Q: Can foods low in Vitamin K still affect my INR levels?

Thanks for your website. I know it will be helpful. My question is, can the foods listed in the low range affect the Coumadin? My levels are staying low. I have been on Coumadin for a month and a half and the last three weeks it has been 1.9, 1.6, & 1.7. They upped the Coumadin from 5mg to 6mg but it is still low. I looked at the food list and the only thing I have eaten that is anything other than in the low range is the mayonnaise. My doctor told me about this website, thinking it might be my diet that is causing it to be low. Please Help.

A: Dr. Gourmet Says...

Thanks for your kind words about the information on Dr. Gourmet. Keep visiting, as the site is updated daily, and do be sure to tell your friends.

Some people do require higher doses of Coumadin® (warfarin). While we consider the normal dose to be in the 5 milligram (mg) per day range, I do have patients on much higher doses. Your physician is right on track to consider diet may be a factor.

It is possible that you are more sensitive to Vitamin K -- everyone is different in how the Coumadin works in their body. Check to see if there is a higher dose of Vitamin K in any multivitamin you are taking.

One option is to replace your use of mayonnaise with other choices of fat. We know, for instance, that olive and grapeseed oil are great for you and making salads that use these oils in the dressings is a good choice. Making the Red Potato Salad instead of a mayonnaise based version is an example. Similarly, there are a number of chicken salad recipes on the Dr. Gourmet site that don't use the traditional mayonnaise, including Mediterranean Chicken Salad, Chicken and Basil Salad and Roasted Tarragon Chicken Salad.

Using other spreads on your sandwiches. Try making Tapenade. Like olive oil the olives are great for you and a better choice of fat. The Roasted Carrot Spread is another example. Choose different flavored mustards at the grocery to add some variety to your lunch.

Keep an eye on foods you might be eating if you are going out to eat, because parsley is very high in Vitamin K and could be a factor for you as well.

Thanks for writing,

Dr. Gourmet
Eat well, eat healthy, enjoy life!