Jaundice and Vitamin K (was: Vitamin D and CLL connection found )

[Guest guest]

Mike,

The jaundice which accompanies AIHA is due to " overload " of

the system as red cells hemolyze at a rate faster than the

liver is able to metabolize the resultant bilirubin (which

is normally converted by the liver into a soluble form and

excreted via the bile into the gastrointestinal tract where

most is then excreted in the stool to which it imparts it's

typical brownish yellow color). The occurrence of jaundice

implies brisk hemolysis and typically is short-lived.

Individuals with impaired hepatic (ie, liver) function may

have more impressive and more long-lived jaundice, which

should prompt an appropriate investigation of liver

function.

In my practice I tried to avoid use of exogenous vitamin K

except in people with impaired hepatic function and

associated impaired coagulation as it is very difficult to

predict how much vitamin to give and how well it will work.

It's intake can make therapeutic use of coumadin (warfarin)

very difficult. Ironically, it almost never provides much

benefit in patients with coagulapathy related to liver

disease...you occasionally would note some benefit

transiently in poorly nourished people such as chronic

alcoholics, but almost never otherwise.

The best course of action if clinical jaundice seems

prolonged in association with AIHA is for both the AIHA and

for the patient's liver function to be reevaluated. A benign

condition such as Gilbert's Syndrome may also be present and

playing a role with prolonged unconjugated

hyperbilirubinemia causing prolonged or chronic jaundice.

Needless to say...I think it is best just to eat your

vegetable. Only modest intake is required.

Good luck,

Rick