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Warfarin and Vitamin K

Overview

Warfarin is a pill that you take regularly to help prevent blood clots or to keep a clot from getting bigger. Coumadin is the common brand name for warfarin.

To make sure that warfarin is effectively thinning your blood, it's important to eat about the same amount of vitamin K every day.

Here's why:

  • Vitamin K normally helps your blood clot so wounds don't bleed too much.
  • Warfarin works against vitamin K. It makes your blood clot more slowly.

So warfarin and vitamin K work against each other in your body, and it's important to keep them in balance. That is why, when you take warfarin, it's important that you not suddenly eat a lot more or a lot less vitamin K-rich food than you usually do. If you do, your warfarin dose may need to be adjusted.

It's up to you to decide how much vitamin K you choose to eat. For example, if you already eat a lot of leafy green vegetables, that's fine. Just keep it about the same amount each day. And if you take a multivitamin that contains vitamin K, be sure to take it every day.

Check with your doctor before you make big changes in what you eat, such as starting a diet to lose weight. And if you want to start eating more of a food that's rich in vitamin K, talk to your doctor about how to add it safely.

Also check with your doctor before you add or change any supplements or herbal products. Some of these may contain vitamin K. If you already take a product that contains vitamin K, don't stop taking it without talking with your doctor first.

Foods that are sources of vitamin K

The following are lists of some foods that are high, moderate, and low in vitamin K.footnote 1

Examples of foods that are high in vitamin K (more than 100 mcg per serving)

Food

Serving Size

Vitamin K (mcg)

Kale, cooked

½ cup

531

Collard greens, cooked

½ cup

530

Spinach, cooked

½ cup

444

Swiss chard, cooked

½ cup

287

Kale, raw

1 cup

274

Spinach, raw

1 cup

145

Endive, raw

1 cup

116

Broccoli, cooked

½ cup

110

Brussels sprouts, cooked

½ cup

109

Examples of foods that are moderate in vitamin K (25–100 mcg per serving)

Food

Serving Size

Vitamin K (mcg)

Cabbage, cooked

1 cup

85

Spinach noodles, cooked

½ cup

81

Green leaf lettuce

1 cup

63

Romaine lettuce

1 cup

57

Broccoli, raw

½ cup

45

Okra, cooked

½ cup

44

Asparagus spears, cooked

5 spears

38

Black-eyed peas, cooked

½ cup

32

Kiwi fruit

1 medium

31

Prunes, dried

5

25

Examples of foods that are low in vitamin K (less than 25 mcg per serving)

Food

Serving Size

Vitamin K (mcg)

Cabbage, raw

½ cup

21

Green peas

½ cup

19

Parsley, raw

1 tablespoon

18

Celery, raw

½ cup

18

Artichoke, cooked

1 medium

18

Blackberries

½ cup

14

Blueberries

½ cup

14

Iceberg lettuce

1 cup

13

Carrots, cooked

½ cup

11

Cucumber, with peel

½ cup

9

Cauliflower, raw

½ cup

8

Green and black tea leaves do contain vitamin K before they are steeped in water. But a small serving of the hot tea itself does not.

How vitamin K and warfarin affect your test results

To find out how well warfarin is working, you will get blood tests to measure how long it takes for your blood to clot. Your lab results are called your Prothrombin Time (PT) and International Normalized Ratio (INR) values. You may just hear about your INR.

Your INR needs to be in a safe range—not too high and not too low. Vitamin K can change how warfarin works, and this changes your INR.

  • Vitamin K lowers your INR values. The lower your INR, the less time it takes for your blood to clot. A low INR means that warfarin isn't working well enough to prevent a dangerous blood clot.
  • Warfarin raises your INR values. The higher your INR, the more time it takes for your blood to clot. A high INR means that warfarin is working too well, so you bleed more quickly and easily. This can be dangerous.

Keeping your warfarin and vitamin K intake steady every day helps keep you in a safe INR range.

References

Citations

  1. Academy of Nutrition and Dietetics (2018). Vitamin K content of foods. Nutrition Care Manual. https://www.nutritioncaremanual.org. Accessed July 17, 2019.

Credits

Current as of: October 7, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: October 7, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Dear patient

I am excited to announce that I will be relocating my practice to Houston Methodist DeBakey Cardiology Associates. Starting November 4, 2024, my new address will be:

Houston Methodist DeBakey Cardiology Associates
6550 Fannin St.
Smith Tower, Suite 1901
Houston, TX 77030

Please note that my phone number and fax number will also change to the following:
24-Hour Telephone: 713-441-1100
Fax: 713-790-2643
Clinical Support Telephone (M-F, 8-5): 713-441-3515

I am excited about caring for you in my new office and hope you will make the transition with me. I will also continue to refill your medications as I have in the past. To assist, please provide your pharmacy with my new contact information.

Please consider checking your prescription refills to verify that you have enough medication on hand to last you until your next visit. Please note that your medical records will remain at my former office until you authorize their transfer. If you choose for me to continue providing your medical care, please complete and sign the enclosed “Authorization for Release of Medical Records” form and fax it to 713-790-2643. Once we receive your authorization, we will be happy to process the request for you.

Thank you for entrusting me with your medical care. My new team and I are dedicated to making this transition as seamless as possible. For help scheduling an appointment and transitioning your care, please call my new office number above.

I look forward to continuing your care at my new location.

Sincerely,
Gopi A. Shah, MD

Dear patient

Dr. Albert Raizner, Dr. Michael Raizner, and Dr. Mohamed El-Beheary are excited to announce that our practice, Interventional Cardiology Associates, will merge with Houston Cardiovascular Associates on November 1, 2024.

Our new offices are similarly located in Houston, near the Texas Medical Center and in Sugar Land. Our in-hospital care will continue at Houston Methodist Hospital in the Texas Medical Center and Houston Methodist Sugar Land Hospital. Importantly, our new offices expand our services with state-of-the-art equipment and amenities. Our core values will always be, as they began over 40 years ago when Dr. Albert Raizner founded ICA:

Integrity – Compassion – Accountability

Our new address and contact information are:

Your medical records are confidential and remain available at our new locations. We consider it a privilege to serve as your cardiologists and look forward to your continuing with us. However, should you desire to transfer to another physician, you may request a copy of your records by contacting us at our new addresses and phone numbers listed above.

We thank you for your trust and loyalty. As always, we will continue to be here to take care of you. Please do not hesitate to contact us if you have any questions or concerns.

Sincerely,

Dr. Albert Raizner,
Dr. Michael Raizner,
Dr. Mohamed El-Beheary