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Should Polycythemia Vera Patients Avoid Vitamin K?

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Published on October 11, 2018

During this Ask the Expert, Dr. Naveen Pemmaraju, from The University of Texas MD Anderson Cancer Center, responds to a Patient Power community member’s question about vitamin K and myeloproliferative neoplasms (MPNs). Should people with polycythemia vera (PV) avoid foods that are high in vitamin K? Dr. Pemmaraju explains the effect vitamin K has on iron levels, how it may interact with treatment and what patients should consider when it comes to diet. Watch now to learn more.

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Transcript | Should Polycythemia Vera Patients Avoid Vitamin K?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Here’s a question from Denise. Denise says, “I have PV, and I’m trying to improve my health by making smoothies containing large amounts of dark green vegetables, such as spinach, kale and watercress. I’ve been warned by some members of our community that these foods will increase iron and raise the hematocrit, putting me at risk. Is that true? And should people with PV avoid these foods that are high in vitamin K?”

Dr. Pemmaraju:           

Well, this is an important question and I remember five to 10 years ago we would say things like, “Well, we don’t really know the answer,” or you know, “Diet doesn’t really have anything to do.” But now with more and more understanding of the total therapy for patients and approach to the whole body, I think this is an important question. So, yes, iron levels do matter. Too low, then you’re iron deficient. (That can definitely happen in our patients.) Too high, potentially may fuel the fire, if you will, for polycythemia vera. 

So, I think iron levels are important to watch and certainly can be increased by what our question is being asked about. But there’s another aspect, too, that some of the medications that we prescribe and take. One example is Coumadin, or warfarin that a lot of our patients know, which is a high-level blood thinner. It’s an anticoagulant. And man, oh, man, that is exquisitely dependent on the vitamin K pathway. So sensitive, that in some patients in some cases even salad consumption, or spinach, so healthy foods because of the vitamin K level in them can alter this level. It’s called the INR. And so, it’s something we have to watch out for. 

So, not only in terms of iron metabolites, but also drug-to-drug interactions. So, it is always best to mention these things when we’re going on new medications. 

Andrew Schorr:                      

Right. Talk to your doctor.  

Dr. Pemmaraju:                       

Talk to your doctor. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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