What is bruising?
Bruising is a common occurrence we all experience that's characterized by black, blue, or red marks on the skin. This can be caused by minor injuries like bumping into the corner of a table to sustaining severe physical trauma, like getting in a car wreck.
Mechanism of Bruising
A bruise is formed when the tiny blood vessels, called capillaries, under the skin burst, making blood seep underneath the skin. A larger bruise is due to more blood seeping out compared to that of a small bruise, which is why it’s common protocol to ice your bruise immediately after an injury to slow the flow of blood to the area. As time passes, your body will reabsorb the blood, making the bruise shrink. The color change of the bruise throughout the duration of having it is due to the breakdown of hemoglobin, the protein in red blood cells that carries oxygen .
Why do some people bruise easier than others?
There are many factors that can cause easy bruising.
Vitamin K is a vital piece of the puzzle in the bodies bruising response. It’s known as “the blood clotting vitamin” because it helps make proteins needed for clotting. Two important components of the blood clotting mechanism are the compound prothrombin and platelet cells.
Blood clotting mechanism
Prothrombin is synthesized in the liver and starts the reaction of forming a clot. Prothrombin is converted into thrombin by clotting factor X. Then, thrombin converts fibrinogen into fibrin. So the biochemical process looks like prothrombin > thrombin which turns fibrinogen > fibrin. This final product, fibrin, combines with platelet cells to form blood clots, a process also known as coagulation.
More on Vitamin K
Hypoprothrombinemia, when your body has a hard time stopping bleeding, is a deficiency in prothrombin and is associated with vitamin K deficiency . In a survey, vitamin K supplementation increased platelet count in about 27% of people. Those deficient in vitamin K will experience increased bleeding as the body cannot properly clot the wound to stop blood flow; this can cause increased bruising as well.
Vitamin K also supports the health of arteries by breaking down calcium to prevent hard deposits from forming in artery walls.
Vitamin K is unique because the bacteria in our gut produce small amounts of it. It has two natural forms: vitamin K1 (phylloquinone) which is found in plant foods and vitamin K2 (menaquinone) which is found in animal foods.
Although our bodies make a small amount of it, it’s essential to get adequate amounts in your diet. When babies are born, they have very low amounts of vitamin K in their system and are given a vitamin K shot at birth to prevent dangerous bleeding that could cause brain damage. It's an essential compound to support the functioning of the circulatory system and wound healing.
B-12 helps our body form healthy blood cells, DNA, and supports neurological functioning . Without adequate levels of B-12, new blood cell synthesis will decrease and can lead to increased bruising.
Vitamin C, or ascorbic acid, is a master antioxidant and supports the health of all body tissues. Things like collagen formation, immune system function, wound healing, and maintaining bones and tissues are just a few of it's functions.
Without adequate vitamin C, collagen production is decreased which leads to weakened blood vessel walls. This makes skin more prone to bruising as the vessel walls leak blood easier. In a case where a patient came in complaining of finding unexplained bruises on her body after sleeping, testing revealed vitamin C levels were low and upon increasing intake of vitamin C the patient reported the bruising went away .
Blood thinners can be prescribed to help prevent blood clots; in turn, this leads to easy bruising as it takes your body longer to form a clot.
Over the counter medicine
The common medication aspirin is an anti-platelet drug and can lead to bruising. Non-steroidal anti-inflammatory drugs like Motrin, Advil, and Aleve also inhibit platelet function.
Cortico-steroids thin your skin which provides less cushion for your vessels and make you more susceptive to bruises.
Antibiotics kill bacteria in the gut and are used to treat a wide variety of illnesses. Since a small portion of vitamin K is produced by gut bacteria, antibiotics can reduce the level of vitamin K present which in turn can increase bruising .
Supplements like garlic, ginko, ginseng, turmeric, and fish oil “can inhibit normal platelet functioning and cause bruising” . Some doctors advise their patients to limit garlic and turmeric consumption prior to surgery to minimize bruising post operation.
As we get older, both the skin and the protective layer of fatty tissue thin. This increases susceptibility of bruising as your blood vessels have less cushioning; bruising easier as you get older is a natural side effect of aging.
Several medical conditions cause easy bruising.
Von Willebrand disease is the most common bleeding disorder; it’s caused by a genetic mutation that decreases the amount of von Willebrand factor (VWF), a protein that helps your blood clot .
Hemophilia A is a genetic condition characterized by a missing or defective clotting protein called factor VIII. This increases the time it takes for a clot to form.
Hemophilia B is a condition where your body doesn’t produce enough factor IX (another type of clotting protein). Like Hemophilia A, it can lead to prolonged bleeding or spontaneous bleeding.
Conditions like leukemia, cirrhosis, aplastic anemia, and myelodysplasia decrease platelet count which impacts clotting/bruising .
Common symptoms of a bleeding disorder are listed below and you should consult with your doctor if you’re experiencing them.
· Unexplained nosebleeds (epistaxis)
· Excessive menstrual blood flow (menorrhagia)
· Prolonged bleeding after minor cuts, blood drawing, minor surgical or dental procedures, or tooth brushing or flossing
· Unexplained skin marks, including tiny red or purple dots, red or purple patches, bruises, or small blood vessels that are widened and visible in the skin .
Some people are genetically predisposed to bruising due to having more delicate blood vessels and/or thinner skin. This isn’t usually cause for concern and doesn’t require medical treatment.
How to help
If you frequently experience random bruising that comes out of nowhere it’s a good idea to visit a doctor. In extreme cases, it could be due to a medical condition that needs immediate attention, like the ones listed above. But for most people, it’s likely due to a vitamin deficiency or a genetic disposition that causes you to naturally bruise easier than the average person. Below are some ways to combat easy bruising.
Deficiencies in vitamin C, K, and B-12 can lead to increased bruising; ensuring you get adequate amounts of these nutrients is vital.
Vitamin C is found in lots of foods: citrus fruits, strawberries, cruciferous vegetables, tomatoes, and peppers.
Vitamin K1 is found in plant sources like kale, broccoli, brussels sprouts, spinach and plant oils (like soybean oil). And the other form, K2, is found in animal sources like dairy products, meat, and fermented foods.
B-12 is a common nutrient deficiency for those who don’t eat a lot of animal products. Foods like milk, salmon, beef, egg yolks, and yogurt all have high levels of B-12. If you’re vegetarian, vegan, or just don’t find yourself consuming quality animal products frequently you should consider taking a high quality B-12 supplement.
A component to add to your diet that could help with bruising is flavonoids. Flavonoids are plant compounds similar to vitamins that can provide antioxidant benefits. They strengthen capillaries and help with bruising. The best food sources of flavonoids are berries, onions, kale, parsley, and dark chocolate, to name a few .
It’s difficult to keep track of the amounts of each vitamin we’re consuming every day. To make things easier, opt for a multi-vitamin supplement to ensure you don’t have any gaps in your nutrient intake. Rootine makes high-quality supplements that are formulated for maximal absorption to give your body everything it needs in one simple step.
- Bruising is common and we all experience bruising after getting injured
- Some people do bruise easier than others: pay attention to your intake of vitamin K, vitamin C, and B-12
- The medicine you take could impact how easily you bruise
- If your bruising is severe or you bleed for prolonged periods of time consult with your doctor to rule out an underlying health condition
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