Von Willebrand disease (VWD) is a blood disorder in which the blood does not clot properly. Blood contains many proteins that help the body stop bleeding. One of these proteins is called von Willebrand factor (VWF). People with VWD either have a low level of VWF in their blood or the VWF protein doesn’t work the way it should.

Who is Affected: VWD is the most common bleeding disorder, found in up to 1% of the U.S. population. This means that 3.2 million (or about 1 in every 100) people in the United States have the disease. Although VWD occurs among men and women equally, women are more likely to notice the symptoms because of heavy or abnormal bleeding during their menstrual periods and after childbirth.

Causes: Most people who have VWD are born with it. It almost always is inherited, or passed down, from a parent to a child. VWD can be passed down from either the mother or the father, or both, to the child. While rare, it is possible for a person to get VWD without a family history of the disease. This happens when a “spontaneous mutation” occurs. That means there has been a change in the person’s gene. Whether the child received the affected gene from a parent or as a result of a mutation, once the child has it, the child can later pass it along to his or her children. Rarely, a person who is not born with VWD can acquire it or have it first occur later in life. This can happen when a person’s own immune system destroys his or her VWF, often as a result of the use of a medication or as a result of another disease. If VWD is acquired, meaning it was not inherited from a parent, it cannot be passed along to any children.

Signs and Symptoms: People with VWD might have nosebleeds that: Start without injury (spontaneous). Occur often, usually five times or more in a year. Last more than 10 minutes. Need packing or cautery to stop the bleeding. People with VWD might experience easy bruising that: Occurs with very little or no trauma or injury. Occurs often (one to four times per month). Is larger than the size of a quarter. Is not flat and has a raised lump. Treatments: Desmopressin Acetate Injection. This medicine (DDAVP®) is injected into a vein to treat people with milder forms of VWD (mainly type 1). It works by making the body release more VWF into the blood. It helps increase the level of factor VIII in the blood as well. Desmopressin Acetate Nasal Spray: This high-strength nasal spray (Stimate®) is used to treat people with milder forms of VWD. It works by making the body release more VWF into the blood. Factor Replacement Therapy: Recombinant VWF (such as Vonvendi®) and medicines rich in VWF and factor VIII (for example, Humate P®, Wilate®, Alphanate®, or Koate DVI®) are used to treat people with more severe forms of VWD or people with milder forms of VWD who do not respond well to the nasal spray. These medicines are injected into a vein in the arm to replace the missing factor in the blood.

4 Natural Ways to Help Manage VWD:

Vitamin C: may help protect the body from bruising, keeps gums healthy, and can aid in the healing of cuts and wounds. In a clinical trial published in the journal Diabetes Care, patients with type 2 diabetes given two grams a day of vitamin C showed an improvement in von Willebrand factor significantly greater than the placebo group.

This is a high dose of vitamin C, and the study focused on short-term treatment. Instead of a high dose for the long-term, eating vitamin C-rich foods including guava, red bell peppers, kiwi, and oranges may help symptoms.

Vitamin K: Certain bleeding disorders and prolonged use of antibiotics can cause a vitamin K deficiency. Vitamin K is an essential part of the clotting process; being deficient can cause excessive bleeding.

While supplements are available, vitamin K-rich foods may be a better choice for those with von Willebrand disease. Add leafy greens like dandelion, mustard greens, spinach, kale, turnip, and Swiss chard to your diet each day to make sure you are getting the recommended dietary allowance (RDA) for your age group.

Folate: Essential for making new cells, folate works with vitamin B12 to form hemoglobin in red blood cells. A deficiency may contribute to anemia, common in women and girls with von Willebrand disease.

Stay Active: Walk and do other non-contact activities to stay healthy, maintain a healthy weight, and to fight depression and anxiety. Pilates, yoga, Tai Chi, and other practices where both the mind and the body are engaged are a great choice for von Willebrand disease patients.

Precautions: If bleeding happens in the joint or soft tissue, severe pain and swelling can occur. Avoid activities that cause bruising, including contact sports. In rare cases, uncontrollable bleeding can be life-threatening, and emergency medical attention is required. If you have von Willebrand disease, any type, it is imperative that all physicians, dentists, nurses, and dental hygienists know of the disorder and the severity of the symptoms. Consider wearing a medical ID bracelet in the event of an accident.

Women with abnormally heavy bleeding during menstruation are at an increased risk for developing anemia. Prior to becoming pregnant, women should discuss the potential challenges and dangers with your medical team. For women beginning menopause, the fluctuation in hormones may cause unpredictable and heavy bleeding. Stay in close contact with your gynecologist and hematologist if changes occur.

Talk to your medical team before taking any of the following medications as they are known to increase bleeding:

• All NSAIDs, including ibuprofen, Toradol, and others
• All antiplatelet agents, including aspirin, Plavix, and others
• All anticoagulants, including Miradon, Lovenox, Heparin, and Warfarin

Talk to your hematologist before taking any natural supplements, as they can interact with certain prescribed medications or thin the blood. Supplements are known to affect bleeding, according to Stanford University School of Medicine’s Department of Otolaryngology-Head & Neck Surgery, include:

• Birchbark
• Cayenne
• Cumin
• Evening primrose oil
• Garlic
• Ginger
• Gingko Biloba
• Ginseng
• Grapeseed extract
• Milk thistle
• Omega-3 Fatty acids
• Onion extract
• St. John’s wort
• Turmeric
• Vitamin C
• Vitamin E