Any known link to low Inr readings and Liver problems?

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sheridan07

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Joined
Dec 22, 2008
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322
Location
South Carolina
My PC doctor has found out that my blood work for my liver has come back high for all levels. The doctor thinks it maybe Hep C or fatty liver but won't know for sure until a ultrasound (which I just Had) and more blood work. My question is that, my Inr has been on the lower side for several months now. ( 1.9 being the lowest and 2.7 being the highest) and could my problems with my liver have anything with my inr levels being on the lower side of things? Has anybody else have liver problems and can share their story please?
 
My wife has Hep C. She was taking Baraclude and Herpsa medication before . Now just Herpsa medication. 3 years ago her viral count was in the millions.
Doctor recommend doing a liver biopsy to make sure no damage to the liver. As of today her viral is in the hundreds. Good compare to millions. Her recent blood test continued to show (+) hep B E antigen and (-) E antibody which means her immune system has not converted yet which means she still have Hep C. She is keeping up with the blood test every 3 months and liver ultrasound every year. Hope this helps.
 
Thanks it helps alittle.My Alt is 128 and Ast is 80. They are high but not in the millions like your wife. I hope she gets better soon. There was about 8 blood tests for the liver they did for me and they were all higher than normal. I read that the liver has a lot to do with the body's natural clotting reg. I just hope my liver is not damaged bad enough so the warfarin has hardly any affect on the blood clotting, or not clotting.

My wife has Hep C. She was taking Baraclude and Herpsa medication before . Now just Herpsa medication. 3 years ago her viral count was in the millions.
Doctor recommend doing a liver biopsy to make sure no damage to the liver. As of today her viral is in the hundreds. Good compare to millions. Her recent blood test continued to show (+) hep B E antigen and (-) E antibody which means her immune system has not converted yet which means she still have Hep C. She is keeping up with the blood test every 3 months and liver ultrasound every year. Hope this helps.
 
My husbands liver enzymes were really high to where they thought hep c as well but it ended up being food allergies he was unaware of so if the blood work doesn't explain what is going on get an allergy test. I have no idea about the INR though.
 
Did your INR STAY low even after you increased the dosage of Warfarin? Did you not respond to increased dosages?

The liver is a key organ in the process of creating some of the factors responsible for coagulation. Warfarin is what they call a Vitamin K agonist - meaning that it looks to the body as if it's Vitamin K, the body attempts to use it to create coagulants, but these coagulating agents aren't manufactured.

I personally don't know if a failing liver would INCREASE or DECREASE your INR. (FWIW - there was a CSI show a couple weeks ago where a hepatotoxin (liver poison) was mixed with a drink, causing liver failure, and the people died from internal hemorrhaging -- exactly the opposite of the low INR that you're reporting).

If your INR was low, and didn't respond to steadily increased doses of Warfarin, I'd certainly talk to your doctor. If it was low, and you didn't change the dosage, and it fluctuated between 1.9 and 2.7, as you reported, these changes are probably normal. I think that all of us who've tested have had interesting fluctuations that were hard to explain -- it could just be that, in your case, whoever was managing your dosing may have just not been giving you enough to get you into the 2.5 range.
 
As a nurse we commonly check liver patients INRs and other clotting factors because they tend to have problems with bleeding and have an increased INR. I doubt any liver issue is causing a problem with your decreased INR. Good luck.
 
Thanks to everyone who has answered.They checked for total bilirubin, direct bilirubin, Albumin, AST, ALT, ALK Phosphatase, and total protein. It was 7 not 8 so I was wrong lol. 5 of 7 were above normal levels. They increased my dose and haven't checked yet, but I was just wondering if my liver could keep my inr levels on the lower side. As Lisa has said that it would be an increase not a decrease in inr. Thanks to everyone
 
Hi Lisa,
My understanding is your posting doesn't directly address liver problems associated with high--out of range--INR's. Is there any evidence of this. As a nurse you have confirmed my belief that doctors are overly concerned with high INR because of bleeding and tend to not care so much about low levels causing stroking the main worry of mechanical valve recipients.
Cheers
 
Lance, I was only addressing the question of the relationship between low INR and a possible liver issue, which does not, in my experience, generally happen. I agree that it is extremely important for valve patients to be properly anticoagulated. In my hospital we regularly admit people with subtheraputic INRs that are at risk for clots so we can bridge them properly and adjust the coumadin dosing. I guess it depends on the doctor or facility how INR discrepencies are handled. There is certainly an issue with people having supratheraputic INRs and come to the ER with stomach or other internal bleeding. It is a tough balance.
 

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