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Introduction Many people with glaucoma take nutritional supplements to support eye health. Common examples are fish oil (omega-3 fatty acids), Ginkgo biloba, garlic, curcumin (turmeric), and combinations like Mirtogenol (pine bark extract plus bilberry). These supplements can have blood-thinning effects by interfering with clotting. Taking several at once (stacking) can amplify those effects. In glaucoma patients, too much blood thinning may lead to more optic disc hemorrhages (small bleeds on the optic nerve) and worse outcomes after eye surgery. This article explains how each supplement works on blood clotting, how their effects can add up, and what patients and doctors can do to manage the risk.Blood-Thinning Supplements and How They Work Fish oil (Omega-3 fatty acids). Fish oil pills provide omega-3 fats (like EPA and DHA) that change the behavior of platelets. Animal and lab studies show omega-3s can inhibit platelet aggregation (). In other words, they make platelets less “sticky,” similar to low-dose aspirin. Most clinical trials have not found massive bleeding from fish oil alone, but several case reports warn of trouble when it is combined with other blood thinners. For example, high doses of omega-3 in a patient taking warfarin (plus aspirin) were linked to dangerously high INR (clotting times) and even a subdural brain hemorrhage after a minor fall (). Thus, fish oil can add to bleeding risk, especially if you’re on other anticoagulants.Ginkgo biloba. Ginkgo leaf extract contains compounds (ginkgolides) that block platelet-activating factor (PAF) (). This effect thins the blood in lab and animal models. In one short clinical study, ginkgo did reduce platelet clumping, though routine clotting tests often stay normal. Still, many reports link ginkgo use to serious bleeds when taken with other anticoagulants. Case reports include spontaneous eye hemorrhages (hyphema), brain bleeds, and excess surgical bleeding in people using ginkgo along with aspirin or warfarin (). In fact, large patient databases show a 38% higher risk of major bleeding when people on warfarin also took ginkgo (). Because of this, guides warn against using ginkgo with any blood thinners.Garlic. Garlic (Allium sativum) contains allicin and related molecules that inhibit platelets in a dose-dependent way (). In practical terms, eating normal amounts of garlic is generally safe, but high-dose garlic supplements (or aged garlic extracts) can measurably reduce platelet function. There are case reports of garlic boosting INR in patients on warfarin and causing bruising or bleeding sometimes (). For example, one case report showed that adding garlic supplements to warfarin unexpectedly raised the clotting time (INR) (). Overall, garlic’s antiplatelet effect is weaker than aspirin’s, but when combined with other agents it can contribute to bleeding.Curcumin (Turmeric). The turmeric compound curcumin is a natural anti-inflammatory suspected of blood-thinning effects. Laboratory studies show curcumin blocks platelet activation and aggregation by interfering with enzymes like cyclooxygenase and lipoxygenase (). In other words, curcumin stops the formation of clot-promoting molecules (like thromboxane) and reduces calcium signaling in platelets (). While there are few large human trials on bleeding risk, curcumin’s antiplatelet effect is well documented in animals and in vitro. A recent case report also described a 74-year-old man on clopidogrel