Broccoli and Spinach are Not Likely to Affect INR Blood Test

December 10, 2004

Promising Dutch study of Vitamin K. The somewhat cryptic headline is probably nonsense to most people, but nevertheless has great importance to all those taking blood-thinning (anticoagulating) medicines such as Marevan (Warfarin) and who are doing the regular blood test control, called INR.

If you are undergoing treatment with anticoagulant drugs such as Marevan, you should regularly be tested with a blood test called INR.

This blood test is designed to estimate if the dose you receive is correct, but it should also prevent overdosing in which the blood would get “too thin”. This condition is dangerous and can result in internal bleeding.

12 healthy volunteers were included in a study in which they were given a correct dosage of anticoagulants for 13 weeks and adjusted to a maintenance dose with a constant and stable INR value that would prevent them from forming blood clots.

Then, they were given increasingly large daily doses of vitamin K from 50 mcg. to 500 mcg. during the course of one week. Not until the dose reached 150 mcg. of vitamin K a day taken as a dietary supplement, was any effect on INR observed. Even at this dose, INR was only affected in 3 out of the 12 trial subjects.

When the trial subjects were given food that is particularly rich in vitamin K, i.e. broccoli and spinach, there was no clinically relevant effect on INR because the effect was so transient, and the authors suggest that the reason might be a poor bioavailability of the vegetables. This may be surprising, as kale, spinach, and broccoli can contain up to 400 mcg. of vitamin K per 100 g.

Doses of 100 mcg. vitamin K as an easily absorbable dietary supplement had no effect on INR.

If this study on healthy, young trial subjects can be repeated with the same result on patients with a predisposition to forming blood clots, it would make life significantly easier on a great number of people who every day stare in despair at the long list of foods containing vitamin K that they are not allowed to eat while taking Marevan.

By: Vitality Council

Reference:
Schurgers LJ, Shearer MJ, et al: Effect of Vitamin K Intake on the Stability of Oral Anticoagulant Treatment. Dose-Response Relationships in Healthy Subjects. Blood 2004;104(9):2682-2689.

www.bloodjournal.org
www.iom.dk