In the United States, stroke is the leading cause of disability in adults and the third leading cause of death. Stroke may be due to blood clots or cerebral hemorrhage caused by poor blood circulation. Without oxygen, brain cells can be damaged or die, and the affected brain regions cannot function properly. Risk factors for stroke include high blood pressure, diabetes mellitus, high cholesterol, smoking and atrial fibrillation (cardiac malformation). So far, hypertension is the biggest risk factor for stroke. Stroke will have a negative impact on the physical, psychological and even emotional aspects of patients. The disability after stroke is caused by the damage of corresponding brain cells.

For stroke patients, the recovery after stroke includes various aspects, such as physical therapy, occupational therapy and speech training therapy. It is very important to make full use of these therapies for the recovery after stroke. Medical care is mainly focused on the prevention of secondary stroke. In most cases, anticoagulants such as warfarin or aspirin, ticlopidine or clopidogrel are used for antiplatelet therapy. These drugs are used to prevent the formation and retention of blood clots in the brain, because once blood clots are formed and retained in the brain, they can cause another stroke, but they are not commonly used in stroke cases caused by bleeding.

Coumarin realizes its function by inhibiting vitamin K. due to the high level of vitamin K in green leafy vegetables and green tea, stroke patients should try to avoid this kind of food or at least limit the intake of such food. Physicians use a test method known as the international normalized ratio (INR) to test the effect of coumarin and adjust the actual dosage appropriately in time.

In addition to some foods rich in vitamin K, other natural substances also interact with coumarin. For example, coenzyme Q10 and St. John's wort reduce the efficacy of coumarins. Proteolytic enzymes such as Nattokinase and bromelain, as well as other plants, including ginseng, guizhaocao and angelica, can help improve the effect of coumarin.

Garlic and Ginkgo biloba reduce the ability of platelets to adhere together and increase the possibility of bleeding. Generally speaking, patients with coumarin intake should avoid high doses of these foods or related products, equivalent to not eating more than one clove of garlic or 240 mg of Ginkgo biloba extract per day. Iron, magnesium and zinc also hinder coumarin absorption and activity, so there should be at least two hours between coumarin supplementation and intake of products containing iron, magnesium or copper.

Natural substances for stroke prevention and recovery

From the perspective of natural substances, Ginkgo biloba extract is very important for the recovery after stroke. It can promote blood flow in the brain, provide energy for nerve cells, and have a beneficial effect on blood thickness. The recommended dose is 240-320 mg / day, which is less than the daily recommended dose of coumarin.

There are many supplements that prevent the formation of blood clots, such as omega-3 fatty acids, antioxidants, flavonoids, grape seeds, pine bark extract and garlic. Fish oil (up to 3, 000 mg of EPA + DHA per day) and flavonoid rich extracts have been shown to be safe in combination with aspirin and other platelet inhibitors. However, it should be noted that the use of antiplatelet drugs (including clopidogrel and Ticlid) in combination with a variety of natural antiplatelet agents may increase bleeding.

Studies have shown that there are two forms of choline that are promising in the recovery of stroke: CDP choline and GPC. In a 6-month trial involving 2044 stroke patients, GPC helped 95% of patients recover without any side effects.

The recommended daily dose of citicoline is 1000-2000 mg and that of glycerophosphatidylcholine is 600-1200 mg. So far, no scientific research has found any interaction between citicoline or glycerophosphatidylcholine and coumarin or antiplatelet aggregation drugs.

The latest research also found that nattokinase, a protein dissolving enzyme, has the property of "dissolving blood clots". It has a great potential advantage in improving the recovery after stroke. Its standard dose is 100-200 mg per day, but be careful when taking coumarin or antiplatelet coacervation drugs.