Coumadin and Vitamin K Consistency

[Guest guest]

On June 3 I heard Breedon, PhD RD FADA present on Nutrients

affecting Type 2 Diabetes. She spent considerable time on Vitamin K.

Here is a link to the Vitamin K paper she provided as one of many

electronic handouts

http://www.montanadieteticassociation.org/support-files/aunt-c-vitamin-k-handout\

-final-best-short-version11-10-this.pdf

She is a delightful presenter andI'm sure as animated when she teaches

medical students in addition to clinical practice. One aside she made

was that once when she was presenting to physicians at a convention with

a trade show she happened to sit next to a drug company rep. She

mentioned that it would be very logical for his company to provide

vitamin K in the coumadin med to assure the minimum intake

consistently. She was saddened by his response. He said that then all

the other companies would follow suit and my company wouldn't be ahead,

so why do it.

This paper might be a good one to share with physicians.

Pat Bollinger, MS RD

> Exactly, that should be the practice and most MDs don't realize that their

recommendations to avoid all vegetable are not only not practical but also not

healthy and not with accordance to clinical guidance.

> Just to enhance things a bit. When pts are completely avoiding Vit K, their

INR could be very high, and sometimes, if there is no immediate risk of

bleeding, the treatment may me increasing Vit K intake, instead of manipulating

the drug again.

> Also - , if you have pts who avoided Vit K and you want to start them to eat

vit K foods, given that they will maintain a consistent amount of these food

daily (consistency and daily is key), you may want to inform the MD to follow

closely with INR to ensure therapeutic levels. It may flaxuate till it is stable

but according to this study, it may still remain within therapeutic levels.

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> Merav Levi, RD, MS, CDN

> A dietitian, not the food police.

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

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> " 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)

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> To: rd-usa

> From: dignacassens@...

> Date: Sat, 4 Jun 2011 08:52:25 -0700

> Subject: RE: Re: Coumadin/Cranberry interaction

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> My practice is not to be concerned about eliminating foods of any type, as

> long as the intake of each remains more or less the same each day.

> Institutional menus usually have a number of required servings, so that's a

> simple process. And providing 16 oz of cranberry juice a day I would say is

> within the guidelines I use and have read; to maintain a stable intake of

> food, not increasing and decreasing daily. That way the doc can adjust the

> dosage to an effective level with no adverse effects. As with everything,

> data can be manipulated by those using it. I don't want to eliminate any

> food group or type of food from anyone's diet, rather I work at manipulating

> quantities, preparation methods, and doing some education at all levels.

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> Digna

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

> mimco_2000

> Sent: Saturday, June 04, 2011 4:16 AM

> To: rd-usa

> Subject: Re: Coumadin/Cranberry interaction

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> 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?

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> Mavis , RDLD

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