Anticoagulant treatment and vitamin K.
September 18, 2020
Many people with coronary heart disease, atrial fibrillation, heart failure, myocardial infarction, stroke, or blood vessel problems take anticoagulants. This is administered to limit blood clotting and prevent the formation of clots in the vessels that could create serious complications in the existing disease. The correct use and performance of the treatment is assessed through a blood test called the prothrombin time INR, and its value should remain constant. The higher its value, the greater the risk of bleeding for the patient because the efficiency of the treatment is very high. The most well-known anticoagulant preparations used are coumarols (Sintrom) or warfarin (Panwarfin) and heparins which are considered antagonists of vitamin K and their performance is affected by its intake.
Vitamin K is a fat-soluble vitamin that participates in blood clotting. As a fat-soluble vitamin, it is found in foods that contain fatty substances. Vitamin K is digested, absorbed and transported to tissues with lipids and stored with other lipids in the liver and adipose tissue.
Vitamin K is necessary for the synthesis in the liver of blood clotting factors such as prothrombin. Vitamin K is one of the two vitamins that our body can synthesize on its own, from intestinal microorganisms. The excessive intake of the vitamin has the effect of hindering the action of anticoagulant drugs. More specifically, the greater the intake of vitamin K, the more it favors blood clotting, which contradicts the effect of the treatment. Below is a table of permitted and prohibited foods.
FOOD | ALLOWED | THEY ARE PROHIBITED |
FAT & OIL | Corn oil, sunflower oil, margarine (in small quantities), fshea butter, nuts | Soybean oil, walnut oil, fresh butter |
MEAT | Egg (white only), chicken, pork, beef, shellfish, fish, tuna in water | Tuna in oil, liver, egg yolk |
DAIRY PRODUCTS & MILK | Milk, cheese, yogurt | Full fat dairy |
FRUIT | All raw or cooked, compotes, grapes (in small quantities) | Anemone, strawberries, prunes |
VEGETABLES | Sweet potato, corn, carrots, beets (only the bulb), etcplums, cucumber (without skin), mushrooms, eggplants | Green vegetables (broccoli, spinach, lettuce, greens, okra, green beans), tomato, beet (leaf), parsley, cauliflower, celery, cabbage, sauerkraut, kale, Brussels sprouts, asparagus |
LEGUMES | Beans, fava beans, lentils | black-eyed beans, chickpeas, peas |
CEREALS | Flour, rice, cereals, breakfast cereals (except oats), e.gatata, savory biscuits, snacks | Soy, oat flakes, wholemeal |
SWEET | Sugar, jelly, ice cream, candies, sweet biscuits, spoon sweets, pastes | Honey |
DIFFERENCE | Salt, pepper, spices, garlic | |
ALCOHOLIC BEVERAGES | Lemonade, black tea, instant coffee, cola drinks | Green tea, alcohol |
It goes without saying that you should not exclude these foods from your diet forever, it is good to avoid them for the initial period of adaptation and until the dose of anticoagulant treatment is adjusted. It is preferable and less harmful to prothrombin time values to consume a small amount of green vegetables daily (2-3 forkfuls), that is, to have a steady intake, than to have a whole serving of green salad or oily vegetables once a week.
Much care is still needed in carefully reading food labels as well as in the use of multivitamins or other nutritional supplements that may contain vitamin K and is not widely known. In addition, you should know that frozen foods contain less vitamin K than fresh because part of it is destroyed in freezing, and raw vegetables less than boiled ones. Considerable attention is also needed in the intake of alcohol, which should be limited to small amounts.
That is why for the drawing up of a specialized diet plan, always in collaboration with the supervising physician, it would be advisable to visit a qualified dietician who will help you to combine the intake of vitamin K with the administration of anticoagulant treatment.
Kontopidou Irini
Clinical Dietitian, M.Sc.