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Supplements and Warfarin

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Protimenow

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I'm sure that many of us have struggled with this issue:

We are taking Warfarin, and we're thinking of taking supplements.

Unfortunately, there's no reliable source to determine interactions with herbal (and other) supplements.

Much of this is probably purely anecdotal.

I'm thinking of, perhaps, taking a few new things: DCAA and Longjack Extract. Have any of you had ANY experience with, or know of interactions or effects on INR, when taking either of these?

(Perhaps I'm just lazy - I can test my blood one day, three days, or maybe more days after starting one or the other - this may show how INR is effected, but nothing about what it does to platelets - so I suppose whatever I try will just be taking my chances).

But, again, it may be helpful to know any supplements you're taking and your experience with them.
 

pellicle

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But, again, it may be helpful to know any supplements you're taking and your experience with them.
This is indeed the problem with supplements, they are not pharmaceutical, they adhere to no regulatory stands and are not tested. Probably this is because they don't have significant repeatable medical or health benefits.

So the best you can do in the absence of data is rest and see yourself.

Best Wishes
 

Sheenas7

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I have osteoporosis and all recommendations to take supplements like K2 and MK7 worry me. I asked my cardiologist and he said no to them. Also did some research years ago that did not recommend it be taken with warfarin. So I don't. I use to love chamomile tea. I haven't had it since I started on blood thinner. Jantoven is going ok. So my doctor put me on a every 2 week schedule again.
I had asked me to increase the dose because I was testing 2.4, 2.3 and 2.5 and 2.7. This is testing once a week when I started. He said no. Stay the course.
Before on Coumadin my numbers were more in the 3 range.
 

Protimenow

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Your mid-2s should be okay. I'm not sure which valve you have.

If I recall, chamomile tea may affect your INR -- which is okay, as long as you drink the same amount each day.

I take K2 daily - K2 + Vitamin D in the same pill. I've tested my INR before and after taking it, and it's not affected. You'll probably do best with a name brand.

Read the label carefully -- the manufacturers may sneak something with B1 or some greens, or something, in there to reduce the effects of warfarin. If you start a new K2 from a different source, test your INR the next day, and probably a few days later. You may still be able to take a pill with a standardized dose -- just adjust your Jantoven dose to account for its effects.
 

Protimenow

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I have osteoporosis and all recommendations to take supplements like K2 and MK7 worry me. I asked my cardiologist and he said no to them. Also did some research years ago that did not recommend it be taken with warfarin. So I don't. I use to love chamomile tea. I haven't had it since I started on blood thinner. Jantoven is going ok. So my doctor put me on a every 2 week schedule again.
I had asked me to increase the dose because I was testing 2.4, 2.3 and 2.5 and 2.7. This is testing once a week when I started. He said no. Stay the course.
Before on Coumadin my numbers were more in the 3 range.
This is indeed the problem with supplements, they are not pharmaceutical, they adhere to no regulatory stands and are not tested. Probably this is because they don't have significant repeatable medical or health benefits.

So the best you can do in the absence of data is rest and see yourself.

Best Wishes
That's pretty much how I approached it.

The problem with some of these things is a) you may not see any benefits (or be able to recognize them), b) these things may not show any recognizable benefits for weeks or months after starting them, c) unless you take only ONE new supplement at a time and watch for effects, it'll be hard to determine WHICH supplement is causing changes in your INR or physical health.

(It took me a while to realize that something as potentially innocuous as Caffeine can screw with my heart rhythm -- I can just imagine what OTHER stuff can do to it).
 

tom in MO

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Moderation in all things including supplements. My cardio said to tell him if I start taking any supplements or OTC medications on a regular basis. He told me to stop taking the vitamins and fish oil that he told me to take pre-AVR.
 

ScribeWithALancet

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Moderation in all things including supplements. My cardio said to tell him if I start taking any supplements or OTC medications on a regular basis. He told me to stop taking the vitamins and fish oil that he told me to take pre-AVR.
I generally take name brand supplements for consistency. However, I also test weekly. If a new supplement, I test twice a week for the first week. I found a slight change in my INR from K2. When we added it, just 50 ug, my INR dropped slightly and I had to add 1/4 of coumadin to my daily amount. When we bumped it up to 100 ug, I had to add another 1/4 ug of coumadin to keep my INR in the middle of my range (We try to keep it around 3.0 and my range is 2.5 to 3.5 with the generally safe range of 2.0 to 4.0). My pharmacist is happy with my results and tells me to keep self-managing. He likes the very small dose changes now that I have convinced him by spreadsheets and graphs that many small dose changes over a period of time are better then a large dose change occasionaly.
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I take K2 in the MK4 form because it seems to last a shorter period of time (one week) in my system. My wife take a mixed pill with both MK4 and MK7 because she found a study that this mix seemed to reduce fractures the most in senior citizen ladies. However, she is not on Coumadin.
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As I once read on this forum, whenever taking a new drug, medicine, or supplement, test - test - test. And whenever possible use a Brand name for consistency of the medicine. I prefer American made or even better German made for consistency. Our son discovered that Germany regulates the Vitamin supplement industry for consistency of the major ingredients. He was unsure whether they regulated the inactive ingredients. You should be able to slowly add in the K2 without a major effect. But - test - test - test. The small amount of K2 I took drove my INR down from 3.0 to 2.4. However, it took just a tiny adjustment of my coumadin to bring it back to 3.0.

Whereas Pellicle had no effect from K2 and I did - I had no measurable effect from fish oil, either when starting it or when stopping it. Everyone is different. Test - Test - Test. But that is why we use INR test meters so we do have to Go TO THE LAB - GO TO THE LAB - GO TO THE LAB. However, we regularly eat fish - usually salmon but sometimes cod.

Walk in His Peace,
Scribe With A Lancet
 

Protimenow

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Scribe -- I agree with what you've written.

I do one supplement at a time, and test for effects -- and repeat the test a few days later. My weekly test will also, perhaps, show effects (although INR may slightly fluctuate weekly). I make small adjustments, too.

Testing with a meter is good - I'm getting tested at a lab every month or so.

My personal issue, already mentioned ad nauseum, is that the Coag-Sense and CoaguChek results diverge as the INR rises -- and the CoaguChek XS result is usually closer to the lab.

If I didn't still have a lot of Coag-Sense strips, I would consider just using the XS meter -- for me, Coag-Sense seems to report lower than lab results. In a way, this is reassuring - if the Coag-Sense gives me 2.1 or 2.2, I can be fairly comfortable that my INR is probably above 3.

I take K2, and haven't seen any changes in my INR.

I discontinued things like fish oil and quercetin, and don't really like taking ANY supplements if I don't need them.

But, to repeat Scribe with a Lancet, test, test, test when appropriate.
 
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