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Can You Take Natural Supplements While On Coumadin

Herbal Supplements

Not everyone’s body is built the same. A significant portion of the population requires the use of blood thinners or anticoagulants to reduce their increased risk of developing risky, life-threatening blood clots. One of the most prescribed anticoagulants is Coumadin (warfarin). Those on anticoagulants like warfarin are trying to maintain their INR. Many herbal antioxidants are also known anticoagulants, that when taken with warfarin can thin the blood beyond the desired effect.

While globally Coumadin is heavily prescribed, in the USA it has been largely supplanted by more specific anti-thrombogenics that do not require weekly blood tests to determine levels.

What Does INR Mean?

Red Blood Cells

INR stands for the International Normalized Ratio. This is a calculation based on a prothrombin time (PT) test that measures how long before a clot starts forming in a blood sample. These tests are performed most commonly on those with abnormal blood clotting and to test the effectiveness of the blood-thinning medication Coumadin (warfarin).

Why Don’t Antioxidants Play Nice With Warfarin?

The main enzyme for processing coumadin is CYP2C9. If a substance inhibits this enzyme (CYP2C9), then it will increase the levels of warfarin in the blood and the opposite is true as well. If you take an herb, eat a plant, eat anything really that changes the activity of that enzyme, it will cause changes in your bleeding times. This is why many physicians choose more modern anticoagulant medication

Ginkgo at a 24% concentration is known to interfere with coumadin. Green tea inhibits CYP2C9 as well. St. John’s wort does as well. Quercetin, scutellarein, baicalein, morin, apigenin, chrysin, and catechin-3-gallate are some more flavonoids that can interact with this enzyme.  Turmeric can have an effect on levels of Coumadin in serum as well.  

Powdered Turmeric & Raw Turmeric

This enzyme is affected by oral sulfonylurea hypoglycemics, NSAIDs, COX-2 inhibitors, angiotensin II receptor inhibitors, antidepressants, and antiepileptics as well.

Frequent Blood Tests Are Important

Fortunately, most people on warfarin have blood checks weekly or multiple times per week. If something that you ate or another medication that you took changes the activity of the drug, you will know quickly and be able to modify things.

Blood test

As you can understand, hundreds of substances could potentially interfere with the CYP2C9 enzyme. You will need to discuss this and your entire diet with your treating physician before taking any health-enhancing substances.  

Natural Supplements That Do Not Effect CYP2C9 Enzyme

Some great supplements that can still be taken while on the blood thinner coumadin include tart cherry extract, omega-3 fatty acids, PEA (palmitoylethanolamide), and resveratrol.  These powerful natural antioxidant supplements do not interact with the CYP2C9 enzyme and should be safe to take in conjunction with coumadin.

Tart Cherry Extract is a great anti-inflammatory that we believe works as well as NSAIDs without all the side effects. It helps reduce inflammation and pain in muscles and joints while fighting off free radicals. 

Dr. Meredith Warner Baton Rouge Orthopedic Surgeon

Dr. Meredith Warner is the creator of Well Theory and The Healing Sole. She is a board-certified Orthopedic Surgeon and Air Force Veteran.

She is on a mission to disrupt traditional medicine practices and promote betterment physically, spiritually and mentally to many more people. She advocates for wellness and functional health over big pharma so more people can age vibrantly with more function and less pain.

At Well Theory, Our surgeon-designed products are FDA Registered and formulated to help people:

  • Manage the symptoms of musculoskeletal pain
  • Recover vibrantly from orthopedic related surgeries
  • Fill the gaps in our daily diets
  • Manage pain associated with inflammation