Vitamin K in Foods for Anticoagulant Users

Taking anticoagulant medications?

My family member is taking anticoagulant medication, and the doctor advised that foods containing vitamin K should be limited to 0.5 bowls per day, and certain herbal medicines should be avoided.
I would like to ask the pharmacist if there is a more comprehensive table that lists foods containing vitamin K commonly found at home.
Most of the vegetables I can think of that are commonly consumed at home contain vitamin K, which makes it seem like we can hardly eat vegetables.

Niming, 20~29 year old female. Ask Date: 2019/04/10

Dr. Liao Huiling reply Pharmacology

1.
For information regarding food composition, please refer to the Taiwan Food Nutritional Components Database provided by the Ministry of Health and Welfare's Food and Drug Administration at https://consumer.fda.gov.tw/Food/TFND.aspx?nodeID=1782.
Individuals taking the anticoagulant medication Warfarin are often advised against consuming "large" amounts of vitamin K-rich green vegetables, as this may reduce the effectiveness of Warfarin.
However, insufficient intake of vitamin K can also pose health risks.
Therefore, it is recommended to maintain a balanced diet with a stable daily intake of vitamin K, avoiding sudden increases or decreases in vitamin K consumption, and to have regular follow-up appointments to monitor coagulation function.

Reply Date: 2019/04/10

More Info

Vitamin K is a crucial nutrient that plays a significant role in blood clotting and bone health. For individuals taking anticoagulant medications, such as warfarin, managing vitamin K intake is essential to ensure the medication's effectiveness. Warfarin works by inhibiting vitamin K-dependent clotting factors, so fluctuations in vitamin K levels can affect how well the medication works.

Understanding Vitamin K
Vitamin K exists in two primary forms: K1 (phylloquinone), found mainly in green leafy vegetables, and K2 (menaquinone), found in fermented foods and animal products. Foods rich in vitamin K1 include kale, spinach, broccoli, and Brussels sprouts, while K2 can be found in foods like natto, cheese, and egg yolks.

Dietary Recommendations for Anticoagulant Users
1. Consistent Intake: It is not necessary to eliminate vitamin K-rich foods entirely; rather, the goal is to maintain a consistent daily intake. Sudden increases or decreases in vitamin K consumption can interfere with the effectiveness of anticoagulant therapy. For example, if a person typically consumes a certain amount of leafy greens, suddenly increasing that amount can lead to a decrease in the anticoagulant effect of warfarin.

2. Portion Control: As your family member's physician advised, limiting vitamin K intake to about 0.5 bowls of vitamin K-rich foods per day can help manage the interaction with anticoagulants. This means being mindful of portion sizes and frequency of consumption.

3. Monitoring: Regular monitoring of INR (International Normalized Ratio) levels is crucial for individuals on anticoagulants. This blood test measures how well the blood is clotting and helps determine if the dosage of the anticoagulant needs adjustment. Keeping a food diary can help track vitamin K intake and its correlation with INR levels.

Common Foods Containing Vitamin K
Here is a list of common foods that are high in vitamin K:
- Leafy Greens: Kale, spinach, collard greens, Swiss chard, and mustard greens.

- Cruciferous Vegetables: Broccoli, Brussels sprouts, and cabbage.

- Herbs: Parsley, basil, and cilantro.

- Other Vegetables: Green peas, asparagus, and green beans.

- Fermented Foods: Natto (a Japanese dish made from fermented soybeans) is particularly high in vitamin K2.

- Dairy Products: Certain cheeses and egg yolks contain vitamin K2.

Conclusion
While it may seem challenging to manage a diet rich in vitamin K while on anticoagulants, it is possible with careful planning and monitoring. Encourage your family member to maintain a balanced diet that includes a variety of foods while being mindful of vitamin K intake. Consulting with a healthcare provider or a registered dietitian can provide personalized guidance tailored to their specific dietary needs and medication regimen. This approach not only supports their health but also ensures the effectiveness of their anticoagulant therapy.

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