NEW YORK – The blood-thinning medication Hillary Clinton has been taking for years under the pharmaceutical brand name Coumadin was initially introduced and marketed in 1948 as a pesticide designed to kill rats and mice, notes a prominent New York physician.
Hoffman is a New York City physician who hosts the nationally syndicated radio program “Intelligent Medicine.” He is past president of the nation’s largest organization of complementary and alternative doctors, the American College for Advancement in Medicine, or ACAM. He’s the founder and medical director of the Hoffman Center, specializing in an approach that combines nutritional and metabolic medical assessment tools with high-tech innovations in traditional medicine.
Makes rats bleed to death
Hoffman explained that Warfarin caused rats to hemorrhage to death, “so the pharmaceutical companies figured if you took only a little bit of rat poison, you won’t hemorrhage to death, you just get a little blood-thinning.”
“But that’s why the therapeutic window for Coumadin is narrow,” he said. “In other words, too little Coumadin and it’s not enough – too much Coumadin and you can bleed to death.”
He said Coumadin is “an unwieldy medication, and any patient prescribed Coumadin has to be modified frequently with a blood test to make sure you’re not on too much Coumadin, or too little.”
He also pointed out that Vitamin K can interfere with Coumadin.
“So, if you eat too many green-leaf vegetables, or if you take green tea, it neutralizes the Coumadin. There are problems with Coumadin in that it’s tricky.”
On Wednesday, WND reported Hillary Clinton’s publicly available medical records show she was first placed on Lovenox, a blood thinner, in 1998 to treat blood-clotting problems in her legs on extended airplane flights. The anticoagulant was replaced with Coumadin, which she began taking after developing a blood clot in her head from a fall and a concussion she suffered in December 2012.
Requires constant medical tests
The website of the American Heart Association publishes “A Patient’s Guide to Taking Coumadin/Warfarin,” authored by doctor of pharmacy Karen Fiumara and medical doctor Samuel Z. Goldhaber, which explains the need to closely monitor patients prescribed the drug:
The goal of warfarin therapy is to decrease the clotting tendency of blood, not to prevent clotting completely. Therefore, the effect of warfarin must be monitored carefully with blood testing. On the basis of the results of the blood test, your daily dose of warfarin will be adjusted to keep your clotting time within a target range.
The blood test used to measure the time it takes for blood to clot is referred to as a prothrombin time test, or protime (PT). The PT is reported as the International Normalized Ratio (INR). The INR is a standardized way of expressing the PT value. The INR ensures that PT results obtained by different laboratories can be compared. It is important to monitor the INR (at least once a month and sometimes as often as twice weekly) to make sure that the level of warfarin remains in the effective range. If the INR is too low, blood clots will not be prevented, but if the INR is too high, there is an increased risk of bleeding. This is why those who take warfarin must have their blood tested so frequently.
Unlike most medications that are administered as a fixed dose, warfarin dosing is adjusted according to the INR blood test results; therefore, the dose usually changes over time.
Hoffman said that if Hillary Clinton is on Coumadin, she would need to be constantly monitored with standard tests like the INR.
“The nice thing about Coumadin is that we know Vitamin K reverses its effect. So, if the patient is anticipating a normal bleeding incident, for instance, if the patient is going to have surgery, you have the patient take Vitamin K to reverse the effects of the Coumadin.”
WND also reported Wednesday that Hoffman warned that Coumadin can cause excessive bleeding that can turn even a minor injury into a life-threatening event. He believes Clinton could be at risk of excessive hemorrhaging, even cerebral hemorrhaging, from otherwise minor falls or other accidents.
The Federal Drug Administration, in a drug safety communication May 13, 2014, commented on an article comparing Coumadin with Pradaxa, a more recently developed anticoagulant.
“Bleeding that may lead to serious or even fatal outcomes is a well-recognized complication of all anticoagulant therapies,” the FDA said.
The Johns Hopkins Hospital Medical Center warns that those taking Coumadin should obtain a blood test every two to four weeks to make sure their blood is thinning to the correct degree, without bleeding complications.
The widely respected Cleveland Clinic website also has a warning that Coumadin may cause excessive bleeding.
Hoffman also indicated that Hillary’s three incidents of blood clots – in 1998 and 2009 in her leg and in 2012 in her head – made him suspect she had a predisposition to develop blood clots that might be genetically determined.
“There are multiple tests to determine whether or not a patient has a predisposition to form blood clots,” Hoffman pointed out. “Hillary’s multiple incidents of blood clotting suggest to me she should be tested for a genetic, or family, predisposition to develop blood clots.”
On Wednesday, WND noted that in January 2013, as Clinton was being treated for the incident of cerebral venous thrombosis, or CVT – the blood clot in her head in the space between the brain and the skull, behind her right ear – doctors quoted in media suggested she had been tested for a genetic predisposition to form blood clots and the results were positive.
The New York Daily News on Jan. 1, 2013, quoted Dr. Alan Boulos, chief of neurosurgery at Albany Medical Center, saying the type of blood clot in the brain that Clinton suffered “can be life-threatening if the thrombosis is extensive or if the patient doesn’t have other channels to drain the brain.”
Boulos also told the Daily News that it was not clear whether the fall that led to Clinton’s concussion caused the blood clot in the brain or if the blood clot led to the fall.
Boulos stressed it is “rare for head trauma to trigger problems like these,” concluding the likely culprit is a genetic predisposition.
A posting on the National Blood Clot Alliance’s website titled “The Genetics of Thrombophilia,” explains thrombophilia, the medical term used to describe the condition where the blood has an increased tendency to clot:
Thrombophilia is usually categorized into two types–acquired and inherited. In acquired thrombophilia the abnormal clotting is usually related to a specific cause, such as prolonged periods of bed rest after surgery, trauma to the leg, or having cancer. People with inherited thrombophilia tend to form clots due to a genetic predisposition inherited from their parents. People with inherited thrombophilia may have a family history of relatives with abnormal or excessive blood clotting. This brochure will explain how genes play a role in blood clotting and are related to inherited thrombophilia.
Despite the severe risks of taking Coumadin, Hoffman said it may be the better alternative for some patients.
“I take a real-world perspective, in that I acknowledge lifestyle measures help, but in a person who has a blood clot, it would be pretty irresponsible to say, ‘Look, I know the mainstream answer is to take Coumadin, but instead I’m going to say just do these lifestyle changes and you will be OK,’” he said.
“That would be medical and legal suicide and it would put the patient at risk,” said Hoffman.
“So, unfortunately, we have to use these medications like Coumadin which are terrible because a stroke is a catastrophe,” he said. “And we’re not talking here about a mild problem, we’re talking about a potentially fatal or totally debilitating consequence that we are trying to prevent.”
He said another problem is “you can’t depend upon Hillary Clinton to adopt the type of lifestyle changes that would be required.
“One of the lifestyle changes that would be required is to stop flying in airplanes for hours and hours. Airplane trips are notorious for causing blood clots,” he said.
“Hillary Clinton has a lifestyle predisposition to blood clots. She is sitting and she may not be all that fit, and she is old.”
Hoffman agreed that Clinton may have to be on Coumadin or other prescribed blood-thinning medications for the rest of her life.
“The CVT that Hillary experienced is a relatively rare circumstance with a blood clot forming in the sinuses in the brain cavity between her brain and her skull behind her ear,” he said.
“If I had a patient who came to me with Hillary’s history of blood clots, I would do the tests to determine her susceptibility to blood clots,” he added. “I would also send her to a neurologist. She should have regular tests like MRIs done to monitor her situation, and I would suspect she would be prescribed anticoagulants for an indefinite future until further notice.”
He concluded: “Bottom line, Hillary should probably stay on the Coumadin, for better or for worse.”
‘Nasty side effects’
Hoffman was recommended to WND by the Alliance for Natural Health, headquartered in Atlanta, a medical lobbying group committed to “shifting the conventional medical paradigm from a focus on surgery and drugs to a naturopathic approach incorporating dietary changes, vitamin supplements, and lifestyle.”
The Alliance for Natural Health warns in a bulletin, titled “Hillary Clinton Prescribed a Dangerous Blood-Thinner,” that Coumadin has a long list of nasty side effects.
They include blurred vision and confusion – both of which Clinton has been reported to have experienced – plus a tendency to bleed excessively even from minor injuries.
After Clinton recovered sufficiently from the concussion and brain clot suffered in December 2012 to testify before Congress on Benghazi in January 2013, the New York Daily News reported she was wearing medically modified eyeglasses. Attached to each lens by transparent adhesive tape was a Fresnel prism designed to treat the double vision resulting from the concussion and blood clot.
On Nov. 16, 2015, Judicial Watch released an email exchange between her aides Huma Abedin and Monica Hanley dated Jan. 26, 2013, regarding Clinton’s schedule. They indicated it was “very important” to go over phone calls with Clinton because the former secretary of state was “often confused.”