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Anticoagulation
Coumadin® and You : The Art of Eating
Usually for most, the decision of what to eat can often be the easiest decision. For a patient on Coumadin® this simple decision is not so easy. There are many things to consider since any sudden changes in your diet, such as crash dieting, may affect warfarin's action.
In particular, the amount of vitamin K in your diet will alter the effect of warfarin, because it is used by your liver to manufacture clotting proteins. For example, during the summer months many people increase their intake of vegetables high in vitamin K (see list below), which increases the amount of warfarin required to maintain adequate blood thinning.
FOOD |
Approx. 100 gs |
Vitamin K micrograms |
High vitamin K content |
| Alfalfa |
punnett |
425-850 |
| Spinach |
3 cups raw |
240 |
| Broccoli |
2 stems and flower cluster raw |
200 |
| Lettuce |
2 large head leaves |
200 |
| Soya beans |
3 tablespoons |
190 |
| Cabbage |
1 cup shredded raw |
125 |
| Beef liver |
100 grams |
100 |
| Wheat bran |
2 cups |
80 |
| |
Intermediate vitamin K content |
| Bacon |
1 large rasher |
46 |
| Wheat germ |
1 cup |
37 |
| Cheese |
100 grams |
35 |
| Butter |
5 tablespoons |
30 |
| Pork liver |
100 grams |
25 |
| |
Low vitamin K content |
| Asparagus |
7 spears |
21 |
| Potatoes |
1 medium |
20 |
| Oats |
1 cup |
20 |
| Green peas |
1 cup |
19 |
| Ham |
3 slices |
15 |
| Carrots |
1 cup raw |
15 |
| Green beans |
1 cup sliced raw |
15 |
| Strawberries |
12-14 medium |
13 |
| Whole eggs |
100 grams |
11 |
| Minced beef |
100 grams |
7 |
| Chicken liver |
100 grams |
7 |
| Tomato |
1 medium |
5 |
| Cow's milk |
100 ml |
5 |
| Apple, banana, orange |
1 medium piece |
less than 5 |
| Wheat flour |
1 cup |
4 |
| Bread |
3-4 slices |
4 |
Today's nutrition is an essential component of Warfarin Therapy. One should always be aware of their Vitamin K intake; however, it is important to know that you do not need to entirely avoid foods containing vitamin K if you use blood-thinning medications.
Individuals receiving blood-thinning medications are monitored with daily blood testing at first and frequently afterward to see if the medication is doing its job of preventing clotting. If large doses of vitamin K prevent the anti-clotting effects, the blood test should pick it up and the dose of the blood-thinning medications should be raised.
A normal diet produces only a mild effect on your blood-thinning medication. Your doctor can adjust for that when determining your medication dose. Eat about the same amount of foods that contain vitamin K that you ordinarily do.
It is not advised to go from eating a large quantity of vitamin K foods to none at all because over the course of time the effectiveness of your medication may be altered. This could put you at increased risk for a blood clot or serious bleeding.
It is important to know that it is not necessary to restrict leafy green vegetables from your diet. Leafy green vegetables are loaded with pytochemicals that have been repeatedly shown to help prevent heart attacks and cancer. The key is to consume consistent intakes of foods rich in vitamin K on a daily basis.
MyPyramid replaces the Food Guide Pyramid introduced in 1992. MyPyramid is part of an overall food guidance system that emphasizes the need for a more individualized approach to improving diet and lifestyle. It incorporates recommendations from the 2005 Dietary Guidelines for Americans, released by the U.S. Department of Agriculture and U.S. Department of Health and Human Services in January 2005.
The MyPyramid symbol represents the recommended proportion of foods from each food group and focuses on the importance of making smart food choices. This can be found at the mypyramid.gov website.
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The research team compiled information on 170 adult atrial fibrillation patients who had
developed intracranial hemorrhage while being treated with warfarin and compared that
data to information from 744 randomly selected patients from an anticoagulation clinic who
had not developed hemorrhage during the same time period. The study groups included only
patients taking warfarin for atrial fibrillation.
In this largest study to date of individuals with atrial fibrillation, absolute rates of
ICH were low in anticoagulated patients. Rates were similar both on and off warfarin for
patients aged 80 years. Although ICH rates increased with age, age did not independently
predict short-term mortality after ICH. Therefore, the benefits of warfarin in reducing
ischemic stroke outweigh the risk of ICH, especially in the elderly population.
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