Diet and Meds

People on coumadin are allowed to eat greens and foods with vitamin K...as long as the intake of these foods remain consistent. If someone consistently eats a large amount of greens everyday, they will need to take a larger coumadin dose to balance it out. The trouble can arise when there is a change in someone's diet and they are now taking in more or less vitamin K. If the coumadin dose isn't adjusted for it, then the INR wil be increased or decreased. Consistency is the key. The resident in your post who stated she can't have greens needs to be reeducated. After all, greens are part of a healthy diet, why would we tell anybody not to eat them? We give coumadin all the time on my floor, and we have never asked for a doctor's order to restrict foods. Like I said, intake of vitamin K needs to be consistent. Just a side note, when educating patients about coumadin, don't forget to tell them to ask their MD before taking vitamins as some of them have vitamin K in them. I should also add that people should avoid or drink small amounts of certain beverages like cranberry juice and alcohol as they can increase the effects of coumadin.

A facility I worked at in a past life actually had "coumadin diet" as a selection. 1800cal ADA Low Fat/Low Chol 2gm Na+ Caffeine Free Lactose Free Coumadin diet. As an example.

Was this real dark leafy greens or iceberg lettuce? The nutritionist at my facility will fight to the death with anyone that suggest pts on coumadin can't eat greens.

I'm thinking that one serving of greens wouldn't impact anyone's INR. I've been doing this for years and we've never restricted anyone's diet because they were on Coumadin.