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Acquired warfarin resistance and weight-reducing diet
Archives of Internal Medicine
|March 1, 1981
Summary
High vitamin K intake from vegetable-rich diets can cause warfarin resistance. Adjusting diet significantly reduced warfarin resistance in a patient, highlighting dietary factors in anticoagulation therapy.
Area of Science:
- Pharmacology
- Nutrition Science
- Internal Medicine
Background:
- Acquired warfarin resistance is often due to drug interactions.
- Increased dietary vitamin K intake is a potential, though less common, cause of warfarin resistance.
Observation:
- A 31-year-old woman exhibited warfarin resistance despite normal pharmacokinetic profiles.
- Her warfarin dose was 35 mg daily, with a prothrombin time of 14s (control 12s) and a half-life of 26 hours.
Findings:
- Switching the patient from a vegetable-rich, weight-reducing diet (1,277 mcg vitamin K) to a regular diet (360 mcg vitamin K) significantly decreased her warfarin resistance.
- Pharmacokinetic studies showed no impaired adsorption or increased catabolism of warfarin.
Implications:
- Vegetable-rich, weight-reducing diets may lead to relative warfarin resistance due to high vitamin K content.
- Dietary management, specifically vitamin K intake, is crucial for optimizing warfarin therapy in certain patient populations.
- Further research into end-organ resistance mechanisms related to diet is warranted.