Coumadin (Warfarin)

Patients taking Coumadin (warfarin) often ask, “How can I get off this drug? Are there any natural alternatives that would work just as well?” Many are tired of the inconvenience and discomfort associated with having blood drawn every 4-6 weeks to monitor the drug’s anticoagulant action, or may worry about the risk of abnormal bleeding. Some detest experiencing unpleasant side effects like weakness and abdominal discomfort, and others simply don’t like the nature of warfarin (it’s used as rat poison in large quantities).

Despite all the negative aspects of Coumadin use, there’s a reason it is so widely prescribed… With an unparalleled ability to thin the blood and prevent blood clotting, it has a fantastic track record of protecting against stroke. A stroke is death of brain tissue caused by the lodging of a blood clot, or fragment of one, in an artery and subsequent prevention of blood flow to the brain. Hence, while there are some people on Coumadin who may benefit from switching to natural alternatives, certain higher-risk individuals really need to stay on it to prevent strokes.

Who Should Stay on Coumadin?

As of yet, there aren’t any blind studies which demonstrate that any natural alternative is as effective against stroke as Coumadin; Coumadin is the best preventative option for patients who are likely to experience blood clotting or stroke related to clot displacement. In general (without knowing a person’s medical or family history), staying on Coumadin is often recommended for people who have:

  • Hearts with enlarged chambers or valves that do not function properly;
  • Had an extensive heart attack; the resulting scar tissue can weaken the left ventricle and allow blood to clot more easily;
  • Prosthetic or mechanic heart valves, or a pacemaker; blood is more likely to stick to the artificial surfaces;
  • Endured an embolic stroke (one of three kinds of strokes, where a fragment or clot of blood pumps from the heart to the brain); or
  • Atrial fibrillation, where atria don’t contract; blood can form pools and become sluggish.

The one exception here is patients with “lone” AF… Patients who have had AF occur only once or twice and have an otherwise healthy heart – of normal size, and without enlarged chambers or leaky valves – may be candidates for more natural Coumadin alternatives as long as they are not otherwise prone to blood clots or other heart risk factors like diabetes.

Coumadin Alternatives

A person taking Coumadin, who is not in any of the abovementioned situations, may want to try more natural blood thinning alternatives, such as:

  • Nattokinase – an enzyme extracted and purified from natto, a traditional Japanese soybean dish. Nattokinase is a good supplement to take to help thin the blood. It helps prevent blood clots by reinforcing the actions of plasmin, an enzyme in the body that breaks down fibrin – 100 mg daily;
  • Fish Oil – 2-3 grams daily;
  • Garlic – 1-2 grams daily in capsule form, or as much raw garlic as you can tolerate;
  • Vitamin E (as mixed tocopherols) – 100 – 200 IU daily;
  • Bromelain (an enzyme derived from pineapple) – 600 mg daily;
  • Aspirin– As an anti-platelet agent, aspirin also has anti-clotting properties, and is frequently prescribed to help manage cardiovascular disease. While aspirin is also used to prevent ischemic strokes, it is less effective than Coumadin for preventing clots and strokes. It can also increase risk of hemorrhagic stroke (triggered by a leaky blood vessel in the brain);
  • Grounding– connecting to the Earth’s electromagnetic energy has been shown to help improve zeta potential, the tendency for red blood cells to repel one another. Grounding is also cardio-protective in that it can support heart rate variability and can help reduce stress by relaxing the body (as shown through increased parasympathetic nervous system activity).

If you take Coumadin, it is extremely important to consult with your prescribing physician if you are considering adding natural blood thinners to your program; hopefully s/he is holistically-minded and has knowledge of natural medicines (if not, bring him or her literature about them). It can be dangerous to mix Coumadin with natural alternatives because excessive bleeding can occur; this is especially problematic for people over the age of 85 because they are at higher risk of hemorrhagic stroke. Stopping Coumadin use entirely can also dramatically change blood viscosity, so be sure to discuss potential risks and benefits of all courses of action with your physician if you are considering natural alternatives.

Other Coumadin Concerns

Vitamin K2 is a Coumadin antagonist, which means it can limit Coumadin’s blood thinning capability. However, K2 plays an important role in cardiovascular health. It helps get calcium into bones instead of letting the mineral build up in arterial walls, which can cause arteriosclerosis. It’s important then, for people on Coumadin to abstain from vitamin K2 supplementation, and to instead eat leafy green vegetables and/or cheese, which contain vitamin K1 and K2, to avoid deficiency…. The key is moderation.

The same reasoning applies to grounding. While people on Coumadin may stand to benefit from standing barefoot outdoors for an hour or so each day, utilizing a grounding device for many hours a day or overnight is not recommended because of risk of excessive bleeding. People who wish to ground to improve their quality of life must work with their physician and get tested regularly to determine the thickness of their blood.

Note: Coumadin (warfarin) is the most commonly prescribed oral blood thinning agent; other blood thinners that doctors may use include Heparin, Lovenox (enoxaparin sodium), Normiflo (ardeparin sodium), and Orgaran (danaparoid sodium).

© 2011, 2014 HeartMD Institute. All rights reserved.

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20 Comments

  1. Marinda Vorster

    on March 24, 2014 at 6:10 am

    Reply

    I have a Anti-Trobine III deficiency. Had my first DVT in left upper leg when I was 25 and again when I was 38 (again in left upper leg). Drs only identified mentioned problem the second time around. I am using warfarin the past 16 years and dosage is 10mg 2x per week and alternative days 7.5mg. This is high dosage but I am stable with INR for years. I am seriously consider to change to Nattokinase for the obvious reasons. Will it be advisable? Just your opinion please. I am desperate to make the change. Thank you for the very interesting information.

  2. Marinda Vorster

    on March 24, 2014 at 6:18 am

    Reply

    I forgot to mention that my daughter of 28 has the same generic problem and had her DVT’s at the age of 13 and again 20. The same left leg. I am trying to find a better solution for the both of us. One more question…in case of excessive bleeding as result of an accident for example, will there be a way to stop bleeding immediately?

  3. Marcy b

    on June 23, 2014 at 3:20 pm

    Reply

    I just have a hard time thinking this is a medication for humans as when I grew up on our farm in Iowa, we put warfarin in the corn crib to kill the rats…just sayin! Caused them to bleed to death!

  4. Ken Eicher

    on June 24, 2014 at 2:31 am

    Reply

    I.m taking Xarelto for Afib. Does this piece apply to Xarelto also?

  5. Dr. Stephen Sinatra

    on June 26, 2014 at 2:40 pm

    Reply

    I’ve been in the CVD arena for 40+ yrs & have seen the good, the bad, and the ugly…I’ve seen people with cardiac disorders who, on their own volition, came off of Coumadin despite my pleas to stay on it. Some of these patients had horrific strokes with paralysis of half their bodies. Many people die of strokes. Clearly, I think there’s an advantage to using Coumadin, despite the fact that it’s been called “rat poison,” and the reason is, because it works! Clearly, Coumadin is a double-edged sword, however in some situations it is extremely therapeutic and does the job it’s supposed to do. Ultimately, it’s up to the patient and physician. Read my full response at https://www.facebook.com/SinatraMD

  6. Charles Ullian

    on July 4, 2014 at 7:34 pm

    Reply

    I am very sympathetic with this group of frustrated folks addicted to pharmaceutical nightmare drugs, as I am a member. All the Cardiologists who have seen me are completely ignorant and more alarmingly disinterested in any nutritional approach, period. They curse the internet and any attempt to self help, and call Dr. S a fool. They are drug pushing pharmaceutical puppets. Please, can anyone tell me where I can find an integrative cardiologist in Central Florida. Thanks for all your advise Dr Sinatra. I desperately need to see a doctor who echoes your thinking. Thanks for any info. Charlie

  7. David

    on August 14, 2014 at 6:44 am

    Reply

    Hi I had an aortic valve replacement in 1993 and have been on warfarin ever since. The valve I have is a titanium Star Edwards valve . Is there any natural alternatives that I could take instead? I am interested in alternatives and especially grounding .

  8. Dee

    on August 27, 2014 at 10:50 pm

    Reply

    Charlie you might call Dr, Elyaman, Ocala, Fl, He is an integrated GP. He may not be taking any new patients. He thinks very highly of Dr. S. and has been to some of his lectures in the past.

  9. POed

    on September 1, 2014 at 2:38 pm

    Reply

    No straight answers here.

  10. Furthermore

    on September 5, 2014 at 10:51 pm

    Reply

    I have been on coumadin for 23 years following a mechanical aortic valve replacement. Over the past two years my doctor has been concerned about a bit of bone density loss. I seem to have halted it with D3 and have now added Vitamin K2. It sounds like a great preventive for me but I knew I would have to go slow in adding the K2 since I need to keep the blood thin enough. I have worked up to 90mcg per day in the MK-7 form over a two month period and am happy to say that my lab work has shown no bad effects whatsoever on my prothrombin time. – The INR has remained very constant.

    I would, however, recommend that if you are on coumadin, add K2 supplements gradually. It might help keep your bones and arteries optimal while avoiding stroke risk.

  11. Mary Hardy

    on September 28, 2014 at 7:58 pm

    Reply

    I wanted to share some information with you. I had been on Coumadin for almost two years. I went through a spell for about two months that they could not get my INR regulated. I must mention that I am also hypothyroid and have had a total thyroidectomy. The Coumadin Clinic where I live was getting frustrated at not being able to get me regulated and recommended that I be changed to Xarelto. I have Factor V Leiden (a genetic, hereditary disorder that causes blood clots), and I have had 2 DVTs and multiple pulmonary embolisms. I was on Xarelto for a year and it completely messed up my thryoid levels. I have felt terrible for the last 10 months. After multiple doctor visits, it was determined that I was better off on Coumadin. Just FYI.

  12. juliet

    on October 1, 2014 at 10:31 pm

    Reply

    Find a functional medicine doctor or cardiologist at – try Dr Hyman or Dr Hanaway at the Cleveland Clinic Functional Medicine Program.

    [quote]I am very sympathetic with this group of frustrated folks addicted to pharmaceutical nightmare drugs, as I am a member. All the Cardiologists who have seen me are completely ignorant and more alarmingly disinterested in any nutritional approach, period. They curse the internet and any attempt to self help, and call Dr. S a fool. They are drug pushing pharmaceutical puppets. Please, can anyone tell me where I can find an integrative cardiologist in Central Florida. Thanks for all your advise Dr Sinatra. I desperately need to see a doctor who echoes your thinking. Thanks for any info. Charlie[/quote]

  13. Sophy

    on October 15, 2014 at 6:15 pm

    Reply

    you sound like you are my twin because i TOO have Factor Five Leiden, i TOO go to a coumadin clinic, i TOO have had 2 DVTs, and i TOO have had multiple pulmonary embolisms. ive only been on warafin for about a month but when i developed a headed for five days that wouldnt go away, felts completely sick to my stomach most of the time, and felt like it was interfering with my quality of life, i had to stop it. i was told id need lifetime therapy of the drug, but i cant live like that. im looking for info to see if nattokinase is a good supplement, and maybe some grounding.

  14. Suzanne

    on October 15, 2014 at 8:57 pm

    Reply

    All I know is I have thick blood. I am tired of taking warfrin which I have now been on for 2 yrs. I hate going once a month to have it checked and talk to the Dr every six months. I need a way to get off it for good like with a good diet

  15. Gwynedd

    on October 17, 2014 at 3:12 pm

    Reply

    Dear Dr. S., Thank you so much for taking the time to write your article. I have been on coumadin since December 2013. I had been hospitalized for pulmonary embolism. Previously I had had the Widowmaker heart attack in 2009. It was a major heart attack with approximately 50% heart muscle damage, and one stent in the LAD. Between the two occurrences I have been hospitalized twice with severe angina, and was eventually diagnosed withPrinzmetal’s. I am taking several cardiac medications, and had Clopidogrel switched out and coumadin added: after the pulmonary embolism. I used to argue about all my mint. Now I am simply a cheerleader for them. I am simply grateful for whatever will keep me alive!!! People fight so hard to return to “normal.” Bgr8fl

  16. Elizabeth Kenoyer

    on December 10, 2014 at 11:15 pm

    Reply

    I have mechanical heart valves. I have to take alot of coumadin. I hate coumadin and have suffered terrible side effects. I want an alternative and natural alternative to coumadin NOW please. Help me.

    Thanks.

    Sincerely,

    Elizabeth Kenoyer

  17. louise

    on November 1, 2015 at 2:53 pm

    Reply

    They had the strokes because they stopped taking the poison- Coumadin/Warfarin. How about not prescribing this poison in the first place.

  18. Ellen Armstrong

    on January 12, 2016 at 3:00 pm

    Reply

    I have been taking it for nine years l had six blood clots in my leg they got all of them but two that was in my foot I was told there your foot not enough room in the foot to work on it I haven’t had any more trouble since that I’m tired of taking this I want to get off of it any suggestions

  19. J. CASEBOLT

    on August 22, 2016 at 10:47 pm

    Reply

    DEAR DOCTOR SINATRA, IN HAVE BEEN TAKING YOUR OMEGA Q PLUS WITH RESVERATROL ON AUTO SHIPMENT AND AM VERY PLEASED AS IT HAS HELPED TO LOWER MY CHLOESTEROL & TRIG. QUITE A LOT. I AM 82, AND NEED A HEART ABLATION WHICH WILL BE DONE TOMORROW. MY DOCTOR TOOK ME OFF YOUR SUPPLEMENT AND AFTER MY PROCEDURE WILL BE GOING ON ELIQUIS TO PREVENT BLOOD CLOTS. CAN I GO BACK ON YOUR SUPPLEMENT WHILE ON ELIQUIS? PLEASE ADVISE. THANK YOU

  20. HeartMD Editor

    on August 24, 2016 at 9:54 am

    Reply

    Hi J., We hope you’re off to a speedy recovery! Omega-3 supplements like Omega Q Plus with Resveratrol are so beneficial for the heart, but, yes, you do need to proceed with caution when also taking a blood thinning drug, as blood can become too thin. Be sure to work closely with your physician and keep him or her informed about your dosage. And don’t ever stop taking your blood thinning drug in favor of an omega-3 supplement unless your doctor thinks it’s okay. Best wishes!

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