Platelets, also known as thrombocytes, are small blood cells that circulate in the blood and are involved in the clotting process to stop bleeding. Some dietary supplements can affect platelet number and function, either increasing or decreasing their clotting ability. Using supplements that impact platelets should be done with caution, especially for those taking anticoagulant or antiplatelet medications.
What are platelets and what do they do?
Platelets, or thrombocytes, are disc-shaped small blood cells produced in the bone marrow. Platelets circulate in the bloodstream for about 10 days before they are removed by the spleen. The normal range for platelets in adults is 150,000 to 450,000 platelets per microliter of blood.
The main role of platelets is to stop bleeding through clot formation. When a blood vessel is injured, platelets are activated and aggregate together to plug the wound. They also release substances that further stimulate the clotting process and attract other cells to help with repair.
Low platelet count, a condition called thrombocytopenia, impairs the blood’s ability to clot and can lead to easy bruising or excessive bleeding. An abnormally high platelet count, or thrombocytosis, increases clotting risks.
How medications affect platelets
Some medications that affect platelets include:
- Anticoagulants like heparin and warfarin – these prevent clotting and lower platelet function.
- Antiplatelet medications like aspirin and clopidogrel – these inhibit platelet aggregation and clot formation.
- Thrombopoietin receptor agonists like eltrombopag – these stimulate increased platelet production.
People taking anticoagulant or antiplatelet medications need to be cautious about also taking supplements that can thin the blood or impact platelets. Doing so increases the risks of excessive bleeding from cuts, bruises or internal bleeding.
Dietary supplements that increase platelets
Some supplements that may increase platelet number and activity include:
Vitamin B12
Vitamin B12 plays an important role in red blood cell and platelet production. Low B12 levels can lead to enlarged platelets. Supplementing with B12 for those deficient may help increase platelet count.
Folic acid
Folic acid is also involved in blood cell and platelet production. Folate deficiency has been associated with enlarged platelets and reduced platelet count. Correcting a folic acid deficiency with supplementation may help normalize platelet number.
Vitamin C
One study found that vitamin C supplementation increased platelet aggregation in healthy adults, especially when taken with vitamin E. More research is needed, but high dose vitamin C may potentially improve platelet clotting function.
Vitamin E
Like vitamin C, vitamin E supplementation may also increase platelet aggregation. Combining vitamins E and C together may have an additive effect in boosting platelet function.
Fish Oil
Omega-3 fatty acids from fish oil supplements may slightly increase platelet number in some individuals. Fish oil also appears to reduce platelet aggregation when consumed in high doses over the long term.
Coenzyme Q10
CoQ10 is produced naturally in the body and plays a role in energy production in cells. Some research has found CoQ10 supplementation to increase platelet count and function. However, more studies are needed on its effects.
Quercetin
Quercetin is a plant flavonoid antioxidant found in fruits, vegetables and teas. It may help increase platelet production in the bone marrow and improve platelet aggregation at high doses.
Supplements that decrease platelets
Some supplements may reduce platelet number or inhibit platelet aggregation. These include:
Omega-3 Fish Oil
High dose and long-term fish oil supplementation appears to impair platelet function and reduce aggregation. This may be beneficial for cardiovascular health but can increase bleeding risks.
Vitamin E
Large doses of vitamin E greater than 400 IU per day may have an anti-platelet effect. This could interfere with platelet clotting in those taking anticoagulant or antiplatelet medications.
Magnesium
Magnesium supplementation can act as a natural blood thinner and platelet inhibitor. It seems to reduce calcium stimulated platelet aggregation. Too much magnesium could prolong bleeding time.
Nattokinase
Nattokinase is an enzyme extracted from fermented soybeans that seems to have anticoagulant effects. By breaking down fibrin and plasmin, nattokinase inhibits platelet aggregation and has blood thinning effects.
Ginkgo biloba
Extracts from the ginkgo biloba tree have anti-platelet activity and can act as a natural blood thinner. Ginkgo should be avoided by those on anti-clotting medications due to increased bleeding risk.
Garlic
Garlic has blood thinning properties that impair platelet aggregation. It seems to inhibit platelet production and activation. High garlic intake could prolong bleeding time.
Ginger
Ginger may have some anti-platelet effects, particularly in individuals with elevated platelet levels or increased tendency for aggregation. More research is still needed.
Green Tea
Green tea contains flavonoids that can inhibit platelet clumping and aggregation. Drinking large amounts of green tea could therefore have an anti-platelet effect.
Summary of supplements that increase or decrease platelets
| Increase Platelets | Decrease Platelets |
|---|---|
| Vitamin B12 | Omega-3 Fish Oil (high doses) |
| Folic Acid | Vitamin E (high doses) |
| Vitamin C | Magnesium |
| Vitamin E | Nattokinase |
| Fish Oil | Ginkgo Biloba |
| Coenzyme Q10 | Garlic |
| Quercetin | Ginger |
| Green Tea |
Role of diet in platelet function
Diet and nutrition have a major impact on platelet activity and risk for abnormal clotting. Some dietary tips to optimize platelet function include:
- Eat a balanced diet rich in fruits, vegetables, whole grains and healthy fats from fish, olive oil, nuts and seeds.
- Avoid saturated and trans fats that may increase platelet aggregation.
- Limit sugar intake that can increase inflammation and clotting risk.
- Increase intake of natural antioxidants like vitamins C and E, beta carotene and polyphenols.
- Eat foods with vitamin B12, folate and iron to support healthy blood cell and platelet production.
- Increase omega-3 fatty acids from fish, walnuts and flaxseeds.
- Limit alcohol intake to moderate levels as heavy drinking impairs platelet function.
- Quit smoking, as it can lead to hyperactive platelets.
- Drink green tea and eat onions, garlic, ginger and other foods that may have mild anti-platelet effects.
Who should be cautious with supplements that affect platelets?
Those who should use extra caution with supplements that impact platelet activity include:
- Individuals taking anticoagulant or antiplatelet medications like warfarin, heparin or aspirin – high risk of bleeding.
- People with blood clotting disorders like hemophilia or von Willebrand disease – impairing platelet function can increase bleeding risks.
- Those with low platelets or thrombocytopenia – should avoid supplements that further reduce platelet number.
- Individuals undergoing surgery – abrupt changes in platelet function prior to surgery can increase bleeding risks.
- People with cardiovascular disease – interfering with platelets could increase heart attack or stroke risk if clots don’t form properly.
- Anyone with severe liver or kidney disease – impaired clearance of supplements could lead to excessive platelet inhibition.
It’s a good idea to let your doctor know about all supplements you are considering taking if you have a bleeding disorder or are taking anticoagulant medications. Blood tests can help monitor platelet count and function to avoid issues.
Safety and side effects
When taken at recommended dosages, most supplements that affect platelets are safe for otherwise healthy individuals. However, some potential side effects can occur:
- Easy bruising – Excessive platelet inhibition leads to increased bleeding and bruising.
- Excessive bleeding – Particularly problematic with surgery, cuts or childbirth.
- Internal bleeding – Bleeding into the brain, intestines or other areas can be life-threatening.
- Blood in urine or stool – Sign of bleeding into the kidneys, intestines, stomach or esophagus.
- Anemia – Prolonged bleeding episodes deplete iron stores and reduce red blood cells.
- Heart attack or stroke – In those at high cardiovascular risk, excessive platelet inhibition could prevent clotting when most needed to stop a heart attack or stroke.
Combining multiple supplements with antiplatelet effects can increase the risk of bleeding problems. Stay hydrated, avoid injury, and monitor for signs of bleeding or bruising. Discuss any concerning symptoms with your healthcare provider promptly.
Conclusion
Platelets have an important role in the clotting process to prevent excessive bleeding. A number of dietary supplements can impact platelet number and function, either increasing platelet activity or inhibiting it. Supplements that increase platelets include vitamin B12, folic acid, vitamin C, vitamin E, fish oil, CoQ10 and quercetin. Supplements that may decrease platelets include high-dose fish oil, vitamin E, magnesium, nattokinase, ginkgo biloba, garlic and ginger.
Anyone taking anticoagulant medications should exercise caution with supplements that affect platelets, due to increased bleeding risks. Monitoring platelet count and function is important for those using supplements known to impact platelet aggregation. As always, it’s best to consult your doctor before starting any new supplement regimen.