Fish oil and Warfarin

[Jackie]

My Cardio suggested that I take at least 1000mg daily. I picked up some Nature Made 1200mg. It suggests 1 or 2 softgels 2 times daily with a meal. Anyone know if this will affect my INR? And what dose do you take? Any information will be greatly appreciated.

 

[ctyguy]

I take 1200mg every night when I take my Coumadin. You might see a slight tick in your INR but I'd venture to say you won't see any changes in your daily dosage because of Fish Oil.

 

[Ross]

I'm taking a mix of fish oil, flaxseed oil and borrage and my INR did shoot up. All of these combined are responsible. Normally with just the fish oil, you may see a slight rise, but nothing dramatic like my Omega 3,6,9 formula.

Be sure to make use of Al Lodwicks site. Just about all of your questions can be answered there.

http://www.warfarinfo.com/fishoil.htm

 

[Jackie]

Thank you Scot and Ross for the information. I started it yesterday and my INR was 2.9 so I will check it next Wednesday as see what it is then.

 

[Ross]

Thank you Scot and Ross for the information. I started it yesterday and my INR was 2.9 so I will check it next Wednesday as see what it is then.

With mine, I went from 2.7 to 4.1, so you may not want to wait a full week to test again.

 

[Bina]

I do the same as Ross.....anything that may cause a big change in my INR warrants a test after 4 days.

 

[Guest]

Fish oil and warfarin

Fish oil and warfarin

I've been taking 1000 mg three times a day for the two years I've been on coumadin and then warfarin. My levels are very stable.

 

[kpearse]

Weird, I just started taking fish oil today. I'm getting checked out on Friday, like to see what it does to my inr.

 

[ALCapshaw2]

My Cardio suggested that I take at least 1000mg daily. I picked up some Nature Made 1200mg. It suggests 1 or 2 softgels 2 times daily with a meal. Anyone know if this will affect my INR? And what dose do you take? Any information will be greatly appreciated.

BE CAREFUL with large doses.

My Cardio told me to take 1000 mg (he is pretty conservative) but NOT 2000. He also limits me to a Baby Aspirin (81mg) per day and prefers NO vitamin E beyond what is found in a multi-vitamin. None of these should affect INR BUT they can make Bleeding more likely.

2 Doses 2X/Day at 1200mg/dose = 4800mg
That's a LOT.
Also note that their recommendation most likely NOT directed at patients on "Blood Thinners" (forgive me Ross... making a point) a.k.a. AntiCoagulants.

'AL Capshaw'

 

[Jackie]

My INR last week was 2.7, I started taking 1200mg of Fish Oil on Wednesday. One week later it is 3.0. It doesn't seem like it has done much to my INR, it's right where I want it to be. Thank you for all your input.

 

[tobagotwo]

It's not the fish oil, but what's in the fish oil that is good for your heart. The most common number I've run into for studies is 1,000 mg (one gram) of combined EPA and DHA omega-3 fatty acids.

Standard fish oils might require three or more softgels to get that. There are concentrated brands that can lower that amount significantly. Also, if the fish oil is salmon oil, try to get wild-caught salmon oil, as farmed salmon have been rated as having a higher amount of mercury in their bodies.

There are also mixed oils, such as Ross is taking, or vegetable-only oils that also have these omega fatty acids. They take longer to develop the same blood levels, but there is no evidence that they don't work just as well when they get there. The benefit of mixed oils is that they have other omega FAs as well. However, not all of them have been shown to have a positive effect.

It should be considered that people with congestive heart failure do not appear to have a positive effect from fish or other oils, and may actually do worse.

Daily Vitamin E dosages over 400 IU have been linked to earlier death (no explanation given in the study). As that is already way over the necessary amount, that's enough warning for me.

Garlic's supposed benefits have been disproven in several large studies. Fortunately, garlic at least won't hurt you, except possibly for your social life.

Be careful of large, continuing Vitamin D dosages, as it is toxic in high doses. This piece from the Wikipedia about vitamin D indicates something else for our tissue valve people in particular to consider the possible risk of:

http://en.wikipedia.org/wiki/Vitamin_D

In the absence of vitamin K or with drugs (particularly blood thinners) that interfere with Vitamin K metabolism, Vitamin D can promote soft tissue calcification.[5]

[5] ^ Price PA, Faus SA, Williamson MK (February 2000). "Warfarin-induced artery calcification is accelerated by growth and vitamin D". Arterioscler. Thromb. Vasc. Biol. 20 (2): 317?27. PMID 10669626. http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=10669626.

Best wishes,

 

[COLLEEN S]

It's not the fish oil, but what's in the fish oil that is good for your heart. The most common number I've run into for studies is 1,000 mg (one gram) of combined EPA and DHA omega-3 fatty acids.

Standard fish oils might require three or more softgels to get that. There are concentrated brands that can lower that amount significantly. Also, if the fish oil is salmon oil, try to get wild-caught salmon oil, as farmed salmon have been rated as having a higher amount of mercury in their bodies.

There are also mixed oils, such as Ross is taking, or vegetable-only oils that also have these omega fatty acids. They take longer to develop the same blood levels, but there is no evidence that they don't work just as well when they get there. The benefit of mixed oils is that they have other omega FAs as well. However, not all of them have been shown to have a positive effect.

It should be considered that people with congestive heart failure do not appear to have a positive effect from fish or other oils, and may actually do worse.

Daily Vitamin E dosages over 400 IU have been linked to earlier death (no explanation given in the study). As that is already way over the necessary amount, that's enough warning for me.

Garlic's supposed benefits have been disproven in several large studies. Fortunately, garlic at least won't hurt you, except possibly for your social life.

Be careful of large, continuing Vitamin D dosages, as it is toxic in high doses. This piece from the Wikipedia about vitamin D indicates something else for our tissue valve people in particular to consider the possible risk of:

http://en.wikipedia.org/wiki/Vitamin_D


Best wishes,

OOH I didnt want to hear this! My GP put me on 50,000units of vitamin D every other week. Now tissue calcification? Hm, well I go for echo next week, so...slow breaths...

 

[tobagotwo]

Note that it says soft tissue calcification, not soft tissue valve calcification. I don't know if it translates out to be an issue there or not. It certainly is disturbing to read...

Best wishes,