INR level dropped after excercising

[Brian]

Hi there,
I just did my weekly visit to the Vampires only to find that my INR level, which had been stable and steady for two weeks prior has dropped from 2.2 to 1.6. The only thing we can think that has caused it is the amount of walking that I have been doing. I am now walking for an hour at 3.2 mph and a distance of 3.3 miles, that is in the morning. Then if I get ambitious, I'll walk an other 2+ miles at night. Has anyone else had a big swing in INR levels from excercising more vigerously? The anticoagulation clinic thinks that could be the reason..not the problem..the reason.. Most excercise is never a problem..only a benefit in the end..

 

[Ross]

More excercise means more blood flow which means faster metabolization of Warfarin. Your improving physically, now it's time to adjust your dose accordingly.

 

[tommy]

Brian,

My INR ropped a little when I began exercising in earnest. My exercise program is coupled with losing weight (more veggies and salads). Only needed a small dose change to get me back in line. Actually, my INR used to hover at the low end of the range. Now it hovers at the high end of the range. I prefer it to be at the higher end.

As Ross has said many times......live your life and adjust the dose. Just be reasonably consistent.

 

[bvdr]

Brian,

Definitely! My coumadin dosage has upped from a low of 2.5mg/day to 7.0mg/day a little at a time as my activity level gradually increased. You, being younger and having a greater and more sudden change, may well have to up your coumadin as well.

 

[Rich]

Hi Brian,
I just went through this myself.
After sitting at a desk for 46 years I retired.
Then this past year I really jumped on some heavy duty projects around the house.
My INR had been steady as a rock for seven and a half years and then took a real nose dive.
It's like the others said, your pushing more blood through your system now and there is not enough medication to keep up with your increased activity.
But keep up the walking, it is the one thing that really got me in shape afterwards.
Just be careful about how they increase your dosage.
My doctor got carried away and put me over the top.
With Al's help and guidance I'm back on track now.

 

[rangerscat]

Me too.........

Me too.........

I just got back from my INR check this morning and mine was down to 1.6. I'm 42 and had my surgery on May 22 of this year. I just started back running and lifting weights and I hope that is what the cause is. They bumped me up from my normal schedule which is Mon, Thurs, and Saturday, 7.5mg Tues, Wed, Fri,5mg to, Mon, Wed, Fri, 5mg Tues, Thurs, Sat, Sun,7.5mg. i usually am at about 2.1-2.2 but it dropped down this time. They used the On-X valve on me. What type of valve did they put in you?

Hope all goes well, and you level out and me too..............

Take care and good luck,

Rangerscat

 

[Karlynn]

Rangerscat
Did they actually have you skipping Sunday, or did you just miss including Sunday as a 5 mg day?

If you were skipping Sunday (which shouldn't be done) then the new dosing schedule gives you a 20% increase to 45/week. And taking a dose 7 days a week is needed.

If Sunday was a 5 mg day - then they only gave you about a 6% increase, which is not nearly enough.

Since your surgery was in May, I'm sure you are getting increasingly more active and you will metabolize warfarin more quickly, requiring higher doses. Don't let them be afraid of having you at the higher end of your range right now to compensate for your increasing need for warfarin.

 

[Philip B]

Exercise & INR Drops

Exercise & INR Drops

Yes indeed, what Ross and the others who have responded to your post have said about exercise and metabolic rate affecting your INR rate reflects my experience.

I'm not an exercise junkie, but I typically golf and bicycle on a daily basis during the summer. Staying within my range has required me to do 5.0 mg of coumadin on even calendar days and 7.5 on the odds. This represents quite a jump from the daily 2.5 mg I took after surgery when my activities simply involved walking and working.

If you are more physically active, you'll probably need to increase how much you coumadin you take to stay within your range. This is not a bad thing.

-Philip

 

[catwoman]

Rangerscat:

Exercise will do it every time!

My husband is going through the same situation as you.
He had MV repair 5/10 and developed an arrhythmia post-op. His surgeon put him on warfarin; our cardio & our PCP agreed it was best for the time being.
John's been walking a lot, at least 2 miles most days, some days up to 4-5 miles.
His INR on 7/18 was 1.5; our PCP's colleague bumped up his dosage but the 5.5% increase didn't satisfy me. I questioned it, and our PCP's RN deferred to my suggestion of at least 10% increase. That brought his INR up to 1.9 on his last test (8/1). I've bumped it up a little more since then.

Likewise, I've been seeing a drop in my own INR. I have a St. Jude.
I wanted to drop whittle off 4-5 pounds (am almost there). So I went back to walking with John + getting on my Trek comfort bike. My INR on 7/27 was 3.4. It's usually at least 3.7, sometimes over 4.0.
I had a TEE on 8/2, and my INR was 2.5 based on the vampires who tested me at the hospital. I intended to retest when I got home; didn't remember to until 8/5, and it was -- -- 2.1. I had not forgotten to take my meds; I was just exercising more and metabolizing the rat poison faster.

So, I've bumped up my dosage from 6.0 to 6.5X7, which usually keeps me in range. Will recheck tonight and see if I need to bump it up any more.

 

[Brian]

Update after 3.5 yrs

Update after 3.5 yrs

Hey Rangerscat,
I thought I had better reply to this so everyone knows that I am still live and kicking... LOL..
INR for me is a none issue.. I eat what I want, and when I want..I try to eat the same amount of vitamine K rich foods daily. I have been a little lazy on that this past few weeks and my INR got a bit high when I tested it today. now after 3.5 yrs later, my excercise routine consists of 75 minutes on the treadmill walking 3.6 mile per hour on an incline setting of 5 with weights in my hands and ankle weights on my ankles... and away I go.. it's awesome. I have never ever once regreted having the mechanical valve installed and having to take rat poison daily.. just pretend it is an aspirin.. people take those all the time..LOL..

Life is good, life is worth living..do it to the best that you can.. and most of all meet each and every day with a smile..

 

[Brian]

Warafin rates

Warafin rates

I forgot to mention.. my doseage I look after myself, because I have my own Coguchek testing unit.. best money I ever spent by a long shot...

My doseage is usually 10 mg/day. Today I dropped it to 5 mg, but will only be lowered for a couple of days.., because my INR was a little on the high side...LOL.. well.. more than a little..
It feels weird to go into the doctors office to get a prescription renewed and tell them what I need and not the other way around of them telling me what I need...LOL..makes me kind of giggle..

Keep smiling and ticking friends..
Brian