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13-08-2018, 09:12 PM
1

Advice appreciated please.

Hello everyone,

Would appreciate a bit of friendly advice if you wouldn’t mind from anyone taking Warfarin.

I was first put on Warfarin in 2013 when I had a Pulmonary Embolism. I came off it after a certain time but then got another Pulmonary Embolism in 2015 so am on them forever I suppose.

I started off going for an INR blood test every two weeks, then once a month, my reading was steady, always somewhere between 2.3 and 2.8 (recommended range 2.5). the highest reading ever was 2.9 which was the visit before this last one. My visit last week was 3 months since the previous visit so they must have been satisfied with the readings even though the 2.9 was rather higher than normal.

But after my last visit last week, I was informed by phone from the hospital that my INR reading had shot up to 4.1.!! They asked me if I had changed my diet, eaten different foods, been on a diet, etc. Then started talking about Vitamin K intake and was I taking too little or too much. That not enough Vitamin K would make my INR reading higher with the risk of bleeding or stroke, (I wondered why my arm would not stop bleeding after the injection!) usually it stops straight away.

Anyway, I digress – When she asked me if I was taking enough Vitamin K, I couldn’t answer her, 3 months is a long time between INR visits to remember if I had eaten something different. No-one at the hospital or the Medical Centre has ever mentioned the necessity of controlling my Vitamin K intake while on Warfarin and I have been happily going along eating whatever and whenever.

I don’t like looking medical things up online for fear of turning into a hypochondriac, but thought I had better start researching about Vitamin K. I nearly dropped when I realised how important it was and how it could affect the Warfarin doing its job. Apparently, I have to have a Vitamin K intake of no more than 90 mpg daily. (my goodness, the take-away Chinese meal I had on Friday was 135!!)

Anyway. I’ve done my research and now know some of the high/low, good/bad foods regarding Vitamin K, but I wondered how anyone else on here fares with their food intake regarding this vitamin.

Do you follow a strict regime managing everything you eat? do you have an indepth list of every food and beverage so you know what is what and how much you can eat? I would be very grateful to anyone on Warfarin letting me know how they manage their food and drink to ensure they don’t go over the recommended adult range of 90 mpg daily, because unless I do a list of every single thing that I consume from the supermarket, butcher and greengrocer, and that doesn’t include spices, sauces, gravies, OMG ! The mind boggles. How am I going to know whether I am taking in enough or not enough Vitamin K?

Thank you very much for any advice you can give to this ignoramus.
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14-08-2018, 07:46 AM
2

Re: Advice appreciated please.

Like you darlin' I too have been prescribed Warfarin because of Pulmonary Emboli (I've had five).

Yes Vitamin K is important!!! - When first prescribed I was told to AVOID all Brassicas i.e. Cabbage, Spinach, Greens, Sprouts & Broccoli. Root vegetables are ok as too are leeks, onions and garlic. I was also told not to eat Grapefruit, (I used to love a glass of Grapefruit juice in the morning) Cranberry (I cannot eat my Xmas Turkey without a dollop of Cranberry sauce!!!).
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14-08-2018, 08:23 AM
3

Re: Advice appreciated please.

Hi

I am not on Warfarin, I am immune to it.

This goes back decades when I did my first Post Grad Research, which was into the effect of Vitamin K and Warfarin Resistance in pregnant Brown rats.

I must have absorbed a lot and developed an immunity to it.

I have a severely injured left leg, prone to DVT and I have had 7 confirmed Pulmonary Emboli.

They ran my Warfarin dose up to 28mg a day before abandoning it.

I manage my blood clotting with diet and exercise, this has worked for 26 years, not impossible to do at all.

It is all about moderation with food, but plenty of exercise.

Any swelling, any sign of a DVT and I self medicate with Heparin.

It is not the end of the world SG, you have a long and happy life ahead of you.

There are plenty of alternatives to Warfarin.
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14-08-2018, 11:23 AM
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Re: Advice appreciated please.

Good morning UJ, thanks for replying. My goodness, 5 PE’S!! You’ve certainly been through the mangle!.

Yes, I really do appreciate just how important Vitamin K with regards to Warfarin is now. Also, the serious consequences if I get it wrong!. I still feel a little peeved though that no-one explained about it both times when I was in hospital. Maybe a Dietician could have explained things to me and I would have ensured I followed the recommendations carefully. As I say, my INR readings were normal for 3 years, but obviously, that seems to have just been down to sheer luck and not from being good!

I do at least now know to be very careful about eating greens, cranberry juice, grapefruit juice and other foodstuffs very high in Vitamin K. I don’t want to live my life constantly worrying what and what not to eat though. As I see it, because my reading was higher, that meant my blood was thinner and at risk of bleeding and/or a stroke, which worried me a little since I found out about Vitamin K from that Hospital phone call, so I am grateful for any reply on here. This Vitamin K is so completely new to me and it’s just trying to find out the number of mpg to the food and drink that I want to eat and will ensure I don’t go over that daily figure of 90mpg that is so vexing to me at the moment.

Do you count these or do you not bother with the number of mpg and just eat anything as normal but with things such as greens etc just take in moderation in your meals?
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14-08-2018, 11:38 AM
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Re: Advice appreciated please.

Hi Swimmy, many thanks for replying. OMG! 7 PE’s !!!! You’ve had some narrow escapes like UJ.

I must say, bravo to you managing on diet and exercise as prevention. When they told me after my second PE that I would be on Warfarin indefinitely, there was a certain relief in knowing that I was taking it to prevent any further happening again, so this information regarding Vitamin K was a real shock.

I really wish I could exercise more, unfortunately, due to COPD, apart from my daily two walks with the dogs around the park and unable to walk uphill, I certainly don’t get as much as I would like to. So I guess I had better concentrate on ensuring my diet is as it should be in future. It doesn’t, however, help when reading online about what and what not to eat, they confuse me even more when they all state.... don’t just suddenly change your diet if you have been taking high or not enough Vit K foods as this can also affect the Warfarin reading. Oh dear.
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14-08-2018, 02:55 PM
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Re: Advice appreciated please.

Originally Posted by shropshiregirl ->
Good morning UJ, thanks for replying. My goodness, 5 PE’S!! You’ve certainly been through the mangle!.

Yes, I really do appreciate just how important Vitamin K with regards to Warfarin is now. Also, the serious consequences if I get it wrong!. I still feel a little peeved though that no-one explained about it both times when I was in hospital. Maybe a Dietician could have explained things to me and I would have ensured I followed the recommendations carefully. As I say, my INR readings were normal for 3 years, but obviously, that seems to have just been down to sheer luck and not from being good!

I do at least now know to be very careful about eating greens, cranberry juice, grapefruit juice and other foodstuffs very high in Vitamin K. I don’t want to live my life constantly worrying what and what not to eat though. As I see it, because my reading was higher, that meant my blood was thinner and at risk of bleeding and/or a stroke, which worried me a little since I found out about Vitamin K from that Hospital phone call, so I am grateful for any reply on here. This Vitamin K is so completely new to me and it’s just trying to find out the number of mpg to the food and drink that I want to eat and will ensure I don’t go over that daily figure of 90mpg that is so vexing to me at the moment.

Do you count these or do you not bother with the number of mpg and just eat anything as normal but with things such as greens etc just take in moderation in your meals?

Yes darlin', you guessed it, I don't eat any of the brassicas, at all. Occasionally I'll eat some green beans, (not sure whether they're loaded with Vitamin 'K' or not), but since its only very rare occasions, I'm not that bothered. I have my INR checked weekly, because I have another blood disorder - I picked up this wonderful little disease - its the flip side to Leukemia - leukemia destroys the white blood cells, this (it has its own name - thrombocytopenia) destroys the red blood cells, - hence the weekly blood tests because I then have to have a different injection every week to kick start the bone marrow into producing more red blood cell platelets. Good 'ere innit!!!
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14-08-2018, 03:17 PM
7

Re: Advice appreciated please.

Hi

Shroppy, have a look at this.

http://www.pulsetoday.co.uk/clinical...030663.article

The new ones don't interact as much as Vitamin K and other things.

You can monitor yourself at home as well, some NHS Trusts pay for it.

I self monitor when I travel, which I do a lot, changes in diet etc.
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14-08-2018, 03:26 PM
8

Re: Advice appreciated please.

LOL UJ, at least it sounds as though you laugh in the face of illness.

GREEN BEANS! I do know this one! I was worrying what I would replace all my greens with for my dinners (peas are fine but can become boring if every day)

Out of your daily allowance of 90 for Vitamin K intake, Green beans are 14.44, so you can easily help yourself to double if you want!
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14-08-2018, 03:28 PM
9

Re: Advice appreciated please.

Sorry, thats 1 cup of green beans cut into 1/2 pieces = 14.4 out of your daily 90.
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14-08-2018, 03:39 PM
10

Re: Advice appreciated please.

Originally Posted by swimfeeders ->
Hi

Shroppy, have a look at this.

http://www.pulsetoday.co.uk/clinical...030663.article

The new ones don't interact as much as Vitamin K and other things.

You can monitor yourself at home as well, some NHS Trusts pay for it.

I self monitor when I travel, which I do a lot, changes in diet etc.
Thank you Swimmy, that made very interesting reading. I cannot see it coming soon to a medical centre near me though. Would be nice if it did.
 
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