Resveratrol & Warfarin Interaction?

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Homeskillet

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Quick question gang. I recently bought some resveratrol—then, afterwards, thought “I wonder if this interacts w. warfarin🤨?” Tonight I came across the following quote while reading online:

Anticoagulant and antiplatelet drugs
Resveratrol has been found to inhibit human platelet aggregation in vitro (53, 155). Theoretically, high intakes of resveratrol (i.e., from supplements) could increase the risk of bruising and bleeding when taken with anticoagulant drugs, such as warfarin (Coumadin) and heparin; antiplatelet drugs, such as clopidogrel (Plavix) and dipyridamole (Persantine); and non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen, diclofenac, naproxen, and others.

**My question: Since I monitor at home, can I still take this stuff and adjust accordingly? Or, would it still be unwise to take this?

Similarly, I am about to have some testosterone pellets injected since my blood tests revealed low testosterone. However, the Dr. said that it is VERY important to take DIM & Vit. K2 in MK-7 form for it to be absorbed efficiently into the body.

DIM is found in cruciferous vegetables such as broccoli, kale, etc...which I have stayed away from since beginning warfarin therapy.

My understanding is that I can take this stuff as long as I stay on it consistently, test weekly (or, since I’m beginning a new supplement, perhaps two times per week), and adjust accordingly.

Your thoughts would be appreciated. Love this forum (tell everyone about it w. heart issues)! Thank you much in advance (May take me a day or two respond, but will do so ASAP.
 

LondonAndy

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I am on Warfarin and Aspirin (among other things), and whilst certainly your INR meter will pick up any changes that might need a revision of dose of Warfarin once you start taking the Resveratol, I am not sure about whether any other doses would be affected.

Also, I eat broccoli quite often, but not consistently. My INR fluctuates marginally all the time, but why this is so I am not sure of the factors, and only rarely do I have to vary my Warfarin dose. When I do it is only for either a single change (eg an extra 2 or 3mg once only if my INR is towards the lower end of my range) or a 1mg per day change if for a longer period. I am currently 1mg up per day having just finished a course of antibiotics for a skin infection that affected my calf, which has surprised me; normally if I take antibiotics my INR rises significantly, eg to 4.0 if I was on 3.0, but this time it has fallen to 2.5 and stayed there even with some booster doses. I am monitoring every 3 days until it remains consistent.

That is partly off topic, but hope it helps.
 

tom in MO

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I'd ask your cardiologist about any interactions with any new drug that you take.

When it comes to testosterone replacement therapy, I know that other delivery forms of testosterone, such as gel, have no contraindications if you are on warfarin.

I would suggest staying away from the implants, since they don't provide a "steady" dose. The dose peaks after implantation and then falls away. If you truly suffer from hypogonadism, your testosterone levels will drop too low to keep you on an even keel.

The normal testosterone activity is that it cycles from high in the morning to lower before bed. The gel delivery form of testosterone, when applied in the morning, makes the most sense since it mimics the body's natural fluctuating testosterone levels. It is the most recommended dosage form and it's covered by US insurance companies if you suffer from hypogonadism.

If you do take the implants, make sure they are an actual manufactured pharmaceutical product and not compounded by a specialty pharmacy. Specialty compounding pharmacies are one of the biggest areas of fraud and mistakes. People have died. One of the most common problems is the sterility of the compounded material. This is key for any drug taken by implantation. If the implants or implantation procedure is not done under sufficiently sterile conditions, you can get a real good infection at the implantation site and even lower into the tissue. I speak from experience. Not only will your body have an infection, it will reject the implant and your body will slowly work the implant out of your body, up and out through your skin.

If you don't have a diagnosis of hypogonadism, testosterone therapy is not really needed. It is not the wonder drug for aging males that is portrayed in advertisements and men's magazines. If a doctor tells you that your levels are not "normal" be aware that nobody knows what is a "normal" level. Testosterone levels fall off as you get older, so normal for a 18yo is not normal for a 78yo. Normal levels are a range and there is generally insufficient data to identify a normal range for a specific age. Testosterone therapy, particularly implants, and testosterone testing are a big money maker for some doctors.
 

Homeskillet

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Ok Gents—got it! That’s what I thought. Man, self testing has saved my bacon sooo many times already. For example, just prior to taking my dose today I thought, “I better test since I have been running high for some reason.” I cannot locate the culprit other than Lycopene and Pomegranate supplements that I started taking to lower my PSA (but from what I read that isn’t supposed to raise INR?). Also been taking Tylenol for pain. Tested at 3.7😡!

Lowered the dose to 7mg down from alternating 8.5 & 9 and drank some hot steeped green tea. Will test tomorrow again. Funny thing is, all of y’all were completely right about my overreacting to warfarin. A bit of a learning curve, but self-testing regularly seems to be key—just like y’all told me 🙄.
 

Protimenow

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Tom: Your comment about testosterone levels declining with age is the reason why men supplement it. A man in 50s, 60s or above, with testosterone levels that are 'normal' for men that age don't function as well as do men in their teens, 20s or 30s. They lose muscle mass, gain body fat, and go through other changes that 'make' them old.
The idea behind testosterone replacement therapy is to supplement the testosterone so that the 'older' man's testosterone levels match what they were then they were in their 20s (or younger).
The higher levels of testosterone improve libido, enable effective workouts that restore muscle mass and reduce fat, and provide other benefits. As noted, there are a few delivery methods - pellets, creams and injections. And, as noted, some can be less effective than they should be and could even be dangerous.
Perhaps the safest (from what I've read) are the bioidenticals - these are made from Yams (which apparently have similar chemistry to male testosterone and can be modified to match human testosterone) - and are applied as a cream.
The injectables and other creams may not be identical to human testosterone.

The overall idea is to make your body and mind 'young' again - not to make sure it's as 'old' as the 'normal' man in your age group.
 

tom in MO

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Tom: Your comment about testosterone levels declining with age is the reason why men supplement it. A man in 50s, 60s or above, with testosterone levels that are 'normal' for men that age don't function as well as do men in their teens, 20s or 30s. They lose muscle mass, gain body fat, and go through other changes that 'make' them old.
The idea behind testosterone replacement therapy is to supplement the testosterone so that the 'older' man's testosterone levels match what they were then they were in their 20s (or younger).
The higher levels of testosterone improve libido, enable effective workouts that restore muscle mass and reduce fat, and provide other benefits. As noted, there are a few delivery methods - pellets, creams and injections. And, as noted, some can be less effective than they should be and could even be dangerous.
Perhaps the safest (from what I've read) are the bioidenticals - these are made from Yams (which apparently have similar chemistry to male testosterone and can be modified to match human testosterone) - and are applied as a cream.
The injectables and other creams may not be identical to human testosterone.

The overall idea is to make your body and mind 'young' again - not to make sure it's as 'old' as the 'normal' man in your age group.
Test. levels vary by individual and by age. There is no "normal" testosterone range for men of a specific age. So shooting for a young man's Test. level is shooting at a target that doesn't exist.

Now hypogonadism is a true failure of man's testicles to produce testosterone. Usually hypogonadism is noted by an individual through the symptoms. If these symptoms are present, the low test. is verified by a blood test (very expensive test by the way.) Testosterone supplements are medically indicated for people that suffer from hypogonadism not for people who are just old.

If I recall my medical history correctly, the Nazis proved testosterone is not the wonder chemical men hoped it would be. However there's a lot of money to be made in helping rich men feel young. It's probably the placebo effect.
 

Protimenow

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Sure there's a range. The range of testosterone for a man in his 20s is higher than the range for a man in his 50s.

This is not about the failure of the testes to produce ANY testosterone - it's just a gradual reduction in the amount produced. Testosterone supplementation can help partially reverse the decline in testosterone.

I'm not familiar with the Nazi studies, or the levels that they raised their subjects to. I suspect that there's a maximum, over which there's no benefit.

I still suggest that the ability to produce more muscle mass, to get a better feeling of well being, and other changes resulting from slightly raising testosterone levels is more than just a placebo effect.
 

Bill B

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There might be a little confusion in this thread about resveratrol or other compounds that may interfere with platelet activity. You cannot "adjust" for them by INR testing they do not affect INR. They definitely can enhance bleeding, but testing INR more frequently when taking antiplatelet compounds is not going to help. Also, Homeskillet was wondering if his elevated INR might be due to taking pomegranate supplements. Pomegranate actually contains a fair amount of vitamin K, about 25mcg per cup of juice. So, depending on how concentrated the supplement is, I would expect it to lower INR, if anything. That's what happened to me before I knew that pomegranates had some measurable vitamin K. I LOVE pomegranates but haven't eaten them often in recent years. However, I shop at Costco and I couldn't resist a box of 8 large poms for such a good price. I proceeded to devour them over the next week. My INR on warfarin has been very stable over the years, but my subsequent INR was surprisingly low. Googling pomegranate vitamin K content came up with the likely explanation. :-0
 

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