Fish oil can be combined with blood thinners

By RICHARD HARKNESS
Knight Ridder Newspapers

Q. My sister keeps up with the medical news and told me I should consider sterols and stanols to get my cholesterol down to a healthy level. What are they?

A. Your sister refers to the plant-derived substances sitostanol and sitosterol, which reduce the absorption of cholesterol from the digestive tract.

These compounds are used in the cholesterol-lowering margarines Benecol (sitostanol) and Take Control (beta-sitosterol), among other products. They lower LDL cholesterol (the bad kind) by 10 to 15 percent hump.

You’ll get extra bang for the buck by including soluble fiber (oat bran, soy, psyllium) in your diet.

Q. In your column on gout, you suggested a fish oil supplement as a source of omega-3 fatty acids in place of fish, which could lead to gout attacks in those prone to gout.

Is it true that it’s dangerous to take fish oil supplements with the blood-thinners Coumadin or aspirin?

A. Not necessarily. Since fish oils thin the blood, the concern is that this combination might lead to excessive bleeding.

Fish oil, like aspirin and other antiplatelet drugs, thins the blood by preventing platelets from clumping together, so an additive effect would be expected.

Coumadin, on the other hand, works by directly interfering with the blood’s clotting mechanism. Up to 3-6 grams of fish oil daily may not significantly boost the drug’s blood thinning effect, but the research is conflicting.

Caution suggests that those on chronic therapy with either type of blood-thinning drug check with their physician before using fish oil.

Your doctor can gauge the impact of fish oil by monitoring your “bleeding time” (if you take Aspirin or prescription antiplatelet drugs) or your INR (if you take Coumadin).

Besides fish oil, dietary supplements with blood thinning properties include ginkgo, garlic, phosphatidylserine, policosanol, and vitamin E.