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I was diagnosed with RRMS in 2013, and have joined the OMS program since then. This spring I found out that I was born with a bicuspid aortic valve and had it substitued for a mecanic valve 3 weeks ago. As a consequence I will have to take Warfarin (anticoagulant) for the rest of my life. The problem is that vitamin K has an enormous influence on the dosis of warfarin and I am having big trouble to get my INR on the right level (between 2and 3). It is a problem to combine the OMS diet and cutting on Vitamin K as all the food I used to enjoy are very rich on vitamin K (spinach, kale, broccoli, Brussels sprouts, chickpeas, soy products etc). I am getting very frustrated finding out what to eat. Another problem is that I have lost a lot of weight, and I do not know how to get enough calories having had to cut down on soy products because of vitamin K. I do not want to quit the diete as I do believe it makes the difference for my MS (stopped to take any MS drug because of the surgery).
Does anyone have any experience of how to combine the OMS Diet and Warfarin?
Thanks a lot!
Hi Mette

I don't have direction about vitamin K and Warfarin, but I would keep on the diet, fresh fruit, beans, split peas, root vegetables, peppers, tomatoes, squash, there are plenty of other things to eat.

Stay away from olive oil, and go with flax seed oil for as many things as you can.
Be well, live long and prosper!
Hi Farrier,
Thanks for your advice. Yes, I guess I just have to think more of what I choose to eat within the OMS diet as I can see that my favorites are the ones with lots of vitamin K! It is just hard to find the energy to think so much of what to eat, but as time passes I will learn to manage, eating more or less the same amount of vitamin K......
Hello Mette,

Your name suggests that - were not the OMS forum a strictly English only zone - that I could be writing this to you in Danish!

I don't have any personal experience of managing Vitamin K levels so I did a Google search to learn a bit more. I do sympathise with you. We are all so keen to eat a healthy diet and lots of the green leaves and vegetables everyone encourages us to eat are off the menu for you :(

Still, there are so many delicious things to eat in the world that it must be possible to come up with a satisfying regime that observes both OMS and the Courmadin/Warfarin diet principles. I learnt a lot from this site:
http://inrtracker.com/articles/diet/coumadin-diet
I imagine you are already familiar with it? The article on the above page gave me a good overview of the principles one has to observe if one is taking Warfarin and the database of 4000+ foods and their Vitamin K content looks really helpful. I was very interested to see how much the Vitamin K content can vary according to how the food is prepared.

Sweet potato might be a good food for you? I am not having the deadly nightshade family at the moment (tomato, white potato, pepper, aubergine etc) so I am finding lots of different ways to cook sweet potatoes. They are so versatile, good for us and delicious. I often just cut them into wedges and bake/roast them in the oven & and have them with this avocado cream:
http://www.roseglovernutrition.com/avocado-cream/
I think avocado is ok for you, isn't it?

I also make a baked sweet potato with a spicy almond 'feta' stuffing that I could happily eat every day of the year. That should be a good food for you too? I will try to get round to posting the recipe in the 'Recipes' section before too long.

Another favourite food of mine is hummus. The inrtracker.com website suggests that hummus is ok for you too?

I always enjoy a culinary challenge so I will post again when I come across recipes that might be suitable for you.

In the meantime, I wish you all the best.

Jette
The Gut Microbiome is KEY to optimal health.
The OMS site & forum are brilliant! Thanks, everyone! :D
Hi Jette,
Yes, I am Danish so writing you in danish would be easier :D , but as you wrote - this is a forum in English.....
Thank you for your reply, and the links. I will definitely try the avocado cream - sounds delicious!
I am familiar with the INRtrack homepage and it gives a lot of information, but still I find it is a big challenge, especially having to combine it with the OMS diet! But with time I am sure I will manage, I just fealt very frustrated finding even more limitations in my diet. First I have to get the INR level correct, and then it's a question of trying to maintain it. The INR nurse told me that many patients get confused in the beginning, but then they learn to manage...I hope so!
But recipes that are both OMS and Warfarin friendly are most welcome! :D
By the way, don't you find it hard to find good flaxseed oil in DK?
Stay well, and thank you!
Mette
Hello again, Mette!
I have been thinking more about your situation. The article on 'The Ultimate Coumadin Diet' page that I linked to in my earlier message suggests that the really important thing is not to avoid Vitamin K but to keep one's level stable. So one strategy is actually to take a low level Vitamin K supplement every day - the thinking being that if one has a steady base-line level of Vitamin K then what you eat won't make such a dramatic differences.

But to the extent that you do want to avoid foods with a lot of Vitamin K in them, and eat some calorie rich foods, almonds might be a good way forward for you? The NRI-Tracker database says they have 0 Vitamin K. The Maple Spice food blog has a brilliant recipe for an almond "feta" that you can either a) bake and eat as a cheese or b) use as an ingredient in baked dishes - just as we used to use cream cheese in our pre-OMS days. That's what I mostly do. Here is the almond feta recipe:
http://www.maplespice.com/2011/04/baked ... l-oil.html
And here is the one for a 'cheese' to cook with:
http://www.maplespice.com/2011/04/spanakopita.html
The spinach in the Spanakopita recipe is obviously not appropriate for you, Mette (but if anyone else is reading this - it's a brilliant recipe !) but you can use the 'cheese' mix in lots of different ways. On the Maple Spice site, for example, there is a suggestion for using this almond 'feta' as a filling for pasta shells that are then baked in a tomato sauce. That might be a good recipe for you?

There are posts on the forum suggesting that we need to be careful about how many almonds we consume because of their saturated fat content but A) in his 2016 book George Jelinek said not to count (saturated fat) but just eat the right foods. And almonds are definitely a healthy, OMS approved food! B) in your case, the Ultimate Gourmadin Diet page suggests that up to a third of your calorie intake ought to come from fats as Vitamin K needs fat to be absorbed into the body.. So while you can definitely observe the key OMS diet principles and avoid dairy, meat, fried and processed food etc. I suspect it might be not be appropriate for you to observe an ultra strict OMS protocol and avoid all saturated fat?

On the subject of fat, the Ultimate Gourmadin Diet page suggests that you need to be 'sensible' about the use of (extra virgin) olive oil. You could use almond oil for cooking and dressings, I suppose? I also wondered if algae oil might be a good option for you?
viewtopic.php?f=61&t=7894&p=48500&hilit=Algae+oil#p48500
Unfortunately this brand is only available in the USA at the moment (I have written to the company saying we are keen to buy it in Europe too!). Algae oil does appear to be getting quite a lot of positive attention - both as a vegan Omega 3 supplement and as a culinary oil - so maybe companies elsewhere in the world will start producing culinary algae oil too.

Another food that looks as if it might be suitable for you is butternut squash? The recipe below is incredibly simple and makes an utterly delicious spread or dip. Fantastic on its own or as an accompaniment to other foods, I could also imagine this making a sophisticated layer in a terrine or filling in a roulade. It is worth using a really good honey for this dish (I use an Italian chestnut honey).
https://www.ft.com/content/dfa5efdc-e6c ... 144feabdc0
The recipe suggests a topping of hazelnuts which might be a bit high in Vit K for you. You could omit them, or use lower Vit K sunflower seeds for some crunch (perhaps dry-toasted in a pan?).

I often just roast peeled chunks of butternut squash until they are well cooked and have a few brown bits on them. Then serve with a good dressing. I made a really lovely dessert cream the other day from tahini, strong coffee send maple syrup. Which made me think that tahini + lemon juice + salt + pepper and maybe a bit of ground coriander seed or similar might make a really nice dressing for you? Both tahini and lemon juice have 0 Vitamin K, according to the database. That dressing would also be good on a salad of iceberg lettuce (which is the best lettuce for you, I think?) and prawns? I keep a bag of cooked prawns in the freezer for quick salad meals.

In my first post above, I suggested that sweet potato might be a good food for you? My all-time favourite way of cooking sweet potato has to be to bake the sweet potatoes, scoop out the cooked flesh and mix it with the Maple Spice almond feta mix (using spices instead of the dried herbs), put the mixture back in the shells & put them back in the oven until they are golden. It's so good I could happily eat this every day! (I will try and get round to posting full instructions for this dish in the Recipe forum).

Two other good recipes for using sweet potatoes come from the brilliant Copenhagen-based Canadian food blogger Sarah B.
https://www.mynewroots.org/site/2010/10 ... -hummus-2/
https://www.mynewroots.org/site/2009/05 ... alafels-2/
Both the above recipes call for chickpeas or chickpea flour. The 'The Ultimate Coumadin Diet' page suggests that Chickpeas and hummus are OK for people on a Warfarin diet but if you prefer to avoid them, you could (as Sarah B says) omit the chickpeas altogether in the sweet potato hummus and use an alternative flour in the sweet potato falafels?

Lentils are a good food for you, aren't they? If so, you may like to know about this soup - one of my favourites.
http://www.seriouseats.com/recipes/2014 ... ecipe.html
The parsley in the gremolata might not be suitable for you, but I would strongly encourage you to add the lemon juice at the end. It makes a lot of difference.

Are you happy to eat cauliflower? I have just posted a link to a brilliant Roasted Cauliflower & Brandy pate in the Recipe forum:
viewtopic.php?f=22&t=7902
Another pate recipe that might appeal to you is this Tomato & Sunflower one by Sarah B:
https://www.mynewroots.org/site/2010/05 ... ed-pate-2/

While you are on Sarah B's My New Roots website, you could have a look at her Gado-Gado recipe?
https://www.mynewroots.org/site/2017/02 ... gado-gado/
Her Gado-Gado sauce is made with almonds. The recipe would need a few changes to be OMS friendly (replace the coconut sugar & milk with something more suitable) and you would obviously need to make sure the vegetables suited you in terms if their Vitamn K content. But then you might have a really tasty dish In your repertoire?

You mention the difficulty of buying good flaxseed oil in Denmark. I am actually living in the UK at the moment, so I am able to buy really fresh flaxseed oil from flaxfarm.co.uk, where it is grown and freshly pressed. They will send orders to Denmark so you could always consider that? The U.K. Pound is cheap at the moment!

I wish you good luck with finding things to eat. I will keep you in mind and post again if I think of other recipes that might suit you.

All best wishes,

Jette :)
The Gut Microbiome is KEY to optimal health.
The OMS site & forum are brilliant! Thanks, everyone! :D
I realise that this is quit a old post, but for a variety of reasons I haven't been around the OMS forums for ages. I had some experience with Vit K and warfarin after undergoing "open heart surgery". I say open heart surgery but it was't actually, the surgeons had to gain access via sternotomy to what they needed to fix - my aorta.

I had quite a battle with the doctors about Vit K and warfarin, but it came down to a couple of things which I will try and put as simply as possible. Firstly, Vit K affects the metabolisation and effects of warfarin, as you were probably told. However, maintaining a steady intake level of K and not having boom or bust intakes is the best way to deal with this. Secondly, along with a few other things, Vit K2 is actually an essential part of the body's utilisation of Vit D. Mostly Vit K intake comes from the green leafies as K 1, and your body turns this into K2, which along with Vit D helps to ensure that calcium gets sent to where it is supposed to - i.e. bones etc, instead of floating around in your bloodstream and making standard Docs have panic attacks about hypercalcaemia. So, if you are taking a fairly high amount of Vit D, which many/most OMSers are, Vit K to help it along is not always a bad idea. This is despite the view that some people hold about "we get everything we need (apart from Vit D) from OMS without needing to supplement" (Vit B12 is another risk area due to the lack of animal products in the OMS diet).

When I first started supplementing with Vit D in line with OMS I had problems and this triggered me to do some specific research as to what might have been causing the issues. In a nutshell, it all got sorted when I started taking some extra magnesium citrate and some Vit K2, and since then I have been doing OK with my Vit d intake and levels. I have also come across a few other people on other forums who have had the same issues and fixed them the same way.

I dealt with warfarin and Vit K issue by firmly insisting that I was going to continue with my K2 and that a balanced approach was necessary and the warfarin dosing would have to be adjusted accordingly. This approach was not as "carefree" as it might sound - after having only just avoided attending my own funeral as a result of the problem which required the surgery I wasn't taking anything lightly (nearly a week in an induced coma and 3 months in hospital tends to make you think pretty carefully about things - I think if the good Prof J were still working in A&E and I'd been carted into his hospital I would have been his "challenge for the day"!!!).

I was only on warfarin for about 8 months but as you will be taking warfarin for the rest of your life I suggest you do some research on the effects of long-term anticoagulant use - there is quite a lot of info out there, although most of it refers to elderly people because they are the population cohort most likely to be on long-term anticoagulants. Also check with your treating doctors if there are any other things you might need to be careful with/about (one of the impacts of what happened to me is that one of my kidneys is now dead and the other one is permanently damaged, so I have to be careful with my intake of potassium rich foods).
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