Can someone tell me please what I should/shouldn’t be eating whilst on warfarin

[Chelsea7]

Hi everyone I’m new to all this, was diagnosed with a blood clot in my leg last week and I’m currently on Fragmin injections but will be going onto warfarin, I’ve noticed some people talking about not being able to eat certain foods can you please tell me more about this? Thank you

[misswoosie]

Hi Chelsea. Warfarin likes consistency so as long as you don't make any drastic changes whilst on treatment you should be OK.

If you do want to do that then you need to tell the clinic. For example, if you decide to go on a calorie/fat/carb controlled diet to lose weight, or if you decide to go on a cabbage soup diet for a week.

Same with alcohol. Obviously stay within the recommended safe amounts and try and keep it constant. The absolutely worst thing for warfarin is binge drinking, but even a couple of units if you usually don't drink anything can knock make the blood result (INR) go higher than the prescribed target which is usually 2.5

It's important to know that some herbal remedies and supplements can affect warfarin, so again, tell the clinic if you're taking anything like that.

Vitamin K is a vitamin that we all have in our body and it helps blood to clot.

Warfarin works against Vitamin K to make your blood slightly less likely to clot, or "make it thinner" if you like. When you've had a blood clot they prescribe warfarin so that the clot you already have won't get any bigger and to prevent any new ones forming

The more vitamin K you have (eat) the more warfarin you'll need to get the blood to the correct "thinness" which is OK.

Younger, fitter people usually need considerably more warfarin to achieve the correct thinness anyway. A frail, elderly person might only need 2mg daily whilst a younger person may need 10mg or more.

Have you been given a Yellow warfarin booklet? You should have been and the information is all in there.

QUOTE FROM THE BOOK which is online here

medicines.org.uk/emc/rmm/10...

Are there any dietary restrictions?

For your good health it is important that you try to be

consistent with what you eat and drink while you are on

warfarin, particularly foods that are high in vitamin K. If you have too much vitamin K in your diet you may see your INR levels go low and your warfarin requirements increase. The following is a list of vitamin K rich foods.

You do not need to avoid these foods as they are very nutritious but aim for consistency in your intake of these foods.

Very high Vitamin K containing foods

Broccoli, Cabbage, Curley Kale, Brussel Sprouts, Collard Greens,

Endive, Dark Green Lettuce, Nettle Leaves, Spinach, Soyabean Oil,

Scallions, Spring Onions, Parsley, Seaweed and Turnip Greens.

High Vitamin K containing foods

Asparagus, Liver, Red Leaf Lettuce, Watercress, Canola Oil,

Rapeseed Oil, Salad Dressing

Green tea, soya and soya protein products should only be

eaten in moderate, consistent amounts and try to stick to

the same brand of these products.

Taking probiotics could in theory increase the production

of Vitamin K in your diet and reduce your INR levels. If you

would like to take probiotics stick to the same quantity and

brand daily and let the staff at the Warfarin Clinic/GP know

if you start or stop these.

Avoid grapefruit juice, cranberry juice, mango juice,

mangoes and seville oranges as they have been linked to

high INR results

End of QUOTE

This is a little misleading and suggests Vitamin K is something that you should be careful about eating because it can be harmful to your health.

"If you have too much vitamin K in your diet you may see your INR levels go low and your warfarin requirements increase"

It should maybe really read "If you suddenly increase the amount of Vitamin K you eat then your INR may go low and your warfarin requirements increase"

[Tillyclot]

Miss Woosie has provided some excellent guidance here and as a patient who took warfarin for over 40 years, I appreciate that you may be wondering if you are going to make significant changes to your lifestyle.

Current rule of thumb is that most clincians will advise that you don't need to make radical dietary changes when you start on warfarin, they will adjust your dose according to your range for your conditon and this will be monitored at regular intervals with INR blood tests.

You don't mention if you will be on anticoagulants for a short period of time or indefinately?

I trust that your Dr has mentioned that there are now a suite of new oral anticoagulants:Apixaban, Dabigatran, Edoxaban and Rivaroxaban which are NICE approved for treatment and prevention of blood clots. These drugs do not need the rigour of regular blood tests to check INR levels as required by warfarin.

I would suggest you speak to your clincian about your options here before embarking on warfarin.

If you decide to go onto warfarin and its for long term, you may wish to consider self - testing/monitoring using a portable handheld device which requires a pin prick of blood.

These devices are not available on the NHS at the moment but the test strips can be prescribed. You will need your clinic/GP support if you go down this route as they will need to discuss if this is suitable for you and the arrangements for reporting your results and dose adjusting.

Self- testing/monitoring has the benefits of allowing you to test at your own convenience, is great when travelling or on holiday and negates having to attend clinics for regular blood tests reducing time away from work or personal commitments

Hope this helps good luck - for more information, visit anticoagulationuk.org website

[Jimbhoy13]

As others have said it is the intake of vitamin K that has to be considered. Big changes in intake can affect INR readings. If vitamin K intake is consistent then your warfarin dosage should maintain a consistent level.

After years on warfarin I have just changed to apixaban and can eat whatever I want in a balanced diet. Less testing on apixaban is also a bonus.

Hope all goes well for you on warfarin or any other anticoagulant you may take.