Q: Does salt increase INR levels?

My girlfriend (age 46) just had a heart valve replacement and was placed on Coumadin. She was told to avoid food with a high sodium content. We have some questions about this and what actually affect her INR levels.

Does salt actually increase the INR level? They also told her she could use "sea salt" in moderation, but from what I have read it's still salt, is this true? Is sea salt really better for you?

What about the lack of iodine in sea salt, I have not found any iodized sea salt yet. Does she need to worry about iodine supplements if using non-iodized sea salt or salt substitutes?

Q: Dr. Gourmet Says...

The sodium content of table salt (sodium chloride) should not have an effect on your girlfriend's INR or her Coumadin® (warfarin). It may be that her doctor wanted to make sure that there are no problems with salt worsening her high blood pressure or issues of fluid overload in the body that could lead to Congestive Heart Failure (CHF).

Sea salt is salt. A teaspoon might have a little less sodium in it because of the fact that sea salt crystals are larger and therefore don't stack together in a spoon like Morton's salt. That said, salt is salt. There are impurities in sea salt that can contribute to flavors in the salt, but otherwise the sodium and chloride are the same. Sea salt is salt and all salt in excess is something that pretty much everyone should avoid. I don't see that sea salt is worth the extra money.

Most folks get enough iodine in a healthy diet. Using a mixture of salt and sea salt should be fine but check with her doctor about the amount of sodium he wants her to have each day. She really shouldn't need to worry about iodine supplements this way.

Thanks for writing,

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