What lifestyle modifications should I recommend to patients with Factor V Leiden to reduce their risk of thrombosis?

For patients with Factor V Leiden mutation, lifestyle modifications to reduce the risk of thrombosis should focus on managing modifiable risk factors such as obesity and avoiding prolonged immobility, especially during long-haul travel or after surgery. Encouraging weight management through a healthy diet and regular physical activity is important to reduce venous thromboembolism (VTE) risk. Patients should be advised to stay well hydrated and to move regularly during periods of immobility, such as long flights or bed rest. Smoking cessation is also recommended as smoking can increase thrombosis risk. Additionally, patients should be informed about the importance of seeking medical advice if they develop symptoms suggestive of deep vein thrombosis (DVT) or pulmonary embolism (PE). The use of graduated elastic compression stockings is not routinely recommended to prevent VTE recurrence but may be used to manage leg symptoms after DVT if appropriate. Patients with Factor V Leiden should be counselled on the importance of carrying an anticoagulant alert card if they are on anticoagulation therapy and informed about the interactions of anticoagulants with other medications, foods, and activities. Family history and personal history of VTE should be considered when assessing risk and planning management, but routine thrombophilia testing in relatives is not recommended. Overall, lifestyle advice should be tailored to individual risk factors and clinical context.