Fish Oil & Bruising

[gifford7]

i have been gorging on salmon for a couple day. Last nite i hard bumped my left arm on the door jam over a 1" purple bruised spot and it tore the skin and started oozing bleeding continuing the next day. I'm on 10mg prednisone and 81mg aspirin. I've had this problem before but this was more severe. I did a web search and see that fish oil is a blood thinner and could worsen the bruising, so time to cut back on the salmon portions. Also plan to go to every other day on the aspirin as approved by my rheumy. [aspirin is for GCA, stroke, arrhythmia, hole-in-heart]

livestrong.com/article/2880...

"Risk of Bruising

Since fish oil is a natural blood thinner, it reduces your blood's ability to clot, and therefore, bleeding caused from capillary damage takes longer than normal to stop. As a result, when veins and capillaries break, blood leaks out of the vessels, pools under the skin and creates a bruise. Fish oil's ability to prevent blood clotting leads to the risk of prolonged bleeding and bruising, especially when consumed in combination with other blood thinning agents.

Interactions With Blood Thinners

The National Institutes of Health advises using caution when consuming fish oil in combination with blood thinning medications. Drugs prescribed to prevent blood clotting include aspirin, Coumadin, Fragmin, Lovenox, Persantine and Plavix. Some herbs and supplements, such as clove, danshen, garlic, ginger and ginkgo, are also known to slow blood clotting and should be taken with precaution if taken in combination with fish oil."

[SheffieldJane]

That is interesting and hitherto unknown by me. Who would have thought it, good old salmon. Thanks for posting.

[Hindags]

Is it only fish oil or any oil containing Omega3?

[HeronNS in reply to Hindags]

my.clevelandclinic.org/heal...

It's the Omega-3 fatty acids which have the effect, no matter the source as far as I can tell. In fact it is this very effect which is one of the reasons they are recommended. Apparently NOT to be taken in any quantity with blood thinning medications, even aspirin!

[SuziCutie in reply to HeronNS]

How interesting. Been taking omega fish oils for years as advised by my optician for dry eyes. Been blaming prey for horrible bruises!!

[HeronNS in reply to SuziCutie]

Well, the pred wn't be helping. Perhaps they are worse because of the omega 3? This could be the reason some people have problems and others don't or only minimal?

[PMRpro Ambassador in reply to HeronNS]

ncbi.nlm.nih.gov/pmc/articl...

It does seen to be a case of what it is combined with - and pred does cause an increased tendency to bleed in some people.

[Jeannie29]

Gifford 7. Good to know x

[PMRnewbie2017]

Steady on everyone! Please don't stop taking your omega 3s. If you are taking anticoagulant (blood thinners) your INR will be checked so you will see if the fish oils are affecting it. Modern diets are heavily biased towards omega 6 which is a precursor of inflammatory Arachidonic acid and thence prostaglandins and cytokines. We need more omega 3 than 6 in our diet to counteract this. Plus for us PMR/GCA sufferers we have an autoimmune inflammatory illness so we need all the anti inflammatory help we can get.

There is not a lot of high quality research around in the area of herbal or dietary supplements. All medicines, even those from natural sources, carry some risks (e.g. digoxin from foxglove leaves!), so it's often a risk vs benefit exercise.

[Purplecrow in reply to PMRnewbie2017]

Thanks for words of wisdom. 🙏🏽

[PMRpro Ambassador in reply to PMRnewbie2017]

Remember though that the INR is meaningless with NOACs and isn't measured.

There is also emerging evidence that dietary omega-3s are better and that omega-3 supplementation does not have the benefits that have been claimed - there are various possible reasons for that, including a possible increased dietary intake:

"The results of a 2018 meta-analysis of 10 randomized clinical trials that included 77,917 patients with a history of coronary heart disease or stroke, or at high risk of CVD were contrary to those of earlier analyses. This analysis found that omega-3 supplementation (376–2,550 mg EPA+DHA/day) for 1 year or longer does not reduce the risk of fatal coronary heart disease, nonfatal myocardial infarction, stroke, or other major vascular events [57]. A 2014 meta-analysis of 27 randomized controlled trials also found that LC- omega-3 supplementation does not significantly lower the risk of coronary disease, including fatal or nonfatal myocardial infarction, coronary heart disease, coronary insufficiency, coronary death, angina, or angiographic coronary stenosis [58]. Similarly, the authors of two meta-analyses published in 2012 concluded that omega-3 supplementation does not reduce the risk of cardiovascular events in patients with a history of CVD [59], and is not effective for the primary or secondary prevention of cerebrovascular disease"

ods.od.nih.gov/factsheets/O...

[HeronNS in reply to PMRpro]

Thanks, PMRpro. I read something about this after I had bought, for the first time, an omega 3 supplement. It tastes horrible, but was so expensive I've been gamely swallowing my 1 tsp a day. Bought two bottles. But now I know it isn't worth it. I don't eat fish any more because our farmed salmon is unsustainably raised and full of chemicals so I'm concerned I'm not getting omega 3 in any amount at all. I just can't bring myself to buy wild Alaska salmon any more as that is becoming fished out and endangered - orcas are dying of starvation because they can't get enough fish. And besides it always seems to be a "product of China" now . What to do? I understand that plant sources of omega 3 are relatively unhelpful.

[piglette in reply to PMRpro]

There was a program on TV about omega 3 supplements not being all they were cracked up to be too.

[TooSore]

My gums bled a little at the dentist office during a cleaning. The hygienist knew about the prednisone but asked if I was taking anything else. When I mentioned fish oil, she said "that explains it" and told me that it increased bleeding. I hadn't realized.

[Telian]

Interesting and useful to know, thanks.

[Anniegal]

Hi,

So appreciate your sharing this.