Combined Deficiency of Factor V and Factor VIII

Combined deficiency of factor V and factor VIII is a rare inherited bleeding problem in which the blood has low levels of both factor V (FV) and factor VIII (FVIII) at the same time. These two proteins are clotting factors that help blood form a stable clot when a blood vessel is damaged. In this disorder, their levels are usually around 5–30% of normal, so clots form more slowly and bleeding lasts longer, but bleeding is often mild to moderate rather than extreme. [1]

Combined deficiency of factor V and factor VIII is a very rare inherited bleeding disorder where a person has low levels of two clotting factors at the same time: factor V (FV) and factor VIII (FVIII). These proteins normally help blood to form a stable clot after an injury, surgery, or even a small cut. In this condition, both factors are usually reduced to about 5–30% of normal, so clots form slowly and break down more easily, which leads to easy bruising, nosebleeds, heavy periods, and prolonged bleeding after trauma or surgery.[]

This condition is genetic and usually follows an autosomal recessive pattern. This means a child must get a changed gene from both parents to show the disease. The main genes are called LMAN1 and MCFD2. These genes help carry clotting factors from one part of the cell (endoplasmic reticulum) to another part (Golgi). If these genes do not work, factor V and factor VIII are not delivered properly into the blood. [2]

People with this combined deficiency can have nosebleeds, easy bruising, and heavy bleeding after surgery, tooth removal, or childbirth. Some people are diagnosed only when they have abnormal blood clotting tests before an operation. The condition is very rare, about 1 in 1,000,000 in many areas, but more common in regions where marriage between relatives is more frequent, such as parts of the Middle East and North Africa. [3]

This disorder is called “combined deficiency of factor V and factor VIII” or “F5F8D.” It is usually inherited in an autosomal recessive pattern, meaning a child must receive an altered gene from both parents to be affected. The condition is rare (about 1 in 1,000,000 people) but tends to be more common in populations where marriage between relatives is more frequent. Most people have mild to moderate bleeding, but some may have serious bleeding after operations or childbirth.[]

Pathophysiology

Combined deficiency of factor V and factor VIII is not caused by a direct problem in the factor V or factor VIII genes themselves. Instead, it is usually due to changes (mutations) in two other genes, called LMAN1 and MCFD2. These genes produce proteins that work together as a “cargo receptor” in the cell’s secretory pathway. They help transport factor V and factor VIII from the endoplasmic reticulum to the Golgi apparatus, where the factors are prepared and released into the bloodstream. When LMAN1 or MCFD2 are faulty, both factors are not transported correctly, so their levels in the blood fall.[]

Because of this transport problem, factor V and factor VIII are produced but do not appear in normal amounts in the blood. Factor V acts in the “common pathway” of coagulation, and factor VIII works in the “intrinsic pathway.” When both are low, the activated partial thromboplastin time (aPTT) and the prothrombin time (PT) can both be prolonged. Clinically, this leads to a bleeding picture similar to mild hemophilia A or factor V deficiency, with mucocutaneous bleeding (nose, gums, skin) and excessive bleeding with dental work, surgery, or childbirth.[]

Other names

This disorder is known by several other medical names. Doctors sometimes use different names in papers or reports, but they all describe the same problem. [4]

One common name is “combined deficiency of factor V and factor VIII”. This is the most direct and clear name, because it tells us exactly which two clotting factors are low at the same time. You will see this name in rare disease databases and in many case reports. [5]

Another name is “F5F8D”. Here “F5” stands for factor V and “F8” stands for factor VIII, and “D” stands for deficiency. This short code is used in genetic and hematology literature, especially in databases that group many rare blood diseases together. [6]

Some sources call it “factor V and factor VIII, combined deficiency of” or “factor V and factor VIII combined deficiency type 1 or type 2” to separate different genetic forms. Type numbers usually refer to which gene (LMAN1 or MCFD2) is affected. [7]

It may also be listed as “familial multiple coagulation factor deficiency” because two different clotting factors are low due to one inherited problem. This name reminds us that the disease runs in families and involves more than one factor. [8]

Types

Doctors can describe different “types” of combined factor V and VIII deficiency based on genes, factor levels, or how the disease shows in the body. These types are not official separate diseases but practical ways to group patients. [9]

LMAN1-related type (Type 1) is the form where changes (mutations) are found in the LMAN1 gene. This gene makes part of a transport protein in cells. When it is faulty, factor V and factor VIII cannot move properly from the cell factory (endoplasmic reticulum) to the packaging center (Golgi), so their levels in blood fall. [10]

MCFD2-related type (Type 2) happens when the main problem is in the MCFD2 gene. The MCFD2 protein works together with LMAN1 as a complex. If MCFD2 is abnormal, the complex cannot carry the two clotting factors correctly. Clinically, bleeding signs are similar to the LMAN1 type, but genetic testing can separate them. [11]

Some experts talk about congenital (inherited) combined deficiency as the classic form, caused by gene changes present from birth. Almost all confirmed cases in the literature are congenital. Bleeding may first appear in childhood, but sometimes diagnosis is delayed until an operation or pregnancy reveals abnormal bleeding. [12]

Doctors may also describe mild, moderate, and severe forms based on how low the factor levels are and how bad the bleeding is. Many patients have mild to moderate symptoms, with factors V and VIII between about 5% and 30% of normal, but serious bleeding can occur after big surgery or trauma. [13]

Very rarely, some people have acquired combined low factor V and VIII due to other illnesses such as severe liver disease or widespread clotting problems. This looks similar in lab tests, but the underlying cause is different and the genes may be normal. These cases are usually not called “classic” combined factor V and VIII deficiency, but doctors must think about them in the differential diagnosis. [14]

Causes

1. LMAN1 gene mutation
The most important proven cause is a harmful mutation in the LMAN1 gene. This gene makes a cargo receptor protein that helps carry factor V and factor VIII inside liver cells before they are released into the blood. When LMAN1 does not work, both factors cannot be transported correctly, and their levels drop together. [15]

2. MCFD2 gene mutation
Another main cause is mutation in MCFD2, which forms a complex with LMAN1. MCFD2 binds to factors V and VIII and helps LMAN1 move them. If MCFD2 is changed, the complex cannot hold and carry these proteins, so they remain trapped inside the cell, and blood levels fall. [16]

3. Autosomal recessive inheritance
The disorder is passed in an autosomal recessive way. This means a person must receive one faulty gene from each parent. Parents often have one normal and one faulty copy and usually have normal clotting. When both parents are carriers, each child has a one-in-four chance to have the disease. [17]

4. Consanguineous marriage (parents related by blood)
When parents are related (for example cousins), they are more likely to share the same rare faulty gene. In several reports, combined factor V and VIII deficiency is more common in families and populations with consanguineous marriages, because the chance of a child inheriting two faulty copies increases. [18]

5. Founder mutations in certain regions
In some countries, such as parts of the Middle East and North Africa, the same mutation appears in many unrelated families. This suggests a “founder mutation,” where one old mutation was passed down through many generations. This pattern can raise local disease frequency even when the condition is very rare worldwide. [19]

6. Combined trafficking defect in the ER-Golgi pathway
Even when we speak in simple words, it helps to know that factor V and VIII must travel inside liver cells from the endoplasmic reticulum to the Golgi. The LMAN1–MCFD2 complex acts as a shuttle. Any defect that disturbs this cargo system can cause both factors to be low at the same time, which is the biological cause of the combined deficiency. [20]

7. Rare changes in other helper genes
A few patients may have changes in other, less well-known genes that help LMAN1 and MCFD2 or help fold and prepare factor V and VIII. Scientific studies suggest there may be more genes to discover, although most known families have mutations only in LMAN1 or MCFD2. [21]

8. Severe liver disease (acquired combined low FV and FVIII)
The liver makes almost all clotting factors. In serious liver disease, factor V and factor VIII can both fall, along with other factors. This is not the classic inherited form, but it is an important acquired cause of combined low levels and may confuse the diagnosis until liver tests clarify the situation. [22]

9. Disseminated intravascular coagulation (DIC)
In DIC, widespread clotting in small vessels uses up many clotting factors and platelets. Factor V and VIII can both become very low. Again, this is acquired and usually acute, often linked to sepsis, trauma, or obstetric problems. It can mimic inherited bleeding disorders but has a very different cause and course. [23]

10. Massive transfusion with factor-poor fluids
Very large volumes of red cells or fluids that do not contain plasma can dilute clotting factors, including V and VIII. This dilutional coagulopathy is usually temporary and improves with proper plasma replacement. It is not genetic but may cause short-term combined low levels on blood tests. [24]

11. Vitamin K deficiency and multiple factor loss
Vitamin K is needed for several clotting factors, but not directly for factor V and VIII. However, in complex illnesses with vitamin K deficiency, malnutrition, or antibiotic use, several factors may be low, and clotting tests can be very abnormal. This may make doctors first suspect a combined factor deficiency before detailed factor assays are done. [25]

12. Chemotherapy or toxic damage to liver cells
Some strong cancer drugs and toxins can damage liver cells, lower clotting factor production, and lead to reduced factor V and VIII levels. Again, this is acquired and usually occurs in very ill patients, but it may confuse the picture and requires careful lab work to separate from inherited disease. [26]

13. Autoimmune disorders affecting clotting factors
Autoantibodies can sometimes attack clotting factors, especially factor VIII (acquired hemophilia A). In rare complex autoimmune states, more than one factor might be affected. This is different from the classic genetic combined deficiency but can cause similar bleeding and abnormal laboratory tests. [27]

14. Severe malnutrition and protein loss
Clotting factors are proteins. Extreme protein malnutrition, or protein loss through kidney or gut disease, can lower many blood proteins, including clotting factors. This may cause milder combined decreases in factor V and VIII and add to bleeding risk in vulnerable patients. [28]

15. Neonatal liver immaturity
In newborn babies, the liver is still maturing. Many clotting factors are naturally lower at birth. In a baby who also has genetic combined deficiency of factor V and VIII, these immature levels can make bleeding worse. This is why some cases are noticed after circumcision or birth-related bleeding. [29]

16. Co-existing von Willebrand disease
Von Willebrand factor protects factor VIII from breakdown. If a person has both combined factor V and VIII deficiency and a separate von Willebrand disease, factor VIII levels can fall even more, and bleeding can be heavier. This combination is rare but important when evaluating unusual bleeding. [30]

17. Pregnancy-related changes
Pregnancy normally raises many clotting factors, including factor VIII, but can also unmask clotting problems during childbirth. In a woman with combined deficiency, the stress of labor and delivery, plus blood loss, can reveal the disease with heavy postpartum bleeding. [31]

18. Surgical trauma in undiagnosed patients
In some people, the combined deficiency is only discovered when they bleed too much during or after surgery or dental extraction. The surgery is not the real cause of the disease, but it reveals the underlying genetic problem because normal clot formation is not strong enough to stop the surgical bleeding. [32]

19. Co-existing platelet function problems
If a person with combined factor V and VIII deficiency also has a separate platelet disorder, such as Bernard–Soulier syndrome or mild platelet dysfunction, the two problems together can markedly increase bleeding risk and severity. Platelets and clotting factors must both work well for normal hemostasis. [33]

20. Unknown or not yet discovered factors
Finally, some families may show a pattern of bleeding and lab results that fits combined factor V and VIII deficiency, but no clear mutation is found even after modern testing. In these rare cases, doctors believe there may be other unknown genes or regulatory factors that have not yet been fully discovered. [34]

Symptoms

1. Easy bruising
Many patients notice bruises on the skin after very small bumps or even without remembering any injury. The bruises may be larger and darker than usual and stay for many days. This happens because the body cannot form a firm clot quickly, so more blood leaks into the tissues when tiny vessels are damaged. [35]

2. Frequent nosebleeds (epistaxis)
Repeated nosebleeds are a common sign. Bleeding may start suddenly, be hard to stop, or last longer than 10–15 minutes. It may happen more in dry weather or with minor nose trauma. Because mucous membranes are rich in small vessels, they are especially sensitive to clotting problems. [36]

3. Gum bleeding
The gums may bleed easily when brushing teeth, flossing, or during dental cleaning. Bleeding can also happen after tooth removal and may be prolonged without proper treatment. This symptom is often one of the first to alert dentists and may lead to clotting tests. [37]

4. Heavy menstrual bleeding (menorrhagia)
Women and girls with combined deficiency can have very heavy periods, with large clots or bleeding lasting more than seven days. They may need frequent pad changes or even blood transfusions in severe cases. Heavy menstrual bleeding is one of the most common symptoms in females with bleeding disorders. [38]

5. Prolonged bleeding from small cuts
Small cuts or minor injuries may take much longer than normal to stop bleeding. The bleeding may stop and then restart. This happens because the first plug forms but is not stabilized well by fibrin, which needs properly functioning factor V and factor VIII. [39]

6. Excessive bleeding after surgery
After operations, circumcision, or dental extractions, people with this condition may bleed more than expected or for a long time. Sometimes this is the first clue, especially if pre-operative clotting tests were not done. Surgeons may notice oozing from the wound that does not match the usual surgical risk. [40]

7. Postpartum bleeding in mothers
Women with combined deficiency have a higher risk of heavy bleeding after childbirth. Bleeding may be immediate or delayed. Because pregnancy changes clotting, problems may only appear at delivery, which is why knowing the diagnosis beforehand is important for planning care. [41]

8. Muscle bleeds and deep bruises (hematomas)
Some patients may develop big, painful swellings in muscles after an injury or injection. These deep bruises are called hematomas. They can press on nerves and cause pain, tingling, or weakness, and they may require medical treatment and imaging to rule out serious complications. [42]

9. Joint bleeding (hemarthrosis)
Although joint bleeding is more classic in severe hemophilia A, some patients with combined deficiency can also have joint bleeds, especially if factor VIII is very low. Joints may become swollen, warm, and painful, and repeated bleeds can damage cartilage over time if not properly treated. [43]

10. Blood in urine (hematuria)
There may be visible red or brown urine, or blood may be found only on lab testing. Bleeding can come from the kidneys, bladder, or urinary tract. This symptom always needs medical evaluation to rule out infection, stones, or other causes, besides the underlying clotting problem. [44]

11. Gastrointestinal (GI) bleeding
Patients may have black, tarry stools or bright red blood from the rectum if there is bleeding in the digestive tract. Sometimes this is due to ulcers or small tears, but the clotting disorder makes the bleeding worse or more prolonged. GI bleeding can lead to anemia if not treated. [45]

12. Bleeding after injections or vaccinations
Injection sites may ooze blood or form large bruises. In children, this may be noticed after routine vaccinations. Doctors and nurses may see that the bleeding is more than they expect for a simple needle stick. [46]

13. Prolonged bleeding from umbilical stump or circumcision
In newborns, bleeding from the cord stump or after circumcision that lasts longer than usual, or seems heavy, may be an early sign. This has been reported in case descriptions of children later diagnosed with combined factor V and VIII deficiency. [47]

14. Symptoms of anemia (tiredness, pale skin, dizziness)
Repeated or chronic bleeding can cause anemia, where the hemoglobin level falls. Patients may feel very tired, dizzy, short of breath on exertion, or notice pale skin and inner eyelids. This is not a direct effect of the clotting factor, but a result of blood loss over time. [48]

15. Rare intracranial bleeding (headache, vomiting, seizures)
In rare severe cases, bleeding can occur inside the skull. Symptoms may include severe headache, vomiting, weakness, seizures, or confusion. This is an emergency. Fortunately, most patients with combined factor V and VIII deficiency have milder disease, but brain bleeds are still an important possible complication. [49]

Diagnostic tests

Below are 20 tests that can help doctors diagnose combined factor V and factor VIII deficiency or its complications. They are grouped into physical exam, manual tests, lab and pathological tests, electrodiagnostic tests, and imaging tests. [50]

Physical exam tests

1. General inspection of skin and mucous membranes
The doctor carefully looks at the skin, mouth, nose, and eyes for bruises, tiny red spots (petechiae), gum bleeding, or dried blood in the nose. This simple, hands-on check can show that bleeding is more than normal and helps guide further blood tests. It cannot confirm the exact factor problem but raises suspicion of a bleeding disorder. [51]

2. Joint and muscle examination
The doctor moves and feels the joints, such as knees, ankles, and elbows, and checks muscles for swelling, warmth, tenderness, or reduced movement. Painful, swollen joints or deep muscle lumps may suggest internal bleeding. This exam helps decide if imaging or factor replacement is needed quickly. [52]

3. Abdominal examination
The abdomen is gently pressed to look for pain, swelling, or enlarged liver and spleen. Tenderness or fullness may suggest internal bleeding or underlying liver disease, which can also affect clotting factors. This exam guides whether ultrasound or lab tests should be done. [53]

4. Neurological examination
The doctor checks strength, reflexes, eye movements, balance, and mental status. Changes may hint at bleeding in or around the brain. In a patient with known or suspected clotting problems, abnormal findings on this exam are a warning sign to order emergency brain imaging. [54]

Manual tests

5. Tourniquet (capillary fragility) test
A blood pressure cuff is inflated on the arm for a few minutes, then removed, and the skin is checked for new small red spots. This simple bedside test checks how easily small vessels leak. In combined factor V and VIII deficiency, it may or may not be abnormal, but it can show a general tendency to bleed. [55]

6. Bedside bleeding time test
In some settings, a small standardized skin cut is made, and the time until bleeding stops is measured while gentle filter paper touches the blood. This is an older test of platelet and vascular function. In combined deficiency, bleeding time may be slightly prolonged, but specific factor tests are much more accurate. [56]

7. Capillary refill and nailbed pressure test
By pressing on a fingernail or skin and watching how quickly color returns, doctors get a rough idea of circulation and possible blood loss. Slow refill can suggest shock from heavy bleeding. This is not specific for factor problems, but it is a quick manual check when bleeding is suspected. [57]

Lab and pathological tests

8. Complete blood count (CBC) with platelets
CBC measures hemoglobin, red cells, white cells, and platelets. In combined factor V and VIII deficiency, platelets are usually normal, but hemoglobin may be low if bleeding has been frequent. CBC helps rule out other blood diseases, such as thrombocytopenia, that can also cause bleeding. [58]

9. Prothrombin time (PT) and INR
PT measures the time blood takes to clot through the “extrinsic” pathway. Factor V is part of this pathway, so PT is usually prolonged in this disorder. INR is a standardized form of PT. A high INR suggests that factor V is low, but PT cannot show the exact factor level, so further tests are needed. [59]

10. Activated partial thromboplastin time (aPTT)
aPTT measures the “intrinsic” pathway of clotting, in which factor VIII plays a key role. In combined deficiency, aPTT is usually prolonged because factor VIII is low. The combination of prolonged PT and prolonged aPTT suggests that more than one factor is reduced, guiding doctors toward combined deficiency. [60]

11. Thrombin time and fibrinogen level
Thrombin time shows how well fibrinogen turns into fibrin, the final clot mesh. Fibrinogen is usually normal in combined factor V and VIII deficiency, so an abnormal thrombin time points to other problems. Checking fibrinogen helps rule out DIC or severe liver failure that affect many factors. [61]

12. Specific factor V activity assay
This is a key test. The lab mixes the patient’s plasma with special reagents lacking factor V and measures clotting. Low activity, often 5–20% of normal, confirms factor V deficiency. When this is paired with factor VIII testing, doctors can tell if the patient has combined deficiency or a single-factor problem. [62]

13. Specific factor VIII activity assay
This test measures how active factor VIII is in the blood. Levels are also usually between about 5% and 30% in this disorder. Combined low factor V and factor VIII, with normal levels of other factors, is very suggestive of classic combined deficiency rather than separate hemophilia A or factor V deficiency alone. [63]

14. Mixing studies (PT and aPTT mixing tests)
In mixing studies, patient plasma is mixed with normal plasma. If the problem is due to missing factors (like V and VIII), PT and aPTT will correct toward normal. If an inhibitor antibody is present, the correction does not happen. This helps separate inherited deficiency from autoimmune acquired hemophilia or other inhibitor states. [64]

15. von Willebrand factor tests
Von Willebrand factor antigen and activity tests check for von Willebrand disease, which also affects factor VIII and causes mucosal bleeding. In combined factor V and VIII deficiency, von Willebrand factor is usually normal. Testing it helps distinguish between these conditions, which is important because treatment strategies differ. [65]

16. Genetic testing for LMAN1 and MCFD2
DNA testing can look for mutations in LMAN1 and MCFD2. Finding two faulty copies in one of these genes confirms the diagnosis and allows family screening and genetic counseling. It also helps separate classic combined deficiency from acquired forms with similar clotting tests but different causes. [66]

Electrodiagnostic tests

17. Viscoelastic testing (TEG or ROTEM)
Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are advanced machines that track clot formation and breakdown in whole blood over time using sensors. They are not specific for combined factor V and VIII deficiency but can show a general pattern of weak clot strength and delayed clotting when factors are low, especially during surgery. [67]

18. Electroencephalogram (EEG) in suspected brain bleeding
If a patient with this disorder develops seizures or sudden changes in behavior, doctors may use EEG to record brain electrical activity. EEG does not diagnose the clotting problem itself, but it can show brain irritation from bleeding or scarring. Together with imaging and lab tests, it gives a fuller picture of brain complications. [68]

Imaging tests

19. CT or MRI scan of the head
A CT scan or MRI of the brain is crucial if there are signs of serious headache, vomiting, weakness, or seizures. These imaging tests can detect bleeding inside or around the brain. In patients with combined factor V and VIII deficiency, such scans guide emergency treatment with clotting factor replacement and neurosurgical decisions when needed. [69]

20. Ultrasound or CT of abdomen and pelvis
If internal bleeding is suspected in the belly, ultrasound or CT can show fluid (blood), organ enlargement, or other problems. For example, they can detect hematomas in muscles, liver or spleen injury after trauma, or other sources of bleeding. These imaging tests work together with clotting tests to manage serious bleeding episodes. [70]

Non-pharmacological treatments

These are supportive and lifestyle-based measures used together with medical therapy, not instead of it. Always follow your hematologist’s advice.

1. Bleeding-risk education
Education helps the patient and family understand the disorder, recognize early signs of bleeding, and know when to seek emergency care. Simple teaching about avoiding trauma, planning ahead for surgeries, and informing all healthcare providers can greatly reduce complications. Written care plans and emergency cards are often provided by bleeding-disorder centers.[]

2. Trauma and contact-sport avoidance
Because even minor injuries can cause prolonged bleeding, people are usually advised to avoid high-impact sports (boxing, rugby, wrestling) and risky activities. The purpose is to lower the chance of joint, muscle, or head bleeding. Low-impact exercise is encouraged instead, so patients can stay fit without increasing bleeding risk.[]

3. Use of protective gear
When physical activity is allowed, protective equipment such as helmets, knee pads, and elbow guards can reduce the severity of injuries. This mechanical protection works by cushioning blows and spreading the force over a wider area, so blood vessels are less likely to tear. It is especially useful for children exploring normal play.[]

4. Dental hygiene programs
Regular brushing, flossing, and dental check-ups reduce gum disease and the need for invasive dental procedures, which can cause serious bleeding. The mechanism is simple: healthy gums bleed less and fewer extractions or deep cleanings are needed. Dentists familiar with bleeding disorders may use topical agents and careful techniques to further minimize bleeding.[]

5. Menstrual management plans
Women and girls often need a coordinated plan involving a hematologist and gynecologist to manage heavy periods. Non-drug strategies include menstrual tracking, iron-rich diet, and planning for factor or antifibrinolytic therapy during the heaviest days. The goal is to prevent anemia and reduce the physical and emotional burden of heavy menstrual bleeding.[]

6. Pre-surgical planning and written protocols
Before any surgery or invasive procedure, the team prepares a protocol that describes how and when to give factor replacement, plasma, and antifibrinolytics. This planning ensures that factor V and factor VIII levels are adequate at the time of incision and stay stable afterwards. Proper planning greatly lowers the risk of peri-operative bleeding.[]

7. Pregnancy and delivery care in specialized centers
Pregnant women with combined deficiency of factor V and factor VIII should be followed in centers with high-risk obstetrics and hematology. The mechanism of benefit is early risk assessment, standardized factor targets, and immediate access to blood products. This approach reduces bleeding during delivery and postpartum and protects both mother and baby.[]

8. Iron-balance and anemia monitoring
Chronic blood loss from heavy periods or nosebleeds can cause iron-deficiency anemia. Regular blood counts and iron studies allow early detection. Non-drug management includes dietary advice (iron-rich foods) and planning to reduce bleeding triggers, so the body can maintain normal red blood cell mass and oxygen-carrying capacity.[]

9. Physical therapy after joint or muscle bleeds
If a joint or muscle bleed occurs, guided physical therapy helps restore movement and strength while protecting against re-bleeding. Controlled exercises improve circulation, reduce stiffness, and support surrounding muscles so the joint is more stable. This can prevent chronic pain and disability seen with repeated bleeds.[]

10. Safe home environment modifications
Making the home safer—removing trip hazards, using non-slip mats, and adding adequate lighting—lowers the chance of falls and injuries. The mechanism is purely preventive: fewer falls mean fewer potential internal bleeds, especially in children and older adults with balance problems.[]

11. Nosebleed first-aid training
For frequent nosebleeds, families learn simple measures: sitting up, leaning forward, pinching the soft part of the nose, and applying a cold pack. These steps compress the bleeding vessels and encourage clot formation. Having clear first-aid instructions reduces anxiety and emergency visits.[]

12. Compression and elevation for limb bleeds
RICE-type measures (rest, ice, compression, elevation) are often used with medical therapy. Compression and elevation reduce hydrostatic pressure and slow blood flow into the injured area, helping clots stabilize and swelling to decrease. This non-drug support is particularly useful for muscle and joint bleeds.[]

13. Avoidance of aspirin and NSAIDs without specialist advice
Aspirin and many non-steroidal anti-inflammatory drugs (NSAIDs) affect platelet function and can worsen bleeding. Education about safe pain-relief options helps patients avoid medicines that interfere with clot formation, reducing bleeding risk during everyday illness or injury.[]

14. Medical alert identification
Wearing a medical alert bracelet or carrying an emergency card allows doctors to quickly know about the bleeding disorder in accidents or emergencies. This speeds up proper lab testing and treatment and helps avoid harmful drugs such as certain anticoagulants.[]

15. Psychosocial support and counseling
Living with a rare bleeding disorder can cause anxiety, low mood, or social isolation. Counseling and support groups help patients cope, share experiences, and learn coping skills. Better mental health supports treatment adherence and quality of life.[]

16. School and workplace accommodations
Teachers and employers may need simple accommodations, such as allowing extra time for medical visits, avoiding high-risk physical tasks, and providing safe environments. These adjustments reduce injury risk and help the person remain active in school or work.[]

17. Regular follow-up in a hemophilia or bleeding-disorder center
Specialist centers provide multidisciplinary care, including hematologists, nurses, physical therapists, and counselors. Regular visits help adjust treatment plans, update vaccinations, and provide emergency plans. This integrated approach is associated with better outcomes in rare bleeding disorders.[]

18. Education about infection-safe blood products
Patients learn that modern plasma and factor concentrates undergo viral inactivation and screening to reduce infection risk. Understanding this helps them feel safer about receiving needed transfusions and encourages timely treatment instead of delaying therapy due to fear.[]

19. Telemedicine and remote monitoring
Where available, telehealth visits can be used to discuss new symptoms, plan surgeries, or adjust therapy without frequent travel. This improves access to expert advice and allows quicker reaction to early warning signs of serious bleeding.[]

20. Genetic counseling for families
Genetic counseling explains inheritance patterns, carrier status, and options for testing other family members. It helps couples understand recurrence risks and supports informed decisions about future pregnancies, early testing, and planned delivery in appropriate centers.[]

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Drug treatments for combined deficiency of factor V and factor VIII

Always remember: exact dosing, timing, and product choice must be decided by a hematologist, using official prescribing information and lab tests. The medicines below are commonly used to manage bleeding or prevent it around surgery in this disorder, often extrapolating from experience in hemophilia A or factor V deficiency.

1. Fresh frozen plasma (FFP)
FFP contains all clotting factors, including factor V and factor VIII, so it is the main way to replace factor V, which is not available as a purified concentrate. It is given intravenously before surgery or during significant bleeding to raise factor levels into a safer range. Dose and infusion speed are based on body weight and response, guided by PT, aPTT, and factor assays.[]

2. Virally inactivated plasma or solvent–detergent plasma
These specialized plasma products provide similar factor replacement to standard FFP but undergo extra viral inactivation steps. They are often used in centers that prefer standardized pooled plasma with reduced infection risk. Doses are similar to FFP and are adjusted to achieve safe factor V and VIII levels during bleeding or operations.[]

3. Cryoprecipitate
Cryoprecipitate is a plasma component rich in factor VIII, fibrinogen, von Willebrand factor, and factor XIII, but it contains little factor V. It can be combined with FFP to optimize factor VIII levels in patients who need both factors corrected. Dosing is weight-based and guided by factor VIII activity tests and clinical response.[]

4. Recombinant factor VIII (e.g., octocog alfa – ADVATE)
Recombinant factor VIII concentrates, such as octocog alfa, are licensed for hemophilia A and used off-label to correct factor VIII deficiency in F5F8D. They are given intravenously, with the dose calculated from body weight and the desired rise in factor VIII activity, according to the official label. They do not correct factor V deficiency, so they are often combined with FFP.[]

5. Other recombinant factor VIII products (e.g., KOGENATE FS)
Several recombinant factor VIII brands (such as KOGENATE FS) provide reliable replacement of factor VIII for bleeding episodes, peri-operative management, or prophylaxis in hemophilia A. In combined factor V and VIII deficiency, these products may be used similarly but always along with plasma support for factor V. Product labels describe weight-based dosing and monitoring with factor VIII assays.[]

6. Plasma-derived factor VIII concentrates
Plasma-derived factor VIII products, purified from donated human plasma, are another option when recombinant products are not available. They raise factor VIII activity to target levels needed for surgery or acute bleeding. As with other concentrates, the exact dose is calculated by the hematologist using body weight and desired factor correction.[]

7. Desmopressin (DDAVP) injection
Desmopressin is a synthetic vasopressin analogue that can temporarily increase endogenous factor VIII and von Willebrand factor in patients with mild hemophilia A and similar phenotypes. It is given intravenously or subcutaneously before minor procedures or for mild mucosal bleeds in selected patients whose baseline factor levels respond to a test dose. The FDA label stresses individualized dosing, fluid-intake restriction, and monitoring for hyponatremia and seizures.[]

8. Desmopressin nasal or oral formulations
Intranasal or oral desmopressin formulations exist and may be used in some patients with bleeding disorders, though not all are specifically indicated for hemophilia. They offer a non-injectable option but have different absorption and dosing requirements. The dose must be converted carefully when switching routes, as noted in FDA prescribing information, and the same fluid and sodium precautions apply.[]

9. Tranexamic acid (intravenous)
Tranexamic acid is an antifibrinolytic drug that stabilizes clots by blocking the breakdown of fibrin. Intravenous formulations are FDA-approved to reduce bleeding in patients with hemophilia during and after tooth extraction and are widely used in other surgical settings. Doses are weight-based and adjusted for kidney function, and labels warn about possible thromboembolic events and seizures at high doses.[]

10. Tranexamic acid (oral – e.g., LYSTEDA)
Oral tranexamic acid tablets are approved for heavy menstrual bleeding and used off-label to reduce mucosal bleeding in various inherited bleeding disorders. Tablets are taken several times a day for a limited period (such as during menstrual days), with maximum daily doses defined in the prescribing information. Common side effects include headache, muscle cramps, and gastrointestinal upset; there is also a warning about clotting risk.[]

11. ε-Aminocaproic acid
Aminocaproic acid is another antifibrinolytic agent used to stabilize clots, especially in the mouth and urinary tract. It may be given orally or intravenously before and after dental or ENT procedures. It works by blocking plasmin, the enzyme that digests fibrin clots, thereby reducing re-bleeding from fragile mucosal surfaces.[]

12. Fibrin sealants and topical hemostatic agents
Topical fibrin glues, gelatin sponges, and oxidized cellulose pads are applied directly to a surgical or dental wound to control local bleeding. These products provide a physical matrix and, in some cases, active clotting proteins that help form a stable clot at the site. They are used as adjuncts, not replacements, for systemic factor therapy.[]

13. Prothrombin complex concentrates (PCCs)
PCCs contain factors II, VII, IX, and X and are not designed to replace factors V or VIII. However, in complex bleeding situations, especially with other coagulopathies, they may be considered by specialists to support thrombin generation. Because of thrombotic risk, their use must follow strict expert protocols and is not routine in isolated F5F8D.[]

14. Recombinant activated factor VII (rFVIIa)
rFVIIa can bypass some parts of the coagulation pathway and is used as a rescue product in life-threatening bleeding or surgery when conventional factor replacement is not sufficient. It directly activates factor X on the surface of platelets, helping to generate thrombin even when factors V and VIII are low. Because of cost and thrombosis risk, it is reserved for selected situations by experienced teams.[]

15. Hormonal therapies for heavy menstrual bleeding
Combined oral contraceptive pills, progestin-only methods, or hormonal intrauterine devices can reduce menstrual blood loss. They work by stabilizing the endometrium and reducing the number of days and amount of bleeding each cycle. Treatment choice, dosing, and contraindications (for example, smoking, thrombosis risk) must be evaluated by a gynecologist and hematologist together.[]

16. Iron supplements (oral)
Chronic bleeding can cause iron-deficiency anemia, so oral iron tablets or liquids are often prescribed. They provide elemental iron that the body uses to build hemoglobin and restore red blood cell mass. Dose, duration, and monitoring are guided by blood counts and iron studies; side effects include stomach upset and constipation.[]

17. Intravenous iron preparations
When oral iron is not tolerated or anemia is severe, intravenous iron infusions can quickly replenish iron stores. These formulations deliver iron directly into the bloodstream, bypassing gut absorption problems. They require monitoring for infusion reactions and are usually given in hospital or infusion centers.[]

18. Red blood cell transfusions
In cases of severe acute blood loss or profound anemia, packed red blood cell transfusions may be necessary. They do not correct the clotting defect but restore oxygen-carrying capacity and stabilize blood pressure. They are always combined with measures to control the underlying bleed, such as plasma and factor concentrates.[]

19. Platelet transfusions (special situations)
If there is an associated platelet function defect or very heavy ongoing bleeding, platelet transfusions might be used. Platelets provide a surface for clot formation and carry some factor V within their granules. They are not standard therapy for uncomplicated F5F8D but may support hemostasis in complex cases.[]

20. Antifibrinolytic mouthwashes
Special tranexamic acid mouthwashes or solutions are sometimes used after dental procedures. Patients are instructed to hold the solution in the mouth for a specified time and then spit it out. This delivers a high local concentration of antifibrinolytic at the wound surface, helping clots stay in place and reducing re-bleeding.[]

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Dietary molecular supplements

These supplements do not replace factor therapy but may support general blood and vessel health. Always discuss supplements with your doctor, especially if you are a teenager or take other medicines.

1. Elemental iron
Elemental iron, taken as ferrous sulfate or similar forms, supplies the iron needed to make hemoglobin and red blood cells. In patients with chronic bleeding, it helps correct or prevent anemia so the body can deliver enough oxygen to tissues. Dose and duration are chosen based on age, body weight, and blood tests, and should follow medical advice.[]

2. Folic acid
Folic acid supports DNA synthesis and red blood cell production in the bone marrow. In people with ongoing low-grade blood loss, adequate folate intake helps maintain a healthy red cell count and prevents macrocytic anemia. It is usually taken once daily in low doses; high doses should only be used on a doctor’s advice.[]

3. Vitamin B12
Vitamin B12 is needed for nerve function and red blood cell production. Deficiency may worsen anemia and fatigue in patients who already lose blood. Oral or injectable B12 is given if levels are low; the dose and schedule depend on the cause (dietary lack, absorption problems) and medical guidance.[]

4. Vitamin C
Vitamin C helps the body absorb iron from plant-based foods and supports collagen formation in blood vessel walls. Stronger vessel walls may be less prone to tiny leaks and bruises. Daily intake can come from fruits and vegetables or low-dose supplements, but very high doses may cause stomach upset and should be avoided without medical advice.[]

5. Vitamin K (only under medical supervision)
Vitamin K is required for synthesis of several clotting factors (II, VII, IX, X), but combined deficiency of factor V and VIII is not primarily a vitamin K problem. However, if a patient also has vitamin K deficiency from poor diet or intestinal disease, replacement may help overall clotting. Because vitamin K can interact with blood-thinning drugs, it must be used only with specialist supervision.[]

6. Omega-3 fatty acids (with caution)
Omega-3 fatty acids from fish oil support heart and vessel health and may reduce inflammation, but at higher doses they can slightly increase bleeding tendency. In a person with F5F8D, low-dose omega-3 might be acceptable, but only after discussion with a hematologist, who can balance vascular benefits against any bleeding risk.[]

7. Multivitamin with trace elements
A balanced multivitamin containing trace elements like copper and zinc may support general health, immune function, and wound healing. It does not correct the clotting defect but may help the body recover from bleeds and surgery more smoothly. Doses should follow age-appropriate recommendations to avoid vitamin toxicity.[]

8. Protein-rich nutritional supplements
Protein is essential for repairing tissues and making plasma proteins, including clotting factors. When a patient has poor appetite or increased needs after surgery, protein supplements can help maintain muscle mass and support recovery. The amount and type should be chosen with a dietitian, considering kidney and liver function.[]

9. Probiotics (supportive)
Probiotics may help maintain a healthy gut microbiome, which in turn supports nutrient absorption, including iron and vitamins. While they do not directly affect clotting factors, better digestion and reduced gut inflammation can indirectly support blood health. Use products with proven safety and discuss them with a doctor in immunocompromised patients.[]

10. Oral rehydration and electrolyte solutions during bleeding
During episodes of prolonged bleeding or heavy periods, maintaining hydration and electrolytes is important. Oral rehydration solutions provide water, sodium, and glucose to support circulation until medical care and factor replacement are given. They do not stop bleeding but help prevent dizziness and low blood pressure.[]

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Immunity-boosting and regenerative / stem cell–related drugs

At present, there are no FDA-approved stem cell or gene-therapy drugs specifically for combined deficiency of factor V and factor VIII. Most “regenerative” strategies are experimental or aimed at hemophilia A alone. Below are concepts and supportive medicines that sometimes enter discussions; they must not be used without specialist guidance.

1. Gene therapy for hemophilia A (research context)
Gene-therapy trials for hemophilia A use viral vectors to deliver a working F8 gene to liver cells so they can make factor VIII. In theory, similar strategies might one day help patients with combined factor deficiencies, but this is not yet standard care for F5F8D. Doses and protocols remain confined to clinical trials with strict safety monitoring.[]

2. Liver-directed gene transfer research
Because many clotting factors are produced in the liver, some experimental therapies target liver cells to improve factor production. For combined deficiency of factor V and factor VIII, modifying the transport machinery (LMAN1/MCFD2) would be complex and is still a research idea, not a practical therapy. Patients should be counseled that current management remains based on plasma and factor replacement, not gene repair.[]

3. Hematopoietic stem cell transplantation (HSCT – theoretical)
In theory, HSCT can cure some inherited blood disorders by replacing the patient’s blood-forming cells. However, for F5F8D the defect involves protein transport in many cells, and HSCT carries substantial risk and is not standard therapy. It might only be considered in extremely rare, complex cases with additional diseases, under research or compassionate-use protocols.[]

4. Erythropoiesis-stimulating agents (for severe anemia)
In people with major chronic anemia who cannot maintain hemoglobin despite iron therapy, erythropoiesis-stimulating agents (ESAs) may be considered. These medicines act on the bone marrow to increase red blood cell production, reducing transfusion needs. They do not correct the clotting defect and are prescribed only after careful benefit–risk evaluation.[]

5. Vaccination and infection-prevention strategies
Good immune function indirectly supports recovery from surgery and bleeding episodes. Staying up to date on vaccines (especially hepatitis A and B for patients receiving blood products) protects the liver and reduces the risk of infections that could complicate treatment. These are standard preventive measures rather than disease-specific “immune boosters.”[]

6. Experimental small-molecule chaperones (future concept)
Because F5F8D results from faulty transport of factor V and factor VIII, future drugs might act as “chaperones” to help the transport proteins fold or function better. So far, this concept is mainly theoretical and discussed in scientific literature rather than clinical trials. Patients should understand that such treatments are not yet available and should not buy unregulated products claiming to “fix” clotting factors.[]

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Surgical and procedural management

1. Elective surgery with planned factor and plasma replacement
Before planned operations (such as appendectomy or orthopedic surgery), doctors correct factor V and factor VIII levels with plasma and factor VIII concentrate. The goal is to reach and maintain safe factor levels during and after surgery until the wound is healed. Careful planning and monitoring greatly reduce blood loss and the need for emergency transfusions.[]

2. Dental extractions and oral surgery
Dental work is a common bleeding trigger. Management usually includes local anesthesia with vasoconstrictors, antifibrinolytic mouthwash or tablets, plasma and/or factor VIII concentrate, and topical hemostatic agents. The purpose is to allow safe tooth removal or gum surgery while keeping bleeding under control during and after the procedure.[]

3. Obstetric procedures and cesarean section
Pregnancy and delivery require detailed protocols in women with F5F8D. For vaginal or cesarean delivery, factor levels are raised with plasma and factor VIII concentrate and maintained for several days postpartum. This approach lowers the risk of postpartum hemorrhage and allows safe use of obstetric procedures such as induction or operative delivery when needed.[]

4. Emergency surgery or trauma management
In emergencies such as accidents or acute abdominal surgery, treatment focuses on rapid plasma and factor replacement, local hemostasis, and transfusion support. Because there is little time for detailed testing, doctors often use weight-based “loading” doses followed by lab-guided adjustments. The aim is to stabilize the patient quickly and prevent life-threatening bleeding.[]

5. Management of intracranial or spinal bleeding
If severe head injury or spontaneous intracranial hemorrhage is suspected, urgent imaging and neurosurgical evaluation are needed. Factor V and VIII levels must be corrected as quickly as possible, and surgery may be required to relieve pressure. Early recognition and aggressive replacement therapy are crucial for survival and to reduce long-term neurological damage.[]

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Prevention and lifestyle measures

1. Have regular check-ups with a hematologist or bleeding-disorder center, even if you feel well.[]

2. Avoid high-risk sports and unsafe activities that could lead to serious falls or head injuries.[]

3. Tell every healthcare provider (including dentists and pharmacists) that you have combined deficiency of factor V and factor VIII before any procedure or new medicine.[]

4. Use safe pain relief, avoiding aspirin and many NSAIDs unless your hematologist approves an option.[]

5. Keep vaccinations up to date, especially hepatitis A and B, to protect the liver and reduce infection risks from blood products.[]

6. Maintain good dental hygiene to reduce gum bleeding and the need for extractions.[]

7. Plan pregnancies and surgeries early with your hematology team so a written protocol is ready.[]

8. Wear a medical alert bracelet or card describing your diagnosis and emergency contact information.[]

9. Monitor for anemia (fatigue, pale skin, shortness of breath) and follow iron and vitamin plans as prescribed.[]

10. Seek psychological and social support to cope with the stress of living with a chronic rare condition.[]

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When to see doctors

You should have regular planned visits with a hematologist to review bleeding history, lab results, treatment plans, and lifestyle issues. However, there are also situations where you should seek urgent medical care. These include heavy or persistent nosebleeds that do not stop with first aid, bleeding that soaks through dressings or pads, black or bloody stools, vomiting blood, sudden severe headache, confusion, weakness, or any head injury. These signs may indicate serious internal bleeding that needs immediate factor replacement and hospital care.[]

Women should contact their doctor if periods are so heavy that they need to change pads or tampons every hour, if they pass large clots, or if they feel dizzy or faint during menstruation. Anyone scheduled for surgery, dental extraction, or invasive tests (like biopsies or endoscopy) should inform the hematology team in advance so preventive treatment can be organized. Early contact allows safe planning and reduces the chance of emergency bleeding problems.[]

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What to eat and what to avoid

1. Eat iron-rich foods such as lean red meat, poultry, fish, lentils, beans, and dark leafy greens to help prevent anemia from chronic bleeding.[]

2. Combine plant iron with vitamin C-rich foods (like citrus fruits, tomatoes, or bell peppers) to improve iron absorption from meals.[]

3. Include adequate protein from eggs, dairy, legumes, and lean meats to support tissue repair and plasma protein production.[]

4. Maintain a balanced intake of folate and vitamin B12 through foods like leafy greens, fortified cereals, milk, and lean meats, to support red blood cell production.[]

5. Limit alcohol, which can damage the liver—the organ that makes many clotting factors—and worsen bleeding problems.[]

6. Avoid crash diets or extreme fasting, which may reduce essential nutrients needed for blood and vessel health.[]

7. Be cautious with herbal products that may thin the blood (for example, ginkgo, garlic, ginseng) and always discuss them with your doctor.[]

8. Stay well hydrated, especially during bleeding episodes or heavy periods, to support circulation and blood pressure.[]

9. Avoid unnecessary high-dose omega-3 supplements without medical advice because they can slightly increase bleeding risk.[]

10. Follow any specific dietary plans from your hematologist or dietitian, especially if you also have kidney, liver, or weight-related conditions.[]

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Frequently asked questions ( FAQs)

1. Is combined deficiency of factor V and factor VIII the same as hemophilia?
No. Hemophilia A is caused by isolated factor VIII deficiency, usually due to mutations in the F8 gene. In combined deficiency of factor V and factor VIII, both factors are low because of mutations in transport genes (LMAN1 or MCFD2). The bleeding pattern can look similar to mild hemophilia, but the underlying biology and treatment planning are different.[]

2. How common is this condition?
Combined deficiency of factor V and factor VIII is very rare, affecting around 1 in 1,000,000 people. It is more frequently reported in populations with high rates of consanguinity, such as some Middle Eastern and Mediterranean groups. Because it is so uncommon, many doctors may not have seen a patient with this condition before.[]

3. Can I live a normal life with this disorder?
Many people with combined deficiency of factor V and factor VIII lead active lives, attend school, work, and have families. The key is awareness, regular specialist follow-up, and proper planning for surgeries, dental work, and pregnancy. With modern plasma and factor therapies, severe complications can often be prevented or managed effectively.[]

4. Will my children definitely have the disease?
No. Because the condition is usually autosomal recessive, both parents must be carriers for a child to be affected. If both parents are carriers, each pregnancy has a 25% chance of an affected child, 50% chance of a carrier child, and 25% chance of a child with no mutation. Genetic counseling can provide individualized risk estimates.[]

5. How is the disorder usually discovered?
It is often detected when routine clotting tests before surgery show prolonged PT and aPTT, or when someone has unexpected heavy bleeding after dental extraction or tonsil surgery. Further factor testing reveals low factor V and factor VIII, and genetic testing may confirm LMAN1 or MCFD2 mutations. Sometimes it is found during investigation of very heavy menstrual bleeding.[]

6. Do I need treatment all the time?
Most patients do not need continuous daily factor replacement. Instead, treatment is usually “on demand” during bleeding episodes and “prophylactic” around high-risk times such as surgery, childbirth, or major dental work. Women with very heavy periods may need repeated planned courses of therapy every month.[]

7. Are there long-term complications?
If bleeding is well controlled, long-term complications may be few. However, repeated joint or muscle bleeds can cause chronic pain and arthritis, and severe untreated anemia can cause fatigue and heart strain. Good preventive care and prompt management of bleeds help avoid these problems.[]

8. Is there a cure?
At present, there is no simple cure such as a tablet or injection that permanently corrects the transport defect. Liver transplantation or stem cell transplantation are not standard cures for this condition. Research into gene therapy and other advanced treatments may change future options, but current care is based on plasma, factor concentrates, and supportive therapies.[]

9. Can I have vaccinations safely?
Yes. Vaccinations are very important, especially against hepatitis A and B if you receive blood products. Most vaccines are given as standard, though sometimes doctors prefer subcutaneous rather than intramuscular injection and may use pressure afterward to reduce local bleeding.[]

10. What should I do if I have a head injury?
Any significant head injury, especially if followed by headache, vomiting, confusion, or drowsiness, is an emergency. You should go to hospital immediately, tell staff about your bleeding disorder, and expect rapid factor and plasma replacement and brain imaging. Early treatment can be life-saving.[]

11. Are all antifibrinolytic medicines safe for me?
Antifibrinolytics like tranexamic acid are widely used in inherited bleeding disorders, but they can increase the risk of blood clots in some situations. The dose and route must follow official prescribing information and your personal risk profile. Your hematologist will advise when and how to use them safely.[]

12. Can I take herbal or “natural” blood-thinning products?
Many herbal supplements advertised for heart or brain health can affect platelets or clotting and increase bleeding risk. Because combined deficiency of factor V and factor VIII already causes bleeding problems, you should not take such products without speaking to your doctor. Evidence for their benefit is often limited, but bleeding risks may be real.[]

13. Does this disorder affect school, sports, and travel?
You can usually attend school and travel, but some adjustments are needed. High-impact sports are discouraged, and teachers or coaches should know about emergency plans. For travel, carry a summary letter, extra medicines if prescribed, and information on the nearest bleeding-disorder center at your destination.[]

14. Is combined deficiency of factor V and factor VIII always diagnosed in childhood?
Not always. People with milder forms may only be diagnosed in adulthood, for example during pregnancy, before major surgery, or after unexpected surgical bleeding. Increased awareness among clinicians has led to more diagnoses in recent years.[]

15. Where can my family find expert help and information?
Families can seek care at hemophilia or rare bleeding-disorder centers, university hospitals, or specialized coagulation clinics. Many countries have patient organizations that provide education, support, and links to expert centers. Your local hematologist can direct you to recognized resources and registries for rare bleeding disorders.[]

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: February 13, 2025.