RE: Coumadin/Cranberry interaction

June 2, 2011

We avoid all cranberry for patients on coumadin. Bristol Myers Squibb clearly

states in their patient information that all cranberry products are to be

avoided. Until they change their patient information, we follow their

directions. " No Cranberry " is clearly stamped on menus for coumadin/warfarin

patients.

Cece

---- Original message ----

>Date: Thu, 02 Jun 2011 14:08:29 -0000

>From: rd-usa (on behalf of " melwv05 " )

>Subject: Coumadin/Cranberry interaction

>To: rd-usa

>

> From what I have found, 8 oz of cranberry juice is

> allowed daily while taking coumadin. Is this the

> latest research? For those who work in a hospital

> setting, what steps do you take to limit cranberry

> juice on a clear liquid diet? Do you go ahead and

> limit cranberry juice on every tray to avoid

> problems?

> Thanks,

> Webber MS, RD, LD

> Princeton, WV

>

This message is intended for the use of the addressee only and may contain

information that is privileged and confidential. If you are not the intended

recipient of this message, be notified that any dissemination or use of this

message is strictly prohibited. Un-intended transmission does not constitute

waiver of attorney-client privilege or any other privilege. If you have

received this message in error, please delete all copies of the message and its

attachments and notify the sender immediately. Thank you.

June 2, 2011

I was not familiar with a cranberry restriction so I just checked two

brochures put out by the company that makes coumadin and it never mentions

cranberries or cranberry juice. What is your source?

Mazarin, MS, RD, CNS

From: rd-usa [mailto:rd-usa ] On Behalf Of

Cece Ohmart

Sent: Thursday, June 02, 2011 10:32 AM

To: rd-usa

Subject: Re: Coumadin/Cranberry interaction

We avoid all cranberry for patients on coumadin. Bristol Myers Squibb

clearly states in their patient information that all cranberry products are

to be avoided. Until they change their patient information, we follow their

directions. " No Cranberry " is clearly stamped on menus for coumadin/warfarin

patients.

Cece

---- Original message ----

>Date: Thu, 02 Jun 2011 14:08:29 -0000

>From: rd-usa <mailto:rd-usa%40yahoogroups.com> (on behalf

of " melwv05 " <melwv05@... <mailto:melwv05%40yahoo.com> >)

>Subject: Coumadin/Cranberry interaction

>To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> From what I have found, 8 oz of cranberry juice is

> allowed daily while taking coumadin. Is this the

> latest research? For those who work in a hospital

> setting, what steps do you take to limit cranberry

> juice on a clear liquid diet? Do you go ahead and

> limit cranberry juice on every tray to avoid

> problems?

> Thanks,

> Webber MS, RD, LD

> Princeton, WV

>

This message is intended for the use of the addressee only and may contain

information that is privileged and confidential. If you are not the intended

recipient of this message, be notified that any dissemination or use of this

message is strictly prohibited. Un-intended transmission does not constitute

waiver of attorney-client privilege or any other privilege. If you have

received this message in error, please delete all copies of the message and

its attachments and notify the sender immediately. Thank you.

June 2, 2011

Go to www.coumadin.com. Click on patient information. AFter the box " Important

Safety Information " there is a series of bullets. The 9th bullet down addresses

alcohol and cranberry products.

Cece

---- Original message ----

>Date: Thu, 02 Jun 2011 13:54:30 -0400

>From: rd-usa (on behalf of " Mazarin "

)

>Subject: RE: Coumadin/Cranberry interaction

>To: <rd-usa >

>

> I was not familiar with a cranberry restriction so I

> just checked two

> brochures put out by the company that makes coumadin

> and it never mentions

> cranberries or cranberry juice. What is your source?

>

> Mazarin, MS, RD, CNS

>

> From: rd-usa

> [mailto:rd-usa ] On Behalf Of

> Cece Ohmart

> Sent: Thursday, June 02, 2011 10:32 AM

> To: rd-usa

> Subject: Re: Coumadin/Cranberry interaction

>

> We avoid all cranberry for patients on coumadin.

> Bristol Myers Squibb

> clearly states in their patient information that all

> cranberry products are

> to be avoided. Until they change their patient

> information, we follow their

> directions. " No Cranberry " is clearly stamped on

> menus for coumadin/warfarin

> patients.

>

> Cece

>

> ---- Original message ----

> >Date: Thu, 02 Jun 2011 14:08:29 -0000

> >From: rd-usa

> <mailto:rd-usa%40yahoogroups.com> (on behalf

> of " melwv05 " <melwv05@...

> <mailto:melwv05%40yahoo.com> >)

> >Subject: Coumadin/Cranberry interaction

> >To: rd-usa

> <mailto:rd-usa%40yahoogroups.com>

> >

> > From what I have found, 8 oz of cranberry juice is

> > allowed daily while taking coumadin. Is this the

> > latest research? For those who work in a hospital

> > setting, what steps do you take to limit cranberry

> > juice on a clear liquid diet? Do you go ahead and

> > limit cranberry juice on every tray to avoid

> > problems?

> > Thanks,

> > Webber MS, RD, LD

> > Princeton, WV

> >

> This message is intended for the use of the

> addressee only and may contain

> information that is privileged and confidential. If

> you are not the intended

> recipient of this message, be notified that any

> dissemination or use of this

> message is strictly prohibited. Un-intended

> transmission does not constitute

> waiver of attorney-client privilege or any other

> privilege. If you have

> received this message in error, please delete all

> copies of the message and

> its attachments and notify the sender immediately.

> Thank you.

>

> [Non-text portions of this message have been

> removed]

>

This message is intended for the use of the addressee only and may contain

information that is privileged and confidential. If you are not the intended

recipient of this message, be notified that any dissemination or use of this

message is strictly prohibited. Un-intended transmission does not constitute

waiver of attorney-client privilege or any other privilege. If you have

received this message in error, please delete all copies of the message and its

attachments and notify the sender immediately. Thank you.

June 2, 2011

From what I've read, the latest human trials says that " normal " amounts of

cranberry products has an effect on coumadin treatment

I believe there was only problems when individuals had extremely excessive

amounts (a la water intoxication) when on coumadin

There is a toolkit and recent studies about the topic from the Cranberry

Institute

http://www.cranberryinstitute.org/

On Thu, Jun 2, 2011 at 10:54 AM, Mazarin wrote:

>

> I was not familiar with a cranberry restriction so I just checked two

> brochures put out by the company that makes coumadin and it never mentions

> cranberries or cranberry juice. What is your source?

>

> Mazarin, MS, RD, CNS

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

> Cece Ohmart

> Sent: Thursday, June 02, 2011 10:32 AM

> To: rd-usa

> Subject: Re: Coumadin/Cranberry interaction

>

> We avoid all cranberry for patients on coumadin. Bristol Myers Squibb

> clearly states in their patient information that all cranberry products are

> to be avoided. Until they change their patient information, we follow their

> directions. " No Cranberry " is clearly stamped on menus for

> coumadin/warfarin

> patients.

>

> Cece

>

> ---- Original message ----

> >Date: Thu, 02 Jun 2011 14:08:29 -0000

> >From: rd-usa <mailto:rd-usa%40yahoogroups.com> (on behalf

> of " melwv05 " <melwv05@... <mailto:melwv05%40yahoo.com> >)

> >Subject: Coumadin/Cranberry interaction

> >To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > From what I have found, 8 oz of cranberry juice is

> > allowed daily while taking coumadin. Is this the

> > latest research? For those who work in a hospital

> > setting, what steps do you take to limit cranberry

> > juice on a clear liquid diet? Do you go ahead and

> > limit cranberry juice on every tray to avoid

> > problems?

> > Thanks,

> > Webber MS, RD, LD

> > Princeton, WV

> >

> This message is intended for the use of the addressee only and may contain

> information that is privileged and confidential. If you are not the

> intended

> recipient of this message, be notified that any dissemination or use of

> this

> message is strictly prohibited. Un-intended transmission does not

> constitute

> waiver of attorney-client privilege or any other privilege. If you have

> received this message in error, please delete all copies of the message and

> its attachments and notify the sender immediately. Thank you.

>

June 2, 2011

From what I've read, the latest human trials says that " normal " amounts of

cranberry products has an effect on coumadin treatment

I believe there was only problems when individuals had extremely excessive

amounts (a la water intoxication) when on coumadin

There is a toolkit and recent studies about the topic from the Cranberry

Institute

http://www.cranberryinstitute.org/

On Thu, Jun 2, 2011 at 10:54 AM, Mazarin wrote:

>

> I was not familiar with a cranberry restriction so I just checked two

> brochures put out by the company that makes coumadin and it never mentions

> cranberries or cranberry juice. What is your source?

>

> Mazarin, MS, RD, CNS

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

> Cece Ohmart

> Sent: Thursday, June 02, 2011 10:32 AM

> To: rd-usa

> Subject: Re: Coumadin/Cranberry interaction

>

> We avoid all cranberry for patients on coumadin. Bristol Myers Squibb

> clearly states in their patient information that all cranberry products are

> to be avoided. Until they change their patient information, we follow their

> directions. " No Cranberry " is clearly stamped on menus for

> coumadin/warfarin

> patients.

>

> Cece

>

> ---- Original message ----

> >Date: Thu, 02 Jun 2011 14:08:29 -0000

> >From: rd-usa <mailto:rd-usa%40yahoogroups.com> (on behalf

> of " melwv05 " <melwv05@... <mailto:melwv05%40yahoo.com> >)

> >Subject: Coumadin/Cranberry interaction

> >To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > From what I have found, 8 oz of cranberry juice is

> > allowed daily while taking coumadin. Is this the

> > latest research? For those who work in a hospital

> > setting, what steps do you take to limit cranberry

> > juice on a clear liquid diet? Do you go ahead and

> > limit cranberry juice on every tray to avoid

> > problems?

> > Thanks,

> > Webber MS, RD, LD

> > Princeton, WV

> >

> This message is intended for the use of the addressee only and may contain

> information that is privileged and confidential. If you are not the

> intended

> recipient of this message, be notified that any dissemination or use of

> this

> message is strictly prohibited. Un-intended transmission does not

> constitute

> waiver of attorney-client privilege or any other privilege. If you have

> received this message in error, please delete all copies of the message and

> its attachments and notify the sender immediately. Thank you.

>

June 2, 2011

From what I've read, the latest human trials says that " normal " amounts of

cranberry products has an effect on coumadin treatment

I believe there was only problems when individuals had extremely excessive

amounts (a la water intoxication) when on coumadin

There is a toolkit and recent studies about the topic from the Cranberry

Institute

http://www.cranberryinstitute.org/

On Thu, Jun 2, 2011 at 10:54 AM, Mazarin wrote:

>

> I was not familiar with a cranberry restriction so I just checked two

> brochures put out by the company that makes coumadin and it never mentions

> cranberries or cranberry juice. What is your source?

>

> Mazarin, MS, RD, CNS

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

> Cece Ohmart

> Sent: Thursday, June 02, 2011 10:32 AM

> To: rd-usa

> Subject: Re: Coumadin/Cranberry interaction

>

> We avoid all cranberry for patients on coumadin. Bristol Myers Squibb

> clearly states in their patient information that all cranberry products are

> to be avoided. Until they change their patient information, we follow their

> directions. " No Cranberry " is clearly stamped on menus for

> coumadin/warfarin

> patients.

>

> Cece

>

> ---- Original message ----

> >Date: Thu, 02 Jun 2011 14:08:29 -0000

> >From: rd-usa <mailto:rd-usa%40yahoogroups.com> (on behalf

> of " melwv05 " <melwv05@... <mailto:melwv05%40yahoo.com> >)

> >Subject: Coumadin/Cranberry interaction

> >To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > From what I have found, 8 oz of cranberry juice is

> > allowed daily while taking coumadin. Is this the

> > latest research? For those who work in a hospital

> > setting, what steps do you take to limit cranberry

> > juice on a clear liquid diet? Do you go ahead and

> > limit cranberry juice on every tray to avoid

> > problems?

> > Thanks,

> > Webber MS, RD, LD

> > Princeton, WV

> >

> This message is intended for the use of the addressee only and may contain

> information that is privileged and confidential. If you are not the

> intended

> recipient of this message, be notified that any dissemination or use of

> this

> message is strictly prohibited. Un-intended transmission does not

> constitute

> waiver of attorney-client privilege or any other privilege. If you have

> received this message in error, please delete all copies of the message and

> its attachments and notify the sender immediately. Thank you.

>

June 2, 2011

I'm followed this with interest. I've been seeing clients whose MDs have

taken them off all vegetables when they started Coumadin tx. Not a word

about Cranberries. Thanks for the link.

From: rd-usa [mailto:rd-usa ] On Behalf Of

Cece Ohmart

Sent: Thursday, June 02, 2011 11:05 AM

To: rd-usa

Subject: RE: Coumadin/Cranberry interaction

Go to www.coumadin.com. Click on patient information. AFter the box

" Important Safety Information " there is a series of bullets. The 9th bullet

down addresses alcohol and cranberry products.

Cece

---- Original message ----

>Date: Thu, 02 Jun 2011 13:54:30 -0400

>From: rd-usa <mailto:rd-usa%40yahoogroups.com> (on behalf

of " Mazarin " <nm.eatrite@... <mailto:nm.eatrite%40verizon.net>

>)

>Subject: RE: Coumadin/Cranberry interaction

>To: <rd-usa <mailto:rd-usa%40yahoogroups.com> >

>

> I was not familiar with a cranberry restriction so I

> just checked two

> brochures put out by the company that makes coumadin

> and it never mentions

> cranberries or cranberry juice. What is your source?

>

> Mazarin, MS, RD, CNS

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On

Behalf Of

> Cece Ohmart

> Sent: Thursday, June 02, 2011 10:32 AM

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Subject: Re: Coumadin/Cranberry interaction

>

> We avoid all cranberry for patients on coumadin.

> Bristol Myers Squibb

> clearly states in their patient information that all

> cranberry products are

> to be avoided. Until they change their patient

> information, we follow their

> directions. " No Cranberry " is clearly stamped on

> menus for coumadin/warfarin

> patients.

>

> Cece

>

> ---- Original message ----

> >Date: Thu, 02 Jun 2011 14:08:29 -0000

> >From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com> (on behalf

> of " melwv05 " <melwv05@... <mailto:melwv05%40yahoo.com>

> <mailto:melwv05%40yahoo.com> >)

> >Subject: Coumadin/Cranberry interaction

> >To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> >

> > From what I have found, 8 oz of cranberry juice is

> > allowed daily while taking coumadin. Is this the

> > latest research? For those who work in a hospital

> > setting, what steps do you take to limit cranberry

> > juice on a clear liquid diet? Do you go ahead and

> > limit cranberry juice on every tray to avoid

> > problems?

> > Thanks,

> > Webber MS, RD, LD

> > Princeton, WV

> >

> This message is intended for the use of the

> addressee only and may contain

> information that is privileged and confidential. If

> you are not the intended

> recipient of this message, be notified that any

> dissemination or use of this

> message is strictly prohibited. Un-intended

> transmission does not constitute

> waiver of attorney-client privilege or any other

> privilege. If you have

> received this message in error, please delete all

> copies of the message and

> its attachments and notify the sender immediately.

> Thank you.

>

> [Non-text portions of this message have been

> removed]

>

This message is intended for the use of the addressee only and may contain

information that is privileged and confidential. If you are not the intended

recipient of this message, be notified that any dissemination or use of this

message is strictly prohibited. Un-intended transmission does not constitute

waiver of attorney-client privilege or any other privilege. If you have

received this message in error, please delete all copies of the message and

its attachments and notify the sender immediately. Thank you.

June 2, 2011

I'm followed this with interest. I've been seeing clients whose MDs have

taken them off all vegetables when they started Coumadin tx. Not a word

about Cranberries. Thanks for the link.

From: rd-usa [mailto:rd-usa ] On Behalf Of

Cece Ohmart

Sent: Thursday, June 02, 2011 11:05 AM

To: rd-usa

Subject: RE: Coumadin/Cranberry interaction

Go to www.coumadin.com. Click on patient information. AFter the box

" Important Safety Information " there is a series of bullets. The 9th bullet

down addresses alcohol and cranberry products.

Cece

---- Original message ----

>Date: Thu, 02 Jun 2011 13:54:30 -0400

>From: rd-usa <mailto:rd-usa%40yahoogroups.com> (on behalf

of " Mazarin " <nm.eatrite@... <mailto:nm.eatrite%40verizon.net>

>)

>Subject: RE: Coumadin/Cranberry interaction

>To: <rd-usa <mailto:rd-usa%40yahoogroups.com> >

>

> I was not familiar with a cranberry restriction so I

> just checked two

> brochures put out by the company that makes coumadin

> and it never mentions

> cranberries or cranberry juice. What is your source?

>

> Mazarin, MS, RD, CNS

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On

Behalf Of

> Cece Ohmart

> Sent: Thursday, June 02, 2011 10:32 AM

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Subject: Re: Coumadin/Cranberry interaction

>

> We avoid all cranberry for patients on coumadin.

> Bristol Myers Squibb

> clearly states in their patient information that all

> cranberry products are

> to be avoided. Until they change their patient

> information, we follow their

> directions. " No Cranberry " is clearly stamped on

> menus for coumadin/warfarin

> patients.

>

> Cece

>

> ---- Original message ----

> >Date: Thu, 02 Jun 2011 14:08:29 -0000

> >From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com> (on behalf

> of " melwv05 " <melwv05@... <mailto:melwv05%40yahoo.com>

> <mailto:melwv05%40yahoo.com> >)

> >Subject: Coumadin/Cranberry interaction

> >To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> >

> > From what I have found, 8 oz of cranberry juice is

> > allowed daily while taking coumadin. Is this the

> > latest research? For those who work in a hospital

> > setting, what steps do you take to limit cranberry

> > juice on a clear liquid diet? Do you go ahead and

> > limit cranberry juice on every tray to avoid

> > problems?

> > Thanks,

> > Webber MS, RD, LD

> > Princeton, WV

> >

> This message is intended for the use of the

> addressee only and may contain

> information that is privileged and confidential. If

> you are not the intended

> recipient of this message, be notified that any

> dissemination or use of this

> message is strictly prohibited. Un-intended

> transmission does not constitute

> waiver of attorney-client privilege or any other

> privilege. If you have

> received this message in error, please delete all

> copies of the message and

> its attachments and notify the sender immediately.

> Thank you.

>

> [Non-text portions of this message have been

> removed]

>

This message is intended for the use of the addressee only and may contain

information that is privileged and confidential. If you are not the intended

recipient of this message, be notified that any dissemination or use of this

message is strictly prohibited. Un-intended transmission does not constitute

waiver of attorney-client privilege or any other privilege. If you have

received this message in error, please delete all copies of the message and

its attachments and notify the sender immediately. Thank you.

June 3, 2011

I was recently on Coumadin for two weeks after major surgery. The only thing I

was told by the surgeon and the physician's assistant was to make no significant

changes to my typical diet. They specifically mentioned to not increase my

usual intake of high Vit K foods but did not mention cranberries at all. Alchol

was also not mentioned but I already knew I could not have any because of a

conflict with another medication.

Anne Jackisch

Largo, FL

Coumadin/Cranberry interaction

> >To: rd-usa <mailto:rd-usa%40yahoogroups.com>;

> <mailto:rd-usa%40yahoogroups.com>;

> >

> > From what I have found, 8 oz of cranberry juice is

> > allowed daily while taking coumadin. Is this the

> > latest research? For those who work in a hospital

> > setting, what steps do you take to limit cranberry

> > juice on a clear liquid diet? Do you go ahead and

> > limit cranberry juice on every tray to avoid

> > problems?

> > Thanks,

> > Webber MS, RD, LD

> > Princeton, WV

> >

> This message is intended for the use of the

> addressee only and may contain

> information that is privileged and confidential. If

> you are not the intended

> recipient of this message, be notified that any

> dissemination or use of this

> message is strictly prohibited. Un-intended

> transmission does not constitute

> waiver of attorney-client privilege or any other

> privilege. If you have

> received this message in error, please delete all

> copies of the message and

> its attachments and notify the sender immediately.

> Thank you.

>

> [Non-text portions of this message have been

> removed]

>

This message is intended for the use of the addressee only and may contain

information that is privileged and confidential. If you are not the intended

recipient of this message, be notified that any dissemination or use of this

message is strictly prohibited. Un-intended transmission does not constitute

waiver of attorney-client privilege or any other privilege. If you have

received this message in error, please delete all copies of the message and

its attachments and notify the sender immediately. Thank you.

June 3, 2011

I was recently on Coumadin for two weeks after major surgery. The only thing I

was told by the surgeon and the physician's assistant was to make no significant

changes to my typical diet. They specifically mentioned to not increase my

usual intake of high Vit K foods but did not mention cranberries at all. Alchol

was also not mentioned but I already knew I could not have any because of a

conflict with another medication.

Anne Jackisch

Largo, FL

Coumadin/Cranberry interaction

> >To: rd-usa <mailto:rd-usa%40yahoogroups.com>;

> <mailto:rd-usa%40yahoogroups.com>;

> >

> > From what I have found, 8 oz of cranberry juice is

> > allowed daily while taking coumadin. Is this the

> > latest research? For those who work in a hospital

> > setting, what steps do you take to limit cranberry

> > juice on a clear liquid diet? Do you go ahead and

> > limit cranberry juice on every tray to avoid

> > problems?

> > Thanks,

> > Webber MS, RD, LD

> > Princeton, WV

> >

> This message is intended for the use of the

> addressee only and may contain

> information that is privileged and confidential. If

> you are not the intended

> recipient of this message, be notified that any

> dissemination or use of this

> message is strictly prohibited. Un-intended

> transmission does not constitute

> waiver of attorney-client privilege or any other

> privilege. If you have

> received this message in error, please delete all

> copies of the message and

> its attachments and notify the sender immediately.

> Thank you.

>

> [Non-text portions of this message have been

> removed]

>

This message is intended for the use of the addressee only and may contain

information that is privileged and confidential. If you are not the intended

recipient of this message, be notified that any dissemination or use of this

message is strictly prohibited. Un-intended transmission does not constitute

waiver of attorney-client privilege or any other privilege. If you have

received this message in error, please delete all copies of the message and

its attachments and notify the sender immediately. Thank you.

June 4, 2011

I find this very interesting. The Vitamin K registery put out by PT/INR test

shows cranberry juice as low in Vit K 0-7 mg. I work in a CCRC with a nursing

home and we give everyone 16 oz of cranberry juice a day and have not reported

any problems. Our UTI rate is almost 0. I also have counseled a patient with

very tight control on his Vit K for 25 years (nothing green or with green

relatives only carrots and mushrooms as vegetables) and he only drinks cranberry

juice for his beverages and never has had a problem. A quick look at the

comments on the studies indicate that the information is inconclusive with the

strongest support coming from a man who started suddenly drinking 2L a day of

cranberry juice per day for a UTI and one who was ill and had almost nothing

but cranberry juice for 2 weeks. It kind of sounds like fear of lawsuit

overkill. Also all of the information was coming from British studies and

patients. Could something else be going on in the diet?

Mavis , RDLD

June 4, 2011

Cranberry juice, as you said as near 0 Vit K. However, the Cranberry-Coumadin

interaction is different then with high-Vit-K foods:

1. Cranberry juice interacts with coumadin the way Alcohol will do with

anti-depressants/abx etc, it enhances the drug activity. YOu can drink it in

limited amount. YOur pts who been drinking 16Oz of it daily possibly are on

lower doses of Coumadin therefore stable within therapeutic levels.

2. Vit K interaction is completely different: Coumadin is designed to undo Vit K

coagulative activity, not the other way around. So - Vit K rich foods are

allowed only if they are consumed in the same amount every day. In other words,

if I am on coumadin, and I report eating spinach 1/2 a cup every single day, I

can continue doing so. However, if I eat that once a week, then I should avoid

it all together. In a hospital setting, or any institute, where the pt does not

have effect on the menu selection (they may choose preference out of what

available but cannot choose what is available every day) - if the facility

serves lettuce every day, the same amount, they can continue to eat it (not to

mention, to achieve Vit K high levels in lettuce you have to eat a head of

lettuce or more). The study sited below also question the bioavailability of Vit

K from these high vit K foods like spinach and broccoli, they suggest that even

though the content is 1000+mcg, that not all and maybe less then 1/2 is actually

available to our body, but this part is not conclusive.

Effect of Vit K Intake on the stability of oral anticoagulant treatment:

Dose-response relationship in healthy subjects, Blood 2004 (14) 2682-2689

Merav Levi, RD, MS, CDN

A dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin

" People don't forget the truth, they just become better in lying " (Revolutionary

Road)

To: rd-usa

From: mimco@...

Date: Sat, 4 Jun 2011 11:15:50 +0000