Reducing Coumadin Risk Through Genetic Testing

Dr. Robert Rodvien, the founder of the Coumadin Clinic at California Pacific Medical Center in San Francisco, identifies some reasons why people need different doses of Coumadin. Certain genes control how Coumadin is broken down by the body and how Vitamin K is recycled. If either gene is different in one individual from the general population, then less Coumadin is needed to produce an anticoagulated state. Scientists call these families of genes CYP2C9 and VKOR. They can be analyzed in the blood or saliva. The genes are not related to each other but, because Coumadin and Vitamin K offset the action of each other, the two proteins produced by the genes can interact to alter the effectiveness of the Coumadin. The United States government in 2010 is testing whether differences in these measured genes  can allow safer use of Coumadin. If the genetic material suggests Coumadin sensitivity, taking less Vitamin K in your diet or avoiding multi-vitamins is neither necessary nor good. It is better to take less Coumadin. Taking these gene tests may allow physicians in the future to decrease the bleeding problems associated with Coumadin .

Dr. Robert Rodvien
California Pacific Medical Center
2100 Webster St.
San Francisco, CA 94115
(415) 717-7044
Dr. Robert Rodvien graduated from Columbia University's Physicians and Surgeons' medical school, and then did his internship, medical residency and hematology fellowship at Tufts. He continued his training at MIT in molecular biology followed by a year at Harvard Medical School and the Beth Israel Hospital in biomaterials. At present, he is at California Pacific Medical Center in San Francisco.

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