My dad, who is 67, is on blood thinners and bruises very easily. He has a few nasty-looking ones on his hands and forearms. Why does this happen? Is there anything he could use to take some of the deep color out of the bruise? He thinks he has read about some herbal remedies that help with this.

A.

It is very important that your father see his doctor right away. Excessive bruising when one is on anticoagulant medication can indicate that the blood is too thin, and there is a risk of more serious hemorrhages. A blood test will be done to check to see if he is receiving too much medication. The medication dose should only be adjusted by his doctor.

While there are a number of natural remedies that can be used to prevent easy bruising in people not on anticoagulants, some of them are contraindicated in people who are. Specifically vitamin K or sources of vitamin K like alfalfa or green tea should never be used with anticoagulants unless the doctor prescribes them. Vitamin C can decrease the effectiveness of anticoagulants and should only be used in supplement form with the doctor's approval.

It is important to know that many other medications can interact with anticoagulants to either increase or decrease their action. Many antibiotics, anti-inflammatory medications, some thyroid medications, and other anticoagulants can significantly increase the blood thinning effect, often to dangerous levels. Be sure that all of your father's health care providers are aware of his anticoagulant medication and always check with the doctor and/or pharmacist about potential interactions with any new medication. It is also very important to consult with the doctor before using over-the-counter medications as well. Aspirin, ibuprofen and other anti-inflammatory drugs, and cimetidine can also cause too much blood thinning when combined with prescription anticoagulants. Even supplements like ginkgo, garlic, feverfew, ginger, vitamin E and fish oil thin the blood and should not be combined with anticoagulant drugs.

The best advice is to always consult with your doctor before starting any medications or supplements if you have a health condition or are taking prescription drugs.

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