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STROKE / thrombosis / phlebitis

Natural Prevention Strategies

Stroke

The term "stroke" refers to a cerebrovascular accident (CVA) where the brain is deprived of oxygen due to blood vessel blockage (80% of strokes) OR  the rupture of a blood vessel which causes bleeding in the brain (20% of strokes). Either of these events deprives areas of the brain of oxygen and can lead to neurological damage. A transient ischemic attack (TIA) is a similar, smaller event, resolving in minutes to hours and without permanent damage. Recurrent TIA’s often precede a true stroke, and the causes of both are the same. Stroke (Cerebrovascular disease) is the most common cause of neurologic disability in Western countries.

Twenty percent of strokes are hemorrhagic, resulting from the rupture of a cerebral artery. Causes of hemorrhagic stroke include hypertension, aneurysm, blood vessel defects (inborn) and excess blood-thinning medication.

The remaining eighty percent of strokes are due to blockages resulting from emboli (a clump of blood cells or atherosclerotic plaque) in a cranial artery. Causes of infarct stroke are atherosclerosis, high blood pressure, excess blood-clotting factors (see "conditions predisposing to blood clot formation," below), blood turbulence (due to arrhythmias, heart valve defects, arteriovenous malformation, and atherosclerosis), diabetes, and vascular inflammation.

A far lesser number of strokes may be due solely to lack of oxygen without a blockage, usually due to sympathomimetic drugs (cocaine, amphetamine), arterial compression caused by bone spurs, or circulatory insufficiency due to decreased overall circulation.

Thrombosis

"Thrombosis" refers to a blood clot that develops in a blood vessel. It is one of the leading causes of death in the Western world.

If a thrombosis forms in a coronary artery, a myocardial infarction may result. When thromboses form in the brain, the resultant oxygen deprivation may result in TIA or stroke. An emboli occurs when a clot breaks free and travels to other parts of the body. If an emboli reaches the brain, again, stroke may occur. Thromboses and emboli can also cause serious damage to lungs, kidneys --- in fact, virtually any organ.

Phlebitis / Thrombophlebitis

"Thrombophlebitis," or deep venous thrombosis (DVT) is the most common presenting vein disorder. Most vein clots begin in the valves of deep calf veins. Tissue substances are released that in turn form clumps of red blood cells (RBC’s). If these clumped blood cells remain in the leg or elsewhere, they cause redness, swelling, and pain. If they dislodge and travel to the brain, they can cause a stroke.

Causes of venous thrombosis include:

  1. Blood vessel lining injury (caused by catheters, septic phlebitis, injection of irritating substances, trauma).
  2. Excess blood clotting (due to malignant tumors, blood cell abnormalities, oral contraceptives and inflammation).
  3. Slowed blood flow (varicose veins, prolonged bed rest, heart failure, dependent immobilization of the legs such as occurs during car or air travel).

Factors which can cause blood clots

Specifically, any one of the following conditions may predispose to blood clot formation:

  • elevated homocysteine levels
  • oxidized LDL cholesterol levels
  • platelet activating factor (PAF)
  • elevated fibrinogen
  • elevated thromboxane A2, prostaglandin E2, lipooxygenase, cyclooxygenase
  • free-radical induced platelet aggregation
  • thrombin activating factor
  • deficiency of tissue-plasminogen activator (tPA)
  • increased blood viscosity
  • increased platelet count
  • increased red blood cell kinase activity
  • inflammation of the arterial wall
  • atherosclerotic plaque
  • elevated triglycerides
  • increased platelet adhesion
  • collagen-induced platelet adhesion
  • arachidonic acid-induced platelet aggregation
  • adenosine-induced platelet aggregation
  • epinephrine-induced platelet aggregation
  • serotonin-induced platelet aggregation
  • antigen-antibody reactions

Fibrin thrombi can be prevented by conventional anticoagulant therapy (heparin or coumarin / coumadin / warfarin compounds), but platelet aggregation is not inhibited by these agents. (Merck Manual p. 586). It is estimated that only 1/3 of all causative agents of thrombosis are blocked by the administration of conventional blood thinning drugs.

Treatment Considerations

Treatment of the underlying cause of thrombosis, and phlebitis which results in thrombosis, are the mainstays of prevention of stroke occurrence and reoccurrence. High blood pressure, high cholesterol (especially with low HDL- the "good" cholesterol), excessive blood clotting ("blood sludge"), and atherosclerosis should be addressed as indicated.  Because of the many and varied causes of thrombosis, a multi-faceted approach to anticoagulation and blood viscosity normalization is surer than conventional anticoagulant (coumadin) therapy alone.

Diet and Lifestyle Recommendations

  • Diet: eat a nutritious diet high in nutrient-rich foods. Plant foods contain phytonutrients which help prevent blood from clotting abnormally.
  • Achieve and maintain a normal weight.
  • Exercise regularly. 30 minutes, 3 times per week minimum.
  • Don’t smoke! Smoking irritates the blood vessel lining and such irritation initiates a chain of events that cause blood to clump.
  • Drink 64 ounces of pure water daily. Dehydration causes blood vessel irritation and can predispose to abnormal blood clotting.

Primary Support

  • Maxi Multi: 3 caps, 3 times per day with meals. Optimal (not minimal) doses of antioxidant nutrients (vitamin A, beta carotene, C, E, zinc, selenium), B6, B12, folic acid, bioflavonoids and magnesium are especially important. Magnesium helps prevent high blood pressure, a cause of stroke.    
  • Omega 3 fatty acids: the anti-inflammatory action of Omega-3’s helps prevent blood vessel irritation.
    Flax seed meal, 2 teaspoons per day with food
    OR
    Flax seed capsules
    : 2-4 caps, 3 times per day (target dose range: 6-12 caps per day)
    OR
    Flax seed oil
    : 1 tablespoon per day
    OR
    Max EPA
    (Omega-3 rich fish oil): 1-2 caps, 3 times per day with meals (target dose: 3-6 caps per day).
  • MAXI-GREENS: 3 caps, 3 times per day. Maxi greens contains a spectrum of the herbs known to maintain  normal blood viscosity. (grape seed, ginkgo, bilberry, green tea).

Additional Support

(Treat known risk factors. Consult an alternative medicine physician for further assistance):

High Cholesterol or Triglyceride levels:

Diabetes (which predisposes to atherosclerosis):

  • Follow additional recommendations for Diabetes

Atherosclerosis:

High fibrinogen:

High homocysteine levels:

  • B6, B12 and folic acid. (NOTE: Maxi Multi contains optimal doses of these nutrients. Take additional B6, B12 and folic acid only if you are not taking Maxi Multi, MyPacks or the equivalent).

High ferritin (storage iron):


Primary Materia Medica for Stroke Prevention

(Professional descriptions follow. For laymen description of these same herbs, please refer to Twelve Important Herbs to Know )

The following list represents the most well-researched herbs for stroke prevention:

Garlic Allium sativa

Garlic is one of the most important cardiovascular botanicals and best documented blood-thinning agents.  It protects against collagen-induced, arachidonic acid-induced, ADP-induced, and epinephrine-induced platelet aggregation. Garlic inhibits cyclooxygenase and lipooxygenase-induced thromboxane A2 synthesis. Clinical studies have also documented garlic’s effectiveness in treating many factors involved in atherosclerosis, including high blood pressure, high LDL-cholesterol, and high triglycerides. Garlic decreases platelet aggregation while simultaneously increasing HDL cholesterol and fibrinolysis.

Ginkgo Ginkgo biloba

Ginkgo exerts considerable effect on platelet aggregation, adhesion and degranulation. Specifically, ginkgo inhibits platelet activating factor (PAF) and reduces platelet aggregation induced by ADP, collagen, and arachidonic acid. It has membrane-stabilizing, antioxidant and free radical scavenging effects, and improves blood flow, oxygen and glucose utilization in the brain. Ginkgo biloba extract (GBE) stimulates endothelium-derived relaxing factor (EDRF) and prostacycline.  In animal studies, GBE has shown to stimulate nerve cell regeneration, making it potentially useful both for stroke prevention and post-stroke treatment.

Turmeric Curcuma longa

Curcumin, the yellow pigment of Curcuma longa, has potent anti-inflammatory and antioxidant effects. It inhibits platelet aggregation by inhibiting thromboxanes and leukotrienes and promoting the formation of prostacycline.

Bromelain Anasas comosus

Bromelain is a mixture of enzymes found primarily in the stem of the pineapple plant. It exerts antiinflammatory effects by inhibition of pro-inflammatory prostaglandins. Bromelain blocks production of kinnins and possesses fibrinolytic activity secondary to plasminogen activator, which may also account for the anti-metastatic properties seen in vivo.

Bilberry Vaccinium myrtillus

The flavonoids in Bilberry, specifically anthocyanosides, promote prostacycline production and inhibit platelet aggregation in a manner similar to ginkgo. The potent antioxidant effects seen in this herb stabilize the vascular system and are therefore useful in treating capillary fragility, venous insufficiency, and varicose veins.

Grape Seed Vitus vinifera

Oligomeric proanthocyanidin complexes (OPC’s) from grape seed and other species, such as Landis’ pine, is one of the most potent antioxidants known. OPC’s trap reactive oxygen species including hydroxyl radicals, peroxyl radicals, and lipid radicals; they also delay the breakdown phase of lipid peroxidation. OPC’s inhibit platelet aggregation in part by raising cGMP levels and protecting against epinephrine renewed cyclic flow reductions. In addition, OPC’s inhibit certain proteolytic enzymes, including collagenase, elastase, beta-glucuronidase and hyaluronidase which can damage the extracellular matrix surrounding capillary walls. This makes OPC’s a useful choice for improving vascular fragility and peripheral vascular insufficiency which can lead to thrombophlebitis.

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