Q: Can I use these nutritional supplements while on Coumadin?

Dear Dr. Harlan,

My question to you is not about foods containing Vitamin K but rather the use of nutritional supplements while on medication. I am not only taking warfarin due to two incidents of DVT and being Factor V Leiden Mutation positive, but also:

1) Hydrochlorot and Diovan for blood pressure
2) Actos and Metformin for Type II Diabetes
3) Vytorin for cholesterol

I want to get as healthy as I can with natural alternatives, perhaps even eliminating the need for these medications. I am 41, overweight and a non-smoker/non-drinker.

Can you provide any insight into which supplements would be beneficial and which I should absolutely avoid? What internet resources can you recommend?

I do appreciate your time. I look forward to your reply!

P.S. I have some specific examples in mind. What do you think of the following?

1) Rhodiola Rosea
2) Aralia Mandshurica
3) Georgian Pomegranate
4) Caucasian Bilberry

Thank you.

A: Dr. Gourmet Says...

You should absolutely avoid such supplements while taking warfarin. There is very little solid research done on supplements and you are putting yourself at very high risk by taking them along with your Coumadin®. There is with the other medications you are taking as well. While there are specific reports about bilberry having interactions with warfarin, it is more complicated than simply whether a specific supplement will cause a problem for you.

Because there is little regulation of the supplement industry, you are never completely sure of what you are getting. Just because the label says bilberry doesn't mean that there are not other supplements contained in the pill you take. Likewise, the source of these products, the quality and the potency varies widely from manufacturer to manufacturer. I recommend that my patients absolutely avoid such "natural" alternatives.

The best natural alternative for you is to discuss a plan with your physician for diet and exercise to help you lose weight. At 41, with the health problems that you have, you want to be in top form. The evidence for the positive effect on health and longevity of eating a lower calorie diet and exercise is compelling. You can read about many such studies on my website in the Dr. Tim Says... section.

Because you have more complex medical issues, including diabetes, it is very important for you to craft a plan that helps you lose weight slowly and carefully. Speak with your doctor about seeing the dietician for the correct number of calories to help you eat better. You can also discuss with your physician beginning an exercise program.

The eatTHISdiet plan on my website conforms to the guidelines of the American Heart Association, and the recipes and meal plans may help you and your dietician get you where you want to be.

Supplements are not a healthy alternative for you. A change in lifestyle is.

Thanks for writing.

Eat well, eat healthy, enjoy life!

Dr. Gourmet