Herbs and medicines
Herbs That Interact With Blood Thinners: Saw Palmetto, Horny Goat Weed and Nettle
Three herbs in SodaPeak matter if you take a blood thinner. Memorial Sloan Kettering says not to take saw palmetto with warfarin. RxList says horny goat weed may slow clotting, and that nettle's vitamin K can work against warfarin. Ask your doctor or pharmacist before using SodaPeak with any blood thinner.
Written by the SodaPeak editorial teamUpdated · 9 min read
The concern
Which herbs in SodaPeak interact with blood thinners?
Three of SodaPeak's eight ingredients are flagged with blood thinners: saw palmetto, horny goat weed and nettle root. Two may add to bleeding risk, and one may make warfarin work less well.
Blood thinners are prescribed after a stroke, a heart attack, a stent, a blood clot or for an irregular heartbeat called atrial fibrillation. The dose is a fine balance, and herbs can tip it either way.
The label makes this harder. SodaPeak prints one 1,200 mg total for all eight ingredients, with no single amount (FDA labeling guide ch. IV (blends)). Your doctor cannot judge the dose from the bottle.
At a glance
How does each herb affect blood thinners?
Saw palmetto and horny goat weed may raise bleeding risk, while nettle root may weaken warfarin. The table sums up what each source says, with the most each herb could weigh in SodaPeak by label math.
| Herb | Most per 2 capsules | Effect named | Drugs named by the source |
|---|---|---|---|
| Saw palmetto | 400 mg | More bruising and bleeding | Warfarin, other blood thinners, clopidogrel (MSK: Saw palmetto) |
| Horny goat weed | 1,200 mg | May slow clotting | Anticoagulants and antiplatelet drugs (RxList: Horny goat weed) |
| Nettle root | 300 mg | Vitamin K may reduce warfarin's effect | Warfarin (RxList: Stinging nettle) |
The amounts are ceilings: the real amounts are almost certainly lower, because eight ingredients share 1,200 mg. A lower amount is still not a known safe amount.
Herb 1
Is saw palmetto safe with warfarin?
Memorial Sloan Kettering Cancer Center (MSK) says do not take saw palmetto with warfarin or other blood thinners, because it may increase bruising and bleeding. MSK adds that it may increase the effects of clopidogrel, a common antiplatelet drug (MSK: Saw palmetto).
MSK cites case reports. One person on rivaroxaban, a newer blood thinner, had bleeding around the heart. Others had heavy bleeding during an operation and a blood collection under the skin after surgery (MSK: Saw palmetto).
Case reports do not prove every user will bleed, but a cancer center still tells patients to avoid the combination. Saw palmetto also failed to beat placebo for prostate symptoms in NIH-funded trials (NCCIH: Saw palmetto), so there is little to gain in exchange. Read more in saw palmetto and the prostate.
Herb 2
Can horny goat weed thin your blood?
It may slow blood clotting. RxList lists a moderate interaction between horny goat weed and both anticoagulants and antiplatelet drugs, with a higher chance of bruising and bleeding (RxList: Horny goat weed).
Horny goat weed is listed first in SodaPeak's blend, so it is the largest ingredient: up to 1,200 mg per 2 capsules. RxList also says it may lower blood pressure, and MSK reports a case of a fast, irregular heartbeat (MSK: Epimedium). That is a second reason to ask first if you have a heart rhythm problem.
See the horny goat weed ingredient page for its full profile.
Herb 3
Why does nettle matter with warfarin?
Nettle contains vitamin K, and vitamin K helps blood clot, which can work against warfarin. RxList lists warfarin among nettle's moderate interactions for this reason (RxList: Stinging nettle).
Warfarin works by blocking the body's use of vitamin K. That is why people on warfarin are told to keep their vitamin K intake steady, not to cut it out. A new source, such as a daily supplement, can shift the balance and change your blood test results.
If your doctor agrees you can try a product with nettle, take it the same way every day and ask whether you need an extra blood test. Do not start and stop it without telling the clinic that manages your dose.
The newer blood thinners do not work through vitamin K. That does not clear nettle; the bleeding concerns about the other two herbs still apply.
Procedures
Should you stop these herbs before surgery?
Yes, ask about it well before the date. RxList says to stop horny goat weed before surgery because it slows clotting (RxList: Horny goat weed), and NCCIH notes that supplements can matter before surgery (NCCIH: Using supplements wisely).
The FDA also says supplements can interact with surgery and with lab tests (FDA 101: Dietary supplements). Your surgeon or dentist sets the timing, based on the procedure and any blood thinner you take. Write SodaPeak and all eight of its ingredients on your pre-op form.
Call your doctor about large bruises, bleeding gums, nosebleeds that do not stop, or pink urine or black stool. A sudden bad headache, vomiting blood, or weakness on one side needs 911.
Ask first
What should you tell your pharmacist about supplements?
Tell your pharmacist every supplement you take, with its full ingredient list, not just its brand name. NCCIH advises telling all your health care providers what you use (NCCIH: Using supplements wisely).
Bring the label
Show the bottle or a clear photo of the Supplement Facts. SodaPeak's lists eight ingredients in one blend.
Name every medicine
Include your blood thinner, daily aspirin, blood pressure pills and anything for diabetes.
Ask three questions
Does any ingredient raise bleeding risk? Does any change how my blood thinner works? Do I need an extra blood test?
Bottom line
Can you take SodaPeak if you are on a blood thinner?
Only with your doctor's okay. Saw palmetto, horny goat weed and nettle root each carry a blood thinner caution, and the label hides their amounts. Never stop or change a blood thinner to make room for a supplement. Read the full SodaPeak side effects overview.
FAQ
Herbs and blood thinners: common questions
Does saw palmetto cause bleeding?
It can in some people, mainly those on blood thinners. Memorial Sloan Kettering reports bleeding cases, including bleeding around the heart in a person on rivaroxaban and heavy bleeding during and after surgery. It advises against taking saw palmetto with warfarin or other blood thinners.
Is horny goat weed safe with warfarin?
Ask your doctor first. RxList says horny goat weed may slow clotting and lists a moderate interaction with anticoagulants such as warfarin and with antiplatelet drugs. It is the largest ingredient in SodaPeak's blend, at up to 1,200 mg per 2 capsules.
Does stinging nettle affect warfarin?
It can. Nettle contains vitamin K, and RxList lists warfarin among its moderate interactions because vitamin K can make warfarin work less well. If your doctor allows it, keep your intake steady and ask whether you need an extra blood test.
Which herbs should you avoid with Eliquis or Xarelto?
Ask your pharmacist about any herb that may raise bleeding risk, including saw palmetto and horny goat weed. Memorial Sloan Kettering reports a serious bleed in a person taking saw palmetto with rivaroxaban, the drug in Xarelto. Do not combine them without your doctor's approval.
How long before surgery should you stop herbal supplements?
Your surgeon sets the timing, so ask at your first pre-op visit, not the day before. RxList says to stop horny goat weed before surgery because it slows clotting. List every supplement and its ingredients on your pre-op form, including blends like SodaPeak.
What should I tell my pharmacist before taking a supplement?
Show the full ingredient list, not just the brand name, and name every medicine you take, including daily aspirin. Ask whether any ingredient raises bleeding risk or changes how your blood thinner works, and whether you need an extra blood test.
What are signs of bleeding on a blood thinner?
Watch for large or unexplained bruises, bleeding gums, nosebleeds that do not stop, pink or dark urine, and black stool. Call your doctor if you notice them. A sudden severe headache, vomiting blood, or weakness on one side of the body needs 911.
Who wrote this
Written and reviewed by
Plain-language pages built from the bottle label, the order page and linked public health sources such as NIH, FDA and CDC.
Last updated . Read our editorial standards and how we check reviews. This website is run by a U.S. stocking partner for SodaPeak, not by the manufacturer. We earn money when you buy through our order links.
Keep reading
More about SodaPeak
Side effects
Side effects and drug interactions for all eight SodaPeak ingredients, plus a five-question safety check.
Read more
Who it's for
A five-question check, plus who should skip SodaPeak and who needs a doctor's okay first.
Read more
Horny goat weed
Horny goat weed leads the blend at 150 to 1,200 mg, but its sexual-health use rests on tradition, not trials.
Read moreU.S. stocking partner for SodaPeak
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