Our organism is like a machine made up of thousands of parts and gears that must work perfectly. If one is missing, a general error occurs. Those pieces, in our real body, would be the proteins we need to maintain homeostasis. One of them is fibrinogen, a little known protein but of indispensable value for our organism.
Today we will explain what exactly it is and what can cause high fibrinogen, as well as its consequences and whether there is treatment for this problem.
What is fibrinogen?
Fibrinogen is a protein that regulates blood coagulation, a normal body process and essential if we suffer a cut in the skin. It is responsible for stopping bleeding and participates in the body’s hemostasis process. However, a high fibrinogen level in the blood can cause clotting disorders that can lead to serious diseases.
This protein is synthesized in the liver and transported to the blood plasma to fulfill its mission. Other proteins, such as prothrombin, calcium, tissue factor, etc., are also involved in coagulation.. During hemostasis, thrombin converts fibrinogen into fibrin, which is able to create a ‘wall’ and ‘plug’ the wound so that it does not bleed. Afterwards, platelets also aggregate and produce a clot that eventually plugs the wound.
Fibrinogen can also undergo the opposite process: fibrinolysis, in which fibrin activates plasmin to degrade clots. It is then inhibited by fibrinogen. It is the body’s way of ensuring that clots are broken down when they are no longer needed and are not formed unnecessarily.
If a doctor requests a test of blood fibrinogen levels, the cause is usually to learn how the clotting process works in a patient. The test itself is very simple: a blood sample from the vein is needed, preferably taken from the fasting patient for up to 12 hours. If you are taking any medication, your doctor may recommend that you stop taking them (especially if they are anticoagulants).
To obtain results, a standard amount of thrombin must be added to the collected sample to measure the time it takes to clot and form fibrin. With this test, the amount of fibrinogen in the blood can be determined. The longer it takes for the clot to form, the less fibrinogen in the blood. Let’s see what the normal values are:
From 200 to 400 mg/dl in adults.
From 160 to 400 mg/dl in children under 5 years of age.
From 80-90 to 375-385 mg/dl in infants less than 1 year old.
If the results obtained are not within this range, they can be considered high or low, each with different ranges. The highs are as follows:
- 400 – 600 mg/dl (not very high). As this may be a one-time event, a reanalysis will probably be performed to see if the values are stable.
- 600 – 700 mg (moderately high). Concern increases, because if blood pressure is also elevated, the risk of a possible cardiovascular accident increases.
- More than 700 mg/dl (excessively high). The chances of clots forming and damaging the heart or brain are very high.
Regarding low levels, there are 3 types of deficiency:
- Afibrinogenemia. It is the complete absence of fibrinogen in the blood. It is extremely unusual and, although it does not necessarily cause bleeding, it is very serious.
- Hypofibrinogenemia. These are low levels of protein (less than 200 mg/dl). May be due to minor bleeding.
- Dysfibrinogenemia. Although protein levels are normal, fibrinogen does not function normally. It should be studied whether this malfunction is congenital or acquired, and may cause thrombosis or bleeding.
Why is the fibrinogen value altered?
As mentioned above, fibrinogen can be temporarily altered and return to its normal value on its own. These cases may be related to pregnancy, menstruation, bleeding, blood transfusion or drug reactions. Some of those that can alter the levels of this protein may be:
- Oral contraceptives.
- Estrogens.
- Steroids.
- Antituberculosis.
- Antiandrogens.
- Aspirin.
- Warfarin.
- Cholesterol-lowering drugs.
If a low fibrinogen level is observed, in addition to the factors we have discussed, it may also be due to tobacco use or conditions (hereditary or not) such as:
- Tumors.
- Severe malnutrition.
- Nephrotic syndrome..
- Inflammatory disorders (rheumatoid arthritis).
- End-stage liver disease.
Causes of high fibrinogen
The physician may order a blood fibrinogen test if he/she sees abnormal bleeding or clotting situations in the patient, i.e., difficult-to-contain bleeding that appears along with obvious bruising and menstrual disorders. If we talk about high fibrinogen, there are several causes that can produce it:
Stress
After performing any mission or task that requires a lot of stress, fibrinogen levels increase immediately. In addition, if a patient has elevated cortisol levels, he or she will also have elevated fibrinogen levels. This relationship may be due to the upregulation of fibrinogen genes by IL-6, a cytokine that promotes inflammation.
Pregnancy
An elevated fibrinogen level can be observed in pregnant women, which is completely normal and for one purpose: to avoid excessive bleeding at delivery. During pregnancy, the levels of this protein can increase up to 3 times its normal range. After about 4-6 weeks after delivery, the values return to normal.
Tobacco
Both smokers and ex-smokers have higher fibrinogen levels than non-smokers (53% and up to 11% more fibrinogen, respectively). Undoubtedly, smoking increases the amount of fibrinogen in the blood, and its normal values do not return to normal until 15 years after quitting smoking. Special care should be taken by smokers with diabetes and/or high cholesterol, as the amount of fibrinogen is even higher.
Birth control pills
Oral contraceptives increase fibrinogen levels, especially those with a high estrogen concentration. These can increase fibrinogen because they increase the expression of the FGG gene and, therefore, the production of the protein.
Hormone replacement therapy can help reduce protein levels in postmenopausal women, but with unremarkable results.
Genetic mutations
Genes account for 34 to 46% of the variation in fibrinogen levels in people. One disorder that can cause high fibrinogen is homocystinuria.. It causes blood levels of the amino acid homocysteine to increase. It can inhibit the breakdown of fibrinogen, resulting in elevated levels.
Age
Age may be a cause of an elevated fibrinogen level, as concentrations in older people usually increase by about 0.1 – 0.2 g/L every 10 years.
Cold temperatures
Although it may seem strange, low temperatures favor an increase in the levels of this protein. During the coldest months of the year, therefore, its concentration tends to increase. The values should be checked during this time to ensure that they are not exaggerated.
Diet
Iron intake (from meat) and high glycemic index foods in the diet, also associated with heart disease, can cause an increase in fibrinogen, in addition to low blood concentrations of minerals and vitamins. If we follow a diet rich in cholesterol and fatty acids we are also causing our fibrinogen levels to increase.
Although we already know, if we suffer from high fibrinogen, it is essential to promote a diet in which fruit and vegetables are the protagonists.
Obesity
People who are overweight tend to have elevated fibrinogen. However, no causal relationship has been demonstrated. Body fat and chronic inflammation partially determine fibrinogen levels, so as long as you eat a healthy, balanced diet you can combat irregular fibrinogen levels.
How can high fibrinogen levels be lowered?
An altered blood fibrinogen value should always be monitored. The physician should know the patient’s levels and status at all times, as well as whether the patient has developed any new symptoms. If there are wounds that are slow to close because levels are low, the chances of infection increase.
On the other hand, if excessive clotting is observed, even when it is not necessary, there is a likelihood of cardiovascular problems. If thrombi form, they can cause infarctions or embolisms in the patient.
If the fibrinogen concentration is at levels that require hospitalization, it is up to the physician to choose the most appropriate treatment given the patient’s characteristics (sex, age, physical condition) to help the protein levels return to normal. You can use antiplatelet agents or anticoagulants.
If you want to prevent both an increase and a decrease in blood fibrinogen, you can follow these tips:
- Maintain a healthy lifestyle, including a balanced diet and moderate exercise appropriate for each person.
- Try to engage in pleasurable, stress-reducing activities.
- Prevent any type of cardiovascular disease.
- Smoking cessation (if smoked).
- Reduce or eliminate alcohol consumption from the diet.
If you need a test to know your fibrinogen levels in blood, in Ambar Lab we can help you: our clinical laboratory is a support to the maintenance of public health. Through our work, a diagnosis can be confirmed or not. Ambar Lab’s technicians and professionals analyze biological samples to study them in order to study, prevent, diagnose and treat diseases. You can check if we offer the test you are looking for in our catalog or, if you have specific questions, please contact us
