Coumadin Green Vegetables
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interaction of green leaf vegetables and coumadin? pre ion

lady T replied: "green leafy veggies have alot of vit. K. vitamin K counteracts the effects of coumadin.. coumadin increases the bloods clotting time... (the blood doesn't clot as fast as it normally would) vitamin K reduces the bloods clotting time. vitamin K is often given to patients before surgeries, especially if they have been taking coumadin, warfarin or asparin... all of which increase the clotting time."

tom5551 replied: "Coumadin (warfarin) is a vitamin K depressant. Vitamin k is a necessary compnonent of two of the factors out of 13 that come togethor to cause clotting. Depressing Vitamin K slows clotting. Green leafy vegatables are high in Vitamin K so people who are on coumadin treatment occasionally have to have dosages adjusted because of diet. Technically there is no interaction, green leafy vegatables do not affect coumadin at all, they do put more vitamin k into the body which must then be compensated for by increasing the dosage of coumadin."

I know someone that had a mitral valve replaced because of leakage. She is now taking Coumadin and was told? she could not have some dark green vegetables or Vitamin K by the doctor . She likes to eat healthy foods so this makes planning meals a little more difficult. Has anybody else had this experience or know anything about this drug..? She wants to know the reason that she was taken off of baby aspirin and put on Coumadin. She wants to know the reason that she was taken off of baby aspirin and put on Coumadin.

Equisetum replied: "Vitamin K is vital in helping blood to clot. Coumadin works by blocking this pathway. If one day she eats lots of leafy green vegetables, with all that vitamin K they contain, her blood will not be sufficiently anti-coagulated. Her INR results will be all over the place, and her dosage will have to be adjusted constantly."

cardiophile replied: "Vitamin K antagonises the effect of Coumadin. So foods containing Vitamin K will neutralise the effect of the drug, leading to clot formation in the replaced valve, which is a dangerous situation. Whatever vegetables she is planning to take should be in a regular fashion so that her doctor can adjust the dose of Coumadin accordingly. If she takes Vitamin K containing vegetables without the doctor's knowledge, doctor will adjust the dose to a higher level, seeing the INR test result at a lower level. Then if she stops taking the vegetables, the INR will go high and she will have bleeding manifestations. Baby aspirin is not enough to prevent clot formation in a mechanical valve, Coumadin is required."

The Doc replied: "Yeah, the reason she can't have food that contains a lot of vitamin K is because the way warfarin causes anticoagulation (blood thinning) is by interfering with the body's ability to use that vitamin, which is necessary to make several proteins which are necessary for proper clotting. So if you eat lots of vitamin K, you're actually taking the antidote to warfarin, we even use it in the hospital to reverse the effects if somebody comes in with a very high INR (indicating too much anticoagulation). It's just the way the drug works, nothing can be done to change that, it's really the only effective oral anticoagulant we have."

Dr. C replied: "Patients with mechanical mitral valves (vs. bioprosthetic) need life-long anticoagulation because they may have a high rate of red blood cell destruction due to valve-blood interactions. Aspirin alone is not enough. Patients with bioprosthetic valves (tissue valves) generally do not need warfarin (Coumadin). Warfarin works by preventing the body from turning vitamin K into various clotting factors. Its effectiveness is measured by an INR. Vitamin K is found in green leafy vegetables. As a result, eating a diet high in vitamin K may make the warfarin less effective, requiring a higher dose. However, contrary to most doctor's beliefs, patients should NOT completely avoid eating vitamin K sources when on warfarin. It is true that patients with low vitamin K intake need lower Coumadin doses to achieve a therapeutic INR. However, they are more likely to have an unstable INR, spend less time in a therapeutic INR range, and at higher risk for complications due to a very high INR (bleeding) or very low INR (clotting, red blood cell destruction). Patients should continue to eat regular, small amounts and avoid large meals of these vegetables. A 1/2 cup of spinach is enough to alter your INR. In fact, there is even evidence that regular supplementation with vitamin K can improve INR stability. You or your acquaintance should discuss her concerns with her physician."

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