question on advice I was given

[Orangebrittainy]

This was by my discharge nurse and it just doesn't sound right.

She told me that if I want to eat anything with vitamin K at all, then I had to eat it every day. I am new to this, so it doesn't make sense, although I am glad to be in this thread because it is helping me figure out a lot of things. Personally the only foods I have seen that is super high in Vitamin K that I eat are lettuce and Broccoli. I was thinking of just getting them in about twice a week. Everyday is just overkill for me. I don't eat anything every day of the week, I get sick of it by then.

 

[Michelle D]

I'm not on coumadin but I'm on a very low sodium diet and I have a new sensitivity to dairy, so figuring out what to eat has been a pain. Everything is so bland that eating has become a chore.

 

[Jkm7]

You are right to question that advice. Consistency is important but there are limits to exactly how consistent you must be and still keep your INR in range. Most any food you have on a regular basis is fine as long as you use some moderation and eat it or other foods containing Vitamin K on a consistent basis. If you love spinach salads, have them in moderation but have them (or other Vitamin K foods) about the same amount from week to week. If one night you want spinach salad, the next night you might want broccoli. Or maybe you have soy milk in your cereal. Keep you consumption of Vitamin K foods relatively the same but doesn't have to be the same food.

I only took coumadin for 2 12 months after my bovine replacement but was very interested to learn as much as I could. Never know if (I hope not), I'll have to take it again some day.

 

[catwoman]

This was by my discharge nurse and it just doesn't sound right.

She told me that if I want to eat anything with vitamin K at all, then I had to eat it every day. I am new to this, so it doesn't make sense, although I am glad to be in this thread because it is helping me figure out a lot of things. Personally the only foods I have seen that is super high in Vitamin K that I eat are lettuce and Broccoli. I was thinking of just getting them in about twice a week. Everyday is just overkill for me. I don't eat anything every day of the week, I get sick of it by then.

Brittany:

I don't eat salad or broccoli EVERY day, but I do consume vitamin K foods quite frequently.
What most people new to warfarin/Coumadin aren't told is that oils and fats also contain vitamin K.
There are numerous types of lettuce and some have more vitamin K than others.

I wouldn't agonize over what you're eating. In a normal, healthy person, about 40-50% of their normal vitamin K needs are produced in the intestine. So you should already have some vitamin K in your body. However, those foods that are rich in vitamin K also have other beneficial nutrients and minerals, so don't ignore vitamin K foods just because they have vitamin K.

What you shouldn't do is to avoid these foods and then pig out, say eat only cole slaw for 7 days straight.

A consistent diet doesn't have to be a boring one.
I get my vitamin K by eating stir-fry broccoli-chicken (or beef); cole slaw (not all cole slaw was created equal -- some is very very good and some needs to be fed to hogs :-( ); spinach salad; large tossed salad; grilled asparagus (mmmmmmm if marinated in an olive oil-balsamic concoction first!); guacamole, etc., etc.

Just eat YOUR normal diet -- foods you like -- and be consistent about those. Your warfarin dosage will be adjusted according to your INR, which is affected by your activity level, RXes and OTCs, your healthiness, etc., as well as food.

In time, you won't give it a second thought. Been there, done that.

 

[nngbwh]

Catwoman is right- Just eat your normal diet- foods you like and be consistent. I remember my INR was out of whack for the first few months after surgery. Just be patience. Now I swear I eat salad everyday for lunch and my INR been stable.

 

[Bina]

This was by my discharge nurse and it just doesn't sound right.

She told me that if I want to eat anything with vitamin K at all, then I had to eat it every day. I am new to this, so it doesn't make sense, although I am glad to be in this thread because it is helping me figure out a lot of things. Personally the only foods I have seen that is super high in Vitamin K that I eat are lettuce and Broccoli. I was thinking of just getting them in about twice a week. Everyday is just overkill for me. I don't eat anything every day of the week, I get sick of it by then.

Vitamin K is in many foods that we wouldn't suspect....oils, pie shells, fruits, etc. It is an essential nutrient.
The docs just don't want patients to suddenly binge on a really high K item and put their INR in a too low zone.
You would need to eat a whole bag of spinach or kale to do that.
Broc and salads are on my menu about 5 days a week, and spinach pizza is a real treat. No need to miss out.

 

[dick0236]

I would continue eating YOUR normal diet and adjust the Warfarin dose if needed. Try to be, more or less, consistent in the amount of salads, greens, etc eaten over the week, but don't "fret over it"...."dose the diet and do not diet the dose".

 

[Rich]

I do have to give that nurse a little credit because most would instruct you to totally avoid any foods that contained Vit K.
As Dick and others said our old saying here is dose the diet not diet the dose.
Be somewhat consistent with your diet but eat what you like.
It will take a few weeks to get your dosage right for you, so don't fret about that either.
I would suggest no binge drinking, that really is a blood thinner.
Keep reading around here and you will learn that Coumadin(warfarin) does not thin your blood. In simple terms it restricts the amount of Vit K that can be absorbed in your liver.
So be careful when a doctor or nurse calls it a blood thinner and beleives it.
With your knowledge gained here you will understand far better than a lot of those people do.
Rich

 

[Philip B]

Diet

Diet

It's really simple... eat what you want... when you want it... it's easier to dose your diet rather than trying to manage your INR with diet.

-Philip

 

[ALCapshaw2]

In the Bad Old Days, Coumadin patients were advised NOT to eat anything which contained Vitamin K.

Astute obsservers and now Studies confirm that it is easier to maintain a stable INR while consuming a "consistent" amount of Vitamin K in your diet. That way, a little more or a little less is represents only a SMALL change overall versus a Large Increase if you were to avoid Vitamin K altogether and then eat some high in vitamin K. My way of being 'consistent' is to eat something green every day. I don't do any calculations, just eat one or two green vegetable servings per day. Seems to work for me.

'AL Capshaw'

 

[Eva]

After my surgery I tried to be consistent and careful, etc, which was a pain then. Now, I just eat whatever I am in the mood for, and I adjust my dose when necessary.

 

[Protimenow]

If you have your own tester and strips, you can certainly track any changes (if any) if you fall severely off of the 'consistency' wagon. It's safer to know if you ned an adjustment a day - or two - or three after your green binge whether or not your INR has dropped to unsafe levels than it is to wait days (or longer) for a test at a doctor's office, lab, or anticoagulation clinic. If there IS a change, it may be risky to wait for too long with an INR of 1.0.

(Here's my question for Al or others -- since Warfarin takes a few days before its effects show up, is it any different for Vitamin K? Would a Vitamin K binge show INR effects tomorrow, or would they only show up two or three days later? )

 

[ALCapshaw2]

If you have your own tester and strips, you can certainly track any changes (if any) if you fall severely off of the 'consistency' wagon. It's safer to know if you ned an adjustment a day - or two - or three after your green binge whether or not your INR has dropped to unsafe levels than it is to wait days (or longer) for a test at a doctor's office, lab, or anticoagulation clinic. If there IS a change, it may be risky to wait for too long with an INR of 1.0.

(Here's my question for Al or others -- since Warfarin takes a few days before its effects show up, is it any different for Vitamin K? Would a Vitamin K binge show INR effects tomorrow, or would they only show up two or three days later? )

It's not likely that anyone could eat enough vitamin K rich foods to cause their INR to drop to 1.0

Good Question about how long it would take a change in vitamin K intake to show up in an INR test.
That's a good question to ask Doctors and/or Coumadin Clinic Nurses. My *guess* is that it would also take a few days to be detectable. I'll have to check...

'AL'

 

[Freddie]

Drink a V-8 and your INR will drop the next day. Most solid foods can be digested within 8 to 24 hours

 

[nngbwh]

I've always wonder if my INR is on the low side since I only test once a month at a coumadin clinic. I should maybe look into
home monitor.

 

[Jkm7]

It's not likely that anyone could eat enough vitamin K rich foods to cause their INR to drop to 1.0

Good Question about how long it would take a change in vitamin K intake to show up in an INR test.
That's a good question to ask Doctors and/or Coumadin Clinic Nurses. My *guess* is that it would also take a few days to be detectable. I'll have to check...

'AL'

How long does it take for a Vitamin K shot to reduce clotting time?

 

[Bina]

I've always wonder if my INR is on the low side since I only test once a month at a coumadin clinic. I should maybe look into
home monitor.

Post op I tested monthly at a hospital lab and for 18 months was perfectly in range.
My choice to get a home monitor was to avoid the trips to the lab and save my arm veins from ruin.
Nelson, getting a home monitor is still a luxury for many people, but it gives a great sense of freedom.

 

[Freddie]

How does it take for alcohol to get into the blood stream? Answer - 20min to an hour, pending on weight and size of the person. Hence the reason some ppl feel the effects of a beer (for example) faster than others.

I would assume, that once the vitamin K shot is given and into the blood stream, the effects should be noticeable within a couple of hours. JMHO

 

[Protimenow]

The effects of alcohol are much different from the effects of Vitamin K on the system. Alcohol goes into the blood and when it reaches the brain, we feel the effects.

A few months ago, a thread carried some discussion about the effects of alcohol on INR. It wasn't the alcohol as much as it was components (Thiocyanines, if I remember correctly) in the red wine, that had an effect on the INR. (Thiocyanines (phthalocyanines? or something) are compounds similar to aspirin that have anticoagulant properties. Too many, and the INRs can climb). If you drink a LOT of red wine, this can possibly have an effect on your INR. If you drink enough hard liquor to damage your liver, this may impair its ability to process Vitamin K. A glass or two of wine with a meal shouldn't be a big deal - especially if your drinking is consistent and you dose your warfarin to take the wine's effects into account.

Vitamin K is much different -- the liver metabolizes it, creating a variety of compounds, including those that influence coagulation. What Warfarin/Coumadin do is appear to the body as if it is Vitamin K, but not be metabolized into those coagulation factors. It's THIS effect (known as Vitamin K Agonism, or as VKA) that enables us to raise our INRs.

The effect of Warfarin takes a few days to be fully seen -- it takes a while for the liver to metabolize it, and for the coagulation factors to be produced (or not). I'm guessing that, all other things being equal, the effects of Vitamin K should take almost as long -- that's why medical professionals use Heparin or other materials, which work differently and produces a faster anticoagulation result, if they want a rapid anticoagulation effect. A shot of Vitamin K probably shouldn't work very quickly - but it might displace the warfarin (or its effects) when being metabolized in the liver, and possibly get a slightly faster result.

As far as testing frequency is concerned, personally I'm comfortable testing every two or three weeks. I have enough strips that I can do my testing weekly, although this probably isn't necessary. If I make a major change in my diet, or add or remove an OTC herbal medication, or forget to take a dose (or worry about somehow taking the same dose twice), I may test a bit more often. It IS a quite empowering feeling to know that you can test your blood more often IF YOU THINK YOU SHOULD, and not have to wait for a biweekly or monthly lab draw.

Bina's comment that self-testing is a luxury for many people is valid. However, in my personal case, I was able to get my meters on eBay. They currently have ProTime 3 meters and ProTime meters - not everyone's favorite meter - for far below $100. The ProTime strips (cuvettes) have built-in quality control, and I trust my results. The cuvettes aren't especially cheap - they're probably around $5-$8 each, and you may have to get a doctor to order them for you - but they're probably much cheaper than the cost a lab would charge and a lot less than a doctor appointment just to get your blood tested. I wouldn't get a CoaguChek S -- the manufacturer has discontinued them and will stop supporting them a year or so from now. There will probably be no strips available. Also, because they don't have quality control built into the strips, the results may not be as reliable as those from a ProTime, a ProTime 3, a CoaguChek XS, or either InRatio machine.

I'm not suggesting that you should buy a meter on eBay -- I'm just saying that I DID, and I'm not dissatisfied with the meters. I'm enjoying the luxury of being able to test without having had to pay the full price for the meter (which I still can't do).

 

[ALCapshaw2]

It's not likely that anyone could eat enough vitamin K rich foods to cause their INR to drop to 1.0

Good Question about how long it would take a change in vitamin K intake to show up in an INR test.
That's a good question to ask Doctors and/or Coumadin Clinic Nurses. My *guess* is that it would also take a few days to be detectable. I'll have to check...

'AL'

I asked one of the CRNP's at my Coumadin Clinic about how fast Vitamin K acts to lower INR.
Her response was that taken Orally (i.e. food or pill) it would show a lower INR in a day (assume 24 hours). A shot with Vitamin K can lower INR in a couple of hours.

I did not ask about quantity (i.e. dose) of Vitamin K.

As we know from our experiences, INR can drop faster than it rises.
It always takes longer to increase INR than to lower INR.

'AL Capshaw'