Does Elevated Blood Viscosity Impact Outcomes in COVID-19?


What Improves Blood Viscosity?

Treating blood viscosity means treating the causes:  Hematocrit can be lowered by the simple expedient of donating blood on a regular basis.  Blood donation (or therapeutic phlebotomy) addresses two of the contributing factors to blood viscosity:  hematocrit and RBC flexibility.  This is because the drop in hemtocrit after blood donation stimulates the formation of new RBCs.  Younger RBCs are more flexible than older ones.  By regularly donating blood, you remove older, stiffer erythrocytes from circulation, to be replaced by younger, more deformable red blood cells. 

Plasmapheresis can improve plasma viscosity by removing excessive high-weight molecular proteins, Hydration is also essential for optimal plasma viscosity.  Supplements have a role to play also.  Higher vitamin D levels are positively associated with improved RBC deformabiity and lower blood viscosity in post-menopausal women.  It may be more than a coincidence that higher vitamin D levels are also associated with lower risk for COVID-19 and better outcomes.  An exhaustive discussion of supplements that can improve blood viscosity is beyond the scope of this article, but a few that I have mentioned in the past are fish oil, nattokinase, phosphatidyl choline, Gingko biloba, and vitamin E.  The November 2021 issue of the Townsend Letter also had a couple of excellent articles on the treatment of long-term COVID-19.  Do those treatments also improve blood viscosity?  Another interesting question.


Should We Be Testing Blood Viscosity?

Read this issue now!

I work for a lab that does whole blood viscosity testing, so it could be argued that I am biased. It is no accident that I ended up in laboratory medicine.  My year of clinical lab diagnosis was one of my favorite classes at Bastyr, thanks to our excellent professor (thank you, Dr. Sheryl Berman).  I have seen lab results motivate patients to take their health seriously, and I have seen lab results change doctors’ approach to cases and with good results.  For the most part, I think more data is better than less, so yes, I have a bias toward lab testing in general.  Could whole blood viscosity monitoring be used to guide treatments and alleviate symptoms of long-haul COVID-19 by helping us improve systemic perfusion?  I think so, but it is still an open question. 

I would like to thank my friend and colleague, Dan Cho, of Health OnVector, for his assistance in gathering much of the research for this article and helping frame the discussion.  His assistance was invaluable, and I could not have done it without him. 


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Dr. Pushpa Larsen graduated from Bastyr University in naturopathic medicine, naturopathic midwifery, and spirituality, health and medicine. She worked as a research clinician for the Bastyr University Research Institute and as affiliate clinical faculty for Bastyr University, training students in her clinic. She practiced in West Seattle for 10 years before joining Meridian Valley Lab as a consulting physician 12 years ago. She is currently the manager of consulting and education and a member of the development team. Dr. Larsen has consulted with hundreds of doctors every year on the use and interpretation of 24-hour urine hormone profiles, blood viscosity tests, and other tests offered by Meridian Valley Lab.
plarsen@meridianvalleylab.com

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