? about Supplements and Coumadin

[Guest]

I met with the very nice Cardiac Rehab Nutritionist today, I don't eat enough fruits and veggies (knew that, told her I was not a big eater overall) and I don't drink enough water (knew that too), they don't count tea, coffee, or propel and gatorade towards meeting the 64 oz recommended amount.

She suggested I add flaxseed to my diet and fish oils to reduce the amount of coumadin I will need to take to stay in range.

Do you all think this is a good idea or have you found that it did not effect the amount of coumadin necessary to keep you in range? I really don't want to add anything in the form of supplements until I'm kept in range on the good stuff.

 

[Cooker]

I have never heard of taking any supplements that will reduce the amount of coumadin needed. The main thing is to just be consistent with your diet. Everybody is different and require different dosages.

 

[Bina]

Louise that is a perfect example of people not having a clue about Coumadin.
I'm shocked that a cardiac nutritionist is telling you such things....
Flax and fish oil are beneficial to cardio vascular health, but they have no anti-coagulation properties that would be reflected in your INR. I believe in eating a variety of foods in moderation. There are so many ways to incorporate fruits and veggies into your diet, you will figure it out.

 

[Ross]

Flaxseed can increase your INR. Knowing this, you can still use it, but be prepared to make a dose change in your Coumadin. Your right, until your stable for quite some time, I wouldn't do it.

 

[Susan BAV]

Hi Louise -

Just for what it's worth--and please note that I am not recommending anything here--but earlier today, when I happened to be searching something else, I did happen to stumble across several sites recommending garlic or vitamin E for such as you mentioned.

I don't know if they were "quack" sites or not. Perhaps.

But as you mentioned, and as some more experienced ones here also mentioned, stability is probably the most important thing for you right now. Take care.

 

[Ross]

Vitamin E

An isolated case was reported in 1974 of vitamin E (up to 1,200 IU per day) being associated with increased anticoagulation (blood thinning) in a patient treated with warfarin.11 A study of 12 people undergoing warfarin therapy found that additional vitamin E (100 IU or 400 IU per day) did not induce a clinical bleeding state.12 Moreover, a double-blind trial found that supplementation with vitamin E in amounts up to 1,200 IU per day had no effect on warfarin activity.13 It now appears safe for people taking warfarin to supplement vitamin E despite information to the contrary often provided by doctors about this purported interaction. These warnings are based on the isolated case report from 1974.


Garlic

Garlic has been shown to help prevent atherosclerosis (hardening of the arteries), perhaps by reducing the ability of platelets to stick together.34 This can result in an increase in the tendency toward bleeding.35 Standardized extracts have, on rare occasions, been associated with bleeding in people.36 Garlic extracts have also been associated with two human cases of increased warfarin activity.37 The extracts were not definitively shown to be the cause of the problem. People taking warfarin should consult with a doctor before taking products containing standardized extracts of garlic or eating more than one clove of garlic daily.


Take the message for what it is, I won't say that it's accurate, but tread carefully. I know I eat alot of Garlic and a far share of Vit E. I can't say that I've seen anything major happening to my INR to date.

http://www.vitacost.com/Healthnotes/Drug/Warfarin.aspx

 

[Guest]

Thanks everyone. I am not changing or adding any supplements for now.

The other thing she mentioned is that flaxseed can help reduce cholesterol, mine is a little high but my good cholesterol is 65. When I was doing a lot of yard work, planting, and hauling summer before last, it dipped to 185. With my new valve, I should be able to do more this New Year and get it under 200 again.

 

[Blanche]

I did a search on INR and anticoagulation and found some articles that claim that Omega-3 oils do have an effect on INR. You might want to do some searches on Google for this.
Kind regards,
Blanche

 

[catwoman]

Louise:

Ditto on others' advice: Focus on stabilizing your INR. Don't worry about trying to take anything to reduce how much warfarin you need to be in range. (Anyone who suggests doing so needs to get re-educated on anticoagulation management.)
Our motto here: Dose your diet, not diet your dose!!!!!!!!!

Taking Oatmeal and other grains will also help reduce cholesterol levels. Salmon and other fish will provide you omega 3 fatty acids (plus protein).

Look for a copy of The Mayo Clinic Heart Book. it has a chapter on reducing risks, which includes info on nutrition that may help. I found a copy at a used bookstore (Half Price Books, I think), but I've also seen a newer edition at Barnes & Noble or Border's.

Supplements are not ideal substitutes for the real thing. For example, yes, you can take vitamin C tablets, but eating an orange or grapefruit also provides fiber + other nutrients.

BTW, I don't usually drink enough water either. When I don't, my INR goes up. When I increase my water intake to a normal level, my INR goes down. Reason: Warfarin is more concentrated in your blood when you're not drinking as much water.

 

[Karlynn]

Here's what Al Lodwick has on fish oil (omega 3) http://www.warfarinfo.com/fishoil.htm

Your nutrionist shouldn't be worried about how much Coumadin you need to take to stay in range. The dose you require to stay in range is the dose that is healthy and right for you. There is no advantage to your health to be on a lower dose of Coumadin.

If you start taking flax seed and fish oil for it's other health benefit know that it will affect your INR and your dose will probably need to change. It's important that you stay regular with it or your INR will start bouncing around.

 

[frank10b]

are there any sites where it talks about what supplements are good for going into heart surgery. my nutritian levels are down and I need to buld my self up however I dont have the energy to eat much at all and because of my CHF my stomach is not wworking all that well. most sites are just trying to sell somthing, I know.

 

[Ross]

Not really, best thing to do is eat sensibly or what you can tolerate and hope for the best.

 

[Blanche]

Frank:
You might want to consult your doctor. Our doctor raves about the B vitamins, eapecially B6, B12, and folic acid.

A good, comprehensive multi-vitamin does most people good. But, if you take anticoagulants, you must be sure to take that multi-vitamin each and every day. Some vitamins do effect anticoagulation. If you take the same multi each day, you can deal with changes in INR by making changes in your antioagulant dose.

Hope this helps,

Blanche