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Dietary Supplements

Many people use dietary supplements and herbal remedies to help prevent specific ailments or to complement more traditional medical treatments. However, some of these can be harmful for people with bleeding disorders because they may interfere with clotting or cause prolonged bleeding. Below are some dietary supplements with potential harmful side effects.


Garlic is used with the belief that it treats or prevents heart disease, high cholesterol, and high blood pressure. It is generally considered safe, but side effects can include upset stomach, headaches, and fatigue. Garlic also may cause increased bleeding and interact adversely with insulin; anticoagulants; immunosuppressive agents; and protease inhibitors, such as those used for HIV therapy.


Ginger is best known for its anti-nausea properties. Generally, ginger is considered safe but may interact with prescription blood thinners, such as heparin and warfarin, and the platelet inhibitor, ticlopidine. Except in unusual circumstances, these drugs are not used for treatment of people with bleeding disorders because they prolong the time it takes for blood to clot. Ginger may also increase the risk of bleeding.

Milk Thistle

Milk thistle has a long history of use for treating liver diseases, such as cirrhosis and hepatitis, and gallbladder disorders. However, people with bleeding disorders who have a liver condition should contact their health care provider before using milk thistle. Side effects of milk thistle may include indigestion, headache, and itching. People with allergies to daisies, artichokes, or kiwi may also have an allergy to milk thistle. Milk thistle may lower blood sugar levels and may reduce the effectiveness of oral contraceptives.


Dietary supplements containing ephedra have been banned in the United States since 2006. It was previously a popular weight-loss supplement and was also used to enhance sports performance. Ephedra has been linked to flushing and sweating, irregular or rapid heart rhythms, heart damage, strokes, seizures, psychosis, and death.

Ginkgo Biloba

Traditionally, ginkgo biloba has been thought to improve mental function, slow macular degeneration, and improve blood circulation, although large clinical studies have not demonstrated a benefit. Ginkgo may increase bleeding symptoms and the effects of antiplatelet or anticlotting drugs, which can result in uncontrolled bleeding or hemorrhage. It may also decrease the effectiveness of immunosuppressive drugs and adversely affect the use of insulin and oral diabetes drugs.

Talk with your health care provider before taking any vitamins or supplements.