Dangerous drugs and food combinations. Wash Post 5-20-14, cinnamon

[Marty]

This quote from a longer article.
"And cassia cinnamon-the most common inexpensive cinnamon sold in the United States- contains high levels of a compound that can thin blood. So it can be dangerous for people with heart problems who take the blood thinner warfarin; an alternative spice is the more expensive( but arguably tastier) Ceylon cinnamon, sold in gourmet stores.

 

[newmitral]

Hi Marty,

Thanks for the warning. I tried to find the original Washington Post article, and it seems they were quoting from a Men's Health article which can be found at this link:
http://www.menshealth.com/health/dangerous-drug-food-combinations

I find this particularly interesting since I have the occasional mystery spike in my INR where it jumps up to over 4.0 for no reason that I could think of. However, cinnamon could very well be the culprit since I do have a sweet tooth and have been known to occasionally eat large quantities of cookies/pastries that no doubt contain a goodly amount of cinnamon.

I will make a further study of this over the next few weeks to see if I can correlate my own INR jumps with eating cinnamon. As it happens, I just got a new coaguchek meter to test alongside my Inratio2 because of their strip recall problem, so I'll be making extra INR home tests anyway. It will be a tough job eating all those cinnamon rich pastries but someone's got to do it.

 

[Protimenow]

Yes, but you'll have to somehow determine whether those Cinnamon pastries are made with real Cinnamon or Cassia.

The question regarding cassia might be one of dosage -- and I would suspect that if cassia had a significant effect on INR, there may be more warnings about it, and there would probably be some reports of people who aren't on warfarin but ate a lot of things made with cassia having high reported INRs and possibly even some bleeds.

I'll read that article and see what it says (and perhaps do some more checking into whether or not it makes sense). I'll also see if I can confirm that Cassia contains high levels of coumarin -- and state that, again, if this has an impact on people on warfarin, then there should be significant effect on people who ingest a lot of cassia. (I wonder if those cinnamon flavored 'red hot' candies are made with cassia, and if so, why aren't there reports on the dangers that these may pose).

Thanks for the heads up

 

[Jkm7]

I've read similar about vanilla extract people bring back from Caribbean vacations particularly from Cozumel, Mexico.
It is said that some of the bottles contain coumarin and can interact poorly for people taking coumadin.

 

[Protimenow]

I've also seen some things about the artificial 'vanilla' -- it may be cheap, but it's also dangerous stuff (from what I've seen and read). It may be cheap, but, personally, I would avoid it.

I've seen some other things about Cassia -- one article says that Cassia contains coumarin and that it can be hard on the liver. The article http://www.drfuhrman.com/library/choosing_the_right_cinnamon.aspx doesn't go on to state anything about its effect on anticoagulation. (Of course, anything that can damage the liver can also mess with coagulation, so it may not be unreasonable to conclude that if you have enough cassia, you could be looking at increased INR - if not some major liver damage.

 

[clay_from_nj]

Of course you know that quality artificially produced vanillin is chemically identical to what is extracted from natural vanilla beans...

 

[Protimenow]

Yes. But the cheap stuff is NOT vanillin -- it's another chemical that could be harmful (I can look it up, but recall that it is NOT a synthesized vanilla replacement, it's an entirely different chemical that can be harmful).

 

[newmitral]

As I indicated above that I would, I made a first test of cinnamon's effect on my own INR.

On Wednesday evening, I measured my INR at 2.5.
On Friday evening, I had two Cinnabon(tm) "Minibon" rolls as dessert. Cinnabon claims to use Indonesian cinnamon, which is one of the "cassia" sources containing a moderately high amount of coumarin.
On Saturday morning, my INR measured 3.1

So, the tests are inconclusive, since my normal INR variation can easily be 0.5 or more in 3 days. However, the results are consistent with the possibility of cinnamon causing an increase in my INR. This was not a huge spike as a result of 2 cinnamon minibons, but it was at least a single test measurement increase.

Further tests, and more cinnamon rolls, will be needed to answer the question in a more scientifically rigorous manner. In the interest of science, I will press on.

 

[Protimenow]

I appreciate the sacrifice that you're making, in the interest of scientific rigor.

As a nutritional supplement, I've seen cinnamon capsules from a few companies. I don't know if the source of this cinnamon is indicated on the bottles. It may be somewhat more scientifically valid if you (or whoever else may be interested in some testing) used those controlled dosage capsules as your source of cinnamon, rather than the Cinnabons.

Just a suggestion...

 

[newmitral]

Cinnabons for Science - Episode 2
(Attack of the Scones???)

At great personal sacrifice to my waistline and my blood-sugar levels, although with a high degree of satisfaction to my taste buds, I continued my experiment to see if cinnamon containing coumarin might be an explanation for the occasional unexplained spikes (to 4.0 and above) in my INR.

After 2 more cinnabon minibons on Sunday evening for dessert, an INR test on Monday morning gave a result lower than the prior result: INR= 2.9 on Monday morning.

So, the preliminary conclusion seems to be that, in my particular case, the cinnamon is not likely to be the cause of my occasional unexplained spikes in INR.

To recap:

Wed May 21, INR = 2.5
Fri May 23 - ingested 2 test pastries
Sat May 24 - INR = 3.1
Sun May 25 - ingested 2 test pastries
Mon May 26 - INR = 2.9

So, while far from having a rigorously controlled scientific study, nor a statistically significant sampling of results, anecodal evidence suggests that I need to look elsewhere for the cause of my own particular INR mystery spikes. The fluctuations above, with the addition of the cinnamon to my normal diet, is simply showing the same sort of daily variations I typically see in my own INR without the cinnamon.

Nevertheless, this may be a case where some folks are more sensitive than others to the effects of the coumarin in the cinnamon, so your mileage may vary.

 

[Marty]

My Safeway bakes large very sweet cinnamon rolls that I buy whenever available. They sell out fast. My target INR is 2.5-3.0. I adjust my dose If INR is under 2.0 or over 4.0.( using the 10% rule) I truly see no consistent cinnamon effect. I do not know the type of cinnamon Safeway uses, but it does not seem to affect my INR significantly.

 

[newmitral]

Cinnabons for Science - Grand Finale

As tasty as the cinnabons may be, in the interest of returning to a more healthy diet, I have made the final data point in my experiment on cinnamon versus INR.

On Monday evening, I upped my game to 3 cinnabon minibons. On Tuesday evening, my INR was at 2.7, down from the previous test on Monday morning.

The full history:

Wed May 21, INR = 2.5 (evening test)
Fri May 23 - ingested 2 test pastries
Sat May 24 - INR = 3.1 (morning test)
Sun May 25 - ingested 2 test pastries
Mon May 26 - INR = 2.9 (morning test)
Mon May 26 - ingested 3 test pastries (evening)
Tues May 27 - INR = 2.7 (evening test)

So, as far as I'm concerned, that puts the final nail in the coffin regarding the possibility that past occasional unexplained spikes in my INR might have been caused by cinnamon. The variation day to day is what I normally see in my INR. I realize this variation may be higher than most folks see, but it is typical for me.

I leave it to other brave souls who can better tolerate the calorie increase and sugar overload to carry on the experiment if they so choose.

 

[chaconne]

As has been my experience with ingesting kale and cranberry juice, I suspect one would have to ingest a lot more cheap cinnamon than the amount in 3 cinnabons to have a significant effect on INR

 

[Marty]

I agree. I bought a dozen freshly baked very cinnamony rolls this AM . I eat one bun every AM with coffee and will not worry about it.

 

[tom in MO]

"Of course you know that quality artificially produced vanillin is chemically identical to what is extracted from natural vanilla beans..."

Not really. Vanilla extract is a complex mixture, vanillin is the main ingredient. There are lots of compounds in vanilla extract. They vary by location and strain.

Most people's palates can't tell the difference when vanillin is used to compliment other flavors (e.g. brownies.) But in things like vanilla ice cream, most people can tell the difference between the real deal and the laboratory substitute.

 

[clay_from_nj]

Yes Tom, I wholeheartedly agree about the complexity and (at least sometimes) superiority of natural vanilla extract. I just wanted to dispel any notion that the artificial vanilla (vanillin) that most of us buy at the supermarket is not dangerous. We sometimes automatically regard "artificial" with bad or poisonous, when that is rarely the case, and it pays to remember that many "natural" substances can be very bad for you. If you put hydrogen and oxygen in a suitable container and ignite, you will create real water, which differs from the "natural" variety only in the lack of impurities in the laboratory-created version. In my head, I classify "natural" sweeteners, like stevia, in the same group as artificial sweeteners - icky tasting, and with generally no place in my kitchen. And, honey, molasses, and agave nectar are still full of real sugar, with absolutely the same health effects and therefore should be used with the same care.