It was the Cinnamon...

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pellicle

Professional Dingbat, Guru and Merkintologist
Joined
Nov 4, 2012
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Queensland, OzTrayLeeYa
So I thought this subject had come up and indeed in 2017 we have this post in a "post recovery" thread by Dreamy

https://www.valvereplacement.org/threads/a-week-after-surgery-my-story.876755/post-878689

most of the navigation in that is broken but if you progress manually you can find the discussion underneath that. You'll see that I was initially a bit skeptical that Cinnamon was the actual cause in her situation.

However it was raised again by a friend of mine (who once was a member here) when he told me that he'd found that Cinnamon was a prime suspect in his INR variability as he has Cinnamon in his coffee. Picture below is a reference for how much he puts in his coffee (that's a teaspoon)
1728080170933.png


He found this caused approximately a 1 point INR shift. I don't know how much Dreamy added to her smoothie.

So the following links may be interesting reading.

Mechanisms of Herb-Drug Interactions Involving Cinnamon and CYP2A6: Focus on Time-Dependent Inhibition by Cinnamaldehyde and 2-Methoxycinnamaldehyde

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543486/


the importance of the gene CYP2A6

CYP2A6 - an overview | ScienceDirect Topics

https://www.sciencedirect.com/topic...a major role,, pilocarpine, and valproic acid


lastly a report from the literature

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726349/

An 80-year-old man on dabigatran with a known history of NV-AF presented with a 1-day history of haematemesis and black stool which began 3 days after he had started taking a boiled mixture of ginger and cinnamon. The patient was hypotensive and treated as a case of gastrointestinal bleeding and haemorrhagic shock. Despite continuous aggressive resuscitation measures including administration of a reversal agent for dabigatran, we were unable to control bleeding and the patient died within 24 hours. The interaction of ginger and cinnamon with dabigatran led to fatal bleeding.​


Interesting stuff ... so now I have another SHTF solution (to supplement red wine and tomato and turmeric based goat curries). Cinnamon coffee.

I'm going to do an experiment on this (as tomorrow is INR day)

Best Wishes
 
Interesting. I used to put cinnamon in my Ovaltine (or something that I drank). I haven't used cinnamon for more than a year.

I might be crazy enough to check it out, too - I wonder if the effect is immediate (or within a few hours) or requires a certain level of the cinnamon compounds to effect INR. Pellicle and I know how to manage a higher INR - but if you don't quite understand dosing, this may be one of those 'don't try this at home' kind of experiments.
 
Vitamin K supplementation is often used as a treatment for a Warfarin (a coumarin drug) overdose. If you are worried about your previous coumarin intake, stop eating Cassia Cinnamon immediately, consult with your physician, and be sure to include foods high in Vitamin K in your diet.
https://paleofoundation.com/ceylon-vs-cassia/
 
I've never found anything I eat or drink to interact with Warfarin except if I'm on vacation and drink more alcohol than usual. When I'm going to be drinking more than usual, I stick with Bloody Marys made with V-8 to balance the alcohol against the vegetables!
 
There are actually two kinds of cinnamon (or one, if you consider the rarer cinnamon - I've forgotten its name - to be the REAL cinnamon). Cassia cinnamon is, IIRC, from Mexico. They're not the same.

If you're using cinnamon and are worried about what it does to your INR - get a meter. Self-test. If you know how to manage your dosing, and your INR does actually climb, you can stop using as much, and your INR should go back down, or you can take K1 and retest every day or two for changes.

Testing is the best way to detect changes in your INR.
 
I've never found anything I eat or drink to interact with Warfarin except if I'm on vacation and drink more alcohol than usual. When I'm going to be drinking more than usual, I stick with Bloody Marys made with V-8 to balance the alcohol against the vegetables!
this just sprang to mind (because I'm Australian and I grew up watching The Paul Hogan Show)

 
There was a period when I drank cinnamon tea every morning, using a heaped teaspoon of cinnamon. During that time, my INR increased by 0.1. Despite its benefits, I stopped because I didn’t enjoy the taste.
Now, I only add a dash of cinnamon to my warm drink which I prepare with 1 or 2 heaped teaspoons of flaxseed instead of coffee/tea. This change hasn’t affected my INR.
 
I was convinced this was the case when I was on warfarin. There was a week when my INR jumped from 2 to 3.3 for no apparent reason, and my only diet change was drinking fresh ginger and cinnamon tea every day. The warfarin specialist was baffled but insisted that diet wouldn’t have any significant effect apart from grapefruit 🤷🏻‍♀️
 
Hi Zara

I was convinced this was the case when I was on warfarin.

this post by Eva doesn't mean that it wasn't the case for you
There was a period when I drank cinnamon tea every morning, using a heaped teaspoon of cinnamon. During that time, my INR increased by 0.1

which is because as I understand it there is a genotype involved in the metabolism of the anticoagulant part of Cinnamon so both experiences can be correct...

Thus its down to "test and know thyself"

Best Wishes
 

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