Coagulation

[Sambaqui]

Does anyone know if the rate at which blood coagulates can be measured? Is there a test available on the NHS? And is there an optimum rate that is recommended for those of us with AF?

[BobD Volunteer]

INR tests are the norm if you are either not on any anticoagulant (INR1) or on Warfarin but this is not affective if you are on DOAC/NOAC which works on a different part of the clotting process and does not need measuring. If you have AF and have been recommended to take anticoagulation there is no suitable natural method so either Warfarin tested by INR or one of the NOACs is the only solution. With Warfarin the ideal INR is between 2 and 3 and is done under NHS care. Please don't risk your health by thinking you can do this any other way.

[Sambaqui in reply to BobD]

Thanks BobD. I will take your advice.

[KathFrances in reply to BobD]

What about the Watchman device? I know this isn't yet available on the NHS, but it can be fitted privately and I've seen a study which found that it has the same level of anti stroke effect as Warfarin, without side effects.

[Hidden]

Prothrombin time (PT) is a blood test that measures how long it takes blood to clot, the normal range is 11-15.3; I was 14 on my last test. A prothrombin time test can be used to check for bleeding problems. PT is also used to check whether medicine to prevent blood clots is working. A PT test may also be called an INR test.

Having had a blood clot in my leg 15 years ago, I am extra cautious with any unusual pains in the leg. In the last 6 months, I had to trouble A & E twice and each time they took a D-dimer blood test; evidently under 500 fine, 500-1000 could be a clot and over 1000 almost certain.

Hope that helps a bit.

[Sambaqui]

Yes, it does. Thank you very much.

[ILowe]

There is a link between the Prothrombin time, and the INR. Traditionally, and in some parts of the world (sigh) only the PT is provided, which, for technical reasons, is a very very poor indicator and depends heavily on the local reagents used in the testing. This has been solved by each batch of reagents being tested by the factory, and a conversion chart provided per batch. Perhaps in Britain this is now done electronically, but a few days ago at my lab I saw the technician literally take a set-square and read off the result, converting the PT into the INR (International Normalised Ratio). You can imagine the scope for human error here, with a tired technician working on his own, with no double-checking.

[Sambaqui]

Thanks, ILowe. I am new to this and am trying to understand the coagulation process, which seems to be complex. Since my first known AF episode in January (and because my appointment to see an NHS cardiologist was not to be for 5 months) I have been consuming various natural plants and roots in the hope that these would help slow my coagulation. The drug companies seem to acknowledge that these do have an effect since they tell patients not to take them alongside medication.

Dr Gupta has kindly responded to a question from me saying that "a natural 'blood thinner' may do the same job as traditional anticoagulant, [but you would] need a large scale population study to confirm your hypothesis". Like everyone, he recommends medication. and of course I would certainly want to avoid a stroke, if that is at all possible.

I now have a blood test coming up in anticipation of an anti-coag clinic appointment. And I shall take the medication that is recommended. However, I am curious that there seems so little research into the effect of 'natural' remedies.

I hope to determine what exactly the blood test reveals and - taking from your experience - also how it is read. Perhaps, too, what a healthy reading of coagulation for someone with AF should be. Thanks again.

[ILowe in reply to Sambaqui]

The PT (then the standardised form, INR) is precisely defined. The clotting system in the human body is a wonder. It is an intricate system of chemicals etc which are coordinated and interact. It is incredibly beautiful and is a cascade which is more beautiful then most waterfalls. Clotting can be slowed down by interacting with one or more points, which is why Warfarin works differently to the newer drugs. A good place to start is en.wikipedia.org/wiki/Proth...

[Sambaqui]

Yes, it seems clotting is a wonder indeed! Thanks very much for the wikipedia link. AF is certainly teaching me about wonders of the body I knew nothing about.