JohnCalderwood
Well-known member
Hi Guys,
Why are we not suppose to drink green tea on coumadin? Just wondering. Thank you.
Why are we not suppose to drink green tea on coumadin? Just wondering. Thank you.
Why are we not suppose to drink green tea?
- Thread starter JohnCalderwood
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I think it's because it's green, kind of like the green leafy vegetables that you're supposed to avoid, which I don't.
Ross
Well-known member
You can drink green tea, just don't sit down and drink a gallon a day. It will decrease your INR if you go overboard. I drink about 3 12 oz bottles of it a week, on occasion. I've had no problems. It's just more nonsense purported by the pros. Well, it's not nonsense if you over indulge, but you already know that over indulging in anything with Vit k is going to be a problem, but can be adjusted for.
GREEN TEA INTERACTIONS WITH WARFARIN
Green tea is used by many people because it is thought it may help protect against cancer. (1) However, green tea contains vitamin K. When brewed, the concentration of vitamin K is low, but in large quantities this may still be enough to cause a decrease in the INR of a patient taking warfarin. There is one case report available in the literature
Case report1,2)
44 year-old male with hypertension, Marfan’s syndrome, and St. Jude mechanical heart valve in the aortic position, taking 7.5 mg warfarin daily for 14 months with fluctuating INRs. His INR dropped from 3.79 to 1.37 in 22 days, and further to 1.14 in another month. The patient stopped drinking green tea and the INR recovered to 2.55 in one week. There is a strong temporal relationship of an interaction here between green tea and warfarin.References:
1: Taylor JR, Wilt VM. Probable antagonism of warfarin by green tea. Annals of Pharmacotherapy 1999; 33:426-8.
2: http://www.micromedex.com Complementary and Alternative Medicine AltMedDex, as seen on March 1, 2001.
©2001 Patricia Chuong
And they seem to hide that darned green tea all over the place! As I have stated previously, my cardiac surgeon's PA told me to avoid green tea and, with a vary difficult period of my getting my PT-INR in the correct zone, I followed her advice. I just hate how they keep putting green tea in places that are not even tea!
Wouldn't it be nice if products thought to increase/decrease anti-coagulation were tested on non-anticoagulate requiring volunteers? Prescribe warfarin to them for the test duration, choose a range, and have them consume varying amounts of green tea. Keep checking the INR.
Such volunteers would not be in jeopardy from fluctuating INR's.
The case report quoted above does not include the amount of green tea injested nor the state of the patient's health in general or the activity level. Also why was the INR allowed to drop so substantially over the course of the test.
Actually I think the case study is so vague as to be considered "bunk". Do people actually believe this stuff?
Such volunteers would not be in jeopardy from fluctuating INR's.
The case report quoted above does not include the amount of green tea injested nor the state of the patient's health in general or the activity level. Also why was the INR allowed to drop so substantially over the course of the test.
Actually I think the case study is so vague as to be considered "bunk". Do people actually believe this stuff?
Ross
Well-known member
The pros do. I don't. As soon as people understand that everything can be adjusted for, they do it and prove them wrong. Wouldn't it be nice if the pros realized this?
The key is LARGE quantities. I don't care what your eating with Vit K. If you eat large quanities or drink it, your going to drop your INR. Common Sense folks. That's what it's all about.
AgilityDog
Well-known member
And there's a huge difference in the amount of K in grocery store green tea products versus the very strong stuff you buy at health food stores, too.
Most of the stuff in the grocery store isn't very strong, and you'd have to drink a lot.
But a friend of mine is a bit of a food fanatic (she feeds her dogs on the R.A.W. or B.A.R.F. diet) and takes a strong green tea extract every day. She had to go on coumadin for pulmonary emboli once upon a time, and the clinic made her stop taking her extract (rather than just adjusting the durned dosage).
Most of the stuff in the grocery store isn't very strong, and you'd have to drink a lot.
But a friend of mine is a bit of a food fanatic (she feeds her dogs on the R.A.W. or B.A.R.F. diet) and takes a strong green tea extract every day. She had to go on coumadin for pulmonary emboli once upon a time, and the clinic made her stop taking her extract (rather than just adjusting the durned dosage).
Most likely, a cup or two a day is just fine.
hook
Well-known member
I may get stoned for this, but I eat anything I want; in moderation of course. Now, I'm not talking about fried chicken and hamburgers for every meal, but I have red meat, salads, green veggies, and even a little salt in my food (mostly the kind that comes in restaurant food). I do eat the greens in moderation, and I do not pick up salt shakers or soy sauce. I have seen no major fluctuation in my INR.
Now on the other hand, you don't want to have a normal diet with minimal green things, and then go on a big salad kick. An intake swing like that may be significant. I pledged to eat more veggies so I figure it will all average out be the end of the week. I still only take 3mg per day to maintain my levels. You need to make sure you try and get a home testing device; it will simplify your life.
Food tip for those who like Sushi, and miss the soy sauce. Most Japanese Restaurants have a ginger dressing for their salads. Ask the server for a small bowl of that, and dip your Sushi in that; it freakin rocks.
Now on the other hand, you don't want to have a normal diet with minimal green things, and then go on a big salad kick. An intake swing like that may be significant. I pledged to eat more veggies so I figure it will all average out be the end of the week. I still only take 3mg per day to maintain my levels. You need to make sure you try and get a home testing device; it will simplify your life.
Food tip for those who like Sushi, and miss the soy sauce. Most Japanese Restaurants have a ginger dressing for their salads. Ask the server for a small bowl of that, and dip your Sushi in that; it freakin rocks.
Ross
Well-known member
Why would you get stoned for this? I eat fried chicken, hamburgers, basically everything bad for you, goes into me. I AM NOT A SPARROW. I eat lots of spinich, brussel sprouts, broccoli, and other professionally forbidden items. Bottom line, my dose is adjusted for this diet. It's simple. Really it is. The great coumadin cookbook says you can only eat 5 brussel sprouts. Screw that. I eat 12 to 15 in a serving. Asparagus and everything else. You have to make the adjustment for a higher level of Vit K and everything works out. I'm semi consistant. Al Lodwick calls my diet the dumpster divers diet, but hey, I'm eating what I want!
Too many people by into the rubbish that you have to follow the no no list. What they don't know is, the no no list belongs in the garbage can.
Oh, you are a man after my own heart. I could probably eat 20, but keep it to 15.
Ross
Well-known member
Dr. Gourmet and the others say will perish. What say you?
The dark green veggie thing is a generalization, but not a bad one. There is a relatively HUGE amount of vitmain K in spinach and kale and other things called "greens" (e.g., collard, mustard, dandelion), enough to completely reverse your INR if you eat a cup of that stuff. A cup would be between a quarter and half pound - quite a bit of greens to say the least - but that would do a number on your coag by providing 1000 mcg or so of vitmain K. After that, the vitmain K content falls off pretty rapidly. Standard iceberg lettuce is very low in vitmain K - a whole head (over a pound) has only about 100 mcg, which barely makes the RDA for vitamin K. Confusion arises from long lists created by uncritical reading of basic USDA information, so things like pie crust get on some lists, even though an ENTIRE crust has less than 100 mcg, simply because that is the portion the USDA used in their table, putting pie crust in the top 30. Then there are these single case reports of a guy who licked a green crayon and then found his INR was lower than expected on the next test.
I don't get real excited about any of this. I eat what I eat. Chocolate's not on the list, so I'm pretty happy. However, I am extremely sensitive to warfarin, now on only 1.5 mg/day for 6 days and 3 mg the last day of the week, and I have some trouble staying in range. So, I tried to get a decent idea of what food might be a factor, and the list is rather short. For things like green tea, it would be nice if vitmain K content were spelled out, so we'd know if it has any significant amount in it, but it's not a requirement for nutritional labelling. So, there's no real good way to know. Drink what you want and adjust your dose if needed. I'll just stick with chocolate as my main health food.
http://www.nal.usda.gov/fnic/foodcomp/Data/SR17/wtrank/sr17w430.pdf
I don't get real excited about any of this. I eat what I eat. Chocolate's not on the list, so I'm pretty happy. However, I am extremely sensitive to warfarin, now on only 1.5 mg/day for 6 days and 3 mg the last day of the week, and I have some trouble staying in range. So, I tried to get a decent idea of what food might be a factor, and the list is rather short. For things like green tea, it would be nice if vitmain K content were spelled out, so we'd know if it has any significant amount in it, but it's not a requirement for nutritional labelling. So, there's no real good way to know. Drink what you want and adjust your dose if needed. I'll just stick with chocolate as my main health food.
http://www.nal.usda.gov/fnic/foodcomp/Data/SR17/wtrank/sr17w430.pdf
Ross
Well-known member
Bill I eat at least a cup of spinich, more then a cup of brussel sprouts, broccoli, asparagus, you name it, I eat far more then one should, but I have my dose adjusted for that much also. People just have to eat like always and let that diet be dosed. Too many people are doing the same stupid thing, that all new people to anticoagulation do, and try to count their vit k intake per day and it just doesn't work. All one does by doing that is driving themselves insane.
I can remember what it was all like when I was new to anticoagulation. I believed everything I was told, the coumadin cookbook was a must have, the no no list must be adhered too, etc.
When your veins are getting poked 2 times a week and your INR is all over the place, you've done all the right things by what you were told and your still not stable, you begin to question what you've been told, then you start learning that most everything you've been told is utter nonsense.
I can remember what it was all like when I was new to anticoagulation. I believed everything I was told, the coumadin cookbook was a must have, the no no list must be adhered too, etc.
When your veins are getting poked 2 times a week and your INR is all over the place, you've done all the right things by what you were told and your still not stable, you begin to question what you've been told, then you start learning that most everything you've been told is utter nonsense.
My first year post op I was nervous and avoided excess Vitamin K and had a totally stable INR....but I really missed my "greens". Then, in 2007, I found VR.org and I learned that I could indeed eat some greens. Guess what? My INR is still stable and I am gaining valuable vitamins from the added greens. Pass the broccoli
Ross
Well-known member
My first year post op I was nervous and avoided excess Vitamin K and had a totally stable INR....but I really missed my "greens". Then, in 2007, I found VR.org and I learned that I could indeed eat some greens. Guess what? My INR is still stable and I am gaining valuable vitamins from the added greens. Pass the broccoli
Oh I remember your first days well. I kept thinking, why does she ask, but is defensive as all get out about the answers. I didn't think we'd ever get you to try our ideas.
<groan> Just took a peek at his site, well, I'm alive and kicking, and I think that's pretty darn good, and INR is very stable. Right now I am trying to decide between broccoli or Brussels sprouts with dinner tonight.
Ross
Well-known member
Tell me, did you see 1 green item listed in his professional Coumadin diet? I mean WTH, your body needs these essential nutrients. What is it with these people that think it has to be avoided?
P.S. If I were you, I'd have both!
Stinking hot and humid day today.....I chose a very green cole slaw, scrambled eggs, and fresh baked whole grain bread. YUM.
