Daily News (Los Angeles)

A field of cows and blood thinner

- Columnist By Russell Myers ToYourGood­Health@med. cornell.edu.

I'm taking the blood thinner Eliquis. I wonder if I can stop taking it and go on something natural, like tea or something else. Thank you.

— M.K.

Please don't.

Long ago, farmers noticed that cows were dying from internal bleeding if they ate sweet clover hay that had stayed damp and gotten moldy. A scientist at the University of Wisconsin in the 1920s identified the culplrit: dicoumarol, a naturally occurring chemical in the moldy hay that was preventing the cows' blood from clotting. The research was supported by the Wisconsin Alumni Research Foundation, which found that the substance from the moldy hay blocked the effect of vitamin K.

A related, more powerful anti-clotting compound was synthesize­d and named “warfarin,” which was initially marketed as a rat poison. In 1951, a person attempting suicide with warfarin recovered fully after treatment with vitamin K, and doctors realized that this drug used in low doses might be effective for people with a tendency to clot too much.

The brand name of that drug was Coumadin, and it worked and has prolonged many lives. Naturally occurring substances have made some of the most important medicines for centuries.

Anticoagul­ants need to be used cautiously. Life-threatenin­g bleeding can occur if doses are even a little too high. They are only used if the risk of a blood clot (especially in the lungs, heart or brain) is high. Warfarin was used for many years, but has been partially supplanted by newer medicines, like apixaban (Eliquis). The newer formulatio­ns don't require blood testing. Still, the dose needs to be precise and personaliz­ed for you by your doctor.

There are many natural substances that can partially block the tendency to form blood clots, but few are both safe enough to use and powerful enough to substantia­lly reduce the risk of a person with a disease that causes increased blood clotting. Most natural supplement­s and teas that purport to do so are NOT safe and effective for you to use in place of your prescripti­on medicine.

Read the label carefully; it will tell you this the tea or supplement is not to be used to treat any medical condition. It's not a good idea to stop your medicine without an explicit instructio­n from your physician and a plan for an alternativ­e.

I am an individual with continuous back pain. I was (and still am at 76 years young) a carpenter. I have had several back surgeries (disc removals, fusion, opening of the spaces around the spinal cord). I continue to abuse my back, but I love my work, as it gives much satisfacti­on.

As a result, I take a lot of ibuprofen. I recently finished an article about an individual whose doctor told him his kidney failure was related to overuse of ibuprofen. Is this a reality that I should be concerned about?

— P.F.

It is absolutely a real issue, with at least 2.5 million episodes of acute kidney injury each year in the U.S. caused by anti-inflammato­ry medicines like ibuprofen.

For any given individual, the risk is somewhere between 1% and 5%. That being said, the risk increases as we age, and taking ibuprofen if you are dehydrated (from sweating, vomiting or diarrhea) also increases the risk of developing acute kidney injury. People who take large amounts of anti-inflammato­ries are also likely to have deteriorat­ion of their kidney function over time.

I think you would be wise to get your kidney function checked periodical­ly. You can continue to take ibuprofen if your kidney function is in the normal range and stable, but decrease (or stop) your use if your kidney function is declining.

ACROSS

1 Oil grp.

5 Snooty person

Trash Backside Sharpen, like a skill Metropolis that’s home to the Qutb Minar

“Mi ___ es su ___”

Red in the middle, like a steak Prepared to shoot an arrow “Satisfied yet?!” Nonprofit’s URL ending, often

Dover’s state: Abbr. Totally absurd Side dish often eaten with two hands

“It’s ___ easy being green” Ruin “Yippee!” Fully learned A link might lead to it Mentally hazy Opposite of happy Compete for a seat

Carrier with a shamrock in its logo “Mine, mine, it’s all mine!” desire

Make a mistake 9 14 15

16

17

18

19

20

23

24

25 28

34

35 36 37 40

41

42

43

44

46

48 49 50

Rage Watershed moment ... and a hint to the first words of

20-, 28- and 44-Across Express a view

“Not gonna happen!” NASDAQ debuts

Pasta often served with vodka sauce Barely there? Without “rocks” Optimal

Train for a bout

“G.I. Jane” actress Moore DOWN

1 Apex predator of the ocean

Fruit in many still life paintings Opposite of difficulty Stick whose box might have a builtin pencil sharpener “No idea” gesture Biblical ark builder Making a blip

Paging device

June 6, 1944 It might pull a bit

“Tickle Me” Muppet

58

59

60

61

62 63

64 65

66

2

3

4

5

6

7

8

9 10

11

12

13 21

22

25

26

27

28

29

30

31

32

33 35

38

Mash potatoes, say? Baby goat Rock that sounds like a conjunctio­n Cleared of snow Bengaluru’s country

“For ___” (1966 Beatles song) Engaged in conflict

Enjoy some panipuri

Key ring attachment “That’s a total ___-out!” Chicago airport

“___ One: A Star Wars Story” Ceaselessl­y Fridge decoration

Colts’ and Cowboys’ org. 39 40

42

45

46

47

49 50

51 52

53

54

55

56

57

58

Luau dish “What ___ I thinking?” “Let’s hit the waves!” Reactions to bad jokes Test for college srs. << button on a remote Deduce Risked a traffic citation

Fork prong “Mom” actress Faris Fishing line holder Musical whose name is 3/4 vowels Fencer’s blade Wander around

Italian wine region

Can’t CTRL Me nail polish brand

Answers to yesterday's puzzle

 ?? ??

Newspapers in English

Newspapers from United States