Vitamin D, Fish Oil and NOACS?

[Coco51]

Hi folks. On GP advice, and following the example of many lovely people on this forum, I take Vitamin D as one of my daily supplements. (The others are Vitamin C and Magnesium). I'm also taking Apixaban and other meds for BP and AF. I've noticed on the Vitamin D container label it says that the Vitamin D is derived from fish oil. Now, I believe fish oil has anticoagulant properties, so is it OK to take it with NOACs or will it significantly increase the danger of bleeding? We're told to avoid Ibruprofen and Aspirin for that reason. Can't find anything addressing this online.

Any thoughts anyone?

[Afibflipper]

You’d have to check with a pharmacist who are usually very helpful or GP - all I know is I had to stop my high strength fish oils but you can eat the fish itself. Some vitamin D replacements come in gel capsules so wonder is the vitamin D possibly in fish oil in the caplets. I’ve just finished a 7 week high dose prescribed course from my GP and just told to continue with over the counter ones, wasn’t told dose or to get tablets or gel caps etc - I’d just check your personal position first incase there’s another reason not to take them.

[Coco51 in reply to Afibflipper]

Good advice thank you. I'm thinking I might get a version of vitamin D made without the fish oil. But it's a shame to miss out on the benefit of fish oil without some risk/benefit analysis. Beginning to wonder if I'm overthinking this!

[Afibflipper in reply to Coco51]

I don’t think so, I’m the same. One minute fish oils high strength are great to protect the heart now we can’t take them (at first I thought super healthy stuff I’ll do it all (now ooh no don’t do that!) Better safe thinking than sorry you didn’t - enjoy your day x

[Peony4575]

I have always taken a fish oil capsule and still do. I also take vitamin D. I eat a lot of fish . No one has suggested I stop since starting anti coagulant

[Jennifer53 in reply to Peony4575]

Your anti coag will be prescribed based on your inr on fish oils. You will need to contact your clinic if you stop the fish oils

[Peony4575 in reply to Jennifer53]

Thanks for that wasn’t aware I thought I was just on the bog standard 60mg Edoxaban and dose would only be changed if my weight fell below a certain point . I have been taking exact same omega 3,6&9 capsule for decades so unless they stop making it will carry on . I thought INR checking was only a thing on Warfarin . Learning all the time

[Coco51 in reply to Peony4575]

I don't think inr is measured for NOACs, so I was told. Just kidney and liver function annually. Inr is for warfarin.

[BobD Volunteer in reply to Peony4575]

It is. DOACS work on a different part of the clotting process.

[Auriculaire in reply to Jennifer53]

INR is only relevant for those taking Warfarin. No measure of coagulation factors is tested for those on DOACs.

[Peony4575]

The mechanism by which aspirin and other anti inflammatory Ed can cause bleeding is totally different than fish oil. Problem is if aspirin caused a bleed when you are taking an anti coagulant obviously the bleed as with any major bleed becomes much more serious . If fish oil was a big problem there would be a lot of information online

[Coco51 in reply to Peony4575]

Good point. There are a few accounts of small studies (75 patients) saying bleeding more likely with Vitamin D, but they don't mention in what form the D comes in. No headlines!

Egjournals.lww.com/bloodcoagu...

And plenty more on benefits of D for preventing thrombosis

intechopen.com/chapters/76246

[Peony4575 in reply to Coco51]

Thank you for that !

[john-boy-92]

I take dabigatran and I've been taking vitamin D and fish oil for years. I've had colonoscopies, cut myself clearing scrub in a nature reserve, but other than when a clip gave way on a scar after the removal of a 20mm flat polyp, bleeding has not been a problem.

[Coco51 in reply to john-boy-92]

Good news. Thank you.

[Auriculaire]

Plenty of vit D supplements are made from sheep's wool. You need to check that your vit D supplement from fish oil does not contain large amounts of vit A as well. It is not a good idea to get vit D from cod liver oil ( as was prescribed in 50s when I was a kid) as the proportion of vit A is too high. There is a lot of confusion between anti coagulants and anti aggregants in substances that have blood "thinning " properties. Most are anti aggregants ie they stop platelets clumping together whereas anti coagulants prolong the time it takes for the blood to clot. Many people take a fish oil supplement without a problem when on anticoagulants. The important thing is not to take too much. Usually up to 1000mg a day is considered safe.

[Coco51 in reply to Auriculaire]

interesting distinction between anti-coagulants and anti-aggregants. Thank you. And yes 1000 is what I take.

[Coco51 in reply to Coco51]

Sheeps' wool is a new one for me!

[ozziebob]

And here's some more good news about maintaining Vitamin D serum levels at the higher end of the range ... medscape.com/viewarticle/98...

You might need to join Medscape to read the article, but it's free, and I've had no follow-on issues after joining.

Highly recommended reading.

[Coco51 in reply to ozziebob]

Thank you, very interesting. I wasn't going to give up on the D, just try to find another source than fish oil.

[Gumbie_Cat in reply to Coco51]

I got Vitamin D capsules from Viridian, as I have liked their supplements in the past. I stuck to the government recommended 400IU. (They do higher ones.) It is a vegan product (though I’m not vegan) - and the D3 is extracted from lichen! (That stuff must soak up the sunshine.)

ETA - my daughter mentioned getting a spray, a bit like the magnesium sprays. Most of those are made by Better You I think. (Just checked and it’s an oral spray, lanolin derived.)

[Coco51 in reply to Gumbie_Cat]

Thank you. The health shop has these. But the price! I might give them a try though...

[Gumbie_Cat in reply to Coco51]

I think I shopped around and got a cheaper price via Amazon.

[Belle11]

I used to take fish oil until I got AF and was put on an anticoagulant, rivaroxaban. Just occasionally I've tried fish oil again, but noticed each time that scratches and cuts did seem to bleed a bit more if I add the fish oil back in, so had to stop again. I do eat plenty of oily fish though for omega 3s.

[Coco51 in reply to Belle11]

Funnily enough I have been taking the fish oil based VitD for years. But I hadn't noticed that effect. I will monitor it. Thanks

[Belle11 in reply to Coco51]

How much EPA and DPA in your supplement? I always used to take a high dose of just fish oil and a multi vit and mieral before AF struck. I do take a vitamin D with vit K2 as well as a multi now, but not the fish oil.

[etheral]

Read a few articles in medical

[etheral]

Journals that linked vit D to increased incidents of afib in those who already have it. Out of an abundance of caution, I have stopped taking it. etheral

[Coco51 in reply to etheral]

Wow. Which studies do you mean? I saw a few which prompted my question, but they were quite small.

[etheral]

These were small also. I believe they were in the New England Journal of Medicine ad Journal of the American Medical Association.