INR Issues on Keto?
nicintime
Posts: 381 Member
I just spoke with a friend who is on coumadin, and her levels have thinned considerably since going low carb. (2.7 before, down to 1.6 or 1.7 after going low carb. They want her to be between 2 & 3, and closer to 2.)
The professionals blamed low carb, and some specifically mentioned the green leafy veggies that are high in vitamin K as a problem. She has stopped eating them, and is unfortunately (in my opinion, anyway) considering adding in fruit or other carbs to see if it changes things. I have my doubts....
Has anyone had any experience with this?
I am always suspicious of health professionals blaming low carb for things, and my friend is very much a "always do what your doctor tells you" kind of person, so I wanted to poll the collective wisdom & experience here on the question.
The professionals blamed low carb, and some specifically mentioned the green leafy veggies that are high in vitamin K as a problem. She has stopped eating them, and is unfortunately (in my opinion, anyway) considering adding in fruit or other carbs to see if it changes things. I have my doubts....
Has anyone had any experience with this?
I am always suspicious of health professionals blaming low carb for things, and my friend is very much a "always do what your doctor tells you" kind of person, so I wanted to poll the collective wisdom & experience here on the question.
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I am also on coumadin. If she increased her green leafy vegetables when starting low carb, then that would likely be the culprit. However, she could choose other vegetables with less clotting effect and still do low carb. I keep my green leafy vegetable intake steady. Oddly, low carb tends to make my inr go up ( thinner blood). Maybe it is a result of reduced inflammation.0
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My dad is on coumadin, and the green leafy veggies are a huge no no. That would be the culprit, not low carb exactly, but sort of related.0
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My dad's been on Coumadin for about 20 years and I remember the green leafy veggies having to be very limited. I want to say my mom always serves him sauteed onions with them to help counteract the effects but I could be confused about that.0
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OK, why not just reduce the dosage amount of a risky drug?
mayoclinic.org/diseases-conditions/deep-vein-thrombosis/in-depth/warfarin-side-effects/art-200475920 -
I agree with @GaleHawkins! I believe the dose should be lowered. Also, green leafy veggies prevent the Coumadin from being effective (ie, INCREASING clotting time) , hence the restriction. She has made her body need less medication, likely. Doctors will look at you like you grew a second head when your able to drop a medication, and they certainly don't understand it. They aren't used to patients improving their health, and don't know what to do with it! Encourage her to keep the fruit out of her diet. Imo, increasing the carbs will increase the need for medication. The need for less is awesome!! Good luck to her!!!0
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I have been on blood thinners for 10+years. First Coumadin for 4 years, then Lovenox. My neurologist told me that as long as I continued to eat roughly the same amount of leafy greens that would be no problem. He is associated with Cleveland Clinic. He said that it may take some adjustments on coudamin dosage to find the right INR level. Some doctors don't take the time. I had INR testing weekly, with adjustments as needed for as least a year. Then twice a month, then once a month finally.
Long time lurker, first post. Also, my doc approves of low carb.0 -
If she is going to add fruit, maybe just some berries. They don't have as much insulin triggering effect on blood, so in moderation if her macros for the day allow it, may not be too bad.0
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My hubby was on coumadin a few years back for dvt from an injury. Green veggies where fine but he was told not to change his diet (adding more greens) because that would affect things. Diet needed to be steady.
If your friend is planning on being LC for life, and green veggies are going to be a part of her diet, I think they should change the meds to treat where she is now. Meds should be lowered if they are currently high.
They sound like lazy doctors to me. This is the reason patients are checked so much while on rat poison, the levels need to be right and it's the doctor's job to get it there based on the patient's lifestyle and circumstances.
JMO0 -
If she eats the same amount consistently, (not just one big pile of greens once a week), her vit k will me more consistent and the could adjust the dose accordingly.0
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The doctors should adjust the medication for your friend. In this particular case though with the lower inr number, the med level would have to be raised, not lowered. A lower inr number means thicker blood not thinner. My doctors willingly change my med dose if needed.
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I'm on Coumadin, and I cringe when people are told to not eat leafy green veggies. That's not the way it should work-- a person should eat a healthy diet (there are many beneficial vitamins in leafy greens beyond K), with *consistent* levels of vitamin K, and the Coumadin dose should be adjusted accordingly. The key is consistency.
I find that the vegetable lists that are given to people by my Coumadin clinic are geared towards people eating the SAD-- lots of vitamin K levels are listed for veggies like potatoes, corn, tomatoes, broccoli and spinach, but no data on the whole spectrum of veggies. Its not easy to find reliable vitamin K content online, either, especially for zucchini, chard, avocado, Brussels sprouts, etc. You can find levels listed, but they vary widely from source to source.
And don't get me started on the listing for meats and liver being almost free of vitamin K-- that data was obtained in the 1950s, on cattle that were raised in urban 'farms' at the U of WI and the like. I do not find it surprising that animals fed exclusively grain and corn did not store excess vitamin K in their liver, because they were probably deficient in it! I've found that my Coumadin need increases (INR drops) substantially when I'm at home, cooking with grass-fed beef, wild seafood, and pastured birds. When I'm traveling, though, relying on conventional beef at restaurants, my INR climbs and so I need to take less Coumadin.
The best choice I made was to switch to home-based INR monitoring. I can check it weekly, anywhere I travel, and just call into the clinic rather than an in-person appointment. Alere is the company that my clinic uses for the machine and test strips if your friend wants to look into it.0 -
@GaleHawkins -- Coumadin isn't a med someone will be able to come off of with a low-carb diet alone. A low INR means the blood clots more easily, and most people won't take the risk of a lethal blood clot in the lung, or one causing a stroke or heart attack, to stop it. Unfortunately, there isn't a means of controlling clotting disorders by diet alone. I'm not as familiar with the heart arrhythmias that sometimes require blood thinners, I suppose it's feasible that in the myriad of causes of them, some might have dietary controls.0
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Great info Cheesy.
I am on 13 mg coumadin per day for a blood clotting disorder. I survived Pulmonary Emboli in 2010. The dose could be lower if I chose not to eat vitamin K foods. Considering the vitamin k needs of the body, I just can't.
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I have been on blood thinners for 10+years. First Coumadin for 4 years, then Lovenox. My neurologist told me that as long as I continued to eat roughly the same amount of leafy greens that would be no problem. He is associated with Cleveland Clinic. He said that it may take some adjustments on coudamin dosage to find the right INR level. Some doctors don't take the time. I had INR testing weekly, with adjustments as needed for as least a year. Then twice a month, then once a month finally.
Long time lurker, first post. Also, my doc approves of low carb.
This is the correct information. I have been on coumadin three times in my life (once under the supervision of a Cleveland Clinic doctor). The issue isn't leafy greens, per se - but getting a steady balance between coumadin and anti-coumadin (the leafy greens). If you eat lots of leafy greens, your meds will need to INCREASE, not decrease (as some have suggested). The coumadin makes you clot less (you are on it because you have developed clots that put your health at risk); vitamin K (the leafy greens) make you clot more. So if you eat leafy greens you have to compensate for both your body clotting too much and adding dietary items that make you clot more.
The solution is to get a very detailed chart of the vitamin K content of everything (not just leafy greens), figure out the maximum you are likely to eat, adjust your coumadin dosage for that level, track your daily consumption of vitamin K, then plan to "top off" your vitamin K daily to achieve the maximum.0 -
I agree with @GaleHawkins! I believe the dose should be lowered. Also, green leafy veggies prevent the Coumadin from being effective (ie, INCREASING clotting time) , hence the restriction. She has made her body need less medication, likely. Doctors will look at you like you grew a second head when your able to drop a medication, and they certainly don't understand it. They aren't used to patients improving their health, and don't know what to do with it! Encourage her to keep the fruit out of her diet. Imo, increasing the carbs will increase the need for medication. The need for less is awesome!! Good luck to her!!!
That is dangerous advice. All she has done is decreased her clotting time. This means she needs MORE medication, not less, in order to keep from forming life-threatening clots. INR is a measurement of how quickly you clot, not resolution of the underlying disorder. If you form DVTs, the treatment is to increase the clotting time (bigger INR) to prevent additional clots from forming. If the INR is too low, you are at risk of forming more DVTs, which can break loose, travel to the lungs, and cause death and other unpleasant side effects. The vitamin K from the leafy greens are countering the coumadin, and making it less effective - if it is less effective (and you are clotting more quickly), your long term survival may not be so good.
(I have been on coumadin three separate times for DVT. Mine is a mechanical problem (a birth defect - which has now been surgically corrected), but the risks associated with clotting too quickly are identical whether the underlying cause is mechanical or a clotting factor disorder.)0 -
I was on it for six months after a clot induced by ankle surgery - I have permanent vein and surface skin damage and risks of ulcers and other things that I've managed to evade for 8 years[but may have been increased by Ketp]. My understanding is that you change to a consistent new diet and get your levels re-tested and the dosage changed. At one point I had to go get a blood test every morning followed by a call back to tell me to adjust my dosage.0
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I was on it for six months after a clot induced by ankle surgery - I have permanent vein and surface skin damage and risks of ulcers and other things that I've managed to evade for 8 years[but may have been increased by Ketp]. My understanding is that you change to a consistent new diet and get your levels re-tested and the dosage changed. At one point I had to go get a blood test every morning followed by a call back to tell me to adjust my dosage.
Pretty standard on coumadin. The bigger issues is that if you don't eat the exact same foods every day you risk an unpredictable INR. If you are going to eat leafy greens (or other vitamin K heavy foods), you need to track vitamin K with a specific daily goal & top off if your amount is low.0
