Can Anxiety Cause High D-Dimer?

Anxiety can cause all sorts of unusual symptoms and side effects. Whereas much of the population is familiar with the common effects of anxiety, such as worry or a high heart rate, there are some less well-known side effects, as well. For instance, did you know that anxiety can actually cause hair loss? Or that you’re more likely to smoke or vape nicotine or other substances if you have an anxiety disorder?

These are just a few of many unusual side effects of anxiety and stress. But what about, say, medical tests? Is it possible for anxiety to affect the outcome of your lab results?

This article will explore this question specifically in relation to one common test: The D-dimer. Furthermore, we’ll aim to answer the question, “Can anxiety cause high D-Dimer?”

What is D-Dimer?

To start, let’s talk about what D-dimer is. In this section, we’ll discuss how D-dimer is built up in the blood, as well as how the D-dimer test is used to diagnose – or rule out – clots and clotting disorders.

What is a Clot, and How Does it Turn Into D-Dimer?

When you get a cut on your body, such as a paper cut or a knife wound, your body has a mechanism to make the platelets in your blood clump up. This process is known as clotting, and it’s essential to stop the bleeding and start the healing process. Once the bleeding stops and your body begins to cover over the wound, the clump of cells and proteins – known as a clot – starts to break down again.

At the end of this process, you’re left with a bunch of cells and partial proteins floating around in your blood. One of these partial proteins is called D-dimer. In time, this D-dimer protein should break down and disappear from your blood.

However, if you have a blood clot such as a DVT (deep vein thrombosis) or a PE (pulmonary embolism), D-dimer may not dissipate. These clots are potentially dangerous, as they can travel to your leg or lungs, respectively. Furthermore, if you have multiple areas of injury, or if your blood is clotting too much or for no reason, D-dimer proteins may build up to dangerous levels in your blood.

What is the D-Dimer Test Used for?

This is where the D-Dimer test comes into play. Doctors may order D-dimer tests in order to rule out DVT or PE as the cause of your medical symptoms. If a D-dimer test comes back negative, this is an indication that a clot is not likely to be present.

On the other hand, a positive D-dimer does not mean that a clot is present – just that a high level of D-dimer proteins is in the blood. Additionally, D-dimer tests are also used to test for and measure the effectiveness of treatment on DIC (disseminated intravascular coagulation). This is a potentially life-threatening disease that leads to blood clots forming in the small blood vessels of your body, which can also cause internal bleeding.

Evaluating the Science Behind Anxiety & D-Dimer?

So, now that we know what it is, we’ve come to the big question: can anxiety cause a high D-dimer? Let’s see what science has to say on the matter.

Study 1: Anxiety Was Found Not to be Linked to Higher Levels of D-Dimer

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538031/)

This multicenter, observational study, peer-reviewed and published in the journal Academic Emergency Medicine, evaluated ED (emergency department) patients for pulmonary embolism with a quantitative D-dimer. The goal of the study was to determine the predictors and indicators of a positive D-dimer test. The study included a total of 2,500 patients across races and genders, with 1,903 turning out D-dimer positive.

The authors determined that there were several predictors for high D-dimer, including:

Drug use
Increasing age
Gender
Surgery
Arthritis

However, this study did not find that anxiety can cause a high D-dimer.

Study 2: Drug Use, Gender, & Other Factors Led To Higher D-Dimer Levels For Anxiety Patients

(https://pubmed.ncbi.nlm.nih.gov/18716423/)

This controlled study, published in the peer-reviewed journal Psychotherapy and Psychosomatics, involved a group of anxiety patients and a healthy control group of 29 individuals each. All participants were given a questionnaire, examined for anxiety and depression, and subjected to a blood draw. Then, every subject’s blood was tested for hemostatic function, or the ability to clot.

The authors of the study found that after controlling for variables such as gender and drug use, patients with anxiety were more likely to clot. At the same time, however, they found that they broke down the fibrins (part of the blood clot) faster than the control group. This led to a short-term burst of higher D-dimer levels in the anxiety group than the control group.

Study 3: Over-clotting of the Blood & Anxiety

(https://pubmed.ncbi.nlm.nih.gov/15479990/)

This controlled study looked at the effects of anxiety on hypercoagulation (over-clotting) in almost 700 working men and women from two German companies. Every participant was asked to complete a questionnaire rating their anxiety levels, and afterward had blood drawn and tested for levels of D-dimer and fibrinogen, another clotting factor. The results were published in the journal Psychotherapy and Psychosomatics.

This study found a few results relating to anxiety and clotting factors, notably:

Almost 100 subjects with high levels of panic had high D-dimer and low fibrinogen levels in their blood
The nearly 600 subjects who reported panic feelings rarely or not at all had much lower levels of D-dimer and fibrinogen in their blood

The study called for more exhaustive testing to conclusively rule that anxiety could be related to higher levels of D-dimer. At the same time, however, it also suggested that fibrin turnover – leading to high levels of D-dimer in the blood – could be related to sudden anxiety and panic.

So, Can Anxiety Cause High D-Dimer?

The science at this point is somewhat inconclusive on whether or not anxiety can cause high D-dimer. While some studies find no correlation between anxiety and clotting factors, others determine a positive correlation between panic and increased clotting in the blood.

In turn, this leads to higher levels of D-dimer in the blood. At this time, it appears that studies waver toward a yes; anxiety can cause high D-dimer. However, more testing is needed to clearly establish whether the link exists.