On Thursday I developed double vision, and a friend who is a nurse took me to the ER. Since it had already been 2 hours, he advised me to say that I also was having right-sided weakness and dizziness so that I would be seen immediately (there is a 4-hour window after stroke to avoid damage). I was in the hospital for two days, and the CT scans, MRI, carotid artery ultrasound, and neurological tests were all good. The physical and occupational therapists said all was fine. The double vision went away after two days. The neurologist diagnosed it as a TIA based on my presenting symptoms (which really only was the double vision, but I didn’t tell him that because the nurse who got me in had good intentions). I’m going to see the eye doctor tomorrow to rule out any eye issues. I was prescribed Plavix for 20 days, and daily aspirin and Lipitor. I won’t take statins. For that reason my primary doctor previously said I could take red yeast rice, which I didn’t continue, because I didn’t know how much of my high cholesterol then was due to the stress of my husband dying, moving, selling my house, etc. However taking only one 600 mg. RYR did lower my cholesterol from 253 to 235. Current hospital tests show cholesterol 243, Trigl. 50, HDL 74, LDL 159, Cholesterol/HDL 3.3, non HDL 169, which is not a big change from previous tests. My sister who is 10 years older and in good health has lipids similar to mine. I will assume that it was a TIA and I will consider the Plavix since it is only for 20 days, and I would think that there are no herbs or supplements that are comparable. I remember you saying, and I also had read about a meta-analysis that demonstrated that aspirin was really not effective. For short term I am taking aspirin, but for long-term, other than ginger and garlic, what other herbs would be more effective for stroke prevention? We didn’t get into that very much in the cardiovascular therapeutics class. Are there any herbs that should be avoided on Plavix? As an interesting related issue, for two weeks prior to this I went on a low-fodmap diet to address long standing gas, bloating, and constipation issues. I cut out grains, legumes, onion, garlic, and some brassicas. Because I wasn’t eating foods like oatmeal for breakfast I was eating more eggs, and even had some beef, which I hadn’t eaten in decades. I found this study linking TMAO production from not only carnitine, but phosphatidyl choline in eggs: https://svn.bmj.com/content/3/2/44. Who knows if such a short term, but radical change in diet for me, would have such an effect but it’s interesting. Since I may have dysbiosis, maybe there are certain bacteria that are TMAO factories when giving the right foods. This week I started on a spore probiotic (8 billion) with S. boullardii, B. clausii, B. subtilis HU58, and B. coagulans HC this week for the gut issue. A functional M.D. online said these are effective as part of an early treatment protocol for SIBO, and it was helping. I will get back to my former diet, leaning more to a Cretan Mediterranean diet.

However, there also is this study on aspirin and TIA: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321490/

Also, what is your experience with nattokinase?

Interesting study on nattokinase: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043915/ Now I will stop bugging you!

I worked out a plan using only aspirin and red yeast rice, since I am at low risk. I am running it by my doctor tomorrow. I’m still interested in what you might know about nattokinase and serrapeptase for this issue.

While on Plavix I would avoid Dan Shen, Hong Hua, Kudzu, Red Root. They would all be indicated after stopping there Plavix. Also herbs to stabilize plaques such as Gobi berry, Amla, Blueberries, I doubt short term changes had any effect . I have used nattokinase occasionally with some patients and it seemed to work a little bit, it is not even close to a Plavix or blood thinners, Lumbrokinnase (from earthworms) seems to work bit better I haven't used serrapeptase