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If bleeding lasts long or bruises come easily, targeted assessment is worthwhile.
Also known as: bleeding tendency · hemophilia A/B · von Willebrand disease · clotting disorder
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The opposite of a clotting tendency: blood clots too slowly. Causes: inherited factor deficiencies (haemophilia, von Willebrand), liver disease, vitamin K deficiency or blood-thinning drugs. Signs: easy bruising, wounds that bleed long, nosebleeds — and joint bleeds in haemophilia.
Type of disorder, missing factor, the emergency preparation, the centre’s phone number. In an accident what is in the pocket counts, not what is in the head.
Acetylsalicylic acid and the anti-inflammatory painkillers additionally block the platelets. Paracetamol does not. That one distinction saves many bruises.
Vaccinations and other injections can in many cases be given under the skin, with a thin needle and pressure afterwards. Saying so beforehand is enough.
With lead time almost everything can be planned — giving factor, a drug that keeps the clot stable, or a mouthwash. Without lead time an extraction becomes a long night.
In women a heavy, long period is often the first and for a long time the only sign — especially in von Willebrand disease, the most common inherited form. It is a reason for a workup, not just for iron.
Not every bleeding tendency is inherited. A sick liver and a lack of vitamin K — after long antibiotic treatment or with disturbed fat uptake — produce the same picture.
The missing clotting factors are replaced — by infusion, preventively two to three times a week or on demand. That is replacement, not cure; without supply the factor is missing again. Emicizumab works differently: it mimics the bridge the missing factor VIII makes, is injected under the skin and lasts one to four weeks. Gene therapies can let the body make the factor itself; how long that holds is open. Aspirin and anti-inflammatory painkillers are unfavourable here.
Haemophilia A affects about one in five thousand male newborns, haemophilia B one in thirty thousand. Severe means a residual activity under one per cent — then bleeds occur without an evident cause; between five and forty per cent, only after injuries and operations. Without preventive treatment, joint bleeds cause lasting damage over the years, mostly in knees, elbows and ankles. A factor product works at once and lasts eight to twelve hours depending on the type.
A notable bleeding tendency should be medically assessed.
Oestrogen raises several clotting factors. This is why the combined pill is one of the most effective treatments for heavy periods in women with von Willebrand disease or carriers — the same hormone that elsewhere favours thrombosis.
A derivative of this hormone releases stored von Willebrand factor from the vessel wall and thereby stops bleeding. That is one of the most elegant examples of a hormone becoming a medicine.
Every bleed costs iron. With recurring episodes regular ferritin checks are worthwhile — the deficiency builds slowly, long before the blood count changes.
High amounts of fish oil, ginkgo, garlic and ginger as supplements slightly lengthen bleeding time. With an existing bleeding tendency this belongs mentioned — in culinary amounts it is not an issue.
Here a point in the other direction: high doses of fish oil, ginkgo and garlic as supplements slightly lengthen bleeding time. With an existing bleeding tendency this belongs mentioned — in culinary amounts it is not an issue.