Never Combine These 2 Supplements if You’re Taking Blood Thinners, Cardiologists Warn

As a preventative cardiologist at Vital Heart & Vein, Dr. Patrick Kee, MD, Ph.D has heard well-meaning, health-conscious patients on blood thinners explain a morning routine that sets off an alarm in his head. And it’s one he can’t press snooze on: “A green smoothie, a brisk walk and a handful of supplements that promise to make their heart as strong as a marathon-running ox,” Dr. Kee states. “But if they’re one of the millions of people taking blood thinners, their ‘natural’ supplement routine might actually be a recipe for trouble.”

As a medication, blood thinners don’t fit the wellness world’s standards for “natural,” but they’re often necessary.

“The two most common types of blood thinners are anticoagulant and antiplatelet medications,” says Dr. Randy Gould, DO, a cardiologist with Manhattan Cardiology in NYC and contributor to labfinder.com.

Dr. Gould states that people may take anticoagulants (such as Eliquis, Xarelto or Coumadin) because of a clot in the leg (deep vein thrombosis) or an irregular heartbeat (such as atrial fibrillation).

“These types of blood thinners help to dissolve a blood clot or prevent a clot from forming and possibly prevent a stroke,” Dr. Gould adds. “Other people may be taking antiplatelet medications such as aspirin, clopidogrel (Plavix), ticagrelor or prasugrel if they have coronary artery disease and had a recent stent placement or are recovering from a stroke.”

A vitamin-rich diet can support efforts to keep your diet as healthy as possible, but getting nutrients in supplement form can have pitfalls.

“Many supplements have real biologic effects, and when you layer them on top of blood thinners, you can tip into either bleeding or clotting without realizing it,” warnsDr. Joseph Allencherril, MD, a cardiologist with UTMB’s Department of Cardiovascular Medicine.

Avoid these risks by not combining these two supplements if you’re on blood thinners.

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Images By Tang Ming Tung/Getty Images

(Images By Tang Ming Tung/Getty Images)Don’t Combine These 2 Supplements if You’re Taking Blood Thinners

Cardiologists warn against combining high-dose vitamin E (above 400 IU per day) and fish oil if you’re on blood thinners. “If you take both of these together, you are increasing your risk of bleeding,” Dr. Gould states.

Wait…why and how? “Fish oil and high-dose vitamin E both have blood-thinning capabilities,” reports Dr. Ameen Person, MD, chief of cardiology with Kaiser Permanente.  “They both thin the blood by causing your platelets not to function as well. I like to think of platelets as ‘plugs’ that travel through your bloodstream and fill in any holes that become open in your vessels, like the way a plug may fill the hole in a tire to stop it from leaking.”

And Dr. Kee reminds us that blood thinners are already doing the heavy lifting to keep your blood in liquid form, so adding high-dose vitamin E and fish oil makes for a triple threat that opens the floodgates.

“When you combine all three, you’ve essentially removed all the ‘brakes’ from your blood’s ability to clot,” Dr. Kee says. “This can lead to spontaneous nosebleeds, blood in your urine or stool or—more seriously—bleeding in the brain, a cerebral hemorrhage, if you take a tumble.”

Also, more broadly, supplements aren’t as tightly regulated as medications, and they don’t have standardized ingredient lists.

“The amount of active ingredients can vary widely between brands and batches, and proprietary blends can make dosing challenging,” Dr. Allencherril shares. “If you are on a blood thinner, treat supplements like medications—avoid starting new ones casually, and definitely flag anything new before procedures or dental work.”

Related: ‘I’m a Cardiologist—Here’s How To Know When You Should Go on Blood Pressure Medication’

Are There Benefits of Fish Oil and Vitamin E?

Yes, these nutrients have benefits, including for your heart and blood health. “The benefits from fish oil concerning heart health are that it helps lower triglyceride levels, which are fats found in the body,” Dr. Person says. “Vitamin E helps protect your cells from damage that are caused by free radicals.”

Dr. Person explains that free radicals are molecules that can increase your risk of certain diseases and accelerate aging because of cell damage, so vitamin E’s protective benefits matter.

“This cell protection can prevent damage to blood vessels and cells that are found in the immune system,” Dr. Person notes.  

Yet, you don’t need to overdo consumption. Most people over 14 years old benefit from 15 milligrams (22.5 IU) of vitamin E daily. The tolerable upper intake level for adults is 1,000 mg (1,500 IU). However, people on blood thinners may not tolerate this much vitamin E.

“The bleeding concern rises further at 800 to 1,000 IU per day and above,” Dr. Allencherril notes. As for fish oil, most adults benefit from 250–1,000 mg combined of EPA and DHA (fish oil’s active omega-3s).

Related: Never Combine These 2 ‘Natural’ Supplements, Experts Warn

How To Meet Your Vitamin E and Omega-3 Needs Without Supplements

Cardiologists suggest reaching into your fridge and pantry before your medicine cabinet. “Focus on a ‘food first’ approach,” Dr. Kee says. “If you eat a piece of salmon and a handful of almonds, you get the heart benefits without the risk of turning your blood into a non-stop fountain.”

He suggests aiming for two servings of fatty fish a week, such as salmon, mackerel or sardines.

“For vitamin E, you can get plenty of this without hitting the ‘high dose’ danger zone by snacking,” Dr. Kee says. “Try almonds, sunflower seeds, spinach and vegetable oils.”

Up Next:

Related: Never Take These 3 Vitamins First Thing in the Morning, Registered Dietitians Warn

Sources:

Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association. Circulation.

This story was originally published by Parade on Feb 11, 2026, where it first appeared in the Health & Wellness section. Add Parade as a Preferred Source by clicking here.