blood thinners and cod liver oil?

[Jamontoast]

hi everyone hope you all had a good Christmas, I was diagnosed with AF in November so still learning lots from this forum. I am on edoxaban 60mg and Bisoprolol 2.5 as PIP which I have been taking approx every 7 days. I wanted to ask about taking cod liver oil and other vitamins, as I read that fish oil shouldn’t be taken with blood thinners as it thins the blood further - does anyone have any advice on this?

[Taviterry]

FWIW, I Googled "cod liver oil, edoxaban and Bisoprolol", and the first two hits were:

"Can you take cod liver oil with edoxaban? Edoxaban causes bleeding, as can Omega-3-acid ethyl esters ; concurrent use might increase the risk of developing this effect. Manufacturer advises use with caution or avoid."

"No interactions were found between bisoprolol and Fish Oil."

Having spent a lot of time this year Googling the varying combinations of supplements and prescribed medicines that I'm taking, I suggest you may like to do the same in your case, concentrating on the most authoritative websites. You may find that the advice varies.

(Several times in these pages I've mentioned a friend's insistence that I take some expensive Omega 3 gels - she even gave me some for Christmas. Most websites - and the gels' own labelling - advise caution when taking them with blood-thinners, with a daily maximum of 1, 2 or 3 grams being variously given.)

[Jamontoast in reply to Taviterry]

Many thanks - I have heeded your advice and stopped them now, just didn’t think but as I say I’m new to this!

[wilsond]

First of all,love the name,is it from my favourite film ever ' The Sound of Music?'Now then. AF people are not on blood thinners( although some Gps and even other medics who should know better refer our medication as such)

Blood thinner is aspirin, used to regulate the consistency of the blood for those predisposed to ' sticky' blood and hence at risk of furring up the pipes

We are on anticoagulants ,these act on slowing the clotting process,as we are 5 times more likely otherwise ( if you score more than 1 on the scale) to get a stroke due to the heart rythym irregularity leaving residue.

Warfarin needs to be taken with caution I regards to diet,consistency of Vit K food, alcohol etc,inc fish oil.

Nhs advice says the new DOACs such as Apixaban ' might' cause a bleeding risk.

Look on NHs for more info.

Personally, I prefer to maintain health through food itself, such as salmon, herring etc in this case. Supplements can be too much of a good thing!

Best wishes

[Jamontoast in reply to wilsond]

Many thanks - my ‘name’ refers to my fave lunch haha. Sound advice I have stopped the fish oil now, and will rely on diet pending chat with cardiologist (whenever that may be)

[wilsond in reply to Jamontoast]

Good thinking! You're welcome 😊

[Thomas45 in reply to wilsond]

I'm on Warfarin and disagree with your comment that Warfarin has to be taken with caution in regards to diet. Depending on what you mean by "with caution", I'd disagree. My main meal today was a casserole of green vegetables, Brussel sprouts, broccoli, peas and broad beans, as well as butter beans. A lot of Vitamin K which will be offset by a higher dose of Warfain.

[wilsond in reply to Thomas45]

If you are able to keep tabs on your diet ,agree.As you say 'with caution!' As I said. My father was on Warfarin for over 15 years,weekly blood tests and constantly advised to keep things consistent.

One memorable week he went to a Royal Navy do,which had more greens than he should have had,plus several (!) Rum tits. Taci home but next blood test was way out of kilter

My point was,in reference to the cod liver oil supplements mentioned, perhaps with Warfarin caution would be advised, but not definitely DOACs,which I take. However I err on the side of Healthy Eating .

Warfarin does come with quite specific guidance ,as Bob agrees.

Your greens and any alcohol need to be very consistent. Which is caution ,surely?

I like my Apixaban,happy to be on for life and glad to get it after a TIA

But the question was,should fish oils be taken as a supplement? I still say not really if on warfarin,according to nhs guidelines .

[dixiedad in reply to wilsond]

What is a rum tit?

[wilsond in reply to dixiedad]

Haha Autocorrect or operator error. Corrected it. A Rum TOT is a large shot of Rum,and Navy brand Rum is strong.

[dixiedad in reply to wilsond]

Ah. Thank you.

[CDreamer]

Simple answer - it’s a no for cod Liver Oil and anticoagulants.

Latest evidence indicated that Cold Liver Oil does not benefit cardio in any form.

The review provides good evidence that taking long-chain omega 3 (fish oil, EPA or DHA) supplements does not benefit heart health or reduce our risk of stroke or death from any cause. The most trustworthy studies consistently showed little or no effect of long-chain omega 3 fats on cardiovascular health. On the other hand, while oily fish is a healthy food, it is unclear from the small number of trials whether eating more oily fish is protective of our hearts.

cochrane.org/news/new-cochr...

I find CoQ10 helpful but even that is now debatable.

[Silvasava in reply to CDreamer]

There's a trial through the BHF being done at the moment on CoQ10 - I applied but was not suitable so I'm still on OTC .

[Thomas45]

Edoxaban does not thin the blood. It delays coagulation., and is therefore an anticoagulant. The term "blood thinner" is not helpful.A pharmacist can advise you on whether any supplements you wish to take will interact adversely with your anticoagulant.

[Belle11]

I tried taking fish oil while on rivaroxaban (another anticoagulant) and I did notice I bled more easily - just any little scratches tending to bleed slightly - and I stopped it after a few days. But I eat plenty of oily fish.

[Peony4575]

I have been taking a fish oil capsule for decades and didn’t stop taking it when I started Edoxaban . I haven’t had any problems it’s a tiny amount I don’t glue the stuff out of a bottle . I also eat a lot of oily fish . Cardiologist had no problem with my taking it

[JudiHalf]

I too have been taking cod liver oil capsules with Rivaroxoban for years, I only recently found out there might be a problem via this forum. I still take them, just one a day to help with dry eyes and don’t intend to stop.

I think if there was a serious issue, warnings would be given on both medication and the cod liver oil capsules.

[Sixtychick]

I had this dilemma with omega 3 and edoxaban, when first prescribed edoxaban, 4 years ago. I am taking 30mg of Edoxaban and was taking 1000 mg of omega 3. I reduced this to 500mg of Omega 3 and the Dr said this was ok. I also take COQ10, a Pro-biotic , multi vits and magnesium.. Have ok’d all these and they are fine with the Edoxaban, Sotalol and atorvastatin I take. Best to talk to Chemist or Dr, if you’re not sure. A-Fib is an awful thing to have. I had a catheter ablation in September and have my fingers crossed, that my AFib stays away now. 🤞🤞🤞. All the best in your AFib journey and maybe you’ll be offered an ablation eventually. Worth going through it, if it stops your AFib.

[pwoody]

I have had AF for over 5 years and now have it permanently. I take Apixaban as an anticoagulant and I also have taken 500mg cod liver oil for that period of time having checked with the pharmacist first. Coincidentally I only spoke to him again yesterday because I was thinking of taking vitamin D and we went through my medication and the vitamins I take and he said there was no problem. I have never found that I bleed excessively. Hope this helps you make a decision. Happy New Year.

[Taviterry]

Reference suggestions to talk to one's GP or pharmacist: that's good basic advice, but I prefer to do my own back-up research as well on authoritative websites and taking into account my own circumstances. In the past five months, I've had a couple of suspect pieces of advice from my surgeon (who never had access to my medical records) and my GP issuing me with a prescription that the National Institute of Clinical Excellence and other authorities advise against. My ever-changing pharmacist is very hard-pressed and communicates from behind a screen which makes conversation a little difficult in a busy shop.