The COVID and Birth Control Pill Blood-Clot Connection Explained
There have been concerns expressed about COVID vaccines possibly contributing to the rare development of blood clots (thromboemboli). As part of this discussion, the greater frequency between birth control pills (BCP) and blood clots has been mentioned as have the increased frequency of blood clots associated with the COVID infection itself and the even greater frequency of complications if pregnant. These COVID clots cause the complications of reduced pulmonary function, strokes, micro strokes, pulmonary emboli, heart attacks, and even COVID toes. What is not mentioned is the cause of these emboli— increased blood viscosity. Keep in mind that the onset of blood clots, thrombogenesis, is multifactorial and it just takes one small additional factor among many to thicken the blood enough to set off the cascade of clot formation.
The source of increased viscosity can be as simple as dehydration but there are also many medical conditions and prescribed medications that thicken the blood. The one thing all these causes have in common is that they initiate an increase in the cellular waste product call homocysteine. When this molecule builds up, it causes inflammation of the endothelial cells lining blood vessels and by itself increases viscosity. Thicker blood and narrower inflamed blood vessels promote clot formation and therefore, anything that increases homocysteine increases thrombogenesis. Any serious viral infection, including COVID, increases homocysteine which is showing up on blood tests when requested.
The main cause of increased homocysteine, besides viral infection, is a deficiency of the bioactive forms of B12 and folate (B12/F). These two vitamins are required together in adequate amounts to transform homocysteine into a safe molecule. Anything that decreases these two most essential of the essential vitamins causes blood clots and among the prime culprits are prescribed hormones. BCP and hormone replacement therapies (HRT) block the enzyme (MTHFR) that converts artificial folic acid found in multivitamins and food fortification into the bioactive form L-methylfolate that cells use:
BCP(or HRT) → ↓MTHFR→ ↓ L-Methylfolate → ↑Homocysteine→ ↑Viscosity, Endothelial Inflammation → Thrombogenesis→ Strokes, Pulmonary Emboli, Heart Attacks, ect.
Factors that cause a reduction in B12 or folate will sound familiar because they are the same risk factors that increase the severity of COVID illness— ethnicity, obesity, diabetes, age and pregnancy. Pregnancy is a major risk factor for the development of blood-clot illnesses because blood folate is the lowest at any time during the human life cycle. Other prescribed medications that reduce these vitamins and increase homocysteine are metformin and PPIs. If a patient with COVID is admitted and is vegan, slightly obese, taking BCP(or HRT), metformin, and PPIs, she will be at significant risk for blood clots.
Genetics(↓MTHFR), Viral Illness, Hormones, GERD Medications, Metformin, Aging, Weight Gain, Voluntary and Involuntary Veganism, Pregnancy, Poorly Manufactured Artificial Vitamins → ↓ B12 /Folate
To prevent the blood clots due to hormone treatment or COVID infection it would be essential to take optimal doses of B12 and folate in their bioactive forms.
I’ve included some references below:
Mahabir S, et al.
Measures of adiposity and body fat distribution in relation to serum folate levels in postmenopausal women in a feeding study. Eur J Clin Nutr. 2008 May;62(5):644-50
"Based on various calculation models, reduction of elevated plasma homocysteine concentrations may theoretically prevent up to 25 percent of cardiovascular events. Supplementation is inexpensive, potentially effective, and devoid of adverse effects and, therefore, has an exceptionally favorable benefit/risk ratio."
"Vitamin B12 deficiency (cobalamin) is classically associated with megaloblastic anemia. The concern for cobalamin deficiency is not typically investigated once hemolysis is seen. Ten percent of B12 deficiencies present with pancytopenia or hemolysis . Even rarer are cases mimicking a picture of thrombotic microangiopathy (TMA), which is only around 2.5%. The swift identification of this association is imperative in developing an appropriate differential for the diagnosis of cobalamin deficiency and its hematological associations."
RD Jaykar, SC Jadhav, N Chhabra Prospective study of relationship between deep vein thrombosis and homocysteine related group B vitamins International Journal of Surgery, 2020
“Conclusions: Hyper homocysteinemia and related Vitamin B group deficiency are risk factors for Deep vein thrombosis. Hyper homocysteinemia and risk of DVT, this correlation is high among older age group and female patients.”
He JA, e al. Hyperhomocysteinaemia, low folate concentrations and methylene tetrahydrofolate reductase C677T mutation in acute mesenteric venous thrombosis. Eur J Vasc Endovasc Surg. 2010 Apr;39(4):508-13.
”Conclusions: Hyper-Hcy and low serum folate levels were associated with an increased risk of AMVT. The homozygous (TT) genotype of MTHFR gene mutation may be a crucial hereditary risk factor in the development of AMVT for a Chinese population.”
Brenner, B., Arya, R., Beyer-Westendorf, J. et al. Evaluation of unmet clinical needs in prophylaxis and treatment of venous thromboembolism in at-risk patient groups: pregnancy, elderly and obese patients. Thrombosis J 17, 24 (2019) doi:10.1186/s12959-019-0214-8
Hughes CF, Ward M, Hoey L, et al. Vitamin B12 and ageing: current issues and interaction with folate. Ann Clin Biochem 2013; 50: 315–329.