One of my passion’s is getting people off pharmaceuticals. Funny, it did not start out that way. As a conventionally trained cardiologist, there was not much greater joy than writing that first prescription as a medical student.
Let me start out with this….DO NOT STOP ANY DRUG without speaking with your physician first.
What is Coumadin?
Coumadin is the brand name for generic warfarin. It is a blood thinner that blocks vitamin K activity, therefore inhibiting blood clotting. In short, it makes you bleed. Coumadin is often referred to a “rat poison”. This is true, but only because it makes rats bleed to death. But beware, the same can happen to the human consumer.
Coumadin must be carefully monitored by an INR test. The INR measures the level of blood thinning from Warfarin. If the INR is too high, you could have a serious bleed. If INR is too low, coumadin is not working at you are at risk of clotting and therefore negating the reason you are on it in the first place.
Why are You on Coumadin?
There are several reasons why you may be on Coumadin.
- Atrial fibrillation (AFIB)
- Deep venous thrombosis (DVT)
- Pulmonary embolism (PE)
- Mechanical heart valve
- Left ventricular thrombosis
- Post-operative DVT prevention
AFIB is the most common indication for coumadin. Other blood-thinners like Pradaxa, Eliquis, and Xarelto are rapidly gaining market share. Read my blog and watch my video about stroke risk with AFIB. Calculate your score and you will see your stroke risk. I have a blog post on 10 natural blood thinners.
Risk of Coumadin
There are a few reasons why you would want to stop Coumadin
- Risk of serious bleeding. Seriously, although Coumadin can be reverse in an emergency room, you could die while on the way.
- Frequent blood testing to monitor levels. It’s a hassle to try to dial in the blood-thinning nature of this drug.
- Interaction with food and the horrible advice to avoid leafy green vegetables. Yes, doctors tell patient not eat veggies because they contain vitamin K. Cheeze-Its are okay, but kale is not. Typical MD advice.
Getting off Coumadin
- AFIB – Many doctors recommend Coumadin for all people with AFIB. But stroke risk goes up as CHADSVASC score goes up. So, learn your score and then decide if you want to stay on the drug. After all, it is YOUR decision. For example, a person with AFIB who is 64 years of age, female, with no other risk factors on CHADSVASC is a #1. Stroke risk is low and she should not be on Warfarin, in my opinion. The risk of bleeding is higher than benefit.Personally, I think any CHADSVASC score deserves a chance at changing their risk by following my advice in my book, blog posts, videos, and in-office visit. I would LOVE to see you in my office, “upgrade” you, and do the most advanced testing in the world. Check out my post on natural blood thinners. You are the captain of your health, not anyone else. I know first-hand that doctors can be bullies. Don’t be bullied.
- DVT/PE – For a first event DVT/PE, typically 6 months of Warfarin is needed. If the clot was small and/or happened after a surgical procedure, 3 months may be enough. When DVT/PE occurs in the face of cancer or another hypercoagulable state, 12 month or longer may be indicated. Again, there may be a better way that we can discuss in person or on a phone call.
- Mechanical heart valve – This is a situation where Coumadin is life-long. No other blood-thinners will suffice. Hopefully this changes, but as of 2019, it is all Coumadin. Newer mechanical valves require less Coumadin and a lower INR level 1.5 to 2.0. This is good because the higher the INR, the less active vitamin K you have. Vitamin K is critical for heart and bone health. K keeps calcium in the bones and out of the heart arteries.
- Left ventricular thrombosis – Usually this happen after a large heart attack. These people can usually get off Coumadin after 3 months. Again, I can help in this scenario with a personal consultation. Call my office and get on the schedule 480 535 6844.
- Post-op prevention – Follow the recommendations of the surgeon. Post-op DVT is common and easily preventable. Other modalities for prevention are possible and other drugs are commonly used. Stick with their plan.
If you want to discuss your situation, give us a call. We can discuss any other possible options.
Lastly, fish oil. You do not need to stop fish oil while on a blood thinner, just as you do not need to stop eating fish while on blood thinners. Eat fish!