Bleeding: Vitamin K, Bioflavonoids, and Emergencies

What is bleeding, and what are its main forms?

Bleeding (hemorrhage) is the flow of blood outside of blood vessels, resulting from their rupture or abnormal permeability. Its severity depends on the size of the affected vessel, the location, and how quickly it develops. Uncontrolled bleeding can lead to life-threatening hemorrhagic shock—call 15 in case of heavy bleeding or suspected internal bleeding. Vascular support products are available in the iron and blood vitality sections of the store.

• External bleeding: visible, accessible to direct pressure—cuts, wounds, epistaxis (nosebleeds), gingival bleeding (see bleeding gums), hemoptysis—managed with first aid
• Internal bleeding: not visible—deep hematoma, gastrointestinal hemorrhage (rectal bleeding, melena), hemoperitoneum, hemothorax—warning signs (abdominal pain, pale or grayish skin, weak and rapid pulse, intense thirst, syncope) → absolute emergency, call 15
• Functional bleeding: hemorrhoids —menorrhagia—metrorrhagia—recurrent nosebleeds—require medical evaluation to identify the cause
• Chronic bleeding tendency: frequent bruising and ecchymoses — tendency toward prolonged bleeding — may indicate a coagulation disorder (hemophilia, von Willebrand disease, thrombocytopenia) or a nutritional deficiency (vitamins K, C)

Hemorrhagic emergencies: first aid measures

• Heavy external bleeding — what to do before emergency services arrive:
  1. Call 15 (emergency medical services) or 18 (fire department) immediately
  2. Lay the victim down—elevate the injured limb if possible
  3. Apply direct, continuous pressure to the wound with a clean cloth (or gauze pad) for at least 10 minutes without letting up
  4. Never remove an embedded object (risk of making the injury worse)—apply pressure around it
  5. Do not give aspirin or ibuprofen (antiplatelet agents—they increase bleeding)
• Call 15 immediately if: bleeding does not stop with pressure after 10–15 minutes — signs of hemorrhagic shock (pallor, sweating, agitation, thready pulse, loss of consciousness) — suspected internal bleeding — pregnancy with bleeding (obstetric emergency)
• Medications that increase the risk of bleeding: anticoagulants (warfarin, vitamin K antagonists) — antiplatelet agents (aspirin, clopidogrel) — NSAIDs — report any current medications to emergency responders

Nutrition and supplements to support hemostasis

• Vitamin K: an essential cofactor for the synthesis of hepatic clotting factors (II, VII, IX, X—extrinsic pathway)—dietary sources (green leafy vegetables: spinach, broccoli, lamb’s lettuce, cabbage) — 90 to 120 µg/day (EFSA) — extreme caution: patients on VKA (warfarin) — never alter vitamin K intake without medical advice (risk of anticoagulation imbalance)
• Vitamin C: synthesis of collagen in blood vessel walls — strengthens capillary integrity — deficiency → bleeding gums, spontaneous bruising — 500 to 1,000 mg/day
• Bioflavonoids (rutin, hesperidin, quercetin): reduce capillary fragility and permeability — enhance the effects of vitamin C — indicated for capillary fragility and a tendency toward mild functional bleeding
• Arnica: anti-inflammatory and anti-edematous — for topical application to bruises and traumatic hematomas — do not apply to open wounds