dose the diet and no-no's

[Bina]

My hospital also sent me home with a Coumadin book, most of it was general educational reading, but it did include a list of the higher vit.K foods: spinach, kale, broccoli, cabbage, parsley, etc.,and many herbal products were listed as "cautionary" foods. I think the list is meant as a guideline so that newbies don't crash their INR immediately. In the beginning I avoided them totally, now I just have small portions since I don't want them every day anyway. It all works out just fine.
Yes, we can safely ban Okra.

 

[Gnusgal]

Yes, we can safely ban Okra.

But what if it's fried? Fried okra is pretty yummy... Of course, just about anything fried is yummy.

As for me, I wasn't given a list of anything, but I did end up buying the coumadin cookbook shortly after surgery. All of the recipes contain little to no vit. K, but in the back is a long list of common foods and their vit. K content. I have never used any of the recipes, but I have referred to the list a time or two when my INR was high and I wanted to bring it down without changing my dose. Now I just don't worry about it. If I discover I'm a bit high I think about what I've eaten that week. Usually it was a busy week and we had lots of take out with little to no veggies. So I simply make sure I have salads, broccoli, etc. the following week and I am back in range. I rarely change my does anymore. I go up and down all the time, but I never worry too much about it unless it's WAY out of range (one time I came up over 7.0. I changed the dose then. ).

 

[JimL]

The Coumadin Cookbook: Complete Guide to Healthy Meals when Taking Coumadin, by Rene Desmarais, Greg Golden, & Gail Beynon, 2000
It appears to be out of print, since its list price is $16.95, but you can't buy it used for less than $25-30.
p. 409-420 contain a Vitamin K Table.

 

[aussigal]

Karlynn's first post to this thread really spells out how the "Dose the diet" lifestyle works at its best...its really easy, most of us eat basically the same food over a period of a week or two. I have followed this principle for about 18mths now and havent had a change in dose for at least a year, and before then it was to adjust to another med that the dose was altered a tiny bit.

 

[Ross]

Vit K lists are alright to simply see how much k there is in something, but don't sit down with a chart and try to plan how much your going to eat each meal unless you want to drive yourself mentally insane and everyone around you.

The Coumadin Cookbook was an idea. Use it as a recipe book, but nothing more. Here again, they stress avoiding K and it's not necessary at all and does not follow or fall into dosing the diet, but dieting the dose.

 

[Gnusgal]

The Coumadin Cookbook was an idea. Use it as a recipe book, but nothing more. Here again, they stress avoiding K and it's not necessary at all and does not follow or fall into dosing the diet, but dieting the dose.

I agree. Notice I've never actually cooked anything FROM the Coumadin cookbook. And I don't know when the last time I checked the vit. K list might be. I pretty much figure, if it's green, I'm good to go! I will admit to adjusting what I eat, but only because I don't like adjusting my dose. I'm just inconsistent with my eating is all... Yes, I do EVERYTHING backwards. When I am eating what I cook (not eating out all the time) I don't have a problem with fluctuations. It's just when we get busy and eat too much fast food (not much vit. K in fast food...). I agree with everyone else. Don't avoid foods just because they have vit. K. Eat what you want and adjust from there!

 

[heartfelt]

Cooker, Thanks for making me laugh today!! I just left a tear-stained post over at my thread for the blood in my urine that Bina (I think) kindly started for me. And thanks to all of you for the common sense approach to all this that I've read here. I feel utterly beat down by this drug and all the testing and hand wringing and think it's probably, for me anyway, as Ross and Karlynn suggested, that I've been watched over too closely and have now been somewhat conditioned to being over vigilant about this whole new episode of my life. B/c it hasn't been even remotely like my life before VR, then it's become this test of endurance to keep my coumading w/in range of 2.5-3.5 and it's begun to make me wonder what the point of even doin this was other than to help feather another heart surgeon's nest; neither of which I signed up for as improvement of quality of my life. Okay, I know that isn't entirely true, but since I haven't had very many months of being w/in "the" approved of range I am very frustrated. I've tried to play the game according to the "rules" and I just can't, so now it's time for me to take charge of this and do what you all are...enjoying your lives instead of being slaves to this drug and monitoring everything that passes your lips.

Do you have any idea how thankful I am to know my life can be almost normal again?
heartfelt
P.S. Fried okra is right on, but I'll side with you about boiling the stuff.

 

[Ross]

Cooker, Thanks for making me laugh today!! I just left a tear-stained post over at my thread for the blood in my urine that Bina (I think) kindly started for me. And thanks to all of you for the common sense approach to all this that I've read here. I feel utterly beat down by this drug and all the testing and hand wringing and think it's probably, for me anyway, as Ross and Karlynn suggested, that I've been watched over too closely and have now been somewhat conditioned to being over vigilant about this whole new episode of my life. B/c it hasn't been even remotely like my life before VR, then it's become this test of endurance to keep my coumading w/in range of 2.5-3.5 and it's begun to make me wonder what the point of even doin this was other than to help feather another heart surgeon's nest; neither of which I signed up for as improvement of quality of my life. Okay, I know that isn't entirely true, but since I haven't had very many months of being w/in "the" approved of range I am very frustrated. I've tried to play the game according to the "rules" and I just can't, so now it's time for me to take charge of this and do what you all are...enjoying your lives instead of being slaves to this drug and monitoring everything that passes your lips.

Do you have any idea how thankful I am to know my life can be almost normal again?
heartfelt
P.S. Fried okra is right on, but I'll side with you about boiling the stuff.

You'll be normal when we know the full history behind everything going on.

This may sound like a snotty way of looking at it, but without the valve, you'd be dead if not soon, so if taking a pill a day to keep your life is all need be done, you got a great trade off.

 

[Tiffin]

Okay you all mention the Vit. K foods that will decrease INR but what about the foods that are natural anticoagulants which interact with warfarin/coumadin and Increase your INR I?ve notice these are never mentioned

- the list 'recommended to avoid' because they can not predict how high the INR will go: avocado, black licorice, tart cherries (pie cherries) cranberry, grapefruit, mango, papaya, chamomile tea, green/white teas and tonic water.

I forgotten about chamomile tea and was drinking a single cup every nite for a couple of weeks, went to get my monthly test and my INR level had gone up to 6.3 - after questioning what I had done different to my diet This was the only thing. Was told eat a bigger spinach salad & gave up the chamomile tea -Went back the next week and was back in range

I do eat avocado?s I refuse to give them up - the rest I can do without. We have them with our salads a couple times a month. And Yes I eat a salad basically every nite! And lots of green veggies along with all the other veggies.

The reason I ask all this is I?ve heard green tea is a wonderful tool for loosing weight. A cup or two a day somehow interacts with body to help shed pounds. As many of us on Beta blockers I?ve gain weight and want to loose those extra pounds. Should I dare try? Do any of you drink ?green/white teas? on a daily basis? Does it effect your INR?

 

[Ross]

There are none that I know of that raises INR. People make far too much out of things that contain k. Cranberry juice has been cleared, all the rest,, eat like you normally do and it will be compensated for. The hullabaloo is about keeping the INR up, everything you mention if eaten in large amounts will decrease INR.

People need to stop the nonsense. No one should be depriving themselves of any of these. Now Grapefruit juice is something you don't want to take with your Coumadin. Coupule hours later and your fine unles your on another med that it reacts with. http://www.warfarinfo.com/grapefruit-juice.htm

 

[Gnusgal]

Now Grapefruit juice is something you don't want to take with your Coumadin. Coupule hours later and your fine unles your on another med that it reacts with.

Yes, I have always heard grapefruit juice makes it difficult for the body to absorb the meds, or something like that. I can't take it with my lanoxin either. But that doesn't mean you have to avoid it completely.

I eat avocados all the time. I've head that the "problem" is that you never know how much K is in each one, but I've never had any issues with them at all. Love me some guac! Ross is right, don't freak about what you're eating. Just live your life!

 

[Blanche]

With the exceptions of grapefruit and teas, My husband and I eat everything on your list...and, I might say enjoy them too. I do drink tonic water each and every day too. I'm told it's good for a-fib. Actually, my internist suggested the tonic water.

Where did you find the list that you have? There is so much disinformation about anticoagulation. Sure does make it hard for people to become comfortable with their life after surgery.

Kind regards,
Blanche

 

[Bina]

Tiffin, sometimes a little experimenting is a good thing. Everyone does not react the same.
I don't know about teas, as I only drink them when I have a cold.
We recently had a member go nuts on cranberry juice during a very short period of time and his INR was affected. I'm sure that a glass of cranberry juice with breakfast is just fine, but drinking quarts of it in a 1-2 day period is another story.
A while back another member mentioned garlic pill supplements could affect INR. This may be another example of overload, since normal amounts of garlic in cooking and salads is very healthy and not a problem.
Over time, we each figure out what works for us and our personal diet patterns. Like Ross said, "eat normal".

 

[heartfelt]

Bina, I can't wait to figure out what works for me and what doesn't. I didn't know about the avocados (pass me the guac!!) so eating that occasionally could have added to my erratic numbers. My cardio-guy told me NO green teas, which is hard for me since I was having minimum a cup a day before surgery. I didn't even know about chamomile and will have a cup or two of that if I'm having trouble sleeping. I am not to take grapefruit due to taking Lipitor (according to the pharmacist it can cause severe muscle cramping~I asked to find out the consequence so I could weigh out the worth of doing it~so far, I haven't had any, but hey, who knows....) I refuse to give up garlic, but I have quit using garlic pills. I didn't really like them anyway, much prefer garlic toast or putting it into almost everything I cook. I've tried to give up making a whole meal out of fresh spinach, cauliflower, brussel sprouts, etc. like I used to do. I don't really care for meat but eat it when I have to.I have tried to change my diet to accomodate this drug, but it hasn't been easy.
heartfelt

 

[Karlynn]

Everyone - eat what you want. Period. The benefit of knowing what is going to raise your INR or what is going to lower your INR is so that when you get your INR tested you'll know what to expect. They are proving that people who include vit. K in their diets have more stable INR's than those who don't.

All these Coumadin diet restrictions are driving me a bit crazy (or maybe I should say "crazier" ). Just don't binge out on spinach salad for a week without checking your INR? If your INR goes down and you know you'd like to keep eating the spinach salads - raise your dose.

Dose the diet - don't diet the dose. I think many people feel like their current dose should be their dose for life. It won't be and trying to keep it that way is going to drive y'all nuts!

Enjoy life - enjoy the food you eat, and don't get upset if your INR fluctuates around a bit. If your INR is going to go way high or way low - my guess is that it's not going to be food causing it.

 

[KristyW]

Enjoy life - enjoy the food you eat, and don't get upset if your INR fluctuates around a bit. If your INR is going to go way high or way low - my guess is that it's not going to be food causing it.

Hear! Hear!!! What Karlynn says!!!

 

[Tiffin]

Blanche,

The list I received was from Alaska Heart Institute Coumadin Clinic and I took the Class January 2006. Here in Anchorage when they start you on Coumadin each patient attends this 3-hour class. It held monthly for new patients or patients on coumadin that need a refresher who are having dosing problems and need that extra little help in understanding the med.

It tells what the med is, how it been developed, why you use it, how to use it, good things and bad things. What meds interact with coumadin, how different herbal additives may interact, and The person in charge of this class runs the clinic and attends yearly conferences on Coumadin management etc etc.

The list actually comes straight from this class?tells you all about vit k which foods have high levels which foods have low levels. Yes they also are into ?todays? advice: dose the diet not diet the dose.

But the big negative was NATURES OWN ANTICOAGULANTS and those that I mentioned where the ?BIG ONES? to watch - yes some of them also are known to have high levels of Vit K. But the anticoagulant factor was higher. We where told since they grown in different regions and countries that they where hard to predict how high your INR would go and try to avoid them. There are only 3 on the list that I would eat anyhow.

But looking at various sites on the Internet concerning nature?s own anticoagulants it can become mind boggling just as foods rich in Vit K. It is easier to just ignore them all; rather than actually learn something that might be beneficial.

At least Anchorage has a class for patients may it be right, wrong, or indifferent. Looks like many of folks with questions who are new to coumadin only get a quick verbal lesson at the hospital or words of advice from doctor, which is soon forgotten. Or nothing but outdated & wrong advice from their medical personnel.

Thank goodness for those of you with years and years of coumadin to help calm the fears of folks just starting out on coumadin.

With all the studies about coumadin it?s truly amazing that the only thing that is agreed throughout the medical community is that ranges should be: 2.0 - 3.0 tissue and 2.5 - 3.5 mechanical (unless in A-fib then this dose for tissue also).

Maybe some day the medical community will be the same throughout and discussions such as this will be the thing of the past.

I agree with Bina - each of us are different and may react differently to changes in our diet and that it may not hurt to try a few things in normal usage to see how it may effect us.

I?ve been on coumadin for two years - I eat what I want and what I like and it usually it is a monthly habit. I only brought up the prior question up because I?ve not seen discussions here on the boards about foods that have a natural anticoagulant factor and I was curious to see what the responses would be.

Sorry for my long posts also!

 

[Blanche]

Tiffin:
I've been here for a long time and I too have never heard the term "natural anticoagulants." "Nature's Own Coagulants" is another phrase that is foreign to me. I am glad you introduced this topic.
Regards,
Blanche

 

[Ross]

I have tried to change my diet to accommodate this drug, but it hasn't been easy.
heartfelt

And that is why your feeling so poorly about it all. Doesn't surprise me, I had a major round with a hospital dietitian back in April when I was in the hospital. I get my meal and it says on the ticket "Coumadin Restricted Diet". What in the hell is a Coumadin restricted diet? Doctor wanted to know too. Point blank he told her that he doesn't believe in that hogwash, that if one is consistent in their normal diet, the dose is adjusted to suit that diet. Now give me my GREENS back LADY.

There isn't too much I haven't tried. I drink green tea fairly often and haven't seen anything happen from it nor Chamomile, but I don't drink much of it. All I can tell you to do is to try these things in small amounts and see if you see any changes. Most likely you won't. Now I'm not talking about drinking a quart of tea or such, that's binging, but a cup a day for a bit and see.

As an example, the coumadin cookbook has it set that you can only have 5 brussel sprouts per serving. Say what? Not thiis boy! I love my brussels and I eat 10 to 12 as one serving. My dose is adjusted for the larger amounts of K I eat. I include one green item in virtually every meal.

 

[Karlynn]

I love my brussels and I eat 10 to 12 as one serving. My dose is adjusted for the larger amounts of K I eat. I include one green item in virtually every meal.

I could marry Ross and we'd live on brussel sprouts - I LOVE them too!!!!!!