In addition, total antioxidant status increased significantly after dark chocolate consumption. Endothelial and platelet function both significantly improved compared to the control group. In addition, there were no changes observed in glucose or lipid markers. The authors conclude that the benefits are likely due to the antioxidant properties of cocoa flavonoids .
It’s interesting to note that both of these studies on dark chocolate used white chocolate, which contains little to no cocoa, as a control. The first study also included a milk chocolate group, which demonstrated a small but statistically insignificant improvement. These data support the hypothesis that the cocoa flavonoids confer the observed benefits, as dark chocolate is high in cocoa, milk chocolate is significantly lower, and white chocolate has little to no cocoa. In other words, the higher the cocoa content, the more impressive the results, so it’s important to stress that patients not substitute milk or white chocolate for dark.
This powerful Chinese herb also known as Salvia Miltiorrhiza is well known for its cardiovascular benefits, which we have written about previously. To learn about Dan Shen in more detail, check out our previous post. Here we’ll review the high points of how Dan Shen impacts platelet aggregation.
Animal studies show that Dan Shen inhibits platelet aggregation by inhibiting calcium channel mechanisms . In addition, the Tanshinones in Dan Shen reduce cerebral infarction and support the vascular endothelium. Tanshinone also has been shown to inhibit platelet aggregation in piglets by modifying eicosanoid mechanisms . Several herbs and plants are great alternatives to aspirin, which we’ll cover next.
Coleus Forskohlii is an herb in the mint family that is grown in Nepal, Thailand and India. One of the primary active constituents is known as forskolin, which is a diterpene and a potent cAMP stimulator. In animal studies, forskolin has been demonstrated to reduce platelet aggregation , which appears to be due to its ability to activate platelet adenylate cyclase .
Two forms of the peony plant, Paeonia Lactiflor and Paeonia Suffruticosa, both positively impact platelet aggregation and blood coagulation . Two paeonia constituents, paeonal and paeoniflorin have demonstrated anticoagulant and antiplatelet effects . Furthermore, paeonia suffruticosa inhibits fibrosis and thromboxane A2 (TXA2) activation of platelets .
Several natural substances appear to offer similar benefits to reduce the risk of blood clot, stroke and other cardiovascular events, but without the risks associated with daily aspirin consumption. These options are worth keeping in mind for patients who are concerned about their heart health but are concerned about taking low-dose aspirin every day.
When we recommend supplements for reducing platelet aggregation, we look at the ones we’ve reviewed in this article and see whether there are additional reasons why certain ones of these would have additional benefits for other reasons.
For example, pycnogenol (or grape seed extract, which is similar in its activity) is a strong antioxidant. If we suspect oxidative stress on top of wanting to reduce platelet aggregation, we might recommend 100-200mg pycnogenol per day. We would add to that some 80% or greater dark chocolate since that also has antioxidant activity.
If, on the other hand, someone has signs of inflammation, we might instead recommend curcumin in a highly bio-available form (Theracurmin, Meriva, or BCM-95) and Peony root (especially if there is also pain). We may also use omega 3 fish oil, especially if fish intake is less than 1-2 pounds of cold-water fatty fish per day.
If someone has high cholesterol, we might use policosanol 20mg twice daily and possibly also some curcumin.
When blood flow is poor, we would choose Dan Shen together with pycnogenol or grape seed extract.
If there is low testosterone or a goal of weight loss, we might choose Coleus Forskohlii.
In many cases multiple issues are occurring simultaneously and we prefer to use a combination of some of these supplements together with nutrition, lifestyle, stress-management, and mindfulness practices.