Von Willebrand disease is an inherited disorder that causes heavy bleeding that is difficult to stop. To understand von Willebrand disease, you first have to understand blood. Blood contains lots of stuff on a microscopic level – red blood cells to carry oxygen, white blood cells to fight infections, and plasma which contains bits and pieces like proteins and platelets. One of these proteins is called von Willebrand factor (VWF) and its job is to help the blood to clot when there is a cut, scrape or other injury [1].
Normally when you start bleeding, platelets clump together and form a clot to plug the hole and stop the bleeding. Von Willibrand factor is kind of like the “glue” that holds the platelets together. In von Willebrand disease, there isn't enough von Willebrand factor (or it doesn't work well), so clotting takes much longer to form an adequate “plug”. Bleeding can be excessive or take a long time to stop. [2]
Types of Von Willebrand Disease
There are three types of von Willebrand disease, categorised by how much von Willebrand factor (VWF) is in your blood and how well it works:
- Type 1 is the most common form and the mildest form of von Willebrand disease. People with type 1 have low levels of VWF but it works well.
- Type 2 von Willebrand disease, there a normal amount of VWF but it doesn't work well.
- Type 3 is the rarest type of von Willebrand disease, where there is no detectable VWF in the blood. [2]
Symptoms of von Willebrand disease
Believe it or not, this bleeding disorder can be tricky to diagnose. The most obvious symptom of von Willebrand disease is bleeding that takes a long time to clot, but even this symptom can be subtle and “hidden” [3].
Excessive menstrual bleeding can be a symptom of von Willebrand disease but the severity can be unpredictable. Hormonal changes during the menstrual cycle can actually stimulate the production of better-functioning von Willebrand factor, which can mask the severity of the disease.
Pregnancy, stress, and inflammation in the body can also increase von Willebrand factor levels, also disguising the underlying disease [3][4].
Children with von Willebrand disease typically bruise easily, or bleed excessively after surgery, from nose bleeds, or a visit to the dentist [3].
Natural therapies for von Willebrand disease
Von Willebrand disease is a hereditary deficiency of an essential clotting factor, so there is no “cure” but nutrients and herbs can help to manage the symptoms, support blood clotting, and promote blood production.
Nutrients to support blood clotting
Vitamin K
Vitamin K is essential for blood clotting. The recommended daily intake for adults is 70mcg per day, but requirements in von Willebrand disease may be as high as 20mg per day [5] [6].
The body produces most of its own vitamin K – it's a byproduct of fermentation by bacteria in the large intestine. A healthy gut can help to support your vitamin K levels and therefore help with healthy clotting [7]. Consider taking a high strength probiotic, and speak to your naturopath about which bacterial strains would be best for you.
Dietary sources of vitamin K
- ½ cup contains Vitamin K
- Kale: 444mcg
- Natto: 660mcg
- Spring onions: 103mcg
- Cabbage: 85mcg
- Brussels Sprouts: 47mcg
- Broccoli: 45mcg
- (Source: Food Standards Australia New Zealand [8])
Vitamin C
Vitamin C and bioflavonoids like quercetin and rutin don't have any impact on clotting, but they do help to prevent bleeding. They strengthen capillaries and blood vessels so they are less likely to break. You can get high amounts of these from colourful fruits and veggies like kiwi fruit, berries and red capsicum [8].
Blood Supporting Nutrients
After excessive bleeding, the body will need to top up its blood supply ASAP. Many micronutrients are required for the production of blood cells, but don't forget about water! H2O is one of the most important and often-forgotten macronutrients required for all body functions, especially in conditions like von Willebrand disease that involves the loss of fluids.
Nutrient-rich foods which boost red blood cells
Nutrient for Blood Production and Food Sources
- Iron. Red meat, dark leafy greens
- Copper. Supplementing copper can contribute to blood thinning [3], but food sources are safe and essential for clotting to occur. Seafood, beans, nuts, mushrooms and kale are good sources.
- Vitamin B6. Chickpeas, tuna and other fish, potato, banana, tofu, and fruits (other than citrus fruits).
- Folate. Cooked green leafy vegetables (e.g. spinach), rice, asparagus, broccoli, green peas, black-eyed peas.
- Vitamin B12. Oysters and clams, liver, fish, all animal meats, dairy, and eggs. Vegans may need to take a supplement.
- Vitamin A. Sweet potato, dark leafy greens (e.g. spinach), carrots, pumpkin, red capsicum, mangoes, rock melon.
(Source: Food Standards Australia New Zealand [8])
Know your blood thinners
Many common over-the-counter medications and natural medicines act as anticoagulants (blood thinners) – the opposite of what you want if you have von Willebrand disease! Talk to your doctor about switching pain relief meds from anticoagulants like aspirin, ibuprofen, and naproxen to acetaminophen which won't interfere with clotting [9].
Vitamin E and high dose fish oils can also thin the blood by interfering with vitamin K, so be sure to check with a qualified naturopath or nutritionist before dosing up on supplements (food sources are fine though) [10].
Garlic is a powerful anti-inflammatory and immune-supporting herb, but it contains high levels of a compound called ajoene that prevents platelets from clotting together – great for heart disease, but terrible for von Willebrand disease. Food sources should be safe, but check with your naturopath and avoid supplements that contain garlic or garlic extracts [11].
Hormonal regulation for Von Willebrand Disease
Making sure your hormones are balanced can help to boost the body's natural oestrogen production which can decrease the duration of menstrual periods. The oestrogenic oral contraceptive pill is often prescribed to women with von Willebrand disease for this reason. Herbs like Vitex agnus castus or chasteberry can help to normalise the body's oestrogen:progesterone ratio to reduce the risk of heavy periods [12] [13]. Seek advice from a qualified naturopath or herbalist who can assess your hormone ratios.
While von Willebrand's disease is an inherited condition that cannot be cured or prevented, natural therapies like nutrients and herbs can help to reduce excessive bleeding and support clotting.
References
- Yaish, H. M., et al. (2016) Observational Study on Safety and Efficacy of Factor Replacement Therapy in the Management of Von Willebrand Disease Patients - Results from an Ongoing Study with a VWF/FVIII Concentrate. Blood, 128:22. http://www.bloodjournal.org/content/128/22/4968?sso-checked=true
- Kuter, D. J. (2017) Von Willebrand Disease. Merck Manual Professoinal. http://www.merckmanuals.com/professional/hematology-and-oncology/thrombocytopenia-and-platelet-dysfunction/von-willebrand-disease
- Nichols., W. L., et al. (2008) von Willebrand disease (VWD): evidence-based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA). Haemophilia, 14:2, 171 – 232. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2516.2007.01643.x/full
- Shankar, M., et al. (2004) von Willebrand disease in women with menorrhagia: a systematic review. BJOG, 111:7, 736 – 740. http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2004.00176.x/full
- Oseiki, H. (2014) The Nutrient Bible (9th ed.). Bio Concepts Publishing : Australia.
- NHMRC (2014) Nutrient Reference Values - Vitamin K. https://www.nrv.gov.au/nutrients/vitamin-k
- Zhang, Y., et al. (2015) Impacts of gut bacteria on human health and disease. Int J Mol Sci., 16:4, 7493 – 519 https://www.ncbi.nlm.nih.gov/pubmed/25849657
- Food Standards Australia New Zealand (2010) NUTTAB 2010 Online Searchable Database. http://www.foodstandards.gov.au/science/monitoringnutrients/nutrientables/nuttab/Pages/default.aspx
- Amsaliem, M., et al. (2015) Predictors of high on-aspirin platelet reactivity in high-risk vascular patients treated with single or dual antiplatelet therapy. Am J Cardiol., 115:9, 1305 – 1310. https://www.ncbi.nlm.nih.gov/pubmed/25759104
- Cranenburg, E. C. N., et al. (2007) Vitamin K – The coagulation vitamin that become omnipotent. Thrombosis and Haemostasis, 98:1, 1 – 257. https://th.schattauer.de/en/contents/archive/issue/738/manuscript/7611.html
- Londhe, V. P. (2014) Role of garlic (Allium sativum) in various diseases – an overview. Journal of Pharmaceutical Research & Opinion. http://innovativejournal.in/index.php/jpro/article/view/671
- Yavarikia, P., et al. (2013) Comparing the Effect of Mefenamic Acid and Vitex Agnus on Intrauterine Device Induced Bleeding. J Caring Sci., 2:3, 245 – 254. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134154/
- n.a. (2009) Vitex agnus-castus. Monograph. Altern Med Rev., 14:1, 67 – 71. https://www.ncbi.nlm.nih.gov/pubmed/19364195
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