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Blood thinners: What do they actually do?

Updated: Nov 10

Many people take Aspirin (Albyl-E) “just to be safe” , but research shows it can do more harm than good.


Here’s a clear overview of the different types of blood thinners, how they work, and who actually benefits from them.


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Blood Thinners - Two Types, One Important Difference


Not all “blood thinners” actually thin the blood

Many people think blood thinners make the blood thinner. That’s not quite true.

These medications affect how the blood clots, not how thick it is. The goal is to prevent blood clots, without increasing the risk of bleeding more than necessary

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To understand why there are different kinds of blood thinners, we first need to know that not all blood clots are the same.


Two types of blood clots

White thrombi

Form in arteries (the vessels carrying blood from the heart), where blood flows quickly and pressure is high.They’re mainly made up of platelets and fibrin.


Common causes of:

  • Heart attack (myocardial infarction)

  • Stroke

  • Peripheral artery disease (“smoker’s leg”)

Best prevented with antiplatelet medication.


Red thrombi

Form in veins (the vessels returning blood to the heart), where flow is slower.They contain many red blood cells trapped in a fibrin network.

Typical examples:

  • Deep vein thrombosis (DVT – blood clot in the leg)

  • Pulmonary embolism (clot in the lungs)

Best prevented with anticoagulant medication.


  1. Antiplatelet drugs

Antiplatelet drugs make platelets “smoother,” so they don’t stick together too easily and form a clot.

Examples:

  • Albyl-E (acetylsalicylic acid / aspirin)

  • Clopidogrel (Plavix)

  • Brilique (ticagrelor)

  • Efient (prasugrel)


When are they used?

  • After a heart attack, stroke, or peripheral artery disease

  • After a stent is placed in the heart (often combined as dual antiplatelet therapy)


Not recommended for healthy people anymore. In the past, aspirin (Albyl-E) was often given to people with a high risk of heart disease, even if they had never had a heart event.However, large studies, ASPREE and ARRIVE, showed that:

  • The preventive effect was minimal or none

  • The risk of serious bleeding increased


Therefore, antiplatelets are now used only as secondary prevention, for people who have already had a cardiovascular event.


2. Anticoagulant drugs

When the body forms a blood clot, a mesh of fibrin holds it together.Anticoagulants slow down the formation of this mesh, so blood clots form more slowly and less firmly.

Examples:

  • Eliquis (apixaban)

  • Xarelto (rivaroxaban)

  • Pradaxa (dabigatran)

  • Lixiana (edoxaban)

  • Marevan (warfarin – still used for artificial heart valves)

When are they used?

The dose is often adjusted based on age, kidney function, and other health factors.


Risks and side effects

All blood thinners increase the risk of bleeding.This can range from mild to serious:

Minor bleeds – such as bruising or bleeding gums

More severe – such as brain hemorrhage or blood in the stool


Be aware:

  • Dark or bloody stools → contact your doctor

  • Regular blood tests can be helpful, especially in older adults


In short

There are two main types of blood thinners:

  • Antiplatelets → prevent clots in arteries

  • Anticoagulants → prevent clots in veins


    Albyl-E (aspirin) is no longer recommended as general prevention for healthy people. Use blood thinners only when medically indicated – and always in consultation with your doctor.


Take-home message: Blood thinners can save lives, but they can also cause harm if used without the right reason. If you’re unsure whether you need them, or if your dose is right, talk to your doctor or a cardiologist.

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