) refer to Warfarin etc as blood thinners, which is a shame because it makes it more worrying.

The NHS websites have references and advice about the "blood thinner Warfarin", and then they have another page explaining that Warfarin does not actually think the blood 😂.

So just saying when asked by an insurer etc if you take blood thinners, they are referring Warfarin, or at least mine were because I asked them.

Koll

[BobD Volunteer in reply to Hidden]

I agree Koll regarding insurance. It is just me being pedantic I know. Another of my hates is "for free". Drives me mad.

[PeterWh in reply to Pdotg]

Yes you would be and the onus would be on YOU to prove you didn't understand. They would also probably quote NICE publications. Unfortunately no get out.