From the Guidelines
Omega-3 supplements, particularly at high doses, may increase the risk of atrial fibrillation and potentially interact with anticoagulation therapy, whereas whey protein and chai powder are unlikely to have a significant impact on anticoagulation. When considering the effects of omega-3, whey protein, and chai powder on anticoagulation, it's essential to prioritize the most recent and highest quality evidence. According to a 2024 narrative review published in Pharmacological Research 1, omega-3 fatty acids have been shown to increase the risk of atrial fibrillation (AF), with a higher risk associated with doses above 1g daily. Key points to consider include:
- Omega-3 fatty acids may increase the risk of AF, with a meta-analysis of 7 large-scale randomized trials showing a higher risk of AF (HR 1.25; 1.07–1.46, P = 0.013) 1.
- The risk of AF increased in trials testing more than 1g of omega-3 fatty acids daily (1.49; 1.04–2.15; P = 0.042) 1.
- Whey protein and chai powder are unlikely to have a significant impact on anticoagulation, but patients on anticoagulation therapy should still inform their healthcare provider about all supplements they're taking.
- Regular monitoring of INR levels is crucial for patients on warfarin who use omega-3 supplements, especially at high doses. It's crucial for patients on anticoagulation therapy to maintain consistent intake of these products and monitor for any unusual bleeding or bruising, prioritizing their safety and minimizing potential risks to morbidity, mortality, and quality of life.
From the Research
Omega-3 Fatty Acids and Anticoagulation
- Omega-3 fatty acids may increase the risk of bleeding when combined with anticoagulant medications such as warfarin, due to their antiplatelet and anticoagulant effects 2, 3, 4, 5, 6
- Clinical trial evidence has not supported increased bleeding with omega-3 fatty acid intake, even when combined with other agents that might also increase bleeding, such as aspirin and warfarin 2
- However, case reports have shown that high-dose omega-3 fatty acids can lead to increased anticoagulation and bleeding risks when combined with warfarin and other antiplatelet or anticoagulant drugs 3, 4, 5, 6
Whey Protein and Anticoagulation
- There is no evidence in the provided studies to suggest that whey protein affects anticoagulation
Chai Powder and Anticoagulation
- There is no evidence in the provided studies to suggest that chai powder affects anticoagulation
Interactions with Warfarin
- Omega-3 fatty acids can lead to additional anticoagulation when combined with warfarin, resulting from changes in platelet aggregation or vitamin K-dependent coagulation factors 4, 5
- Patients taking warfarin should be educated about and monitored for possible drug-herb interactions, including the use of omega-3 fatty acid supplements 5