Wounds, scratches and surgical operations, which are accompanied by blood loss, would expose a person to mortal danger if the blood could not clot and form blood clots. One of these proteins that prevents huge blood loss is prothrombin. The level of prothrombin in the blood has its own indicators. Exceeding it indicates too a large number of this protein in the blood, which causes blood to thicken and can cause blood clots. Lack of prothrombin is no less life-threatening, since during the slightest bleeding a person can lose a large amount of blood. What is the established norm of prothrombin in the blood, and on what indicators this value depends, we will consider further.
Prothrombin is the protein that rolls up quickly enough, so isolate it from general composition plasma is quite difficult.
In this regard, there are several methods for determining the level of prothrombin, on which the normal value depends.
The prothrombin index, which is calculated as a percentage, indicates that normally in all people, regardless of age, the indicators should fall within the following limits: 95-105
%. The only exception is women during pregnancy, for whom the upper limit is slightly reduced to 98-100%. This process is completely natural and is dictated by the need to insure the body during childbirth, when there is a high probability of heavy blood loss.
The Quick prothrombin study, which has some differences in the detection process itself, has the following limits - 70-120. In older people, the upper limit barely reaches 110, which is also the norm and indicates age-related changes in the body caused by active aging processes. During pregnancy, especially in the third trimester, values up to 110% are acceptable.
An important study that shows how long it takes for blood to clot without exposure to any anticoagulants is prothrombin time.It is measured in seconds and for each age interval has its own norms of values:
Blood clotting too quickly says about its oversaturation with prothrombins, which leads to its thickening and difficulty passing through the vessels.
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Anna Poniaeva. Graduated from Nizhny Novgorod medical academy(2007-2014) and Residency in Clinical Laboratory Diagnostics (2014-2016).
In cases where the indicators differ greatly from the norm, there is a need to carry out additional method INR studies - international normalized ratio. This coefficient reflects the coagulation rate and also indicates possible problems with health. Normally, acceptable INR values are 0.85-1.15.
In order to understand what values are indicated in the analysis, you should understand what methods are used to detect prothrombin in the blood. Let's consider all technologies used in details.
All methods for determining prothrombin based on the biological processes of blood coagulation which occur in several stages. At mechanical damage vessel receives a signal about the onset of bleeding. At the site of injury, thrombin factors are released, activating increased blood viscosity, resulting in the formation of a blood clot. This blood clot plugs the leak, after which the integrity of the vessel is gradually restored.
The coagulation process can have both external factors, and internal ones, the activation of which completely depends on the situation. Analysis for prothrombin can be calculated using several methods that have their own distinctive features.
The most common tests included in a coagulogram are prothrombin time, prothrombin index, prothrombin according to Quick.
Prothrombin time is a numerical indicator, calculated in seconds, which shows how long it takes for blood to coagulate and transform into a blood clot. For each person, this numerical value will be different, due to the characteristics of the body. To conduct the study, venous blood is required, which is transfused into a test tube with an anticoagulant (most often sodium citrate).
The vessel is placed in a centrifuge, where all blood elements, under the influence of centrifugal force, settle to the bottom and are removed. Calcium is injected into the resulting purified blood to neutralize the effect of sodium citrate in a ratio of 9:1. Next, tissue factor is added (a special reagent that acts as a catalyst for the reaction), after which a natural coagulation process occurs.
In cases where there is an increased content of bilirubin, the analysis is carried out using a special apparatus that allows automatic counting.
This indicator is calculated using a formula where the value of prothrombin time in a healthy person is taken, divided by the value of the blood sample being studied, and then multiplied by 100%. The resulting value reflects the activation of blood clotting along the external pathway. This indicator helps to identify liver problems when prothrombin is produced in insufficient quantities, as well as monitor the effectiveness of anticoagulant treatment.
PTI = normal PT index/patient PT index *100%
Data to determine this indicator are taken from a previous study of prothrombin time, which used exclusively venous blood purified by centrifugation.This research method is the most informative and reliable to date. The results obtained as a percentage reflect the activity of the prothrombin complex, which guards blood clotting. To put it simply, the resulting numerical value indicates how quickly all blood clotting mechanisms are launched.
Prothrombin in the blood is calculated according to Quick using a formula where you need to divide the indicator of temporary activity of prothrombin protein by the indicators of the control sample. The data obtained can provide a more complete picture of the state of blood clotting.
The analysis uses blood from a vein, which is cleared of red blood cells.
After this, under the influence of various catalysts and reagents, a study is carried out, the results of which are calculated using the formula.In cases where the coagulogram has conflicting indicators and there is a need for additional research, resort to such analyzes, How:
Prothrombin study included in the coagulogram, which is a mandatory blood test during medical examination, as well as during pregnancy. This analysis may also be prescribed in the following situations:
Since the quantitative and qualitative composition may change throughout the day, to obtain the most reliable results it is recommended to donate blood in the first hours after waking up. At this time everything is vital important functions are just beginning to be activated, so the percentage of error caused by the influence of third-party factors is reduced.
It is important that blood sampling is carried out on an empty stomach, since at the time of digestion and absorption of food a large amount enters the blood nutrients, capable of influencing the rate of blood coagulation. It is necessary to adjust your diet 2-3 days before donating blood, excluding fried and fatty foods, as well as sweets.
Alcohol and any alcoholic beverages should be avoided 4-5 days before donating blood.
Smoking, if it has become a habit, should be stopped 12 hours before the test, since high concentrations Nicotine and tar in the blood can affect the readings, giving incorrect results.
If a person is forced to take any medications on an ongoing basis, this is reported to the doctor, who gives a referral for examination. An appropriate note is made on the control sheet, which will allow the real picture of the state of blood coagulation to be assessed, taking into account the error.
A few days before the analysis, it is recommended to exclude any physical activity that provokes physical fatigue. A person should have a good rest and sleep, and not experience emotional shock or stress.
If the results obtained are below normal or above normal, and the blood clotting time has its deviations, it is recommended to retake the blood a few days later in another laboratory.
The human factor and the peculiarities of laboratory work cannot be underestimated.After the blood test has been performed, the patient is given a transcript containing all the data on the state of blood clotting. It is usually presented in the form of a table divided into several columns. The first column indicates the research methodology and indicator, and the second column indicates the numerical value. The third column contains norm indicators for various groups patients, which makes it easier for people without medical education to perceive the results.
With the transcript received, you must contact the doctor who gave the referral.
He will evaluate the results obtained and decide whether additional studies are needed, or whether the coagulogram data will be sufficient to make a diagnosis.Low prothrombin index values are extremely life-threatening, as they indicate slow blood clotting. This, in turn, is fraught with the development of bleeding, which in a healthy person occurs without consequences or threat to life. Indicators that tend to 80% are considered low. The lower this indicator, the more dangerous the person’s health condition.
Some transcripts contain another column where the reasons for deviations from the norm are indicated. Low readings may be caused by:
External clinical manifestations and symptoms of low levels may be as follows:
An ordinary finger cut can result in the loss of 100-150 ml of blood, and a deeper abrasion can even cause full-scale bleeding that is life-threatening.
In the case when low prothrombin reaches critical levels, that is, the need for hospitalization and full examination. Otherwise, the person is in mortal danger, and any awkward movement can trigger the development of internal bleeding. It is possible to increase the level of prothrombin in the blood of women and men using blood transfusions when it comes to critical situations that threaten death.
Treatment is carried out only after assessing the state of health, as well as after identifying the root cause. Blood transfusions cannot be used continuously.
This is only a necessary measure to support a person’s life in a critical situation.Indicators that significantly exceed the maximum permissible standards are considered no less dangerous. High prothrombin of 110-120% indicates the presence of a high concentration of platelets in the blood, which makes the blood thicker. This in turn makes it difficult for it to pass through the vessels, causing stagnation.
The most dangerous consequence that can develop with prolonged high blood clotting rates is the formation of blood clots. Dense blood clots that move along the bloodstream along with blood can settle on the walls of blood vessels, preventing the flow of blood to individual tissues and organs.
Deadly danger the fact is that a blood clot can break off at any time and, together with the general blood flow, enter the heart, where it will cause it to stop due to valve blockage.An increase in blood viscosity can develop for several reasons:
Some medications can cause blood to thicken, so it is important to tell your doctor before testing.
Experienced laboratory technicians are able to determine the presence of high blood clotting rates after pricking a finger or drawing blood from a vein.If the blood flows too slowly and you have to apply force to take it, then there is a high probability of high prothrombin index values. Special clinical manifestations this pathology does not exist and is often detected during a routine examination or during pregnancy.
It is strictly forbidden to take medications that can thin the blood on your own. Especially if there is a suspicion of progression of thrombophlebitis or thromboembolism. Medicines containing aspirin that thin the blood artificially, can provoke the detachment of a blood clot from the walls of the vessel and its free movement to the heart, which will entail inevitable death.
If the results obtained differ significantly from normal, it is necessary to re-take the test after 2-3 days. If the repeated results turn out to be identical, it means that a number of additional studies will be required, which can indicate the presence of a specific health problem.
Since if there is thick blood There is a high probability of blood clots; patients will definitely need to consult a phlebologist and a cardiac surgeon, who will be able to assess possible health risks. Treatment is selected taking into account individual characteristics each patient, after a full examination and identification of the root cause.
Self-medication is strictly prohibited, as it can cause death.
Since the quantitative indicator directly depends on a person’s lifestyle, the following recommendations can be considered prevention:
In order to promptly identify the presence of pathologies in the body, it is worth paying attention to how quickly the blood clots when a cut occurs.
If the blood is quite difficult to stop, then you need to take the appropriate test and establish the cause of what is happening.It is strictly forbidden to take any medications that can change blood viscosity. Only a doctor has the right to prescribe this type of treatment based on the results of the study.
Thus, prothrombin, the norm of which depends on the research method, shows the ability of blood to coagulate and form blood clots. This property is extremely important, as it provides protection during operations or injuries accompanied by a violation of the integrity of parts of the body.
Prothrombin test (PT, % according to Quick, INR/INR)
Warfarin blocks the synthesis of vitamin K-dependent blood clotting factors in the liver, namely factors II, VII, IX and X. The concentration of these components in the blood decreases, and the clotting process slows down. The optimal anticoagulant effect is observed on the 3rd - 5th day from the start of use of the drug. Warfarin wears off 3 to 5 days after the last dose. The drug is almost completely absorbed from gastrointestinal tract. While taking oral anticoagulants, the INR should be monitored every 3 days. After stable achievement of the recommended therapeutic INR level, switch to once a month. The frequency of INR determinations should be increased with the introduction of new drugs that could affect the effectiveness of anticoagulation, changes in clinical picture, switching to a new batch of the drug. Critical INR values >
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II,V, VII, X.
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Interpretation of results |
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Prothrombin is a protein, one of the most important factors blood coagulation system (factor II), a precursor of thrombin, which stimulates the transition of fibrinogen to fibrin. Prothrombin is synthesized in the liver with the participation of vitamin K, therefore, liver diseases leading to disruption of protein synthesizing function and gastrointestinal tract (primarily intestines), leading to disruption of vitamin K synthesis, affect the results of the prothrombin test.
The prothrombin test is a screening laboratory test that simulates the extrinsic pathway of blood coagulation: this is the clotting time of recalcified plasma after the addition of tissue thromboplastin of a certain sensitivity to the deficiency of prothrombin complex factors (factors V, VII, X and prothrombin itself - factor II) and Ca ions. The test is used to assess the presence of deficiency of prothrombin complex factors and external path coagulation or coagulation inhibitors, monitoring the intake of indirect anticoagulants and, as an additional test, assessing the protein-synthesizing function of the liver.
The results of a prothrombin test can be presented in various forms. In ML "Sinevo" results are issued in following forms:
INR is calculated using the formula:
INR (INR) = (Patient's Prothrombin Time / Normal Mean Prothrombin Time) x ISI,
where ISI (International Sensitivity Index of thromboplastin), also known as MICH (International Sensitivity Index) is an indicator of the sensitivity of the thromboplastin used, standardizing it relative to the international standard. The ISI values of thromboplastins used worldwide range between 1 and 3, and are also set by test system manufacturers for each batch of reagents. Thromboplastins are used in ML "Sinevo" high sensitivity(MIH about 1.0).
INR is a mathematical correction that standardizes prothrombin time measured using various thromboplastins that have different sensitivities. The optimal INR limits that should be achieved during treatment with indirect anticoagulants depend on the therapeutic goals and are determined by the attending physician. INR (INR) = 2.0-3.0 is observed in most clinical cases(primary and secondary prevention thrombosis, prevention of systemic embolism in patients with atrial fibrillation and etc.).
INR (INR) = 2.5 -- 3.5 are observed with recurrent deep vein thrombosis (two or more cases), recurrent systemic embolism, installed mechanical heart valves, etc.
Warfarin blocks the synthesis of vitamin K-dependent blood clotting factors in the liver, namely factors II, VII, IX and X. The concentration of these components in the blood decreases, and the clotting process slows down. The optimal anticoagulant effect is observed on the 3rd - 5th day from the start of use of the drug. Warfarin wears off 3 to 5 days after the last dose. The drug is almost completely absorbed from the gastrointestinal tract. While taking oral anticoagulants, the INR should be monitored every 3 days. After stable achievement of the recommended therapeutic INR level, switch to once a month. The frequency of INR determinations should be increased with the introduction of new drugs that could affect the effectiveness of anticoagulation, changes in the clinical picture, or transition to a new batch of the drug. Critical values of INR (INR) > 6.0 are a risk of bleeding, especially in patients with gastrointestinal diseases, arterial hypertension, kidney diseases, cerebrovascular diseases, etc. It must be taken into account that taking indirect anticoagulants can cause the so-called “warfarin “skin necrosis” is a complication caused by the patient having a deficiency of protein C, therefore, before starting therapy, it is necessary to exclude this pathology.
INR and % prothrombin according to Quick correlate negatively - a decrease in prothrombin according to Quick corresponds to an increase in INR and prolongation of prothrombin time. An increase in prothrombin time indicates hypocoagulation, a decrease indicates hypercoagulation.
The prothrombin test does not reflect a deficiency of factors VIII, IX, XI, XII and XIII, and is little dependent on the use of heparin (in therapeutic dosages).
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Interfering factors. Medicines |
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Screening test for assessing factor deficiencyII,V, VII, X.
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Prolongation of prothrombin time / increase in INR, decrease in % prothrombin according to Quick |
Shortening of prothrombin time |
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Blood analysis
To exclude factors that may influence the results of the study, it is necessary to adhere to following rules preparation:
Today, doctors can diagnose many dangerous diseases even before specific symptoms appear. One of the means early diagnosis is biochemical. An important indicator in this study is the prothrombin rate. Deviation from the norm of this element indicates the presence of problems in the body, which, with timely treatment, will not lead to complex pathologies.
Prothrombin is a protein compound that takes an active part in the process of blood clotting. This protein is produced in the liver and is found in the blood in an inactive state. When a blood vessel is damaged, a complex multi-stage coagulation process is launched in the human body. After several steps, prothrombin takes active form and turns into thrombin, which forms a blood clot.
The norm of prothrombin samples is determined during a special analysis, which also determines a number of other indicators important for the normal coagulation process. The blood factor table contains 13 elements, each of which carries specific function in coagulation, but prothrombin is one of the most important. It is number two in the table, which means its role in our body is very important.
Blood prothrombin analysis is a rather complex study. The difficulty is that prothrombin molecules disintegrate very quickly and determining their exact quantity is problematic. Today in medicine they use prothrombin according to the Quick indicator, which is determined by comparing the clotting time of healthy material with the patient’s blood. As a result of this comparison, experts conclude that the level of prothrombin in the blood increases or decreases.
Normal prothrombin values using this method are calculated as a percentage and amount to healthy people from 70% to 120%. What is what is prothrombin according to Quick? This is a comprehensive blood test. Prothrombin according to Quick is normally calculated together with other indicators - prothrombin index, prothrombin time and INR. Only together can all these indicators give a complete picture of the patient’s blood clotting and indicate to doctors about the presence of problems in the body. Decryption of the analysis is not subject to to an ordinary person and should only be performed by a qualified physician. The norm for women and men of the same age is identical.
The table of norms by age is as follows:
Not all patients are prescribed a prothrombin test. This appointment is given only to those who need to determine blood clotting functions. Thus, a complex of studies is always carried out on patients who are preparing for surgical treatment and pregnant women. Decoding this study allows you to identify dangerous deviations before surgery that can lead to large blood loss on the operating table.
The level of prothrombin in the blood is important in women carrying a child. Pregnant women take a prothrombin blood test every month. This allows doctors to monitor the level of clotting and, if necessary, make appropriate corrections. In the first half of pregnancy, this indicator in the blood of women may be reduced. This is due to hormonal changes and lack of vitamins. By the end of pregnancy, the level of prothrombin in the blood of women is normal. However, sometimes the level of prothrombin in expectant mothers may increase closer to childbirth. This condition also requires correction to avoid complications during childbirth. For women expecting a child, a prothrombin test is of great importance.
In addition to these cases, there is a group of patients who need to undergo examinations regularly, these include:
Prothrombin in a blood test may increase in male and female patients in the following cases:
Often, deciphering the analysis can indicate reduced level prothrombin in the blood. Low prothrombin is characterized by frequent bleeding, including life-threatening bleeding. Most often, a lack of prothrombin is observed in the following pathologies:
In fact, each person can discover problems with blood clotting on their own. You just need to monitor your health more carefully. Reduced prothrombin in the blood can be suspected if you experience prolonged bleeding when injured, if you have frequent nosebleeds, bleeding gums, frequent causeless bruises, etc. What to do with these symptoms? Only a doctor will be able to determine that your reading is below normal and identify the reasons for the deviation.
ABOUT increased content prothrombin can be said when the first signs appear varicose veins veins, for pain in the heart, swelling lower limbs, numbness in the arms and legs.
What do these symptoms mean? These seemingly harmless symptoms can lead to dangerous consequences, especially after fifty years.
Do not delay visiting a doctor if these abnormalities are detected.
These are the first symptoms in which you should definitely consult a doctor to prescribe a test for prothrombin levels in the blood. Before donating blood, you need to follow the standard rules so that the interpretation of the result is as accurate as possible.
Remember that the length and quality of your life depends on your attitude towards your health. It’s better to get your blood tested again than to suffer from dangerous diseases and undergo treatment for years, fearing for your life. Early diagnostic methods allow you to protect yourself from dangerous diseases and correct the body’s malfunction in a timely manner. Trust specialists and do not self-medicate, because to determine the real reason failure can only be determined by a qualified physician based on diagnostic examinations.
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Blood constantly moves in the body of every person. The vessels have a total length of thousands of kilometers, and a large total area of the inner wall.
Men have more than five liters of blood in their bodies, while women have slightly less. Any serious injury or cut may cause bleeding and if not timely treatment a person may die from blood loss.
To prevent this from happening, nature has created a special system under the influence of which the blood coagulates. All possible ones are launched defense mechanisms, the wound will close, and the blood will no longer come out of the vessels.
Prothrombin is a protein compound necessary for complete blood clotting. It is produced in the liver. A prothrombin test is needed to assess blood clotting. The most common and universal method for this - prothrombin according to Quick.
The test reveals the activity of prothrombin in the blood in comparison with certain indicators. This is the ratio of the time at which plasma clotting occurs relative to the same process in the sample.
It is worth noting that the Quick prothrombin test is performed not only to assess blood clotting, but also to understand whether the liver and gastrointestinal tract are functioning properly.
We have looked at what prothrombin according to Quick is, but when should this analysis be carried out? There are certain indications:
A blood test for prothrombin is performed if there is a blood clotting disorder.
Liver diseases.
Because of autoimmune causes increased thrombus formation.
Hemoblastosis, or blood cancer;
Pathology leading to disruption of vitamin K production.
Women in menopause.
Depending on what caused the bleeding, blood can clot in several ways - internal or external. In the first case, this is due to the fact that the vessels are damaged from the outside. This can happen due to abrasions, bites or bruises. In the second case, the integrity of the walls is violated blood vessels from the inside. This is caused by toxins, antibodies, and various pathogenic microorganisms.
Prothrombin time is an indicator by which you can understand how the internal pathway works in the hemocoagulation system.
Prothrombin time increases as a result of the following factors:
The body lacks vitamin K.
Kidney pathologies.
Taking certain medications.
The bile ducts are blocked or inflamed.
Absorption of fats in the intestines is impaired.
The more prothrombin in the blood is lowered, the higher the prothrombin time will be, because in this state the clotting process will be slowed down.
Prothrombin-lowering factors can be:
A decrease in petit occurs in women who are carrying a baby.
Syndrome – DIC.
There is a deviation from the norm of hematocrit.
Prothrombin time may show a low result if the blood was taken incorrectly or the plasma was stored for a very long time before the study.
PTI in the blood is an indicator that reflects the speed at which blood coagulation starts along its internal pathway. It is calculated based on prothrombin time. A low prothrombin index is associated with the same factors as a decrease in PT.
The normal prothrombin index for women is approximately 95%. The normal prothrombin index in men is slightly higher and is about 105%. The accuracy of the analysis depends on many factors, for example, the drugs used in the laboratory.
If prothrombin according to Quick is increased and its value is 150% or more, then there may be many reasons for this:
Diseases in which the activity of vitamin K decreases several times.
A syndrome called DIC.
Various pathologies acquired during life or hereditary, for example, amyloidosis, nephrotic syndrome, etc.
Increased prothrombin may also occur if you have taken the following medications for a long time:
Antibiotics or anabolics.
Aspirin.
Diuretic drugs.
A nicotinic acid.
Inhibitors or heparin.
Prothrombin according to Quick is normal if its value is approximately 100-120%.
Below is a table showing the petit rate:
Women and men at the same age have the same prothrombin level. If a woman is carrying a baby, then the level is slightly higher than normal, but there is nothing wrong with that, after the birth of the child everything will return to normal.
A decrease in the prothrombin index according to Quick always indicates that blood clots form very quickly; many factors can lead to this:
A woman is pregnant or has recently given birth to a baby. These are normal indicators, after the woman’s body returns to normal, the level of petit will return to normal.
Vein thrombosis.
Blood viscosity is increased.
Some medications can also provoke a decrease in prothrombin.
Every pregnant woman should undergo a test such as a coagulogram. Assessment of the condition plus prothrombin tests can identify any dangerous conditions, as for expectant mother, and for her child.
Prothrombin according to Quick (PC) in pregnant women is always slightly lower and this is the norm. The thing is that a new circle of blood circulation appears and the woman’s body is preparing for the fact that during childbirth it will have to lose a little blood.
A PC that is several times lower than normal can lead to thrombosis, and in pregnant women, its increase will lead to severe bleeding at the time of childbirth, and it is possible that it will be not only external, but also internal.
Bleeding due to incompatibility of the Rh factor of the child and the woman will lead to hemolytic complications.
In order to avoid this, women are under the full control of the attending physician, and from the 28th week they are injected with immunoglobulin (anti-Rhesus serum), under the influence of which dangerous antibodies will be destroyed. PI indicators for pregnant women are as follows:
In pregnant women, the prothrombin index should be in the range of 80-100%. For high levels, certain medications are given.
With a low PI level, the risk of bleeding is high. Normal value prothrombin time is approximately 18 seconds.
Any deviation from the norm should be a cause for concern.
Under no circumstances should you try to increase or decrease your readings on your own; you should consult a doctor.
In order to get reliable results, it is necessary to donate blood for tests correctly. Blood is taken before 11 a.m., always on an empty stomach. In order to prepare for the analysis, you need to follow some recommendations:
About three days before you plan to go to the hospital, avoid fatty and fried foods. There is no talk of any alcoholic drinks. All this will be a big burden on the liver.
Three hours before donating blood, you should not smoke, as nicotine will lead to a decrease in the prothrombin index.
If you regularly take any medications, stop taking them six hours before you plan to donate blood, after which you can resume taking them.
On this day, or rather before the test, you cannot engage in heavy physical activity.
It is impossible to take blood samples from women during menstruation; at this moment the indicators will be unreliable.
Blood is taken from a vein, after which it is placed in a special tube with saline solution, is centrifuged, and then a thorough examination will occur.
If the prothrombin index is elevated, it certainly needs to be reduced. People in this category must adhere to special diet, you should only eat foods that will thin your blood. But you need to understand that there are many foods that lead to blood thickening.
So, to normalize prothrombin levels, you need to eat the following foods:
Oatmeal. It not only helps digestion stabilize, but also prevents the blood from becoming thick. It is better to eat this dish in the morning at breakfast.
Prepared from fresh vegetables tomato juice. Many people at this moment make the most serious mistake - adding salt, but this should never be done.
Beets are the best vegetable with which you can reduce prothrombin.
It is simply impossible to imagine a diet without ginger! It is added to tea, or any other dish. Thanks to this, the blood will thin out, and it will also good remedy preventing the formation of thrombosis.
Fish fat. You can buy it at any pharmacy, this is the most the best option to thin the blood.
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