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Hi,

I've recently been put on Warfarin after hip replacement surgery. I've been told to avoid large quantities of certain foods, which would make Warfarin less effective. They include kale, green tea, Brussels sprouts, parsley and spinach. Actually, they are all things that I would normally eat and I am not exactly sure what constitutes large quantities of those foods. Seems they are healthful things and I am not sure why they need to be avoided? And really, how much is too much? Do I need to stop using those things at all out of precaution? 

Thanks for your help. 

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Yes, it is true that Warfarin comes with dietary recommendations, because some foods can prevent the medication from working effectively. Therefore, your doctor should have informed you about what to do in detail. You should not smoke and should drink alcohol only in moderation. It is very important to not change your diet too drastically too quickly on Warfarin. yes, you can eat leafy greens, and you should not cut them out suddenly because that will only make things worse. If you came away from the doctor not understanding the instructions carefully, simply go back and ask until you do understand.
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You are right to look into diet restrictions on warfarin, because there are several.

Yes, leafy greens such as spinach, brussels sprouts, collard greens and chard should be avoided because they are rich in vitamin K. This can decrease the efficacy of warfarin. Small amounts should not pose a problem but large amounts must be avoided at all costs. Alcohol and cranberry juice can actually increase the efficacy of warfarin, which then makes you vulnerable to excessive bleeding. Making drastic changes to your diet suddenly while on warfarin is another thing you should not do. Basically, it all comes down to "do everything in consultation with your doctor".
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Yup, if you're on any blood thinner, including Warfarin/Coumadin, you need to keep an eye on your Prothrombin Time and International Normalized Ratio. So no more than a single serving of a food considered HIGH in vit K and no more than three MODERATE vit K servings. What's crucial is to keep your vit K levels STABLE at all times. No cheating either. This isn't a normal diet. Going off it could really affect your health. Because it is difficult to get used to this new way of eating, just talk to your doc about it until you're sure you understand everything, then follow the recommendations and you will be OK. Good luck with that!
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