Monthly Letters to Pulmonary Patients by Thomas L. Petty

Thomas L. Petty, M.D.

Professor of Medicine, 
University of Colorado

Snowdrift Pulmonary Conference


National Lung Health Education Program
A collaborative project with



HealthOne Center
1850 High Street
Denver, CO 80218
Phone: 303 839 6755
Fax: 303 832 8137

Don't Get Yourself in a Pickle!

May, 2006

Dear Friends

    Historically, getting in a pickle meant a predicament.  It derives from the Dutch,”in de piklel zetten,” which literally means sitting in the pickle brine, full of salt and irritation.

     I have commented before about the high content of salt in canned pickles, up to three grams (3000 mg) in a medium sized dill!  This would put any person with heart disease in more edema, i.e., a predicament (pickle).

     My associate, Louise Nett, has a recipe for sour pickles that accompanies this issue of Second Wind.  They are great and add zest to a sandwich or salad. I started to get hooked on them, for their flavor, and without salt!  Amongst other medications that keep me going, I have to take Coumadin to reduce my clotting mechanisms.  Coumadin is commonly known as a "blood thinner.”  The activity of Coumadin is frequently monitored by measuring the INR, which is known as the international neutralization rate (of a clotting process).

     Shortly after appreciating Louise's salt free pickles, I found out that my INR was way down, meaning that the Coumadin was not controlling the clotting process.  The answer had to be the vitamin K in pickles.  Vitamin K counteracts the effects of Coumadin on some clotting factors, and thus mitigates the tendency to form clots in the legs, lung, heart and brain.  Maintaining a therapeutic range INR is extremely important for persons requiring this drug.

     The main sources of vitamin K in the diet are green leafy vegetables, broccoli, and Brussels sprouts.  Also vitamin K is in Centrum and other multivitamin preparations.  There is no mention of vitamin K in pickles, in any dietary manual that I could find, but now that I control my pickle consumption, my INR is easy to maintain again.

     I thought these facts would keep some of our readers from "getting in a pickle!"

I'll be in touch next month

Your Friend,

  Thomas Petty, MD

Last update:
02 June 2006