Long time reader, first comment.
Thank you for so freely sharing all the information.

Marc

Thank you for this!  I have had this question for a long time given the number of things I take that "thin the blood."

As a veterinarian I've dispensed fish oil capsules for several years.  Some owners give so many that the dogs smell 'fishy' when seen for routine care.  The owner doesn't smell it since they're with the dog a lot.  The coats are gorgeous, something that doesn't often happen in Wyoming at 7000ft altitude.

Hi, Kevin--

My two Boston terriers jump for their fish oil capsules, two every day!

I'm glad to hear from a veterinarian that the coat sheen is indeed from the fish oil.

Due to an afib episode a couple of years ago, I was taking 20 mg of warfarin per day, plus around 5000 mg of EPA+DHA, and never had bleeding issues.  

My INR was always a stable 2.0.

As I've not had an afib reoccurrence, I've replaced the 20mg coumadin with 325mg aspirin daily, and still take around 5000 mg EPA+DHA.  No bleeding issues with that combo either.

Glad this topic came up.
Over the last 5 years, I've had to periodically eliminate my fish oil intake as I would start to bruise badly. My internist said she has seen this occasionally with fish oil and called it "capillary fragility." I bruise easily anyway, but it would really get bad with fish oil. So there must be some quality in fish oil that influences this.

Then about 6 months ago I started a strong supplement change to help with my low bone density--already taking magnesium and calcium but added:
Boron, K2, silica,pomegrantate juice, and BIG increase in vitamin D.
I also increased omegas to 3,000 a day which I was not able to tolerate before.

It has been over 4 months since I have had ANY bruise---which is just unheard of for me. I usually have 3-4 different bruises on arms/legs. So something in these supplements  strengthened my capillaries I guess, and I can now take high fish oil doses!
Anyone else had a bruising problem with fish oil?

Hi, Catherine--

Fascinating observation!

I'll bet it has something to do with the vitamin D, more than anything else. Vitamin D seems to strengthen structural tissues in bones, muscle, heart valves, and perhaps capillaries and other small blood vessels.

Several years ago I bruised easily for a while and attributed it to taking garlic supplements daily.  I started taking Vit C and the bruising stopped.  I don't think it had to do with fish oil (in my case); I don't think I was taking fish oil at the time.

I too achieve rapid blood thinning when taking 2400mg of EPA/DHA per day. That's only 4 pharmaceutical grade capsules. Even after my vitamin d levels were normalized I still got bruising.

I now take Vitamin K2 (MK-7 natto extract) twice a week and it's allowed me to bump my EPA/DHA up to 3600mg with no ill effects or bruising.

It was either supplement or eat a lot of aged cheese, they both seemed to do the trick in my particular case.

Thank you for sharing this study with us.  It helps clarify whether there is a risk for blood thinning from taking fish oils.  This information may help individuals who are taking blood thinning medications and considering adding fish oils to their daily diet.

Catherine,

Without a doubt, your cessation of bruising was due to vitamin k2. I routinely take nattokinase, large doses of fish oil, curcumin, and other blood thinning agents, and if I don't take vitamin K2, I will begin bruising. (I also take high doses of Vitamin D). When I take K2, I have absolutely no bruising.

Vitamin K2 has many clinical trials showing that it helps endothelium  integrity and elasticity.

Also, grapeseed extract and pine bark extract (specifically oligomeric proanthcyanins) has the same beneficial effect.

Daniel,

That's really interesting! There is a lot of research on K2's effect on strengthening weak bones. Bone fractures go down considerably when high doses of K2 are used (Japan is using K2 as osteoporosis treatment) BUT studies show it needs to be in conjunction with adequate calcium and Vitamin D---they work synergistically for bone strength.  So it makes sense that K2 and D could do the same with strengthening fragile capillaries. I am also taking the M7 natto form.

Dave,

Thanks for sharing your experience with this, you've really confirmed it now for me.  I can't believe I have suffered with this for most of my life with no answers (tried high dose Vit C, grape seed, etc) and now within months on K2, there's no bruising and I can tolerate fish oil. Hope my bones are responding this well!
This blog is so helpful....

Thanks for posting this. The question recently came up in our office. I like your assertion that omega-3s restore the blood to normal and remove abnormal clotting. And to comment on a post above, our dog has a beautifully shiny coat and takes 2 pure EPA capsules each day!

I have enjoyed reading That During nearly 3 years of observation, there was no excess of bleeding events in the group taking fish oil. (In fact, the group not taking fish oil had more bleeding events, though the difference fell short of achieving statistical significance.

I've been drinking fish oil for many year and I don't have any chance in my body people use to said me that but I think it is just a rumor.

I'm also especially gratified that a woman now holds our record. I'm uncertain why, but the ladies have been shy and the men remain the dominant and vocal participants in our program. Speak up, ladies!

I haven't heard of this problem
fish oil supplements. But now we know what to tell them when this sort of concern comes up. Fish oil or Omega-3 is really beneficial to health. It's just important that it comes from clean waters.

What is an appropriate dose of fish oil for someone taking coumadin?

Dr. Davis, when  person is taking Tamoxifen...
(1) is it safe to take vitamin k2 or K1?
(2) will fish oil have a role in preventing blood clots?

Gee thanks for ruining my dinner! Lol.

Anyway, I came across this article from Fox News website -

"Low-Carb Diet Could Raise Bad Cholesterol Levels"

http://www.foxnews.com/story/0,2933,587393,00.html

I don't know where to begin to point out why it's misleading...

Frustrating when media does that and only to cause more confusion over low carb diet, high carb diet and such.

Lou.

That Fox News article has already been covered HERE.

Nige.

It says:
"Both groups lost around 6 kilograms (13 pounds). But the individuals on the low-carb diet actually had an average increase of 12 milligrams per deciliter increase in their LDL levels, up from 109 milligrams per deciliter (less than 100 is considered optimal); the high-carb diet group showed a 7 milligram per deciliter decrease, down from 102."

"The low-carb group also showed greater increases in their levels of free fatty acids, which are released into the blood when the body breaks down stored fat. High levels of free fatty acids make it more difficult for the liver to store glucose, which in turn ups sugar levels in the blood. Consistently high sugar levels define diabetes."

So I guess the low carbers started burning fat from their guts as if that is bad and also would not be able to store glucose if they were eating any.

Well duh...

Dr. Davis...that picture should be placed on every bag of bread...

Agreed Lou.

Hey, what's the problem? The rat is by far the most nutritious part of that loaf!

Good one.

Uh, wouldn't that raise the protein level and make it less bad?

At our farm, we have a rule: eat our food, and we can eat you. We draw the line at rats and mice though.

The bread was definitely bad for the dead mouse!

I need to get my glasses checked.  I thought I was looking at a chunk of black mold til reading these comments.  When I took a closer look...yuck.  

It almost looks like a contrived photo.

kevin

So I guess the low carbers started burning fat from their guts as if that is bad and also would not be able to store glucose if they were eating any.

I have been doing some experiments with Blood Glucose control over the past 2 months and have made a huge difference by cutting out grains completely.  Between the reduction in carbs and the addition of some moderate strength training, I have been able to eliminate BG spikes above 150 (now normal highs are in the 120s) and the duration is shorter as well.

Dr Davis I as a neurosurgeon scientist completely agree with you about carbs wheat and glycation but from the literature of diabetics I am far more concerned with lipid peroxidation from PUFA's.  Espcially the omega 6 and 9's which are known to cause six times the "glycation" that glucose does.  I believe a meta analysis was done for Circulation recently and it caused a firestorm in the AHA ACA because of sponsorship issues.  I am more concerned with the guidelines we physcians need to advocate than guidelines that are subject to market forces more than scientific ones.

Dr. K

Dr. K,

I tried to find that meta analysis in Circulation and couldn't find it. Could you please provide the reference. Thanks

I have to say I've found giving up wheat, even cutting down substantially, to be damn difficult because it's so widespread and simple habit. I aim for more lean meats and things like rice for carbs, but so dearly love my breakfast cereal and pizza!

Does anyone have thoughts on aminoguanidine relative to the glycation issue. I took it for some months a few years ago until it got a bit too pricey.

If wheat and omega-9 fatty acids are so unhealthy, why do the southern europeans live so long? Wheat and olive oil are a huge part of the traditional Mediterranean diet.

Meta-analysis Reveals “Heart Healthy Omega-6 Fat” Increases Risk of Heart Disease
Bottom Line: The research upon which the American Heart Association based their "eat-your-omega-6-fat" advisory, is fatally flawed, according to the results of a meta-analysis study, which showed that a steady diet of omega-6 polyunsaturated fatty acids increases the risk of heart disease and death, especially for women [1]. British J Nutr. Dec 2010.

       [Here's a link to the full post http://www.scribd.com/doc/44601571 ]
DR. K

http://omega-6-omega-3-balance.omegaoptimize.com/2010/12/03/metaanalysis-reveals-heart-healthy-omega6-fat-ups-risk-of-heart-disease.aspx

Advanced glycation of peroxidized poly-unsaturated fat rate has definitely been claimed to be significantly higher than rate of glucose advanced glycation.

Dr. Davis' tactic of glucose control does seem easier for patients to see how they can make changes that matter. They are then more open to following his complete program.

A recent autopsy analysis (2010) of ruptured plaque said there was always iron in there; and yet no iron in the intact plaque. Iron cleaved from the blood is a suspected activator of omega-6 lipid peroxidation at the epithelium. When the fibrin polymerizes it seems iron gets trapped.

People's genetics make me wonder if some mega-dose multi-vitamin takers are over doing the iron; vitamin C even boosts it's uptake. Old "southern Europeans" probably never took complex vitamin pills until recently. Wheat germ has soluble iron and those old timers ate white flour products if they could.

@Anonymous neurosurgeon scientist.
Isn't omega 9 MUFA rather than PUFA?
Also there's no reason why a LCHF diet couldn't also minimise PUFA, in preference to SFA/MUFA.

While this post was about endogenous glycation, there is indeed a parallel path of exogenous "glycation," poorly named because many of the so-called exogenous "advanced glycation end-products" do not involve glycation.

I agree with Dr. K that many of the exogenous factors leading to heart disease, aging, and other phenomena are those that lead to LDL oxidation. Oxidized polyunsaturates, AGEs, and oxidized cholesterol are underappreciated phenomena.

A topic for future.

Although I had given up oats and other grains because of their adverse effect on blood glucose,I had not been able to give up toast(sprouted wheat). I finally found a great solution--organic frozen green beans. They are easy to cook and go well with eggs. I have been wheat-free for about a month.I feel good and I don't get hungry as often.

As revelo, I am curious as how is it that italians eat tons of pasta (they use hard grains) and seem to be healthy.

Peter at Hyperlipid has written about this fasting glucose paradox in carb-restricted individuals.  

I have been Paleo (<60 grams of carbs) for two years.  I eat no sugar, fructose or grains of any kind.  Yet my fasting glucose is 90 with all other diabetic indicators normal.  Apparently, high normal fasting glucose is common among LCHF diets.  

I haven't researched this, but since a LCHF diet produces large, fluffy oxidation-resistant LDL, I wonder whether there is a beneficial effect downstream from glycation? Otherwise both a low fat, high carb diet and a LCHF diet would produce the same bad result.  That doesn't quite add up.

Glycation refers only to the initial step of one glucose molecule attaching to a protein without the mediation of an enzyme.  If blood glucose levels are low enough--as would be the case with a HFLC diet--the glucose and protein will disengage and no damage will be done.  If blood glucose remains elevated, the cascade to advance glycation end products will continue to protein cross-linking and all the downstream deleterious effects.  The unavoidable glycation referenced by Dr. Davis is harmless, as long as you avoid refined carbohydrates.  No conundrum there.

Couldn't you also keep your blood sugar low through a lot of exercise (if you're so inclined)?  60g of complex carbs going into a sedentary person with 50% bodyfat is going to have a different effect than the same 60g going into a sub-3 hour marathon runner.