How to Follow a Warfarin Diet [Made Easy]

“How to Follow a Warfarin Diet [Made Easy]” was edited/updated by Aly Bouzek, MS, RDN.

Curious how to follow a warfarin diet? Perhaps you have been told that you need to eat a certain way when on warfarin, but it just seems so confusing? Or maybe you feel (or have even been told) you can never eat greens again?! 

A warfarin diet can be confusing. The goal of this article is to teach you how to follow a warfarin diet. And most importantly, we want to make a warfarin diet easy to understand.

Disclaimer: This article is informational only and is not intended to be medical advice. Always talk to your doctor about changes to your diet. Your individual situation is unique and may have special needs.

What is Warfarin

Warfarin is a type of medication taken to prevent blood clots for certain people with an increased risk for clots (ex. history of heart attack or stroke, pulmonary embolism, irregular heartbeat, etc). (1)

You may also hear warfarin called Coumadin® or “blood thinners”. Coumadin® is the name brand of warfarin. Lower cost, generic options are available as well.

“Blood thinners” is the name typically given to the medication class of anticoagulants. “Coagulants” refers to forming a clot. “Anti” means opposed to or against. So, anticoagulants help to stop clots from forming.

Broken down very simply, warfarin acts to “thin” blood to prevent clots. Of course, it’s more complicated than this, but this is an easy way to understand how this medication works in your body.

Types of Blood Thinners

There are several different types of blood thinners.

Common types of blood thinners include (2):

• Warfarin (Coumadin®)
• Apixaban (Eliquis)
• Edoxaban (Savaysa)  
• Dabigatran (Pradaxa)
• Heparin
• Rivaroxaban (Xarelto)

Your healthcare team helps to determine which blood thinner is the best for you. This is based on your health history, diagnosis, and individual situation.

Warfarin and Your Healthcare Team

You are likely on Warfarin because it’s the medication your healthcare team has determined is best for you. If needed, you can always ask your healthcare team about other blood thinner options. They will help you make choices based on your individual situation.

When on warfarin, it is incredibly important to work closely with your healthcare team. You will need to go in for regular blood tests to see how well the medications are working. And to make changes to your medication doses as needed.

What is a Warfarin Diet

Changes to diet (the way you eat) and other factors can contribute to the need to change your warfarin dosage. Consistency is a word you are going to hear a lot in this article. Because when it comes to warfarin and your diet, consistency is key.

We are going to break down how warfarin and your diet interact in an oversimplified manner. Keep in mind these processes are much more complex, but this is just an easy way to help you better understand your warfarin diet. 

Warfarin and Vitamin K

The most important nutrient to consider when following a warfarin diet is vitamin K.

Warfarin helps prevent blood clots.

While vitamin K helps blood to clot.

If we think of warfarin as a “blood thinner,” we can think of vitamin K as a “blood thickener.”

Scientifically, this is not exactly how it works. But it’s a simple way to remember the relationship between warfarin and vitamin K.

Consistency is Key

In some ways, warfarin and vitamin K are working against each other, so consistency is key.

What does consistency mean here?

It just means to make sure you are eating the same amounts of foods high in vitamin K on a daily and weekly basis.

You don’t want to be eating a large amount of vitamin K everyday then suddenly stop.

On the same hand, you don’t want to suddenly start eating a large amount of vitamin K.

For example, if you drink a green smoothie high in vitamin K every day, then suddenly stop. Or you suddenly start taking a new multivitamin and nutrition drink (both of which contain vitamin K) to get some extra nutrition in your diet.

Sudden changes to your vitamin K intake while taking warfarin could make the warfarin not as helpful in preventing blood clots. Remember: any changes to vitamin K intake in your diet should be done gradually. And in a conversation with your healthcare team.

Benefits of Vitamin K

Vitamin K, like all nutrients, is important for our health.

Avoiding vitamin K altogether can lead to health issues including:

• vitamin K deficiency
• increased risk of bruising
• bleeding problems
• bone issues including a higher risk of osteoporosis
• etc.

Vitamin K plays an important role in helping our blood to clot (this is important if you ever have a cut or scratch!), bone health, and other cellular functions in the body.

Men ages 19 years and older need 120 mcg of vitamin K daily. And women ages 19 years and older need 90 mcg of vitamin K daily. (3)

Warfarin Diet and Safety

Because warfarin and vitamin K are working against each other, big changes to your diet can cause serious health issues. Or at least put you at an increased risk for “bleeding out.”

While none of us expect to get injured, accidents happen. A simple fall, a car crash, or any type of accident can happen to any of us at any time.

If your blood is too “thin” this can cause a significant health risk. You can experience internal bleeding or struggle to get a cut to stop bleeding.

Warfarin is an important, but very serious medication to be taking. It can cause severe bleeding or even death. Anyone on warfarin should be working closely with their healthcare team and getting regular lab work done to determine if medication adjustments are needed.

Remember that with a warfarin diet, consistency is key. Keep in mind that both food and supplements can cause issues.

How to Follow a Warfarin Diet

Following a warfarin diet isn’t as complicated as it seems. You can do this!

Foods You Can Eat on a Warfarin Diet

Pretty much any food without a significant source of vitamin K is fair game when following a warfarin diet. Here is a basic list of foods you can eat on a warfarin diet. Keep in mind, you may have other dietary restrictions based on your individual medical conditions.

Foods you can eat on a warfarin diet:

• Meat, fish, eggs
• Milk, cheese, yogurt
• Grains, bread, rice, pasta
• Fruits of any type
• Red, orange, yellow vegetables
• Most purple and white vegetables

Reading the food label may or may not be beneficial when looking for vitamin K. Vitamin K is not a nutrient that is required to be on the food label. However, brands that add a lot of vitamins and minerals to a food product will often list all of those nutrients voluntarily.

You can also look at the food ingredient list. Look for ingredients high in vitamin K (listed later in this article) or supplemental vitamin K.

Foods to Watch on a Warfarin Diet

You may notice we said foods to “watch” and not foods to “avoid.” These foods are ones that are high in vitamin K. Remember, vitamin K is good for you. It does a lot of important stuff for your body!

There really aren’t any foods you have to completely avoid. But if you choose to eat these foods (foods high in vitamin K), then you need to make sure you are eating reasonable amounts and are consistently eating them.

For example, if you have a ½ cup serving of green vegetables for dinner every night, that is perfectly fine. Suddenly drinking a ton of green smoothies over the weekend would not be a good idea

Foods High in Vitamin K

Think “dark green leafy vegetables,” along with some others listed below: 

• Amaranth leaves
• Asparagus
• Avocado
• Broccoli
• Brussels sprouts
• Cabbage
• Canola oil
• Coleslaw
• Collard greens
• Collard greens
• Dandelion greens
• Dark lettuce
• Dill pickles
• Endive
• Garden cress
• Greens
• Kale
• Lettuce
• Liver
• Mayonnaise
• Multivitamins
• Mustard green
• Okra
• Parsley
• Peas
• Some nutritional drinks
• Soy
• Soy beans
• Soybean oil
• Spinach
• Swiss chard
• Turnip greens
• Watercress

Drinks High in Vitamin K

• Cranberry juice
• Grapefruit juice
• Green tea (has moderate vitamin K)
• Vegetable drinks

While vitamin K is found in a lot of foods naturally, it is also found in nutrition drinks and vitamins. Be sure to read the nutrition label on vitamins, protein drinks, and nutrition supplement drinks to see if they contain vitamin K.

What Happens if You Eat Too Much Vitamin K?

Eating too much vitamin K, or making drastic changes to your vitamin K intake while on warfarin could lead to a blood clot. Signs that you have a serious blood clot are:

• Breathing difficulty
• Pain in your chest
• Swelling, redness, and pain in your legs
• Walking and moving difficulties
• Severe headache
• Vision trouble

Supplements to Avoid on a Warfarin Diet

In addition to foods, there are certain supplements you should watch out for. These are supplements you should probably avoid all together.

Always be sure to tell your healthcare team about supplements you are taking. And ask your healthcare team before starting any new supplements.

Supplements to avoid on warfarin:

• Coenzyme Q10
• Echinacea
• Garlic
• Ginkgo biloba
• Ginseng
• Green tea
• St. John’s wort
• Etc.

If you are already taking these supplements, then please do not stop without first speaking to your healthcare team. 

In addition to supplements, be sure to talk to your healthcare team about the use of alcohol.

Other Tips for a Warfarin Diet

Here are some additional tips for staying healthy on a warfarin diet.

Eat a Balanced Diet

Sometimes people on warfarin believe they cannot have any foods high in vitamin K. Hopefully by now you realize it’s all about consistency. You still need vitamin K for a healthy diet.

Some people who struggle to eat a balanced diet find that a daily multivitamin can be beneficial. We always recommend food first, but recognize the important role of multivitamin supplements.

Every nutrient is important for health. This is why you always hear healthcare professionals promote a balanced diet. A balanced diet contains a variety of different foods and types of nutrients.

Foods to eat daily:

• Fruits
• Vegetables
• Calcium sources (dairy or non-dairy)
• Protein (animal or plant based)
• Whole grains

In addition to eating a balanced diet, be sure to drink plenty of water to stay well hydrated.

Avoid Big Changes

I know we’ve repeated this multiple times already, but be sure to avoid big changes in your diet. This includes starting new supplements and drinking large amounts of alcohol. These can cause serious health issues.

Work With Your Healthcare Team

And finally, always be sure to work with your healthcare team. Get regular blood tests as advised. Notify your healthcare team of any new medications, supplements, or changes to your diet.

Warfarin Diet Conclusion

Following a warfarin diet doesn’t have to be hard. You just need to learn what foods are high in vitamin K and be sure to consume those foods in consistent amounts. Be aware of supplements to avoid. And always work closely with your healthcare team.

If you are interested in additional resources, check out our Warfarin Diet BUNDLE which includes a printable handout and e-book version of this article.

References

1. Warfarin. Medline Plus. https://medlineplus.gov/druginfo/meds/a682277.html. 
2. Types of Heart Medications. American Heart Association. https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/cardiac-medications. 
3. Vitamin K. National Institutes of Health. https://ods.od.nih.gov/factsheets/VitaminK-Consumer/.