Mushrooms And Inr: A Dietary Concern

The international normalized ratio (INR) is a measure of blood coagulation and is found via a blood test called the prothrombin time test. Certain medications, supplements, and herbal products can affect INR, including the blood thinner warfarin. Interactions with food, medications, and other substances can increase the risk of side effects from warfarin, such as excessive bleeding from wounds. Reishi mushrooms, for example, are known to increase the risk of bleeding. In vitro studies on mushroom extracts from eight edible mushroom species found that treatment with mushroom extracts did not result in altered clotting, with prothrombin time and INR values falling within the reference range.

Reishi mushrooms and warfarin

Reishi mushrooms, also known as lingzhi, have been used in traditional medicine in China, Japan, Korea, and other Asian countries for hundreds of years. They are believed to have various health benefits, including boosting the immune system, reducing stress, improving sleep, and treating infections. However, there is limited scientific evidence to support these claims, and the optimal dosage for any condition has not been established.

When considering the use of reishi mushrooms, it is important to be aware of potential side effects and interactions with other substances. One important consideration is the interaction between reishi mushrooms and anticoagulant or antiplatelet drugs, such as warfarin. Reishi mushrooms may increase the risk of bleeding, especially when combined with medications that slow clotting, such as warfarin. Therefore, it is crucial to consult a doctor before consuming reishi mushrooms if you are taking any anticoagulant or antiplatelet medications.

The combination of reishi mushrooms and warfarin may prolong the International Normalized Ratio (INR), which is a measure of blood coagulation. This means that taking reishi mushrooms while on warfarin could further increase the risk of bleeding and bruising. As a result, it is essential to be cautious and seek medical advice before combining these substances.

In addition to the potential risks associated with bleeding, reishi mushrooms may also interact with other medications, such as high blood pressure medications. They can also cause allergic reactions, dry mouth, rashes, upset stomach, diarrhea, headache, dizziness, and insomnia. It is important to note that the safety of reishi mushroom use during pregnancy and breastfeeding has not been thoroughly studied, so it is recommended to avoid consumption during these periods.

INR and prothrombin time

Prothrombin time (PT) is a blood test that measures how long it takes for a blood sample to clot. PT measures the following coagulation factors: I (fibrinogen), II (prothrombin), V (proaccelerin), VII (proconvertin), and X (Stuart–Prower factor). The test is used to determine how well a person's blood is clotting and can also be used to check for liver problems or vitamin K deficiency.

The prothrombin time ratio is the ratio of a subject's measured prothrombin time (in seconds) to the normal laboratory reference PT. The PT ratio varies depending on the specific reagents used and has been replaced by the INR (international normalized ratio). INR was devised to standardize the results of the PT test, which can vary depending on the laboratory and testing method.

The INR is calculated by dividing the patient's prothrombin time by the mean normal prothrombin time. The resulting INR value is a standardised measure of the patient's coagulation factor activity. The INR is used to monitor patients on anticoagulant therapy, such as warfarin, and to adjust their dosage. A high INR indicates an increased risk of bleeding, while a low INR suggests a higher risk of developing a blood clot.

In terms of the effect of mushrooms on INR, one study found that treatment of human plasma with mushroom extracts did not result in altered clotting. The prothrombin time and INR values fell within the reference range and did not vary significantly from the control. However, another study found that exposure of human PRP and leukocytes to mushroom extracts resulted in increased cytotoxicity, particularly with the G. lucidum extract. More research is needed to fully understand the effect of mushroom consumption on INR and prothrombin time.

Cytotoxicity and LDH release

Mushrooms have been studied for their potential health benefits, including their effects on blood coagulation and cytotoxicity. In terms of cytotoxicity and LDH release, certain mushroom extracts have shown promising results in inhibiting cancer cell growth and inducing apoptosis.

LDH Assay and Cytotoxicity

The LDH assay, also known as the LDH release assay, is a widely used method to assess cell death and cytotoxicity. LDH (lactate dehydrogenase) is an enzyme present in all cell types that is rapidly released into the cell culture medium when the plasma membrane is damaged. By measuring the amount of LDH released, the extent of cell damage can be quantified. This assay is particularly useful in determining the cytotoxicity of mushroom extracts on cancer cells.

Mushroom Extracts and Cytotoxicity

Various mushroom extracts have been studied for their cytotoxic effects on different types of cancer cells, including lung cancer and liver cancer. For example, the extract from the mushroom Fomes fomentarius, specifically the polysaccharide MFKF-AP1β, has shown inhibitory effects on lung cancer cell growth. This extract induced cytotoxicity and cellular apoptosis in lung carcinoma A549 cells, as evidenced by an increase in LDH release and morphological alterations.

Additionally, edible mushrooms such as C. comatus and L. tigrinus have demonstrated cytotoxic activity against liver hepatocellular carcinoma cells (HepG2). The extract from C. comatus showed substantial in vitro cytotoxic activity, with chloroform and acetone extracts exhibiting the highest potency. Similarly, L. tigrinus extracts, particularly the n-hexane extract, displayed a high degree of growth inhibitory potential.

In another study, the exposure of human PRP and leukocytes to mushroom extracts resulted in increased cytotoxicity for G. lucidum extract, causing a 5.4 ± 3.9 and 7.7 ± 4.6% LDH release, respectively. However, it is important to note that the investigated extracts did not elevate the erythrocyte sedimentation rate above the reference range.

Blood Coagulation and INR

Regarding the effect of mushrooms on blood coagulation, studies have evaluated the impact of mushroom extracts on human platelet function and coagulation factors. The international normalized ratio (INR) is a measure used to assess blood coagulation and was specifically monitored in these studies. Results indicated that treatment of human plasma with mushroom extracts did not lead to altered clotting or significant changes in INR values compared to a control group.

Vitamin K-rich foods

While the studies on the effects of mushrooms on blood coagulation are inconclusive, vitamin K is known to play a vital role in blood clotting. Consuming more vitamin K can lower your INR, which increases the risk of blood clotting.

If you're looking to increase your vitamin K intake, consider the following:

• Cooked kale—just 1/2 cup (59 grams) provides a significant amount of vitamin K.
• Other leafy greens such as beet leaves, which can be cooked and served as a side dish.
• Fatty meats and liver—these are excellent sources of vitamin K2, although the content can vary depending on the animal's diet and region.
• Legumes and nuts—while they generally contain less vitamin K than leafy greens, they still provide decent amounts.

It is important to note that while vitamin K-rich foods can affect INR and blood clotting, it is recommended to maintain a consistent and balanced diet. Any significant dietary changes should be discussed with a healthcare professional.

Herbal supplements

The intake of vitamin K should be consistent when taking warfarin. A large intake of vitamin K, such as from a spinach salad, could be harmful. High amounts of vitamin K are found in green vegetables like kale, spinach, cucumbers, and cabbage.

Reishi mushroom supplements, for example, are used in Asian traditional medicine to boost the immune system and increase energy. However, they can increase the risk of bleeding and should not be taken with blood thinners such as warfarin.

It is important to consult with a healthcare provider before taking herbal supplements, especially if you are on other medications.

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