Blood thinning/turmeric & fish oil

I am taking warfarin for afib, and have seen the warnings regarding the consumption of turmeric not being recommended for people on an anticoagulant.  " According to the National Institutes of Health, turmeric may slow blood clotting. Avoid combining turmeric with anticoagulant and/or antiplatelet drugs. If you take blood thinning medication, consult with your health provider before eating turmeric in food or taking turmeric supplements." 

And this: "Medication Interactions...

Fish oil should not be taken in combination with prescription blood thinners. Your blood may take too long to clot if an injury or cut occurs. Excess bleeding may result. Examples of prescription blood thinners are warfarin, clopidogrel, heparin and ticlopidine. According to, in rare circumstances bleeding may occur in the brain due to a ruptured artery. The condition, known as a hemorrhagic stroke, is a life-threatening medical emergency.

My question is, why wouldn't it be OK to take turmeric or fish oil on a daily basis, just as we can do with vitamin K foods, as long as we are consistent with weekly consumption of these items?  Any idea?  Thanks!

25 Replies

  • I tend to agree with your hypothesis. Stick to a regular diet and make you warfarin dose fit that rather than worry too  much. Also note that the report must be out of date anyway since it fails to mention NOACs. I love Indian food which uses turmeric a lot so next time I'm due an INR test I must binge on curry or mackerel  for a week before hand and see what happens. Let's keep a sense of proportion shall we.

  • You're right about no mention re NOACs.  I went back to the article, but couldn't find a date for when it was written.  

    My oncologist is a big believer in turmeric, for it's powerful anti-inflammatory and antioxidant properties, so I am pretty faithful about taking turmeric supplements.  

    Fish oil, also a popular supplement, has benefits for healthy people and also those with heart disease.

    I'm new to afib as of January of this year, so I have a lot to learn! Was so disappointed after discovering that these 2 supplements interact with anticoagulants and can elevate the INR, and therefor should be avoided. 

  • I asked my EP about taking fish oils with ACs and he was fine with it but I also saw the warnings - but then again reading the warnings on the leaflets of all meds would put you off taking anything.  Having said that I was NOAC, not Wafarin so INR irrelevant.

  • I take omega 3 &6 supplements and have done for years, before I ever started warfarin. I declared them when first anticoagulated. Nurse said they don't advise taking any supplements but has never urged me to stop.

  • I am not too sure of things like Fish Oil, Tumeric or garlic (or several of the natural anti-coagulants) show up on the INR.  I've tried to find out, but no one seems to know the answer for me.  VitK with show in your INR apparently, so if you have a ton of spinach for dinner your INR will register a low score.  But if you eat turmeric etc, your INR score could be normal, but with a different form of anti-coagulant swimming around in your system.  An example is does aspirin register on the INR.   Two different fronts so to speak.  So, say if you didn't take warfarin, but totally ate all the natural anti-coagulants, would you therefore have a good INR?

  • I think it is important to understand what an anticoagulant actually is. Aspirin isn't. It is an anti platelet. The biggest problem in all this is the stupid and inaccurate description of "blood thinners" which we know they are not. As a result I think it wrong to talk about natural anticoagulants. If there were such things then huge sums of money need not have been spent on finding NOACs to replace poor old maligned warfarin. The points is that these "natural " products are not quantifiable so proper assessment of their efficacy is not possible. Research has shown  me that  cider vinegar is very good at keeping elephants away down here is North Devon. Haven't seen one in years.

  • Just as a matter of interest - my GP surgery is conducting a long term study of Fish Oil as a preventative for stroke - they were advertising for  participants.  I think it was in a specific age range and without high stroke risk factors so wouldn't involve AFers.

  • When I was started on apixaban in December , the haematologist said it was OK to continue with my daily supplements of glucosamine, omega3 fish oils and lutein but to stop taking the garlic supplement as  it could enhance the anticoagulant effect of the NOAC.  My husband was also told to stop taking the garlic supplement before having  surgery in case it caused more bleeding.

  • I used to take turmeric and garlic when not on Warfarin. When first on Warfarin four years ago I asked the sister at the hospital warfarin clinic about continuing with fish oil. Her response was, Why do you think you need it ? 

  • SInce substances like turmeric and saw palmetto have anticoagulant properties, It would seem to make sense to take them and not warfarin or NOACs.  I wonder if any research has been done to quantify their anticoagulant effects.

  • Just posted to Bob - my GP surgery is doing a long term study.

  • That is my question exactly. Cant find anything.

  • I spent some time looking, too, but didn't come up with much.

  • I have been looking at what can't be ingested while taking Warfarin. It is very similar list to natural blood thinning veg fruit and herbs. Doesn't make sense!

  • i think you are making a good point here if i knew it was as good at protecting me as apixaban i would go natural straight away just think of the money these companies would lose

  • As good as apixaban? Wow! Considering all its side effects, I'm not sure that's a reasonable assumption.

    The side effects of the supplements are mostly all good things not life threating like apixaban and others.

  • This is a different topic, but Bob often makes to reference "blood thinners" not actually thinning the blood.  This explains it as well:

    "An anticoagulant is a drug used to prevent unwanted and dangerous blood clots. Although anticoagulants are often called "blood thinners," warfarin does not actually make your blood thinner. Warfarin interferes with the body's ability to make a blood clot. Warfarin is also sold as Coumadin and Jantoven, which are brand names for the generic drug warfarin."

  • I also had wondered why "natural" products didn't do the trick for complete anticoagulation, so I Googled it.  The info below explains why foods/supplements can't be used in place of the prescription anticoagulants:

    May 2015

    10. Other foods and supplements

    It has also been reported other supplements (below) have clot preventative effects. However,

     there was very little solid data found in a review of scientific literature to suggest they should be considered ‘clot preventatives’. The majority of clot prevention claims appear to be based more upon case reports of bleeding (documented instances where a patient experienced excessive bleeding while taking one of these supplements) than on clinical study. In many of the reported instances of excessive bleeding, patients were taking both a supplement and a prescription anticoagulant or antiplatelet medication–so the impact of the supplement alone is less than clear. Here is what was found regarding laboratory study: 

    ginkgo biloba = supplementation does not appear to affect coagulation or bleeding time,

     no impact on platelet studies except in the lab at very high doses 

    ginseng (panax ginseng) = may affect an enzyme necessary in clot formation, no effect

    on platelet function 

    ginger = no confirmed anticoagulant properties in lab studies, possible antiplatelet


    policosanol = may affect platelet aggregation 

    magnesium= inhibited platelet aggregation in lab study

    dong quai = no studies have examined its effects on coagulation, case reports only 

    coenzyme Q-10 = no alteration of platelets found in lab study 

    glucosamine = may suppress platelet activation in humans, shown to effect platelet

     aggregation in guinea pigs 

    lycopene/tomatoes = reported to inhibit platelet aggregation 

    L-arginine = may inhibit platelet response 

    taurine = may reduce platelet aggregation 

    feverfew = no clinical evidence of anticoagulant activity, possible anti-platelet activity 

    selenium = may affect an enzyme necessary in clot formation 

    onion = may effect platelet aggregation 

    resveratrol = inhibition of platelet adhesion, platelet aggregation 

    B-group vitamins = no evidence supplementation prevents DVT/PE

  • What should I do I'm on apixaban but have a homoeopathic lady who treats me for sports injuries and general well-being, she said she can give me a homoeopathic anticoagulant instead of apixaban this is much more appealing to me, I must admit all the time she has treated me my wife, children and grandchildren it has worked 99% of the time we haven't had asprin, paracetomol, ibuprophen or antibiotics for years including the grandchildren.  What do I do? I know it is my decision but thought I would run it by my AF family.

  • I sure wouldn't go the homeopathic way. Its success or lack of it has not been proven at all in terms of how effective it would be as an anticoagulant. I'd definitely go the way of warfarin where you can check the blood levels with an INR, or go with one of the other NOAC's.  

  • I consulted a qualified medical herbalist to see if she could help my AFib. She took a detailed medical history and wrote down all the meds I was taking. She subsequently gave me a large bottle of meds to last me 5 weeks, and a small bottle of tincture to use if I had an episode of AFib. After about 3 weeks I asked her which herbs were in the meds. Despite knowing that I was on a NOAC and taking meds for high blood pressure she included St John's Wort ( def No No with NOAC , says so on the patient info sheet) and meadow sweet( contraindicated for those on NOACs when I researched it online.) The tincture contained Scotch broom, which although it can assist with A fIb, can raise blood pressure. She also told me to buy a particular ( expensive) brand of Turmeric, which I did, then found it was not recommended if you are taking a NOAC. I have used herbal meds bought OTC for years and am still taking hawthorn for my heart, BUT I have rather lost confidence in this lady to be able to treat me safely. There are definitely herbs out there which can have an antiplatelet/anticoagulation effect, eg ginko, garlic and turmeric, but I would not rely on them unless I could have an INR test to prove that they were working, so I shall carry on with my Apixaban. I think you would need to have a great deal of faith in this homeopath to trust her treatment when it comes to anticoagulants.

  • The fact that she included St John's you said, a definite no no, while on an NOAC,...would be enough for me to stop using this person for advice on supplements. NO way; I wouldn't do it. She uses a little of this and a little of that...bad deal; too risky and not worth it. Something as complicated as treatment for afib needs to be done by an MD only, in my opinion. Glad you opted not to take her advice, and go with Apixaban instead. :-)

  • I would have asked her about the St John's Wort. Some of these things have new research done on them, which is hard for MDs to keep up with. And too many MDs are simply drug oriented making trust in that direction difficult too. The doctor priesthood is not what it used to be.

  • thank you barbara 2 just seeing what people think i am very unsure what path to take

  • I have taken Omega 3 super strength capsules daily for years, and when I was diagnosed last year and saw the specialist arrhythmia nurse, he told me that was no problem and to carry on.  Yesterday my daughter (who is on warfarin for a different heart condition) told me she was instructed no fish oil. 

    If your INR is elevated because you take fish oil consistently (being consistent in consumption of many foods and supplements taken whilst on warfarin is key) then your warfarin dose will be adjusted accordingly.  Keep researching!

    Best of luck!

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