Deep Vein Thrombosis (DVT)

First, let me say that acute DVT is not something you should be messing around with. DVT is caused by a clot of blood in the leg (or occasionally arm) and that clot can move up to the pulmonary arteries and block blood flow to the lungs, or up to the brain and block circulation there. This can be fatal. So, you need proper hospital care in this circumstance, and quickly.

If you experience any of these, please call 999 immediately: sudden shortness of breath, chest pains, dizziness, lightheaded, a fast heartbeat or coughing blood.

What I am talking about here is what you can do to stop it happening in the first place, and what you can do to prevent a recurrence in future if you’ve had one. In those cases, there is much that can be done. And we should. Just look at this stat:

In the UK, thrombosis (blood clots) kills more people each year than breast cancer, motor vehicle accidents and AIDS combined.

Anticoagulation UK

What causes deep vein thrombosis?

Essentially, a DVT occurs because blood gets too thick, sticky or can’t return up the legs for some reason. This can be because of pregnancy or people who are just too immobile for some reason. They may simply sit down too much at the office or on the sofa watching telly, be on a plane a long time, or have reduced mobility due to an injury or other reasons. You might even just have had a whack on the leg. The most common reason is immobility in hospital – you are at risk of a DVT for about 90 days after you come out, apparently.

Other people have what’s termed endothelial injury, often after a fracture. Some people just have a tendency to clot more than others – hypercoagulation. That could be caused by medical conditions, such as antiphospholipid syndrome, but is more often just people have ‘sticky’ or thicker blood.

In this case, you need to keep an eye on your platelet and fibrin levels. Those are in charge of your clotting ability. Too much = greater risk of thicker, clottier blood. Your GP should be able to test those; certainly the platelets. You could go for a full cardiovascular health check, too. Always advised, it tells you so much and forewarned is forearmed and all that.

You are at greater risk for DVT if you have been in hospital, as above, have had a DVT before, are 60+, smoke, have or had cancer (especially ovarian, breast, lung or pancreatic), take the pill or other oestrogen therapies (can encourage clotting), are obese (pressure on the legs and veins, excess oestrogen), pregnant or have had heart failure. High blood pressure, overactive thyroid, varicose veins, vasculitis, diabetes or high blood sugar in general, and poor cardiovascular health are also risk factors.

DVT symptoms

It’s often asymptomatic and, sadly, the first we know of it is an embolism (the clot blocking oxygen). If someone does have symptoms, those might be aching legs, swelling, tenderness over the veins and possibly redness or blueness. Sometimes, you can get scaling or ulcers on the location, too. The pain can feel like you’ve strained or pulled something.

DVT can be confused with cellulitis and other venous problems, even muscle strains. If the lymph is not draining properly in the legs, that swelling might look like DVT too.

Note that a clot in your thigh is probably more risky than one in your lower leg.

DVT diagnosis

Quite simple. If the doctor thinks you are at risk of one, they do a blood test and send you for ultrasound usually. Possibly also a venogram, where they inject dye to look at the veins.

DVT treatment

If there is a DVT present, you are usually given blood thinners/anticoagulants for a minimum of three months to break down any clot. It is not advisable to take any supplements whilst you’re on this in case it thins blood too much. Also, check that other meds you’re on aren’t encouraging clotting. I’ve come across that before. Do not stop taking any prescribed medicine unless agreed with your GP.

Alternatively, or as well as the anticoagulant meds, they may suck the clot out via a tube, or insert a ‘vena cava’ in your stomach, a sort-of trap that stops the clot from getting any further up to dangerous areas like the lungs and brain.

DVT prevention

In terms of prevention, both of an original DVT or any further one, the aim is to reduce excess clotting and ‘stickiness’, improve blood flow back up the legs and support the health of the veins themselves – we want them flexible, but strong.

The first thing is to move more – get that blood pumping back up your legs. Don’t be sitting down too long without breaks, avoid crossing your legs constantly and make sure your chair doesn’t squeeze your thighs too much, preventing good blood flow. A daily walk, walking up and downstairs several times, stretching exercises like yoga or Qi Gong and even mini-trampolining has got to help! As has losing weight if you need to. See the Belly Fat Plan and 10 Minute Exercise books here. Do check with your doctor before you start any exercising if you’re recovering from a clot, obviously.

During a hospital stay, check with your carers, but try to keep things moving. Get up and walk about, wriggle your toes, flex your ankles, contract and relax your calf and thigh muscles, move your arms about, twist from side to side. Whatever suits the circumstance. Compression stockings might also help, see below.

Diet is also important. Studies show that people who eat nuts (whole, not roasted and salted!), 3+ portions of fruit and veg per day, especially flavonoid-heavy ones like berries, onions, apples etc and those who follow a Mediterranean type diet have a significantly lower risk of DVT. You can see more flavonoid foods here. Omega 3 fats in fish (and those nuts) are also thought to be anti-coagulant (blood thinning). Keep well-hydrated, too.

Skinbrushing is also an excellent way to improve blood and lymph flow, as is massage. Always go up towards your heart, and never over any prominent veins or tender areas.

Stop smoking. Obvs. And cut down alcohol.

Supplement-wise, you should look at pine bark or pycnogenol mostly. There’s a great article on that here. Prickly ash, yarrow and horse chestnut are also well-known circulation-boosters and are good for vein health overall. I’ve always favoured horse chestnut, found it works a treat.

SHS Vein is a mix that contains many of those. You can get pycnogenol here. Both are high flavonoid products so you only need one, or rotate them month by month.

Venagel is great for applying to the leg itself, getting the horse chestnut right to the problem area. Massage it in gently with upward strokes.

And don’t forget a good multi. This one contains Vitamin K and grapeseed extract, both renowned for vein health and circulation.

Some people also find compression stockings helpful and can improve pain and swelling. They’re often too tight for people, so I found these slightly wider ones for you!

DVT exercises: prevention & post DVT

Here are some exercises you can do if you happen to be immobile for quite a while:

And some if you have had a clot and need prevention exercises:

Deep Vein Thrombosis resources

You can get a lot more information from Thrombosis UK, NHS and Anticoagulation UK.