Food and oral anticoagulants

by | Nov 24, 2023

food-and-oral-anticoagulants

GOAL: Achieve a balance between your vitamin K intake and your anticoagulant medication to stabilize the time it takes your blood to clot.

OBJECTIVES:

  1. Understand how anticoagulants work and the role of vitamin K in your body.
  2. Maintain your usual vitamin K intake.
  3. Learn about other factors that can interact with your medication.

ANTICOAGULANTS: You have been prescribed an anticoagulant, a medication that prevents blood clots from forming in your blood vessels, heart, or around your artificial heart valve. Coumadin™ and Sintrom™ are among the most widely used brands of anticoagulant medication.

VITAMIN K: In addition to playing a vital role in blood clotting, vitamin K also protects your heart and promotes bone health. Adequate and consistent vitamin K intake (90-120 µg/day) will help you meet your dietary requirements while improving anticoagulant stability. Conversely, low vitamin K intake may cause your clotting time to become unstable.

THERE IS NO NEED TO AVOID CERTAIN FOODS: Vitamin K is found in many foods, especially green vegetables. If you enjoy greens, it’s worth noting that many of them are low in vitamin K and can be eaten without restriction.

  • Alfalfa
  • Artichokes
  • Celery
  • Cucumber
  • Fennel
  • Green beans
  • Green bell peppers
  • Iceberg lettuce
  • Kohlrabi
  • Leeks
  • Snow peas
  • Zucchini
The table below provides a list of vitamin K-rich foods. If one or more of these foods are already a regular part of your weekly diet, it’s advisable to continue consuming them in the same portions. Ideally, incorporating one of these foods into your daily diet is recommended.

However, if these vegetables are not currently included in your eating habits (consumed less than once every two weeks), it is advisable not to exceed the recommended maximum portion. The portions mentioned are for vegetables in their raw form, before cooking. If you plan to steadily increase your intake, it’s crucial to inform your doctor so that medication adjustments can be made.

Food Maximum portion (100-150 µg vit K)
Asparagus 12 spears
Beet, mustard and turnip greens ½ cup (125 mL)
Broccoli 1 cup (250 mL)
Brussels sprouts 4 sprouts
Cabbage 1 cup (250 mL)
Celery root (celeriac) ¾ cup (175 mL)
Chicory and watercress 1 cup (250 mL)
Collard greens 1 cup (250 mL)
Curly, Romaine and Boston lettuce 2 cups (500 mL)
Dandelion ¼ cup (60 mL)
Endive 1 cup (250 mL)
Kale ¼ cup (60 mL)
Mesclun 1 cup (250 mL)
Napa cabbage 2 cups (500 mL)
Parsley (fresh) 2 tbs (30 mL)
Soybean sprouts 1 cup (250 mL)
Spinach 1 cup (250 mL)
Spring onions (scallions) ½ cup (125 mL)
Radicchio 1 cup (250 mL)
Rapini 1 cup (250 mL)
Swiss chard ½ cup (125 mL)

Some foods that are low in vitamin K can also have an effect on anticoagulants when eaten in very large amounts. Keep your intake consistent, or ask to have your dosage adjusted if you want to integrate any of the following into your diet:

  • Avocado
  • Flaxseed
  • Mango
  • Soy protein (e.g., tofu, soy milk)
  • Sushi

ALCOHOL:

Alcohol affects clotting time and should be used in moderation.

  • Women: Maximum of 1 drink per day
  • Men: Maximum of 2 drinks per day

One drink is equal to:

  • 1 ounce (30 mL) of hard alcohol (spirits)
  • 4 ounces (125 mL) of wine
  • 10 ounces (341 mL) of beer

CRANBERRY, GRAPEFRUIT AND POMEGRANATE JUICE:

You may drink 1 to 2 glasses (250-500 mL) of these juices if they are already part of your diet, but again, try to be consistent when it comes to the amount you drink. You should however, avoid extracts and concentrates in supplement form.

OMEGA-3:

Foods that contain omega-3s are excellent for cardiovascular health and will not affect your current treatment. Daily doses of 1000 mg of pharmaceutical-grade omega-3 supplements (EPA and DHA) are permitted. Do not exceed this dose unless advised by your doctor.

ADDITIONAL ADVICE:

Natural products and supplements should only be used as prescribed by your doctor. Tell your doctor if you are taking any over-the-counter products. Many supplements can interact with your anticoagulant.

  • Algae supplements
  • Bromelain (pineapple extract)
  • Coenzyme Q10
  • Danshen
  • Devil’s claw
  • Dong quai
  • Fenugreek and Boldo
  • Licorice
  • Feverfew
  • Garlic supplements
  • Ginger extract
  • Ginkgo biloba
  • Ginseng
  • Glucosamine-Chondroitin
  • Green tea extract
  • Natto
  • Papain (papaya extract)
  • Red clover
  • Royal jelly
  • Sage
  • St. John’s Wort
  • Vitamin A and E

Report any significant changes in your eating or lifestyle habits to your healthcare professional:

  • If you start a weight loss diet
  • If you become vegetarian
  • If you experience a loss of appetite lasting more than one week
  • If there are any changes to your medication
  • If you develop a new disease or condition
  • If you stop smoking or make changes to the number of cigarettes you smoke each day
  • If you travel abroad
Reviewed June 6, 2017
®Institut universitaire de cardiologie et de pneumologie de Québec or its licensors. All rights reserved. Partial or total reproduction without prior approval is prohibited. Adapted and/or translated with permission by Vigilance Santé.