Chinese herbs with, or as a substitute for, warfarin?

[Guest guest]

Hi All,

 

Though I cannot remember who, or on what specific List, someone asked

if colleagues could recommend specific CMs that are as potent and

reliable as warfarin as blood-thinners, but safer than warfarin as

regards risk of bleeding or other side effects.

 

In " WARFARIN + CHINESE MEDICINE " www;itmonline;org/arts/warfarin;htm

Subhuti Dharmananda lists many herbs that act on blood and clotting.

 

However, paraphrasing him, he says:

> " Although CHMs, esp Danshen, Chuanxiong, Honghua, + Gegen, are used

> extensively in China to Tx people who otherwise might receive

> warfarin, there is little evidence that these / other CHMs have

> anticoagulant action comparable to that of warfarin / even aspirin;

 

> TCM literature provides some cautions for use of Hbs in bleeding, such

> as during menses, because of concern of increasing total Xue loss,

> indicating that clotting time may be prolonged somewhat;

 

> There is some evidence to suggest that CHMs can interact w warfarin,

> but number of reports is quite low + evidence of effects is limited;

> Danshen is suggested to have such an interaction, but only 3 cases

> have been reported (9), despite its widespread use by persons who have

> Xue coagulation problems; they involved large changes in INR, however;

>

 

> One clinical report of interaction w warfarin involved Danggui (10); a

> laboratory study showed limited interaction (11); Dasuan, Renshen +

> Baiguoye are Hbs mentioned briefly in literature as potentially

> interacting w warfarin;

 

> In a recent evaluation of reports about Hb-drug interactions, few

> publications contained enough data to evaluate actual interaction;

> only 18 / 108 involved warfarin, + most of those involved St; John's

> Wort (11);

 

> In a survey of people in Hong Kong starting warfarin Tx, it was found

> that about 1 / 4 were taking CHMs (12); Their INR values, rather than

> being enhanced, were slightly lower, + this corresponded w a somewhat

> lower dose of warfarin taken by those who were using Hbs;

 

> Thus, it may be possible to use these Hbs along w warfarin Tx, so long

> as monitoring of INR is maintained in order to detect rare

> interactions; When Hbs provide additional benefits to cardiovascular

> system (aside from simple anti-coagulation), effect of total treatment

> may be improved compared to drug Tx alone; It is important to consider

> that when PT test is carried out, it measures coagulation of Xue that

> is removed from body; test does not indicate any conditions of

> vascular system that may lead to induction of clotting; yet, such

> conditions may be very important in determining whether / not a

> serious clotting event will occur; Those other conditions may be

> addressed by Hbs; "

 

Questions for expert CHM practitioners:

 

(1) After multiple coronary arterial stenting, mitral valve repair or

mitral valve debridement and replacement by an artificial valve, if

YOU were prescribed conventional blood-thinners [Warfarin, Plavix,

Nuseal aspirin, etc] would YOU refuse to take the WMs and rely

instead on CHM to prevent clotting, embolism and heart attack?

 

(2) On another, but similar issue, if your cardiologist advised you

to take statins (Crestor or Lipitor, etc) and a beta-blocker (Emcor

or Cardicor, etc) daily for prolonged period, would you do so? Or

would you rely instead on CHMs that are said to have

hypocholesterolaemic and HT rectification action?

 

If we talk the talk, should we walk the walk?

 

Best regards,