Osteoporosis & Warfarin - are they connected?

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Active member
Mar 22, 2009
Moravia NY, USA
After 15 years on Warfarin, and a recent diagnosis of Osteoporosis, I’m wondering if long term use / high dose could contribute to Osteoporosis? Anyone have insight / experience with this?

I’ve always required a high daily dose of Warfarin (12.5mg) to maintain 2.5-3.5 INR. I know every body is different, so have rarely been concerned, but now, I’m wondering…..???

And yes, my doctors & I are actively addressing some other Osteoporosis factors – hyperparathyroidism, post-menopause, body type prone to osteoporosis.

thank you in advance.

(St Jude’s aortic valve, prosthetic ascending arch due to aneurysm, OHS surgery 2009)
I have osteoporosis and have only taken warfarin for three months in my lifetime. There are so many factors that can contribute to osteoporosis risk -- probably no need to look at warfarin as a cause.

In my case it appears to be primarily genetic. My mother fractured a hip at age 66. I have done weight training since age 32 and taken calcium and vitamin D since age 39, so there's not really anything more I could have done to prevent this. Sometimes you just get the unlucky roll of the dice.
There have been studies which show a correlation between warfarin and osteoporosis. One thing to consider is that for many years patients on warfarin were told to avoid or minimize some of the most important foods which help prevent osteoporosis.

Foods such as collard greens, turnip greens, kale, okra, Chinese cabbage, dandelion greens, mustard greens and broccoli are believed to help reduce the risk of osteoporosis. Leafy greens and other vegetables are an important part of a healthy diet and those on warfarin should not be discouraged from eating them. Unfortunately, some folks on warfarin are still following the guidance that was standard 30 years ago, when it was believed that these foods had to be avoided.

This study may be of interest:

"In middle-aged healthy men and women, an easily achieved increase in dietary intake of vitamin K1-rich green leafy vegetables substantially reduces serum tOC and ucOC suggesting increased entry of OC into bone matrix, where it may improve the material property of bone."

I’m wondering if long term use / high dose could contribute to Osteoporosis? Anyone have insight / experience with this?

well there are already some excellent answers, but I thought I'd take a slant from a different angle.

First let me say your dose is not "high" its within what is called normal based on a "normal curve" (which is of course a statistical thing. Lets look for guidance at previous thread competitions

660 mg per day.
Picture this - you go to visit your in-laws for Christmas and you forget your warfarin. You go to the ER and try to convince the doc to write a prescription.
Now if you were successful you trundle down to the local Walgreens to see if they have 7 bottles of warfarin 10 mg tablets on hand.


The why of this is hard to simplify but lets accept this as "out there"

Then there is the rat studies, which finger high warfarin dose in the calcification of arteries.


Basically they fed rats a dose which would be lethal and then injected them with Vitamin K to prevent them dying ... its so incredibly unrealistic that its absurd.

The osteoporsis angle has been largely limited to studies of elderly who are sedentary and fed low vitamin K diets because "people thought that was better". That thinking has since been called into question and some go as far as saying in the literature that it should be struck from the advice.

Best Wishes
Pellicle - that was fascinating! Went back & read that entire 2008 thread on the 660 mg.
Interesting analogy - the left-handed gloves! Who knew?!!

Chuck C - so damn right about the good-for-you-K-foods! I used to eat more greens, but also was drinking more back then...prob not scientifically correct, but learned to balance my INR between the two ;).

Now, I just am anxious...how much would it increase my dose if I DID keep a consistent K in my daily diet!?

My bones need this nutrient now more than ever! I'm analyzing a shift in Benefit over Risk.
I'm working with a Clinical Nutritionist w/ a 40 yr career focused on natural bone health. I'm gonna figure out how to be just fine!!!

Thank you for responding!
If it helps ease your mind, I take 13mg a day.

I also eat a lot of greens and take extra Vitamin K.
It does!! Thank you....
reading the left hand glove analogy really helped me accept/ understand this (thread link in pellicle's post).
Knowledge leads to empowerment!

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