The ABCs of Clots

  Well, it takes a lot of the alphabet, and some of the roman numerals to describe the intense physiological magic that goes into clotting of the blood when it is supposed to and clearing our blood stream of clots when it needs to flow freely! Simplifying an explanation runs the serious risk of being very inaccurate, and yet, we need to talk about all these numbers and letters your gyno throws around when she discusses blood clot risks! This by no means will be an exhaustive discussion, but a bit of knowledge will help you interpret some of those rather confusing pieces of information that seem to come at us from all angles!

To form a clot we have to form what is called a fibrin clot. To form this clot fibrinogen has to be converted to this fibrin stuff that glues together to be the basis of clot. Once that clot starts, it becomes a whole birdsnest full of whatever’s available to buttress up the walls. Stuff like tissue plasminogen activator, clotting factors,  and plasminogen will glom onto the clot. But it all has to begin with fibrin. To generate fibrinogen into fibrin you need a molecule called thrombin to trigger this reaction. Too much clotting is a bit dangerous, so our physiology protects us by having thrombin circulate in the blood stream as prothorombin. In fact we even have a whole conglomeration of molecules that prevent thrombin from forming. Antithrombin III. Other anti-clot molecules work a bit differently, those are the Protein C and Protein S. If you don’t have enough of these thinning factors, normal situations can become serious clots. It is something you would inherit from your parents, and nothing we test for very regularly unless there is a reason to. There are now genetic tests can be done on saliva (perhaps soon on blood) for the genetic tendencies to have these disorders. When we have tested before we are testing the product of the genes, when we test the genes, we test for the inherited ability to make those products, a subtle difference. If the genetic tendencies are found it is really important other close family members get tested. If your body isn’t producing factors correctly you may have something else going on that has made your body react this way (again, in simplistic terms).

For gynos, these conditions are important for contraception, for pregnancy, for menopausal hormone use and for general heart health. So the more you learn about the ABCs of clotting factors the simpler you are making your path to wellness!


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