Natto and INR

[pellicle]

Hi

It happens that someone I'm helping with INR (waves to @Bionic Orange) had an encounter with Natto.

Natto is a rotting mess of stinking slimy soya beans which has somehow developed a following in Japan (probably because they were starving at the time) and is actually very high in Vitamin K2

Various sources list its content as high, for example:

• A study by the vitamin K research group at the University of Maastricht, in The Netherlands, found 1000 mcg per 100 grams (or about 3.5 oz) of vitamin K2 in natto.
• Natto is a Japanese (although I'm sure Koreans also claim it for their own) "food" made from fermented soybeans. It's high in many nutrients that promote good gut health and is the richest source of vitamin K2 available. One tablespoon of Natto contains 150 micrograms of vitamin K2, about twice the recommended intake.

so basically if you're on warfarin you need to be aware of it.

Personally I find that fresh high quality natto smells remarkably like what babies leave in nappies. That its a slimy mess that stinks makes it pretty easy to avoid in my book.

I did a quick search on Natto here and found an old post from 2005:

https://www.valvereplacement.org/threads/do-you-know-about-natto.10946/

To the uninitiated Natto looks like this

Someone who's obviously trying too hard to cover it up with all the seasonings and mustard



So if the smell and the slime didn't put you off it, then I propose just avoiding it. Just like grapefruit its something to be avoided with the keenness of not stepping in something which should have been picked up by the dog owner.

Hope this helps someone else.

 

[ashadds]

@pellicle I have been following your posts here and I want to say I am more confident in a mechanical valve due to this forum. In terms of vit k diet, I have plans of travelling 10 day trips to asia (thailand) or europe. Maybe once a year or 2 years. I have plans on getting a coagucheck, what is the diet recommendation abroad ? for example does it make sense to eat a DV of vit k , 120 mg for men each day and use this chart to get an estimate of what foods to eat to reach DV ?

https://www.drgourmet.com/md/vitk_by_mcg.pdf

 

[pellicle]

Hi

I have plans on getting a coagucheck,

to me that's a no brainer ... so I fully support that

what is the diet recommendation abroad ? for example does it make sense to eat a DV of vit k ,

eat what you want, but IMO eating a good healthy diet is #1 priority. I eat lots of salads (meaning multiple times per week) and eat sauerkraut (or kimchi) on days when I'm not eating salads. I eat asparagus and other greens (broccoli) frequently too

I'd say that in the main what medical professionals might advise (and thankfully the tide is turning) about avoiding greens is plain unsubstantiatable.

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4998867/
Hope that helps

 

[Bionic Orange]

It happens that someone I'm helping with INR (waves to @Bionic Orange) had an encounter with Natto.

This is true. Thank you.

Natto is a rotting mess of stinking slimy soya beans

I love this food but it does not love me, more accurately, doesn't love my INR/Warfarin. My wife is very glad that I have sworn off this food because she agrees with the stink and slime adjectives.

so basically if you're on warfarin you need to be aware of it.

My INR was stable while I was eating a salad daily, and lots of foods like broccoli, avocado, peas, blueberries, etc. on a daily basis. When I introduced Natto for only 2 days (2 packets each time), my INR tanked. I won't be eating this wonderfully delicious health-food again.

Hope this helps someone else.

I hope so too. Live and learn as they say.

 

[Bionic Orange]

So if the smell and the slime didn't put you off it, then I propose just avoiding it. Just like grapefruit its something to be avoided with the keenness of not stepping in something which should have been picked up by the dog owner.

Obviously some people just don't have finely tuned taste buds that are necessary for this acquired delicacy. I'm referring to the Natto, not the .

 

[pellicle]

I love this food but it does not love me, more accurately, doesn't love my INR/Warfarin.

well actually the food does love you because it helped your body remove that rat posion quick smart.

Hey @Chuck C , perhaps this is a good method for a rapid INR drop that should reverse on its own because its the administration of a reversal agent (vitamin K) and you can just continue your regular dose routine and this could drop it enough to help when you get punched in the head?

My wife is very glad that I have sworn off this food because she agrees with the stink and slime adjectives.

literally my first experience with good fresh Natto was in Japan at a friends house, I was sat beside her kid in the high chair and was entertaing and helping feed her (the kid, not my friend) and I was certain that the kid had pooed its nappy. An inspection (peek in behind) revealed "all good".

I ended up eating some that day and soon realised where the smell of poo was coming from. I also learned that the incredible stringy slime formations end up on your chin. I had a beard, which repeated efforts to wash and even using a fine comb left me smelling that for long enough that I shaved it off

There are plenty of cultural dishes (read historical uses of spoiled foods) that are like this, Eg:
https://en.wikipedia.org/wiki/Surströmming
When I was living in Finland I bought some to try, 90% of Finns do not eat it so I had to get it in Helsinki. I smelled it, but didn't actually try eating it ... I put it in the bio-waste bin.

 

[Chuck C]

When I was living in Finland I bought some to try, 90% of Finns do not eat it so I had to get it in Helsinki. I smelled it, but didn't actually try eating it ... I put it in the bio-waste bin.

" A newly opened can of surströmming has one of the most putrid food smells in the world, "

Sounds like lovely stuff.

 

[Bionic Orange]

literally my first experience with good fresh Natto was in Japan at a friends house, I was sat beside her kid in the high chair and was entertaing and helping feed her (the kid, not my friend) and I was certain that the kid had pooed its nappy. An inspection (peek in behind) revealed "all good".

I ended up eating some that day and soon realised where the smell of poo was coming from. I also learned that the incredible stringy slime formations end up on your chin. I had a beard, which repeated efforts to wash and even using a fine comb left me smelling that for long enough that I shaved it off

Too funny

 

[Protimenow]

I may end up going to a dentist in the next week or so. I've been putting up with occasional 'discomfort' in a few of my teeth - amoxicillin helped (took down swelling), but this may be a fight that I lose in the end.

If I have to bring my INR down before seeing the dentist, I won't use Natto to do it -- I'll probably just get a supplement that a) has K1, or b) a multivitamin with K1. I'll check my INR before going to the torture room, and restart my normal dose of warfarin once I'm finished.

 

[Chuck C]

Hey @Chuck C , perhaps this is a good method for a rapid INR drop that should reverse on its own because its the administration of a reversal agent (vitamin K) and you can just continue your regular dose routine and this could drop it enough to help when you get punched in the head?

I like the idea of reducing my INR by 0.2 or 0.3 before boxing. However, I'll experiment with doing this with oral vitamin k2, rather than natto. From the description, I think I might have a hard time keeping the Natto down.

 

[pellicle]

I think I might have a hard time keeping the Natto down.

don't breath in, and just swallow it
also don't get any of the strings on your beard

 

[V__]

I like the idea of reducing my INR by 0.2 or 0.3 before boxing. However, I'll experiment with doing this with oral vitamin k2, rather than natto.

The oral supplements of the vitamin seem to be more controlled/repeatable...

 

[Protimenow]

K2 won't drop your INR. I've been taking K2 and D3 for years.

What you probably want is K1 (or a supplement that includes it).

 

[pellicle]

K2 won't drop your INR. I've been taking K2 and D3 for years.

What you probably want is K1 (or a supplement that includes it).

Why don't you try what he did and see, for science.

 

[Protimenow]

Perhaps he was confusing K1 and K2. Sometimes the bottles only say 'Vitamin K' and don't specify which one it is.

 

[carolinemc]

I may end up going to a dentist in the next week or so. I've been putting up with occasional 'discomfort' in a few of my teeth - amoxicillin helped (took down swelling), but this may be a fight that I lose in the end.

If I have to bring my INR down before seeing the dentist, I won't use Natto to do it -- I'll probably just get a supplement that a) has K1, or b) a multivitamin with K1. I'll check my INR before going to the torture room, and restart my normal dose of warfarin once I'm finished.

Amoxicillin takes care of Infection not swelling. Aspirin or other aspirin like helps the swelling.

 

[pellicle]

Perhaps he was confusing K1 and K2. Sometimes the bottles only say 'Vitamin K' and don't specify which one it is.

He would be me, did you read the first post in the thread? Natto does not contain K1 it contains K2.

let me refresh you

Various sources list its content as high, for example:

• A study by the vitamin K research group at the University of Maastricht, in The Netherlands, found 1000 mcg per 100 grams (or about 3.5 oz) of vitamin K2 in natto.

1 milligram (mg) is equal to 1000 micrograms (μg).

Now if you were looking for an explanation of why his INR suddenly plummeted would you not look to that as being the likely cause?

So that means he had about 2 milligrams (not thousands of a gram) of K2 for two days straight this is actually very close to the reversal dose.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042451/

Lin and Callum recommend 10 mg of vitamin K to reverse warfarin anticoagulation in emergencies.1 However, a dose this high may not be required for all “emergent” situations. It is important to differentiate between emergencies on the basis of severity of bleeding and urgency of reversal of warfarin anticoagulation. Anticoagulation can be reversed with 2.5 to 5 mg of vitamin K administered intravenously in a patient taking warfarin who requires urgent surgery.2 This lower dose of vitamin K is especially important when anticoagulation needs to be resumed once hemostatis has been achieved after surgery.​

Recall that the mechanism of action of Warfarin is Vitamin K recycling antagonization. To the best of my knowledge the body does not store K1 (phylloquinone) but stores K2 (menaquinones). I understood that that the body does not store K1 but converts it to K2 to store and then use in the reactivation of the enzymes involved in the coagulation cascade. If you have a greater understanding of the mechanism involved here please point me to better resources.

I encourage you to repeat his experiment and post your results.

 

[delucadana]

I take natto almost on a daily basis to balance warfarin intake. Normally I take one teaspoon which provides about 115 mcg of vitamin K2 MK-7. If my INR is on low end of my therapeutic range I don't take any but never more than one tsp.

Of course no one I know can stand it except my acupuncturist who recommended it years ago. He has since passed but not from natto!

I have developed a taste for it and wish I could eat more but I don't.

A hundred grams of natto is probably about one cup of volume which is 16 tbsp or 48 tsp. At 115 mcg per tsp that's 5520 mcg per cup or 5.52 mg. That big of a dose of Vitamin K2 mk-7 would be considered an antidote for warfarin toxicity. Depending on how high one's INR was (over 5 is dangerous), probably around 1-10 mg of vitamin K would be administered intravenously to reverse warfarin toxicity.

However, one does not have to stay away from natto, but one must understand its effects.

 

[Chuck C]

K2 won't drop your INR. I've been taking K2 and D3 for years.

K2 drops INR. In fact, in Japan it is used often to bring INR down when a patient's INR has gone dangerously high.

When my INR went to 9.7, due to the Amiodarone, the first thing that the coumadin clinic did was to ask me if I had vitamin k or k2 on hand. As I just had k2 they had me take 25 x 100mcg capsules. It takes a lot of the over the counter capsules, typically of 100mcg each, to drop INR.

To give you an idea of how much K2 Bionic Orange ate, it was 2 packages of 100grams of natto, two days in a row. 100 grams of natto has about 1,000mcg of K2. So, he ingested 2,000mcg of k2, two days in a row. That is the equivalent of taking 20 of your 100mcg capsules, two days in a row. Much different than taking 2 or 3 capsules. 2 or 3, or even 4 or 5, probably not enough to drop your INR. Taking significantly more than that, at some point, will move INR downward.

I take 200mcg of k2 per day. That is not enough to move INR much, and since I am consistent with taking it daily, it would not even move my INR a little. On Friday night I did an experiment, taking an additional 5 capsules of k2, or an extra 500mcg. That was not enough to change my INR. But, I am going to try increasing it gradually, until I get to the point where I get a noticeable drop. I'll let the forum know if I find the leverl of k2 which moves INR.

 

[pellicle]

However, one does not have to stay away from natto

agreed, and also if you have it regularly I think it may even simply work to stabilise your INR.

However if you "go off it" (for instance because you go on a holiday) you may need to monitor for its (absence) effects.

I strongly believe in the idea of 1) dose the diet 2) monitor INR weekly