Foods on warfarin

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Mister_James

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Don't schedule your meals. Enjoy your meals and when you test adjust your dosage. It is that simple.
If you are around 3.0 INR and test weekly or biweekly you will have to binge on greens seriously to bring that number down into danger zone.
Remember when we go for procedures, we stop warfarin and it takes 3 to 4 days to get down to the level of needing to bridge.
So long as you do not stay below therapeutic level for a significant amount of time.
Now if you are one of those who aims for 1.5 to 2.0, the disregard all above.
If you have been avoiding greens like the coronavirus also disregard but if you have a well balanced diet. Your body understands you love your greens. Keep enjoying them.

Now go get some fresh collard greens, remove the mainstem, roll the leaves and finely slice them. Saute onions and garlic in coconut oil (don't mention saturated fat) add the greens with beef bullion and let the cook down stirring so often.

frozen greens have huge chunks of the main stem and that's unappetizing.

Bon apetite.
 

pellicle

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Don't schedule your meals. Enjoy your meals and when you test adjust your dosage. It is that simple.
this

So long as you do not stay below therapeutic level for a significant amount of time.

within the therapeutic window
1658788043299.png

think Goldilocks

Remember when we go for procedures, we stop warfarin and it takes 3 to 4 days to get down to the level of needing to bridge.

this is a rule of thumb and is not my experience or that of others, it can be significantly shorter it can also be longer. Bridging may not be required, so check with your practitioner on how to manage INR and their desired INR needs for the procedure (it may not be onerous at all).


lastly about Vitamin K I would say (to the casual reader) that what @Mister_James says about avoiding greens is backed up by good examinations of "the rules" that guide those in clinics, who actually aren't on warfarin, don't know much and don't appear to keep up with the literature.


In conclusion, the available evidence does not support current advice to modify dietary habits when starting therapy with VKAs. Restriction of dietary vitamin K intake does not seem to be a valid strategy to improve anticoagulation quality with VKAs. It would be, perhaps, more relevant to maintain stable dietary habit, thus avoiding wide changes in the intake of vitamin K. Based on this, until controlled prospective studies provide firm evidence that dietary vitamin K intake interferes with anticoagulation by VKAs, the putative interaction between food and VKAs should be eliminated from international guidelines.

basically test and know thyself is my motto.
 
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ThomasM

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Well I just became a supporting member!
With that being said, you folks will be somewhat amazed at my lifestyle. Like I said, I pretty much eat what I want when I want to eat it, and my weight is very good at around 200 lb. I am 6'1 and somewhat athletic and I am able to maintain a healthy weight. Although, I don't get my blood checked as I should, it was about a month ago I had my PT checked. Before that it was about 6 months since the last check. I am due right now to get it checked, but I'm not sure when that will be. This I am not recommending, and I should get my PT checked, but I don't feel like I am in any danger. If I did I would probably get a check more often. My PT level has been stable over the course of the last 5 years, so it is what it is. I must be doing something right, I am now 67 years old and have had my St Jude aortic valve prosthesis for 35 years.
 

pellicle

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With that being said, you folks will be somewhat amazed at my lifestyle. Like I said, I pretty much eat what I want when I want to eat it,
no, that's pretty much what most of us here do ... why would we be amazed?

Although, I don't get my blood checked as I should, it was about a month ago I had my PT checked
not a good plan ... get a Coaguchek and test weekly. If you don't ... well then you're just waiting to become a statistic of "Usual Care" rates of stroke or life threatening bleeds and contributing to the "bad name" warfarin gets.

Get a used Coaguchek while they're cheap (at least in the USA)

Take care of yourself properly (and that you still use PT instead of INR suggests you've been badly educated on this)

Best Wishes
 

ThomasM

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Hmmm? First you tell me you are not amazed (originally, 'surprised' would have been a better choice of words by me), then you say most folks in here do the same? Then you tell me that's not a good plan, and warn me of the pitfalls? and tell me take care of myself properly, then call me uneducated?
Did you read the part where it said I have had my St Jude valve prosthesis for 35 years? And I'm now 67 years old? If you have something to relate to me, which I think you did, please do it kindly.
Best wishes
 

Superman

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Hmmm? First you tell me you are not amazed (originally, 'surprised' would have been a better choice of words by me), then you say most folks in here do the same? Then you tell me that's not a good plan, and warn me of the pitfalls? and tell me take care of myself properly, then call me uneducated?
Did you read the part where it said I have had my St Jude valve prosthesis for 35 years? And I'm now 67 years old? If you have something to relate to me, which I think you did, please do it kindly.
Best wishes
The eating and the doing what you want, most in here do.

Going six months between INR checks, most do not. Quite surprised you’re not getting harassing calls from your provider. Truth is with a six month gap, we’d have no idea what our INR is doing during that time. You’ve been lucky. There isn’t really a feeling when you’re out of range. By the time there is a feeling, it’s something bad that you should have and could have avoided. A stroke being the worst of it.

I’ve been taking warfarin for nearly 32 years and I wasn’t far off your management style in my 20’s (I was 17 when I started). But as we both know, home testing didn’t exist back then and the lab’s were a pain to deal with. An hour or more out of my day including transportation. I only recall one issue with blood in my urine (like dark brown) and my INR was close to 10. Fortunately it was that and not a stroke for being too low. But it could have been a lot worse.

I’ve been home testing for 12 years now and it’s been far better for me. Mainly just for not having to go in for a blood draw. Very inconvenient when you’re busy with work and kids etc. Now it’s two minutes in the bathroom and a quick email and I’m done. That alone makes it worth it. But also knowing I’m in range gives comfort as well.

BTW - Good on you for supporting. I’m long overdue for that. Maybe I’ll make it a birthday present this year. This is a place I enjoy. 😁
 
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pellicle

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Hi

Hmmm? First you tell me you are not amazed (originally, 'surprised' would have been a better choice of words by me), then you say most folks in here do the same?

ok, so

1659231703325.png


you wrote "you folks will be somewhat amazed" and go on to talk about eating what you want

I then say no, that's pretty much what most of us do and ask "why would we be amazed".

Not sure why you then say this:

Then you tell me that's not a good plan, and warn me of the pitfalls? and tell me take care of myself properly

when I specifically restricted that to your INR management not diet ... how strange

Did you read the part where it said I have had my St Jude valve prosthesis for 35 years?

yes ... and did you read where I spoke about the dangers of INR management that you are undertaking?

And I'm now 67 years old? If you have something to relate to me, which I think you did, please do it kindly.

Superman has spelled it out as well and I thought my points were clear I'll post it again:

not a good plan [to not monitor your INR] ... get a Coaguchek and test weekly. If you don't ... well then you're just waiting to become a statistic of "Usual Care" rates of stroke or life threatening bleeds and contributing to the "bad name" warfarin gets.

if you don't understand that then I'm sorry, but you absolutely do need educating.

Unless you consider yourself too experienced to learn anything anymore. Tell me, do you wear a seatbelt when you drive or only when you 'feel' you'll have an accident?
 
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Superman

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I'm sorry, that didn't come across {PS: I just reviewed what you wrote and still cant see where you say that I "have some good things to say" ...}



can you please explain where I was rude?

It was here:

If you have something to relate to me, which I think you did, please do it kindly.

That Australian bluntness can come across as abrasive in some cultures.
 

pellicle

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It was here:
I'm sorry, but was there something I said intended to be after here:

I can't see it

While on topic where is the acknowledgement of some good things to say as indicated by: "As I said in my last post you had some good things to say,"

Again, I'm sorry but I'm not seeing that either.
 

carolinemc

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Well I just became a supporting member!
With that being said, you folks will be somewhat amazed at my lifestyle. Like I said, I pretty much eat what I want when I want to eat it, and my weight is very good at around 200 lb. I am 6'1 and somewhat athletic and I am able to maintain a healthy weight. Although, I don't get my blood checked as I should, it was about a month ago I had my PT checked. Before that it was about 6 months since the last check. I am due right now to get it checked, but I'm not sure when that will be. This I am not recommending, and I should get my PT checked, but I don't feel like I am in any danger. If I did I would probably get a check more often. My PT level has been stable over the course of the last 5 years, so it is what it is. I must be doing something right, I am now 67 years old and have had my St Jude aortic valve prosthesis for 35 years.
Dude, not a great idea of forgoing the PT check. You run the risk of strokes and other problems if you are not dosed properly. You need to have PT checked once a month or more depending on your meds, or if you have to take Antibiotics for infection. You are in more danger not getting it checked on a regular basis. Talking from someone who got the St. Jude's' leaflet valve 21 years ago. Many things you can react to.
 

pellicle

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Good morning

well based on your later assertion that you are willing to listen (which your post didn't seem to suggest, nor your later replies which contained claims of saying "you felt I had good things to say" but when asked where they were you as yet have not answered) I thought I'd have another attempt at discussion, communication and perhaps guidance.

first and foremost, this is not a US only forum, cultural communications vary across the globe and the english speaking world is bigger than I think you imagine (many in Europe, India and then the other Colonies like Canada and Australia for starters). Australians are not like Canadians we are more direct (Superman called it blunt, but I can demonstrate blunt if asked. Its worth noting Australians are rank amateurs at Blunt when compared to the Finns and I lived there for over 10 years all up), if you had identified as Japanese I would have spoken to you as my sensei (先生 which means you're experience predates mine).

So, firstly I'd like to address this:
I must be doing something right, I am now 67 years old and have had my St Jude aortic valve prosthesis for 35 years.
This is called survivor bias,

Another kind of survivorship bias would involve thinking that an incident was not all that dangerous because everyone communicated with afterwards survived. Even if one knew that some people are dead, they would not have their voice to add to the conversation, leading to bias in the conversation.​

its well documented where people think "I did something right" when indeed it was just the stats. The stats show that some people doing everything wrong can be somehow (probably metabolically) an outlier and never even take their warfarin. I recommend you read this post and the associated links


However despite you (and them) getting off so far in your game of "INR Russian roulette" not everyone does:

1659307420779.png


the key points in there are: irregular warfarin therapy and low INR. I'm not saying you're irregular but we just don't know (and you know the old saying about ASSUME

I prefer to be explicit rather than make and Ass out of anyone.

This I am not recommending, and I should get my PT checked, but I don't feel like I am in any danger. If I did I would probably get a check more often. My PT level has been stable over the course of the last 5 years, so it is what it is.

this of course brings me to the fact that PT is no longer used because it is meaningless. We now use INR which is constructed differently (I can go into that if you wish, but you could start your own reading here)

Did you read the part where it said I have had my St Jude valve prosthesis for 35 years?
I did and I guessed that was some sort of "standing on laurels" rather than addressing the argument or the statements or supplying anything like reasons.

You yourself commented that you didn't think it was the ideal method. Now if you like I can discuss more things which you may or may not know about the possibility of an INR deviance, the reasons for the target in INR being what it is (Eg target INR = 2.5 for aortic valve and no other predisposing factors).

Lastly I'm sorry if I have not provided the required deference to age / reverence to wisdom or other cultural (mysterious to me) requirements to be deemed politeでございます but unless you tell me what's needed I can only guess. Please accept the flowers and rainbows below as an indication of my respectfulness and courtesy in intention.

1659307732768.png


Best wishes
 

Sassy20

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Well I just became a supporting member!
With that being said, you folks will be somewhat amazed at my lifestyle. Like I said, I pretty much eat what I want when I want to eat it, and my weight is very good at around 200 lb. I am 6'1 and somewhat athletic and I am able to maintain a healthy weight. Although, I don't get my blood checked as I should, it was about a month ago I had my PT checked. Before that it was about 6 months since the last check. I am due right now to get it checked, but I'm not sure when that will be. This I am not recommending, and I should get my PT checked, but I don't feel like I am in any danger. If I did I would probably get a check more often. My PT level has been stable over the course of the last 5 years, so it is what it is. I must be doing something right, I am now 67 years old and have had my St Jude aortic valve prosthesis for 35 years.
Hi, I’ve had my St Jude aortic valve for 17 years and like you I eat whatever I feel like. However I have at least a monthly check but if my INR is too low or too high my doctor will adjust the dose and then have a weekly test until it gets back into range. When I joined this site it was the first time I’d heard of people self testing at home. Not sure what other’s do in Australia but I’ve always had my blood taken at one of the Pathology Units or before Covid my local clinic used to do the finger prick test. There has never been any charge for these tests, just have to make the time to have it done. Pleased to see your ST Jude has lasted so long, hopefully mine will see me out.
 

pellicle

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Not sure what other’s do in Australia but I’ve always had my blood taken at one of the Pathology Units or before Covid my local clinic used to do the finger prick test
well I know one or two others and when ever I need a blood test I always ask for a INR sample too, so then I go home and test against my coaguchek to get a comparison. I've encouraged others to to that too (both in NZ and the USA).

So far I've been within 0.2 INR Units
 

ThomasM

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I hope my portions of the conversation are not going off topic as to hijack the thread, but some very good points were made. Firstly, I should be getting my blood tested on a monthly basis, permitting the levels are stable. Thanks to those who 'kindly' prompted me to get my level checked. Funny, I am a bit of a worrier and you would think I would get it checked more often? I just had the Protime/INR tested a couple hours ago and have the results already.
PROTIME Seconds = 35
INR = 3.0
(not bad for an uneducated individual 😏)
These values are just about perfect.
 

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