Should You, Can You, Get Off Coumadin?
© 2011 Health Realizations, Inc.
Millions of Americans take the anti-coagulant (blood-thinning) drug Warfarin, known by the brand name Coumadin. This drug, which decreases the clotting ability of your blood, has been found to reduce the risk of stroke by one-third to one-half, and is widely prescribed to prevent blood clots from forming.
Among the many conditions for which Coumadin is prescribed are irregular heartbeat (arrhythmia), venous thrombosis (blood clot in a vein), pulmonary embolism (blood clot in the lung), and atrial fibrillation (abnormal heart rhythm). Coumadin is also sometimes prescribed for people who have suffered from a previous heart attack or have a prosthetic heart valve.
Although the drug is effective at thinning blood and helping prevent the formation of blood clots in your arteries, veins and heart, this drug is extremely complicated, and potentially dangerous, to use.
The Dark Side of Coumadin
Coumadin was initially developed for use as a rat poison and it is still used for this purpose, which gives you an idea of just how deadly it can be when taken in excess.
The problem is there is a very narrow margin between a dose that's effective and a dose that's dangerous, so people taking the drug must have a lab test done, typically monthly, called the International Normalized Ratio (INR). The INR helps physicians ensure their patients' dosages of Coumadin stay in just the right range, helping to prevent clots rather than trigger excessive bleeding.
Yet, even then it's extremely difficult to keep the drug within this small window of safety. According to the Chicago Tribune:
"Even in the best clinical trials, only about 70% of patients are able to keep the drug within the desired therapeutic range."
Complicating matters further, about one-third of people taking Coumadin have genes that make them especially sensitive to the drug, increasing the risk of serious bleeding and making it even more difficult to determine proper dosages.
Even under normal circumstances, since the drug thins your blood so efficiently you must seek medical attention even from minor falls, cuts or scrapes when taking the drug, due to the bleeding risk. Patients are also warned to use caution when shaving, brushing and flossing teeth, trimming toenails and performing other normal daily activities. It's even recommended that you not use toothpicks while taking the drug.
And there's more.
Coumadin interacts with a laundry list of medications and herbal supplements, leading to a variety of dangerous effects. Among them (this is only a partial list):
- Aspirin or aspirin-containing products and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
- Medications for cancer, cholesterol, colds and allergies, depression, diabetes, digestive problems (including ulcers and heartburn), gout, heart disease, mental illness, pain, seizures, thyroid problems, and tuberculosis
- Oral contraceptives (birth control pills)
- Coenzyme Q10 (Ubidecarenone)
- Cranberry products
- Dong quai
- Ginkgo biloba
- St. John's wort
- Fish oil and omega-3 supplements
- Vitamin K
- Evening primrose oil
Your Diet and Coumadin
Another tricky aspect to taking the drug is its tendency to react with certain foods. Among the most common are vitamin-K-rich foods, as vitamin K can lessen the effectiveness of Coumadin.
Many vitamin-K-rich foods are extremely healthy, including dark green leafy vegetables such as kale, spinach, Brussels sprouts, collard greens, chard, parsley and mustard greens, and patients taking this drug are often warned to stay away from them, thereby missing out on the health benefits of these foods.
Other foods also interact with Coumadin, including cranberry juice and alcohol, which increase the drug's effect and may cause bleeding problems. Quite simply, there are so many foods, drugs, and supplements that interact with Coumadin that taking it can be like playing a game of Russian roulette.
In fact, even under the best circumstances, the drug is riddled with potential side effects, including:
- Severe bleeding
- Black stool or bleeding from the rectum
- Skin conditions such as hives, a rash or itching
- Swelling of the face, throat, mouth, legs, feet or hands
- Bruising that comes about without an injury you remember
- Chest pain or pressure
- Nausea or vomiting
- Fever or flu-like symptoms
- Joint or muscle aches
- Difficulty moving
- Numbness or tingling in any part of your body
- Painful erection lasting four hours or longer
- Skin tissue death (necrosis) and gangrene requiring amputation
- Feeling cold
- Pale skin
- Changes in the way foods taste
- Hair loss
Can You Get Off Coumadin?
It's important to understand that you should not stop taking Coumadin without the guidance of a knowledgeable health care practitioner. However, given this drug's side effects and risks, there is incentive to find a provider who can work with you to eventually get off the drug.
Solve the underlying reason why you're on the drug in the first place. This may mean you need to find out what's causing your arrhythmia, atrial fibrillation, blood clots or other issues, and will likely take the aid of an expert along with the guidance of a holistic practitioner who will help you determine and treat the underlying causes of your specific condition.
The second way to get off Coumadin, according to Dr. Bruce West, is by taking a combination of Nattokinase and omega-3 fats, like fish oil, daily. Nattokinase is an enzyme found in natto, a food made from fermented soybeans. In supplement form, Nattokinase has been found to help prevent and reduce the risk of blood clots, as well as provide heart-protective benefits. Some studies suggest that nattokinase can also reduce the risk of heart attack and stroke.
You will still need to have your blood closely monitored for clotting times if you take this regimen, and again you should not attempt this treatment without the guidance of your physician. However, it may provide a natural way for you to keep your blood thinner naturally, without all of the dangerous side effects of Coumadin.
Also ask your health care provider about additional supportive supplements may be beneficial in helping resolve some underlying causes of arrhythmia.
Again, dealing with blood clots and other conditions that require anti-coagulant drugs is not something you should attempt on your own. However, with the help of a knowledgeable health care practitioner you may be able to address the underlying causes of your health condition so there's no need for a potentially dangerous "cure" like Coumadin.
Cleveland Clinic, Drugs & Supplements, Understanding Coumadin
MayoClinic.com Warfarin Side Effects
ChicagoTribune.com November 16, 2010
ScienceBlogs.com February 19, 2009
U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Blood Thinner Pills
U.S. National Library of Medicine, National Institutes of Health, Warfarin