Millions of Americans are taking thyroid medications on a daily basis and still feeling well. When our thyroid gland is functioning correctly, we feel energetic, our metabolism is working properly and our body temperature is normal.
A normal healthy thyroid gland will normally produce 94% inactive T4 (thyroxine) and about 7% active T3 (triiodothyronine). The inactive T4 will convert to the more potent T3 in the liver, not in the thyroid gland. Here lies part of the problem.

Thyroid medications such as Synthroid, Levoxyl and Levathyroxine only contain synthetic T4. This hormone must be converted to the more potent T3 so you can benefit from your medication. Millions of people across the country do not make this conversion, leading the doctors to increase the dose. One cannot force the medicine to work. The human body must have nutrients present to make the conversion naturally, mainly iodine and selenium.
If you have liver dysfunction, you must correct this problem so your medication can work properly. Those who are diabetics or those with high cholesterol, cirrhosis or associated liver disease need to work with a health practitioner to improve liver health if hypothyroidism is present. This is vital. Without a healthy liver, thyroid medicine only containing T4 will not work. Asking your doctor for medicine that contains T3 such as Armor Thyroid or Nature-Thyroid will help the patient feel better.

Bread Companies Tricked Your Thyroid
Up until the 1970’s bread companies use to fortify their products with iodine and as a nation we didn’t have thyroid issues. Since then the bread companies stopped using iodine in the bread and replaced it with bromide. Bromide fills in the receptor sites in the thyroid meant to for iodine. The bromide causes the present iodine to leave and reduces thyroid function. Add to the fact that chlorine/chloride and fluoride (by product from the aluminum industry) have been added to our water supply and these wreck havoc on the thyroid as well. Bromide, chloride and fluoride diminish thyroid function by removing iodine and creating an environment in which thyroid nodules can form leading to a risk of tumors, either benign or malignant.

What to Do Naturally
Clean up your diet. Avoid the refined sugars, bad fats, and commercialized white flour products. The focus healthy fruits such as fruits, vegetables/sea vegetables, nuts and seeds. These natural foods contain vital vitamins and minerals needed for optimum thyroid as well as liver health. Both organs must be addressed at the same time.

Foods to Eat:

• Brown algae (including the commonly eaten sea vegetables kombu/kelp, wakame, and arame may be unique among the sea vegetables in their iodine content. Some species from the brown algae genus Laminaria are able to accumulate iodine in up to 30,000 times more concentrated a form than sea water.
• Fish, grass-fed and pasture-raised meats, whole grains, and nuts and seeds are good to excellent food sources containing selenium.
• Nuts and seeds are great foods to eat as they will contain the other minerals needed such as manganese and zinc. If you are dealing with insulin resistance or diabetes, add chromium picolinate in supplement form to improve blood sugar response.
• Organically-raised proteins are a good source of the amino acid Tyrosine for thyroid health.
• Dandelion greens are excellent for thyroid health as it contains potassium which is needed for the cells to be more responsive to the thyroid hormone T3.
• Dark leafy greens are good sources of your B vitamins which are used as co-factors helping the needed minerals work more effectively for your thyroid.

NOTE: Do not overdue the eating of broccoli, cauliflower, brussel sprouts and never eat soy products as these will diminish thyroid function. Soy is HUGE NO-NO has it contains mineral inhibitors, phytoestrogens (estrogens slow thyroid function) and goitrogens. Many who eat soy daily will eventually have hypothyroidism. The only soy-related foods that do not inhibit thyroid function are those which are fermented such as miso, natto and tempeh.
​
The Nutrients:
There are some nutrients you will need to improve the health of your thyroid. Please remember that you didn’t get into this state overnight and it will not be corrected overnight, but give it 30-180 days for most people. Remember everyone’s thyroid problem is not the same, so be patient.
Improving Thyroid gland and hormone production: 

• B Vitamins such as B2 is needed for metabolism and thyroid function. A lack of B2 can contribute to low thyroid function. 
• Vitamin B6 helps to regulate the production of thyroid hormones. It also supports the utilization of iodine required for the production of hormones. 50-100mg per day with food.
• Bacopa Mannieri has been shown to support the thyroid’s production of T4.
• Copper plays an important role in thyroid metabolism, especially in hormone production and absorption.
• Coleus Forskohliis is a perennial plant from the mint family.  It contains an active compound called forskolin, which has been shown to mimic the effect of TSH (Thyroid Stimulating Hormone) with regard to iodine uptake.
• Guggelsterones (extracts from the Indian herb Commiphora also known as Myrrh) have been shown to support the concentration of thyroid hormones in the blood especially the ratio of the active T3 to T4 in the blood.
• Iodine is required for the production of thyroid hormones.  It is a component of the thyroid hormones T3 (triiodothyronine) and T4 (thyroxin), and is therefore essential for normal thyroid function. 25-50mg per day in the morning.
• Manganese deficiency can reduce thyroid activity.  Manganese is required for T4 production. 5mg per day.
• Selenium is required for thyroid hormone production, activation and metabolism.  It is an essential component of an enzyme that converts T4 to T3. 200-400mg per day
• Tyrosine is required for the synthesis of thyroid hormones.  A deficiency has been associated with low thyroid function. Take 500-1000mg per day on empty stomach. Do not take if on antidepressants.
• Zinc is involved in the process that converts inactive T4 into active T3. 30-60mg (picolinate) per day with food.

If you have liver dysfunctions then use the following nutrients to improve your thyroid medication's conversion to T3.

• Selenium is required for thyroid hormone production, activation and metabolism.  It is an essential component of an enzyme that converts T4 to T3.* 200-400mg per day
• Milk Thistle is recommended to improve bile flow and remove toxins.
• Lecithin is also recommended if you have a fatty liver and high cholesterol. A fatty liver will prevent a patient from getting the maximum effect from their thyroid medication.
• N-Acetyl-Cysteine is needed as this nutrient will convert into Glutathione, a potent natural antioxidant for improve liver protection and health. Those who use over-the-counter pain medication will have decreased levels of this vital nutrient.

Almond Milk: Creamy and slighty nutty flavor. Great in tea, coffee and in cooking and baking. Easy to make at home by soaking nuts and straining them. Can be sweetened.

Serving Size: 1 Cup
Calories 30
Fat 0g
Cholesterol 0mg
Sodium 180mg
Potassium 170mg
Carbohydrates 1g
Fiber 1g
Protein 1g
Great source of Calcium and Vitamin E.

Cashew Milk: Smooth, creamy, slightly nutty and sweet. Great for cooking, desserts and making cream. Easy to make at home by soaking nuts overnight, blending with water and straining.

Serving Size: 1 Cup
Calories 35
Fat 3.5g
Cholesterol 0mg
Sodium 85mg
Carbohydrates 1g
Fiber 0g
Good source of Vitamin D and Vitamin B12

Coconut Milk: Smooth, fresh and not highly flavored. Compares to semi-skim milk in consistency. Ideal for all uses. Great for cereals, hot drinks and smoothies.

Serving Size: 1 Cup
Calories 35
Fat 3.5g
Cholesterol 0mg
Sodium 85mg
Potassium 170mg
Carbohydrates 1g
Fiber 0g
Protein 0g
Good sources of Vitamin D, Vitamin B12 and Selenium

Hazelnut Milk: Light with a rich nutty flavor. Great in drinks and light desserts, but not suitable for cooking or baking. Ideal for all uses. Great for cereals, hot drinks and smoothies.

Serving Size: 1 Cup
Calories 110
Fat 3.5g
Cholesterol 0mg
Sodium 120mg
Potassium 170mg
Carbohydrates 19g
Fiber 1g
Sugar 14g
Protein 2g
Good source of Calcium, Vitamin D, Vitamin B2

Quinoa Milk: A smooth and creamy non-dairy beverage made from pure quinoa and NOT blended with any other grains. Quinoa, an ancient grain prized by the Incas, dates back to more than 5,000 years. Quinoa is a complete protein and contains essential amino acids making it the super protein for your dietary needs.

Serving Size: 1 Cup
Calories 110
Fat 1g
Cholesterol 0mg
Sodium 70mg
Potassium 110mg
Carbohydrates 12g
Fiber 1g
Sugar 2g
Protein 2g
Good sources of Vitamin C, Calcium and Iron

Oat Milk: Creamy and naturally sweet. Great in cooking, but a little heavy for baking. Easy to make at home by simmering oats and water, cooling and straining.

Serving Size: 1 Cup
Calories 130
Fat 2.5g
Cholesterol 0mg
Sodium 115mg
Potassium 170mg
Carbohydrates 24g
Fiber 0g
Sugar 19g
Protein 2g
Good source of Calcium, Vitamin D, Vitamin B2 and Iron

Hemp Milk: Creamy, with a strong robust flavor than other non-dairy milks so not ideal in hot drinks. Good for cooking in savory dishes.

Serving Size: 1 Cup
Calories 70
Fat 5g
Cholesterol 0mg
Sodium 140mg
Potassium 170mg
Carbohydrates 1g
Fiber 2g
Sugar 0g
Protein 3g
Good source of Calcium, Vitamin D, Vitamin B1 & B2, Magnesium, Phosphorus

Rice Milk: Has a think watery consistency. Light and naturally sweet, it’s great on cereal and in cooking, but a little too watery for hot drinks.


Serving Size: 1 Cup
Calories 120
Fat 0g
Cholesterol 0mg
Sodium 100mg
Potassium 170mg
Carbohydrates 23g
Fiber 0g
Sugar 10g
Protein 1g
Good sources Calcium, Vitamin D and Vitamin B12
Do not use as infant formula.

Flax Milk: The lowest in calories, making it the perfect base for a slimming smoothie snack. You won't find any energizing protein here, so it's not the best beverage when you want a sip that gets you going. Benefits: Natural, Lactose Free, Gluten Free, Non Dairy, Trans Fat Free, Soy Free, Allergen Free, Vegan, Supports Green Farming, Omega3s.

Serving Size: 1 Cup
Calories 25
Fat 2.5g
Cholesterol 0mg
Sodium 80mg
Potassium 170mg
Carbohydrates 1g
Fiber 0g
Sugar 0g
Protein 0g
Good source of Calcium, Vitamin D and Vitamin B12

Goat Milk: Same consistency as cow’s milk. Anti-inflammatory, improves digestion, closer to human mother’s milk, lower in fat, higher in fatty acids, calcium-rich, anti-mucousal. Extremely high in riboflavin, just one cup of goat’s milk offers 20.0% of our daily needs. Add to that high amounts of phosphorous, Vitamin B12, protein and potassium. In fact, Ghandi himself rejuvenated his own health after extremely long periods of fasting through drinking raw goat’s milk.

Serving Size: 1 Cup
Calories 142
Fat 7.2g
Cholesterol 25.2mg
Sodium 115mg
Potassium 170mg
Carbohydrates 11g
Fiber 0g
Sugar 0g
Protein 8.5g
Good source of Vitamin A, Vitamin D and Calcium

Metabolism is the process by which your body converts what you eat and drink into energy. During this complex biochemical process, calories in food and beverages are combined with oxygen to release the energy your body needs to function.

Even when you're at rest, your body needs energy for all its "hidden" functions, such as breathing, circulating blood, adjusting hormone levels, and growing and repairing cells.

The number of calories your body uses to carry out these basic functions is known as your basal metabolic rate — what you might call metabolism.

When we talk about metabolism everyone thinks weight loss. When you have healthy metabolism, you will not gain weight which is true. Let’s take a look at improving metabolism in reference to weight loss and optimal health.

WAYS TO IMPROVE YOUR METABOLISM NATURALLY!

EXERCISE

Exercise for 5 minutes at 3.5 mph. Increase your speed to 4 mph for 60 seconds. Then go back down to 3.5 mph for 90 seconds. Repeat the entire sequence 5 times, twice a week. (To get a more challenging workout, increase the incline or your pace.)

I found this pace to be true. If you like to count the calories on a treadmill. You can burn more at a higher incline in less time.

Rule of thumb on exercises that have a pace like walking, running, treadmill, stationary bikes, etc. You will need to be doing the exercise for 20 minutes before you start burning fat.

STRENGTH TRAINING

Muscle burns at least three times the number of calories as fat, which makes building muscle a priority for boosting metabolism. Not only does muscle weigh more than fat, but it uses more energy, too. The average woman in her 30s who strength-trains 30 to 40 minutes twice a week for four months will increase her resting metabolism by 100 calories a day. That means you're resetting your thermostat to keep running at that rate even on the days when you don't make it to the gym.

Lifting free weights is an excellent way to get your muscles to burn more calories and fat. Lifting free weights each day for 30-1 hour can help keep your metabolism working all day.

Exercise is a gift to yourself that keeps on giving. In a phenomenon known as excess post-exercise oxygen consumption (EPOC), your body can take hours to recover from a robust workout (one intense enough that you can't hold a conversation) and return to its previous resting metabolic rate. The blessing: Your body is actually burning more calories than it normally would—even after you've finished exercising. There’s a catch, though. The better shape you're in, the less benefit you'll get, because your fit body replenishes its energy stores efficiently. You can improve your burn by increasing how often or how hard you work out (think intervals).

OMEGA 3s
Why does eating lots of fish rich in omega-3 fatty acids (salmon, herring, and tuna) help amp up metabolism? Omega-3s balance blood sugar and reduce inflammation, helping to regulate metabolism. They may also reduce resistance to the hormone leptin, which researchers have linked to how fast fat is burned. A study in Obesity Research found rats that ingested large doses of fish oil while exercising lost weight. Also, try flaxseed oil, walnuts, or eggs fortified with omega-3s.

I (Dr. Bond) take 3-6,000mg per day. Do not take less than 3,000mg per day. Only purchase high quality fish oil, not Walmart, Walgreens or CVS.

GREEN TEA
Green tea has long been heralded for its antioxidant polyphenols. But new evidence shows the active ingredient, catechin, may crank up metabolism. Researchers conducted a series of studies in dieters and found that those who went green lost more weight than those who didn't, suggesting that catechins may improve fat oxidation and thermogenesis, your body's production of energy, or heat, from digestion. But how much do you have to drink? According to one study, if you drink five eight-ounce cups of green tea a day, you can increase your energy expenditure by 90 calories a day. Sounds like a lot of tea, but it's not hard to do if you also drink it iced. (Drinking coffee can improve metabolism, but Green Tea’s health benefits outweigh coffee by a long shot)

DON’T STARVE YOURSELF
It's one of the most frustrating realities of Metabolism—if you cut out too many calories, your metabolism thinks times are lean and puts the breaks on fat-burning to conserve energy. Here’s the trick to keeping your metabolism revved up while dieting: Eat enough calories to at least match your resting metabolic rate (what you'd burn if you stayed in bed all day; calculate yours here). That's about 1,330 calories for a 5-feet-4-inch, 150-pound, 40-year-old woman.

Everyone make a journal of all the foods you eat for a week. Then remove the ones that increase blood sugar spikes such as refined sugar products and those with artificial sweeteners.

Eating berries between meals or a handful of nuts such as almonds or walnuts can help keep your metabolism going.

GO ORGANIC
Organic fruits, vegetables, and grains grown without pesticides keep your fat-burning system running at full-tilt because they don’t expose your thyroid to toxins. Non-organic produce, on the other hand, “blocks your metabolism mainly by interfering with your thyroid, which is your body’s thermostat and determines how fast it runs”. (Pesticides, herbicides contain estrogenic properties which slow down your thyroid).

PROTEIN
Your body digests protein more slowly than fat or carbs, so you feel full longer (this depends on the source of protein). In a process called thermogenesis, your body uses about 10% of its calorie intake for digestion. So, because it takes longer to burn protein than carbs or fat, your body expends more energy absorbing the nutrients in a high-protein diet. Another bonus: One recent study from Purdue University found that diets higher in protein may help preserve lean body mass, which is the best fat-burner of all.

Whey Protein: Digests and absorbs the quickest. This is best to use before and exercise. Whey is preferred if you are making a smoothie for breakfast.

Micellar/Casein Protein: Digests the slowest. Professional bodybuilders use this at bedtime to prevent muscle wasting during the night. This protein can be used as appetite suppressant.

Red Meat: Organic Grass-Fed Only. This will digest depending on the strength of your own digestive system. If red meat slows colon elimination in you, it is best to avoid it.

Chicken: Easy to digest and best prepared grilled or baked.

Fish: The best metabolism boosting fish are salmon, mahi mahi, halibut, tuna. Salmon contains your Omega3s. Mahi is the lowest in fat and is a hearty fish and can be prepared many way. Has a great flavor.

EXTRAS
Sage Leaf Tea: Compounds in sage leaf tea help move sugar out of the blood and into your cells, sending the message that it's time to start breaking down nutrients to use for the entire day. Having one cup of this tea with breakfast can help keep your metabolism revving all day long.

Hot Peppers: Chili peppers get their heat from a bioactive compound called capsaicin, which may help curb your appetite by raising your body temperature. Get the fat-fighting benefits by incorporating more red peppers, cayenne, jalapeños, habaneros or Tabasco into your diet.

Papaya: Contains an enzyme called papain, which improves protein digestion and absorption, which is key to boosting metabolism and burning fat. Try incorporating this superfood into your diet. 

Enzymes may not share the superstar status of certain vitamins, antioxidants, amino acids, and other miracle nutrients in the world of conventional health and nutrition, yet a growing number of studies suggest that enzymes very much deserve a standing ovation when it comes to improving overall health and the successful treatment of numerous diseases.

Enzymes perform an all-encompassing function in the development and maintenance of the human body. Dr. Edward Howell, father of enzyme nutrition and therapy, stated that enzymes are the very substances that make life possible. Yet mainstream medicine has frequently ignored this basic fact, undervaluing the enzymes' vital role in health and underestimating their true potential in overall health, including disease management and prevention. Proponents and advocates of enzyme therapy regard enzyme bankruptcy as a lethal health catastrophe, causing countless bodies to shut down prematurely.

Know Your Enzymes

Bodies of research have identified more than 3,000 types of enzymes in the human body. As organic catalysts, enzymes are known to initiate, speed up, slow down, alter or halt about 4,000 kinds of biochemical reactions. Millions of biochemical reactions take place in our body on a daily basis, including respiration, food digestion, assimilation and transportation of nutrients, detoxification of certain organs, blood purification, movement of muscles, production and regulation of hormones, and cell renewal and repair, to name a few. The enzymes make all these processes possible, and they are destroyed once they complete their respective tasks.

There are three types of enzymes: digestive, metabolic, and food enzymes. Digestive enzymes are produced by the digestive organs that aid in breaking down food into more assimilable forms.

The four general classes of digestive enzymes are:

Amylase, which digests carbohydrates, starches, and sugars found in grains, fruits, and starchy vegetables.

Protease, which breaks down protein found in meat, nuts, and cheese into amino-acids.

Lipase, which breaks down fats and oils found in dairy and meat products into fatty acids.

Cellulase, which helps digest fiber.

Metabolic enzymes on the other hand are manufactured by the body's own cells to perform highly specific tasks required in regulating the blood, tissues, and organs.

They are responsible for:

•   Production and growth of new cells
  
•  Repair and maintenance of tissues and organs
  
•  Transportation of blood to the different organs
  
•  Detoxification of the cells, tissues, organs, and blood. 
  

Metabolic enzymes also carry out the delivery and absorption of nutrients in various organs.

The third kind of enzymes is the food enzymes. These enzymes are the vital life force naturally found in raw, uncooked food. By definition, raw food is food heated below 118 degrees F, the highest temperature in which enzymes can still survive and function. There are a lot of well-documented cases that attest to the wonderful benefits and healing power of raw food. The enzymes present in raw food work synergistically with the other nutrients like vitamins, minerals, phytochemicals, antioxidants, and co-enzymes, allowing your digestive system to take its much needed rest and giving your immune system the necessary boost to successfully carry out its search and destroy missions.

The Enzyme and Disease Connection

The problem arises when the body becomes overburdened in producing enzymes due too poor dietary choices like eating cooked, highly processed and preservative-laden foods. According to research, food enzymes are heat-sensitive and die when heated at temperatures above 118 degrees F. When a person ingests enzyme-less food, his body then diverts a lot of its energy to the production of digestive enzymes to break down the carbohydrates, protein, fat, and other nutrients of the food. If a person has been eating cooked, unhealthy food most of his life, his body's line of defense may already be exhausted in its fight against diseases associated with diets high in sugar, sodium, additives, trans and saturated fat, and carcinogenic substances.

This is further compounded by a person's genetic predisposition to certain diseases. The body then struggles more to achieve homeostasis or internal equilibrium, which is needed for all the organ systems to run smoothly and to function properly. Because a lot of energy gets allotted to the manufacturing of digestive enzymes, the production of metabolic enzymes becomes disrupted. The more important tasks of providing immune system back-up, blood purification, and organ detox needed in fighting off disease all take a backseat to the digestion of cooked food. Nevertheless the body does not stop recognizing an unfriendly invasion when it sees one, and in a greatly strained attempt to set all things back to order, it goes on a red-alert mode and uses all its limited energy to follow its natural tendency--which is to heal itself. The body is not meant to be in a state of emergency for a prolonged period of time. When this happens, the body finally breaks down and serious diseases like cancer develop.

Other diseases linked to enzyme deficiency include heart disease, which is a sign of the body's inability to break down fats. Autoimmune diseases such as allergies and arthritis on the other hand are the results of the body's incapacity to digest protein and carbohydrates.

The Enzyme Advantage

Studies indicate that increasing your raw food intake and taking enzyme supplements can be very potent measures in the prevention and healing of certain diseases including cancer. Although raw food already has its own enzymes to digest its own nutrients, the undigested substances circulating in the blood that are responsible for a lot of diseases would need extra enzymes before they could be broken down for elimination. This is where enzyme support comes in handy. The high concentration of enzymes in enzyme supplements can dissolve all the unfriendly substances floating in the bloodstream that are causing damage to various organs. Since bacteria, viruses, and cancer cells are made up of protein, proteolytic or protein-metabolizing enzymes such as protease would greatly assist in destroying pathogens and cancer cells. White blood cells are also heavily dependent on enzymes; a shortage on their supply would therefore result in impaired immune function. It is for these reasons that a mega-dose of enzyme supplements is usually required to restore health to cancer patients.

Various experiments conducted on enzymes demonstrate their versatility and efficacy. Combined with a proper diet and other nutritional supplements, enzymes can perform tasks that are nothing short of miraculous. The use of enzymes among athletes suffering from injury and patients who underwent surgery accelerated the recovery and healing of both groups. In one study, a marked improvement was noted among arthritic patients consuming raw food. In another study, a control group of hypertensive and obese outpatients experienced a significant improvement in their conditions on a raw vegan diet. Enzymes have also been shown to reduce the side effects of chemotherapy among cancer patients. Countless allergy sufferers reported relief upon increasing their enzyme intake. Other reported benefits include the elimination of digestive and colon problems, hay fever, asthma, inflammation, hypoglycemia, and Crohn's disease.

We all know the healing power of nutrients and herbs, but there are a few times when medication and nutrients/herbs can collide. In the case of blood thinning medications we need to gain wisdom. Below are the nutrients and herbs which can interaction if someone is taking a blood thinner. 


Bromelain
In theory, bromelain might enhance the action of anticoagulants. This theoretical concern has not been substantiated by human research, however.

Coenzyme Q10
Coenzyme Q10 (CoQ10) is structurally similar to vitamin K and may affect blood coagulation. Four case reports describe possible interference by CoQ10 with warfarin activity. It remains unknown how common or rare this interaction is. Those taking warfarin should only take CoQ10 with the guidance of their doctor.

Minerals
Iron, magnesium, and zinc may bind with warfarin, potentially decreasing their absorption and activity. People on warfarin therapy should take warfarin and iron/magnesium/zinc-containing products at least two hours apart.

Papain
Papain, an enzyme extract of papaya, was associated with increased warfarin activity in one patient. Persons taking warfarin should avoid papain supplements until further information about this potential interaction becomes available.

Vitamin C
Although case reports have suggested that vitamin C might increase the activity of anticoagulants in a potentially dangerous way, this interaction has not been confirmed in research studies. In fact, a possible interference by vitamin C with the effect of anticoagulants has also been reported. A 52-year-old woman maintained on 7.5 mg of warfarin per day had a shortening of the blood clotting time which was not corrected by increasing warfarin up to 20 mg per day. Further questioning revealed she had begun taking an unspecified amount of vitamin C each morning. After stopping vitamin C, the blood clotting time returned to desired levels. Based on this and other case reports, people taking warfarin should consult with their physician before taking vitamin C supplements.

Vitamin D
In 1975, a single letter to the Journal of the American Medical Association suggested that vitamin D increases the activity of anticoagulants and that this interaction could prove dangerous. However, there have been no other reports of such an interaction, even though tens of millions of people are taking multivitamins that contain vitamin D. Most doctors typically do not tell patients taking anticoagulant medications to avoid vitamin D.

Vitamin E
An isolated case was reported in 1974 of vitamin E (up to 1,200 IU per day) being associated with increased anticoagulation (blood thinning) in a patient treated with warfarin.11 A study of 12 people undergoing warfarin therapy found that additional vitamin E (100 IU or 400 IU per day) did not induce a clinical bleeding state. Moreover, a double-blind trial found that supplementation with vitamin E in amounts up to 1,200 IU per day had no effect on warfarin activity. It now appears safe for people taking warfarin to supplement vitamin E despite information to the contrary often provided by doctors about this purported interaction. These warnings are based on the isolated case report from 1974.

Vitamin K
Warfarin slows blood clotting by interfering with vitamin K activity. Since vitamin K reverses the anticoagulant effects of warfarin, people taking warfarin should avoid vitamin K–containing supplements unless specifically directed otherwise by their prescribing doctor. Some vegetables (broccoli, Brussels sprouts, kale, parsley, spinach, and others) are high in vitamin K. Eating large quantities or making sudden changes in the amounts eaten of these vegetables can interfere with the effectiveness and safety of warfarin therapy. The greener the plant, the higher the vitamin K content. Other significant dietary sources of vitamin K include soybean oil, olive oil, cottonseed oil, and canola oil.

Vitamin K supplementation can be used, however, to counteract an overdose of warfarin. Such treatment requires the supervision of a doctor.

Interactions with Herbs

Asian ginseng  (Panax ginseng)
Asian ginseng was associated with a decrease in warfarin activity in a case report. Persons taking warfarin should consult with a physician knowledgeable about botanical medicines if they are considering taking Asian ginseng or eleuthero/Siberian ginseng (Eleutherococcus senticosus). A 1999 animal study did not reveal any significant interaction between warfarin and pure ginseng extract.

Dan shen (Salvia miltiorrhiza)
Dan shen, a Chinese herb, was associated with increased warfarin activity in several cases. Dan shen should only be used under close medical supervision by people taking warfarin. Sage (Salvia officinalis), a plant relative of dan shen found in the West, is not associated with interactions involving warfarin.

Devil’s claw (Harpagophytum procumbens)
Devil’s claw was associated with purpura (bleeding under the skin) in a patient treated with warfarin. However, key details in this case—including other medications taken and the amounts and duration of warfarin and devil’s claw taken—were not reported, making it impossible to evaluate this reported interaction. Until more is known, people taking warfarin should avoid taking devil’s claw.

Dong quai (Angelica sinensis)
A 46-year-old woman taking warfarin experienced increased strength of the anticoagulant properties of the drug after starting to use dong quai for menopause. The daily amount of dong quai was 1,130–2,260 mg per day. Her bleeding tendency returned to normal after discontinuing the dong quai. While little is known about the potential interaction of dong quai and warfarin, women should discuss the use of the herb with a healthcare professional if they are taking an anticoagulant drug and wish to use dong quai.

Feverfew (Tanacetum parthenium)
Although there are no documented cases of feverfew interacting with warfarin in humans, feverfew has been shown to interfere with certain aspects of blood clotting in test tube studies.

Garlic (Allium sativum)
Garlic has been shown to help prevent atherosclerosis (hardening of the arteries), perhaps by reducing the ability of platelets to stick together. This can result in an increase in the tendency toward bleeding. Standardized extracts have, on rare occasions, been associated with bleeding in people. Garlic extracts have also been associated with two human cases of increased warfarin activity. The extracts were not definitively shown to be the cause of the problem. People taking warfarin should consult with a doctor before taking products containing standardized extracts of garlic or eating more than one clove of garlic daily.

Ginger (Zingiber officinale)
Ginger has been shown to reduce platelet stickiness in test tubes. Although there are no reports of interactions with anticoagulant drugs, people should consult a healthcare professional if they are taking an anticoagulant and wish to use ginger.

Ginkgo (Ginkgo biloba)
Ginkgo extracts may reduce the ability of platelets to stick together, possibly increasing the tendency toward bleeding. Standardized extracts of ginkgo have been associated with two cases of spontaneous bleeding, although the ginkgo extracts were not definitively shown to be the cause of the problem. There are two case reports of people taking warfarin in whom bleeding occurred after the addition of ginkgo. People taking warfarin should consult with a physician knowledgeable about botanical medicines if they are considering taking ginkgo.

Green tea (Camellia sinensis)
One man taking warfarin and one-half to one gallon of green tea per day developed signs based on laboratory testing suggesting his blood was too thick because the green tea was blocking the effect of warfarin. Removal of the green tea caused normalization of his blood tests. Those taking green tea and warfarin together should have their blood monitored regularly to avert any problems and should consult with a doctor, healthcare practitioner and/or pharmacist before taking any medication.

Herbs containing coumarin derivatives
Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with warfarin and may cause bleeding. These herbs include angelica root, arnica flower, anise, asafoetida, celery, chamomile, corn silk, fenugreek, horse chestnut, licorice root, lovage root, parsley, passion flower herb, quassia, red clover, rue, sweet clover, and sweet woodruff. Dong quai contains at least six coumarin derivatives, which may account for the interaction noted above. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.

Quinine (Cinchona species)
Quinine, a chemical found in cinchona bark and available as a drug product, has been reported to increase warfarin activity. People should read labels for quinine/cinchona content. People taking warfarin should avoid quinine-containing products.

Reishi (Ganoderma lucidum)
As it may increase bleeding time, reishi is not recommended for those taking anticoagulant (blood-thinning) medications.

St. John’s wort (Hypericum perforatum)
According to a preliminary report, volunteers taking 900 mg per day of St. John’s wort were given a single dose of an anticoagulant similar in action to warfarin. There was a significant drop in the amount of the drug measured in the blood. Seven case studies reported to the Medical Products Agency in Sweden also found a decrease in the anticoagulant activity of warfarin when St. John’s wort was taken at the same time. This may have occurred because certain chemicals found in St. John’s wort activate liver enzymes that are involved in the elimination of some drugs.46 47 People taking warfarin should consult with their doctor before taking St. John’s wort.

Interactions with Foods and Other Compounds

Alcohol
Alcohol use, especially long-term heavy drinking, can decrease the effectiveness of warfarin. People taking warfarin are cautioned to avoid alcohol.

Food
Some vegetables (broccoli, Brussels sprouts, kale, parsley, spinach, and others) are high in vitamin K. Eating large quantities49 or making sudden changes in the amounts eaten of these vegetables, interferes with the effectiveness and safety of warfarin therapy. Eating charbroiled food may decrease warfarin activity,while eating soy meal foods and cooked onions may increase warfarin activity. The significance of these last two interactions remains unclear.

Olestra
The FDA-approved fat substitute, olestra, interferes with fat absorption, including the absorption of fat-soluble vitamins. Vitamin K, a fat-soluble vitamin, is added to olestra to offset this adverse effect.Since vitamin K interferes with the activity of warfarin, eating snacks containing olestra may also interfere with the drug’s activity. The impact of eating snacks containing olestra has not been evaluated in people taking warfarin. However, until more is known, it makes sense for people taking warfarin to avoid olestra-containing foods.