Vitamin K, which is in some foods, has an important role in blood clotting, and how warfarin works.
Dos and Don’ts After a Blood Clot
If you’ve had a deep vein thrombosis (DVT) in one of your legs or arms, it’s sometimes normal for that limb to stay slightly swollen after treatment. After a clot in your lungs (a pulmonary embolism, or PE), you might feel mild pain or pressure in your chest. But watch out for new or worse pain, pressure, or cramping in your calf. That could signal a new DVT. Shortness of breath or fainting could be signs of another PE. If you have any of these, call 911 and get medical care right away.
Do: Know Your Odds
2/13
If you’ve had a blood clot before — whether in your leg, arm, or lungs — your chances of another one are higher. Your risk is also greater if you:
- Have cancer, an inflammatory disorder (like Crohn’s disease), a rheumatologic disorder (like rheumatoid arthritis), or a blood clotting disorder
- Are over 40
- Are overweight or obese
- Smoke, especially if you take birth control pills
Don’t: Hurt Yourself
3/13
Your doctor may prescribe clot-fighting drugs called anticoagulants, or blood thinners. These can make you more likely to bleed from small injuries, so it’s important to be careful when trimming your nails. You should wear gloves when you use sharp tools, and wear safety gear for sports and hobbies. Check with your doctor to see what other activities might not be safe for you.
Don’t: Eat the Wrong Foods
4/13
If you take the blood thinner warfarin (Coumadin, Jantoven) to ward off clots, you’ll need to watch what you eat. Vitamin K can affect how the drug works. So you have to be careful about the amounts of kale, spinach, Brussels sprouts, chard, or collard or mustard greens you eat. Green tea, cranberry juice, and alcohol can affect blood thinners, too. So ask your doctor about them.
Do: Get Moving
5/13
Exercises like walking or swimming can help you heal after a clot. They boost your blood flow and may make you feel better. If you had a pulmonary embolism, activities that get your heart pumping, like running or dancing, can make your lungs stronger. But talk to your doctor first about how much is right for you.
Do: Ask About Other Medicines You Take
6/13
If you take warfarin and certain other blood thinners, you shouldn’t take aspirin unless your doctor says it’s OK. That’s because it can raise your chances of major bleeding. Some antibiotics can keep these medicines from working the way they should. You should be careful with over-the-counter herbal supplements. A few, including ginseng, flaxseed, and fish oil, can also affect how blood thinners work.
Do: Share Information
7/13
Let all your doctors know if you’ve had a blood clot of any kind. And if you take blood thinners, tell your dentist when you make your appointment. Follow any instructions they give you to prepare for your visit.
Do: Ask About Compression Stockings
8/13
These special tight-fitting socks keep a certain amount of pressure on your leg, and that can help with blood flow after a DVT. Your doctor might also recommend them after a PE to boost your circulation.
Don’t: Sit Too Long
9/13
Try not to stay seated for more than 2 hours at a time — get up and walk around regularly. If you had a DVT in one of your legs, don’t cross your legs when you sit down. That position can affect your circulation. Be mindful of this when you’re on long flights or driving for a long time.
Do: Travel Smart
10/13
If you’re in a car, take breaks often to stretch your legs. Deep knee bends can help get your circulation going. On a plane, try to move around the cabin once an hour. While you’re in your seat, flex your ankles to keep blood flowing. And drink plenty of water — dehydration can make a clot more likely.
Do: Watch Your Weight
11/13
Obesity can strain your veins and make them weak. And if you have diabetes, make sure it’s well controlled. If it’s not, it can damage your blood vessels.
Don’t: Be Afraid to Ask for Help
12/13
It’s not unusual to feel anxious or depressed in the first few weeks after a DVT or PE. If those feelings are severe or they don’t go away, and you don’t feel like doing your normal activities, tell your doctor. They might be able to give you medication or a referral for talk therapy. A support group of people who’ve had the same problems may help, too.
Do: Be Careful During Pregnancy
13/13
Women who’ve had a DVT or PE have higher odds of another one when they’re pregnant. It’s important that they work with their doctors and watch their health closely. Even if they’ve stopped taking blood thinners, they might need to take them again, possibly as long as 6 weeks after delivery.
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Mayo Clinic: “Deep Vein Thrombosis,” “Pulmonary Embolism,” “Warfarin Diet: What Foods Should I Avoid?”
National Blood Clot Alliance: “Living Your Best Life While Taking Blood Thinners,” “Blood Clot FAQS — Follow Up Care,” “Does Pregnancy Cause Blood Clots?”
University of North Carolina Hemophilia and Thrombosis Center: “I’ve had a blood clot,” “FAQ: Is it normal to be anxious or depressed after a clot?”
CDC: “Venous Thromboembolism.”
Indiana Hemophilia and Thrombosis Center: “Clotting Disorder FAQs.”
National Heart, Lung, and Blood Institute: “Deep Vein Thrombosis.”
What to know about the warfarin diet
People taking the blood thinning medication warfarin may need to moderate vitamin K levels in their diets. Vitamin K may interfere with the effectiveness of warfarin.
A doctor may prescribe warfarin to someone who has had a blood clot in the past, as they are at a higher risk of blood clots in the future. Other factors that increase the chances of a blood clot include:
- obesity
- pregnancy
- long periods of inactivity
- smoking
- irregular heartbeat
- trauma
- older age
- chronic inflammatory diseases
- diabetes
- high blood pressure
- high cholesterol
Warfarin works by slowing the production of clotting factors, which the body makes by using vitamin K from food. Levels of vitamin K in a person’s diet could influence the effects of warfarin.
It is possible that vitamin-K rich diets can reduce the effectiveness of warfarin.
Share on Pinterest Asparagus is high in vitamin K.
Vitamin K, which is in some foods, has an important role in blood clotting, and how warfarin works.
The liver uses vitamin K to produce clotting factors, which are cells that help to control bleeding and enable blood clots to form.
Warfarin disrupts this clotting process by inhibiting an enzyme in the liver that uses vitamin K to form clotting factors.
Warfarin can reduce the chances of a dangerous blood clot forming by increasing the time it takes for the liver to produce clotting factors.
It is possible that eating a diet rich in vitamin K could reduce the effect of warfarin on clotting factors.
The American Heart Association (AHA) suggest that eating vitamin K-rich foods may counteract the effects of warfarin, and lower the prothrombin time. This is the time it takes for a blood clot to form.
The AHA’a list of 19 foods high in vitamin K includes:
- amaranth leaves
- asparagus
- broccoli
- Brussels sprouts
- coleslaw
- collard greens
- canned beef stroganoff soup
- endive
- garden cress
- kale
- kiwifruit
- lettuce
- mustard greens
- soybeans
- spinach
- Swiss chard
- tuna fish in oil
- turnips
- vegetable drinks
It is not necessary to cut out foods that contain vitamin K entirely. The foods that contain vitamin K also have other nutritional properties that contribute to a healthful diet.
It is important to note that the guidance varies on how much vitamin K people on warfarin can consume.
For example, a recent systematic review suggests a diet that restricts vitamin K intake is unlikely to improve the efficacy of warfarin. The authors suggest that keeping vitamin K levels consistent may be more beneficial.
The average person only needs a small amount of vitamin K, around 60 to 80 micrograms (mcg) per day. As this amount is so small, it can be easy for vitamin K levels to fluctuate across different days, creating a problem for people on warfarin.
Keeping vitamin K levels stable, and within a normal range, may reduce its effect on the actions of warfarin. Keeping a food diary and being aware of foods that are high in vitamin K can help a person keep track.
Share on Pinterest Drinking alcohol can be harmful for people taking warfarin.
Alcohol can also affect the action of warfarin and, therefore, the risk of developing blood clots.
High levels of alcohol consumption can alter the way the body metabolizes warfarin.
The AHA suggest that, on average, men should drink no more than one or two drinks per day, and women should drink no more than one drink per day.
Examples of one drink are a 12-oz beer, a 4-oz glass of wine, 1/5 oz of 80-proof spirits, or 1 oz of 100-proof spirits.
Drinking too much alcohol can be particularly harmful for people taking warfarin. A study of 570 people in 2015 found that alcohol misuse has links to a higher risk of major bleeding in people taking warfarin.
Warfarin can help to prevent dangerous blood clots. It works by slowing the production of clotting factors, which the body makes by using vitamin K from food. Levels of vitamin K in a person’s diet could influence the effects of warfarin.
People taking warfarin must avoid eating too many foods that are high in vitamin K, but it is not necessary to avoid these foods entirely. A stable diet, containing around 60 to 80 mcg of vitamin K is desirable.
People on warfarin must also ensure that they only consume alcohol in moderation. High levels of alcohol may affect the metabolism of warfarin and increase the risk of major bleeding.
Last medically reviewed on February 12, 2019
- Alcohol / Addiction / Illegal Drugs
- Cardiovascular / Cardiology
- Nutrition / Diet
- Pharmacy / Pharmacist
How we reviewed this article:
Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- A patient’s guide to taking warfarin. (2016).
https://www.heart.org/en/health-topics/arrhythmia/prevention–treatment-of-arrhythmia/a-patients-guide-to-taking-warfarin - About bleeding disorders. (2014).
https://www.wfh.org/en/page.aspx?pid=635 - Blood clots. (n.d.).
http://www.hematology.org/Patients/Clots/ - Roth, J. A., et al. (2015). Alcohol misuse, genetics, and major bleeding among warfarin therapy patients in a community setting.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478047/ - These foods are low in vitamin K. (n.d.).
https://myafibexperience.org/media/38922/71a6b53f3a04feb171843072d98557b7-vp_warfarin-card_030316.pdf - Violi, F., et al. (2016). Interaction between dietary vitamin K intake and anticoagulation by vitamin K antagonists: is it really true?: A systematic review.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998867/ - Vitamin K. (2014).
https://lpi.oregonstate.edu/mic/vitamins/vitamin-K - Warfarin interactions with food. (n.d.).
https://www.ihtc.org/warfarin-and-vitamin-k/
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