Monday February 9, 2009

Case: 68 year old male presented to ER with left sided weakness and CVA (stroke) is suspected. Patient has chronic history of atrial fibrillation and is on coumadin 4 mg every day and record shows previously consistent therapeutic INR of 2.6 but today patient's INR is 1.4. According to wife, patient is very compliant with his medicines, rather he is very health conscious and lately start doing more healthy diet consist of frequent green tea, fish oil, ginseng, canola oil etc.


Answer: Green Tea carries a huge amount of Vitamin K. It is also present in clinically significant amount in other healthy diets and herbals like fish oil, ginseng, canola oil etc.

Related Web site: WarfarinDosing.org

Its a free Web site to help doctors begin warfarin therapy by estimating the therapeutic dose in patients new to warfarin. This site is supported by the Barnes-Jewish Hospital at Washington University Medical Center, the NIH, and donations. Estimates are based on clinical factors and (when available) genotypes of two genes: cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase (VKORC1).