“Don’t eat spinach.” That is what I was told when I first started taking Warfarin—at least, that is what I heard.
In 1996 I had open heart surgery twice in one week. During the first surgery, my mitral valve was replaced with a St. Jude valve. Then, just before I was scheduled to go home, my medical team discovered that the new valve was not working correctly. So, one week later, I went through surgery again and received a second, new St. Jude mitral valve.
The second surgery was a success. My second new valve was working. I was ready to go home but before I could be discharged, I had to meet with a hospital nutritionist to discuss the implications of taking Warfarin. The nutritionist arrived and discussed diet and Vitamin K, but I didn’t hear any of it. I was mentally and physically exhausted and I just wanted to go home. I reviewed the brochure she gave me and thought, “I can’t eat anything healthy.”
After that, I avoided green leafy vegetables. I wasn’t religious about it, though. Occasionally, I binged on broccoli or had a big, green, leafy salad. When I did that, my INR crashed and my warfarin dose was adjusted up. Then, after my next blood test, my INR was adjusted back down because it was too high.
When I began writing the Ten Commandments of Coumadin, I learned two very important rules about eating while on Warfarin:
Don’t eat foods high in Vitamin K occasionally. Plan your meals to include them on a regular, consistent basis. Your INR will remain stable and your Warfarin dosage will be changed less frequently. Your diet will work with your Warfarin and not against it.
When you eat foods high in Vitamin K, balance them with foods that slow blood clotting. For as many foods that are high in Vitamin K, there are foods that slow down the rate at which your body forms blood clots. These foods contain salicylates, Vitamin E, omega-3 fatty acids, bromelain, and natural antibiotic properties. Several of them are perfect for your spinach salad, including garlic, onions, and virgin olive oil. (You can find out more about foods that slow blood clotting from the Science of Eating website.)
Another very important reason to NOT avoid Vitamin K is the long-term result of Vitamin K deficiency. Vitamin K is needed for the blood clotting process but is also needed to absorb calcium into your bones. For more information on this, read my article, The Other Vitamin K. It describes the dangers of osteoporosis and atherosclerosis for people on Warfarin for the long-term.
So, enjoy your spinach salad! Have a healthy, green salad once a week, add garlic, onions, and berries, and dress it with olive oil. Vitamin K in the green leafy vegetables will be balanced by the salicylates in the garlic, fruit, and olive oil. The result will be a more balanced INR.