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).

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29 Comments

  1. Marinda Vorster

    on March 24, 2014 at 6:10 am

    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

    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

    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

    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

    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

    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

    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

    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

    No straight answers here.

  10. Furthermore

    on September 5, 2014 at 10:51 pm

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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!

  21. Akbar Amir

    on December 18, 2016 at 5:22 pm

    Hi, I’m Akbar from UAE. I had a hemorrhagic stroke for 6 years on the right side. This was so tough for me because i never imagined myself in this way. I lost my speech and i was obviously useless because i could not perform any activity without any support, i could not walk, i used to enjoy driving but none of this i could do again. I was totally paralyzed. The worst part was the emotional aspect of it. I cry very easily and have no control over it because all the doctors or physiotherapist i met were not helpful at all. I am, however, very lucky that i was able to find a very effective alternative natural treatment to stroke that cured me completely. It has been two years now and i still can drive, i actually thought the cure was not permanent but now i am fully convinced and that is why i decided to write this. If you have stroke or any paralysis just contact Dr Joseph on (josephalberteo @ gmail. com) for more information or advise and i am sure his medicine can help you too. I hope this helps someone out there.

  22. Marcia Panebianco

    on April 9, 2017 at 9:30 pm

    having very bad effects from coumadin. would rather die than lived like this. Is there anyone in NE PA who can help?

  23. Joan H.

    on May 31, 2017 at 7:21 pm

    Dr. Sinatra, I have been on Warfarin since I broke my femur, 5.5 yrs ago, when I got DVT (which could “maybe” have been avoided if wasn’t made to wait 48 hours for the femur repair surgery). I took Warfarin for 6 mos. was able to stop as had two ultra-sounds which remained the same, but 2 mos. to the day I was in ER and told the DVT evidently was not eradicated, back on Warfarin.
    Last year I had another ultra-sound and it was pronounced that DVT was not evident. However, I wanted to get off Warfarin and hematologist advised against it as my Factor VIII was high (I do not have clotting gene). It is high but I have researched Nattokinase and would like to try it. Doctors say I shouldn’t and I cannot purchase from my chiropractor unless I can stop Warfarin with my doctor’s okay, fearing that my blood might become too thin or susceptible to non-clotting, if take it with Warfarin. I have a Catch 22 here.
    What is your take on Nattokinase? I have read that having a clot due to injury surgery such as femur repair, when gone, should be able to get off. I have read many good reviews for Nattokinase and what it can do sounds like what would be ideal. I have heard only positives, no negatives and that surprised me.

  24. HeartMD Editor

    on June 8, 2017 at 3:47 pm

    Hi Joan,

    Blood thinners are tricky and you especially need to exercise caution when conditions like DVT have been present. Often times, a traditional blood thinner is the way to go, and they are lifesavers. Whether or not a natural blood thinner can be substituted is a case by case decision. You would have to make this decision with your doctor. If you are looking for another opinion or information on utilizing nattokinase I would suggest contacting one of the cardiologists on Dr. Sinatra’s Top Docs List as Dr. Sinatra would not be able to advise you on this matter. In particular I’d recommend you start with Dr. James Roberts in Ohio. He co-authored “Reverse Heart Disease Now” with Dr. Sinatra and would be able to advise you on blood thinner alternatives.

  25. Susie T.

    on July 12, 2017 at 2:31 pm

    Dr. Sinatra, I have been doing a lot of reading on your web site since I have been taking warfarin following the discovery of a DVT in early January of 2012 that extended from mid calf to mid thigh in my right leg. The specialist I saw in Florida indicated that I would need to stay on warfarin for the rest of my life since I have both Factor V Leiden inherited from one parent and another concern that contains the word “lupus” but is not related to the lupus disease. I have since that time moved to a much smaller community in Indiana and my INR is being monitored by my family physican’s Coumadin Clinic. I get frustrated at times with the ups and downs of INR regulation but so far have not been ready to try one of the newer blood thinners. Am I on the right track in thinking that living with the ups and downs of my INR regulation is my best solution? I was 70 when this DVT was discovered and have had no further incidences of DVT. Thank you.

  26. Larry M.

    on September 2, 2017 at 7:17 pm

    I purchased the “Awesome Foursome”. I then did my homework (a little late) and found that 3 out of 4 were not compatible with Coumadin. D-Ribose
    Am I correct?

    Thank You

  27. HeartMD Editor

    on September 3, 2017 at 4:14 pm

    Hi Larry, Dr. Sinatra says: “Coumadin can indeed be a lifesaver and be problematic as well. When on it, you must closely work with your own and personal physician. Although there are a few case studies with Q10 and Coumadin interactions, I’ve used Q10 in most of my patients on Coumadin as well as D-Ribose, Magnesium, and L-Carnitine. If you’re considering taking these supplements, just be sure to tell your physician about it – he or she needs to know about any drugs or supplements you take, and even dark leafy vegetables you eat, while on bloodthinners like Coumadin.” Best wishes.

  28. Allison Harrison

    on September 5, 2017 at 5:10 am

    My Dad was taking warfarin for 6 years after having a triple bypass. After surgery, he had a clot in his leg and lost it. He was confined to a wheelchair after. He never walked again. At 69 years old, out of the blue he developed a cough. Got to coughing so hard that it looked like his entire mid section from side to side had become a bruise. Found himself short of breath often. Doctor said it was from the blood thinner and that he had busted capillaries. At the same time this happened, he also noticed his belly had become hard. It didn’t shake anymore. He was a big man of about 330 pounds. Took him back to the doctor. They did all kinds of tests. Said he had pneumonia. Gave him an antibiotic. Couple days later they call and want him to come back to the office. By this time, his leg and foot had begin to seep a clear fluid. On the return visit, the doctor tells him he has an abdominal aortic aneurysm. Sets him up appointments with surgeon for that and a lung specialist for his shortness of breath. She also changes his antibiotic and completely takes him off his warfarin. From this point for the next week, Dad got worse and worse. He got to where he couldn’t catch his breath. And he would have “panic attacks”. His last visit to doctor was on a Friday. By Wednesday of the next week, we called an ambulance to come get him. And by 1am on Saturday he was dead. I have read several articles that state not to cold turkey stop warfarin. I have also read information saying that quitting warfarin can cause pulmonary embolism. I have also read pulmonary embolism is hard to diagnose due to its similarities with the symptoms of pneumonia. My question is this. Since Dad was put on warfarin after triple bypass surgery and having a clot that cost him his leg, is it possible that him stopping warfarin completely could have caused another clot that lodged in his lung and cost him his life??

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