Vitamin E and Coumadin

Q:  In an article dated May 24, 1999, you indicated that taking Vitamin E was not a problem if you are on Coumadin. However, I enclose the printout I received from my pharmacy when I first began to take Coumadin, which indicates that Vitamin E may interact with Coumadin. Additionally, I enclose a copy of my Johns Hopkins Medical Newsletter of May 19, 1999, which indicates that if you are taking Coumadin, you should avoid megadoses of Vitamin E because it is a nutrient that affects circulation.

I think you may want to reconsider your suggestion in your May 24th article and perhaps suggest that a reasonable amount of Vitamin E might be 200 international units, at the most. What do you think?

Q: In your column in the Health and Science Section of the Milwaukee Journal Sentinel, you answered a question regarding taking Coumadin and Vitamin E. Your response was that Vitamin E should not affect the Protime level.

I am 72 years old and am taking Coumadin because of a blood clot condition in my leg. I was very disappointed when my doctor advised me that I definitely could not continue taking Vitamin E because it would affect my Protime level. Therefore, I am confused after reading your May 24th column.

A:  Vitamin E at doses of 100 or 400 units a day, when given to people on Coumadin (warfarin), did not affect their protime level (measure of the their blood clotting) in at least two studies. The most recent of the studies, done at the University of California at Davis and published in 1996 in the American Journal of Cardiology, concluded that "vitamin E can safely be given to patients who require chronic warfarin therapy."

The Johns Hopkins article cautions against megadoses of vitamin E, which would be in the range of 1000 units or more, but according to research on people and animals, 400 units a day should be fine.

Dr. Rebekah Wang-Cheng is a former Professor of Medicine at the Medical College of Wisconsin. Her medical advice column, which answers health-related questions from readers, also appeared in the Milwaukee Journal-Sentinel.