diarrhea from coumadin

[ALCapshaw2]

You (Witzkeyman) wrote:

"I have a low tolerance for the coumadin, but am not interested in seeing a GI doctor, because the effects of some of those drugs that work on stomach acids can have horrible side effects."

Two Questions:

1 - How do you KNOW that you have a "low tolerance for the Coumadin"? Did a Doctor tell you this or is that a GUESS on your part? How do you KNOW that your diarrhea is not a result of some OTHER medication you are taking? For some reason, you seem averse to seeking medical evaluation from Doctors who could actually diagnose your issues.

2 - Could you be more specific about the "horrible side effects" from drugs that "work on stomach acid" and provide the Names of the Drugs you are concerned about? Several of our members take such drugs and I'm sure they would be interested in what you have learned about them.

BTW, INR testing "every couple of days" is WAY Too Often.
Testing and dosing should NOT be done more than Twice a Week, preferably no more often than every 4 days. For stable patients, most Coumadin Clinics recommend 4 weeks between tests. Concerned patients may find every other week works well.

'AL Capshaw'

 

[Cooker]

Hey witzkeyman.....I think you are just worrying the *&%# out of yourself.....You are making this WAY to hard.....Listen to these fine folks that have gone before you.....Save yourself a lot of time and anguish....Please.

 

[warrenr]

weekly dosage amount

weekly dosage amount

Witzkeyman,

How many day's have you had diarrhea? How long have you been on 25mg coumadin per week? They need to stop treating the symtoms of your diarrhea and find the cause and treat the cause. You need to see a specialist in that area.

I am aware that INR level compared to weekly coumadin dosage is different for everyone but it seems that for a 43 year old person that 25mg per week is quite a low dosage amount to maintain a therepuetic INR. Do you have any underlying medical conditions that you haven't mentioned? Have you had a liver function test? Have you had a Genotyping typing test? Thyroid function test?

Somebody correct me if I am wrong, but again 25mg per week coumadin seems like a low dosage amount for a 43 year old person to maintain a therepuetic INR!!!!!!!

 

[Ross]

There is a whole lot about this thread that seems terribly wrong. I'm venturing to say that witzkeyman has never been managed correctly and is taking the bull by the horns, but WITHOUT proper education.

 

[Cooker]

Witzkeyman,

How many day's have you had diarrhea? How long have you been on 25mg coumadin per week? They need to stop treating the symtoms of your diarrhea and find the cause and treat the cause. You need to see a specialist in that area.

I am aware that INR level compared to weekly coumadin dosage is different for everyone but it seems that for a 43 year old person that 25mg per week is quite a low dosage amount to maintain a therepuetic INR. Do you have any underlying medical conditions that you haven't mentioned? Have you had a liver function test? Have you had a Genotyping typing test? Thyroid function test?

Somebody correct me if I am wrong, but again 25mg per week coumadin seems like a low dosage amount for a 43 year old person to maintain a therepuetic INR!!!!!!!

I agree?find the source of the diarrhea (not trying to be funny) ? If diarrhea is persistent can?t it cause fluctuating INR due to dehydration? And I was not being an ass in my previous post?..worry and anxiety can cause diarrhea.

Don?t know about the dose; at 52 I?m on 40mg/week but I know whatever dose it takes is the correct one.

 

[Freddie]

Don’t know about the dose; at 52 I’m on 40mg/week but I know whatever dose it takes is the correct one.

I don't mean to hijack this thread but.............I'm 46, 126lbs and taking 42mg/week and I eat anything I want - I eat all my veggies. My range is 2.5 to 3.5 and have been steady with 2.5 for the past 4 weeks.

But 25mg/week does sound low.

 

[Bina]

Well at least I am not the only one thinking that this thread is getting scary.

Witz, you are new to ACT, best is to aim for a stable INR without messing with herbals, supplements, etc. There is time for that later.

Keep seeing docs to find the diarrhea trigger!
It could be meds, diet, stress, or anatomical in nature (liver, pancreas, etc.).

I am 49 yrs, 105 pounds, low activity, eating broc twice weekly....coumadin is 19mg/week.
We are all very different in our processing.

 

[Blanche]

When taking Coumadin, it is the amount you take to keep the INR in range that is important. One of our members takes more than 20.0 daily in order to maintain her range. That amounts to 140.0 plus Coumadin per week. And, this member is in wonderful health and has been taking this amount, 20.0 or more daily for 8 years or more.

I am years younger than Albert and 60 pounds heavier and we both take 6.0 per day. The right amount of Coumadin is the amount you take to keep the INR in range....nothing more and nothing less.

Thanks, Bina, you are correct. This is getting VERY SCAREY. Thanks for noting that and posting it. Can you imagine the problems that this might cause if someone trys to replace Coumadin with spinach!!!!! I'm glad you brought this up.

There's already too much disinformation here. I fear some nubie might come along and believe some of the totally incorrect and outrageous suggestions.

PLEASE, somebody, Lock This Thread Down!!!!!!

Blanche

 

[njean]

hey Lisa,
thanks for bringing up gingko, because I took gingkobiloba before my surgery. I feel it helps me think clearer, but that's besides the point. I have read that if you taked a certain amount of St. Johns Wort and Gingko Biloba, you can counter the effect to stablize the INR. I'm not interested in lowering the INR. I'm interested in raising, although I'm at a very premature stage presently.
You are eating veggies, and to me this is a perfect example.
I have a low tolerance for the coumadin, but am not interested in seeing a GI doctor, because the effects of some of those drugs that work on stomach acids can have horrible side effects.
You are taking Coumadin to fit your lifestyle, as I would like to do the same. I must also use precautions also, because if the diarrhea stops, the INR goes down. My doctor and surgeon were more concerned at lowering my INR, and said that higher INR's are dangerous as you can hemmorage and bleed in your brain. I was also told that there are ways to dissolve a clot with certain drugs. I didn't ask about if the clot would dissolve completely or move around causing other problems. the general feeling I am getting is that clotting doesn't happen overnight. It is usually when a person takes St. Johns Wort, drinks beers regularly, or eats brussel sprouts on a semi-regular basis. I am a little obsessive-compulsive, and I know I will be testing myself every other day for the rest of my life, but that is just how I am.

Personally, I have always been very skeptical on the benefits of some supplements & will not take any, unless I clear it with my doctors.

I'm not sure if anyone saw an episode of "Dr. G", the Chief Medical Examiner, Dr. Jan Garavaglia that aired this past week. There was a 53 yr old woman that died suddenly in her sleep one night. The autopsy revealed NOTHING out of the ordinary; she was what appeared to be a healthy, vivacious 53 year old woman with no medical issues whatsoever. So Dr. G was stumped!

Weeks went by & the case really disturbed Dr. G so she decided to have a talk w/the woman's husband to try to see if there was anything that would shed some light on why this woman died in her sleep. The husband started digging through receipts, etc., & found out that his wife had been spending approximately $200 a week on supplements she would purchase over the Internet. She took 40 different supplements a day!!!! One of the supplements was DHEA which produces estrogen & testarone. During the last few weeks before her death, her husband said that his wife would have sudden angry outbursts which were totally out of the ordinary for her because she was such a sweet & life loving person. And too, she had been losing her hair for a long period of time, so much, that she had to start wearing wigs! But she continued taking the supplements which in Dr. G's assessment, was what eventually killed her!

Just thought I'd throw this out there! Beware!

 

[Lisa in Katy]

njean - I agree regarding supplements. There is just not a lot of quality control. Many come from other countries. My friend took Gingko religiously "for her memory" and when scheduled for a hysterectomy, didn't even mention it to her doctor because she didn't think of it as a medication. She even took some to the hospital with her and took them according to the directions on the bottle. Unfortunately, she had a major problem with bleeding and what should have been a 2 day stay stretched out to 7 days, got a transfusion, and took Iron pills for quite some time. She was extremely weak for several weeks. While she was in the hospital, a nurse overheard her ask her husband to go to the health food store and the nurse was wise enough to ask questions. They finally put it together.

Blanche - I'm confused about the misinformation that you refer to - other than what Witzkeyman has posted, which I think comes from inexperience not misinformation. I didn't see anyone suggest that Coumadin be replaced with spinach. I think that any new person that stumbles upon this thread (which is unlikely since the topic isn't considered pleasant ) would see it for what it's worth. People with experience trying to convince an inexperienced person to not take supplements until his INR is stabilized and to not set unrealistic goals for dosage requirements.

 

[Philip B]

Worries

Worries

Hey Witzkeyman,

You've probably realized from the number and passion of the replies to your initial post that you're worrying us.

There is a lot of good advice in these replies. I believe Lisa is right on target with her comments about getting your INR stabalized and working with professionals to get it stabalized. It sounds like you're struggling with the INR-coumadin issue and doing the home monitoring thing is probably not a good option until you reach the point where you are very comfortable with INR and coumadin issues.

If the diarrhea you are experiencing is a side effect of coumadin, it may not be a long term effect. Your body may simply need more time to make adjustments which allow you to tolerate the drug. Is the diarrhea a result of the coumadin you are taking or the result of something else like worrying too much or some kind of herbal supplement?

I find my INR fluctuates more as a result of my activity level rather than as a result of diet. My INR fluctuates quite abit within my zone depending on how my level of activity affects my metabolism. I'm usually on the high end or the low end of my zone. I also find that excessive stress tends result in diarrhea and an occasional skin rash.

It would really be nice if there was a herbal substitute for coumadin or if one could simply manage INR with diet. Several members have noted very accurately that these options are not viable. I hope you are taking their words of wisdom to heart.

We really hate to see you struggling with these issues and hope the decisions and choices you make will result in you being with us for a long time. Please find yourself a doctor whom you have confidence in and work with him/her to positively resolve your issues. Good luck.

-Philip

 

[Karlynn]

I think the disturbing part is that the person with inexperience doesn't seem to be believing the people with experience and keeps coming up with new ideas around what he believes is his Coumadin problem. So people keep posting having to correct the poor ideas that are posted. It's getting confusing and unless people read and reread - bad ideas can be taken as worthwhile suggestions.

Witzkeyman - please understand that there is no better, safer way for you to maintain an in-range INR. If there were, you'd see many of us doing it. Coumadin is your best bet. Low doses of Coumadin mixed with other supplements or drugs is an unsafe - dangerous way to approach your Coumadin management and is much more dangerous than diarrhea

Coumadin is not a dangerous drug - mismanagement of Coumadin has dangerous, life-threatening results. We are attempting to get you on-board with correct warfarin protocol. This is not a time to be your own scientist.

 

[Nancy]

My husband was on Coumadin for 33 years.

He had no problems with diarrhea for most of that time.

He did however, develop diarrhea towards the end of his life, not related to Coumadin, but some of his multiple medical problems, including CHF induced liver problems, and GI problems.

While I do not think Coumadin causes diarrhea, I do think that diarrhea can cause INR instability. That did happen to Joe. Coumadin depends on a healthy digestive tract, and diarrhea is not a healthy GI tract situation.

Your main problem is that you need to see a GI specialist and yes, you may have to have some of those icky tests to try to determine what is going on in your intestines.

Once the problem is addressed, it will become much easier for you to keep your Coumadin level regulated.

Please see the proper specialist. You don't go to a shoemaker if your pants need hemming.

We all want you to be as healthy as possible and really care about what happens to you.

 

[Lisa in Katy]

Witzkeyman, I think you mentioned that you are taking SAMe. I found this. It could explain your rash and diarrhea. The part about blood in the stool is also very scary for those of us on Warfarin.

Side Effects and Safety Concerns
The most common side effects of SAMe are digestive complaints, particularly nausea. Other side effects include skin rash, lowered blood sugar, dry mouth, blood in the stool, thirst, increased urination, headache, hyperactivity, anxiety and insomnia.


Again, I repeat, supplements should be avoided at least until your INR is stable.

 

[witzkeyman]

You (Witzkeyman) wrote:

"I have a low tolerance for the coumadin, but am not interested in seeing a GI doctor, because the effects of some of those drugs that work on stomach acids can have horrible side effects."

Two Questions:

1 - How do you KNOW that you have a "low tolerance for the Coumadin"? Did a Doctor tell you this or is that a GUESS on your part? How do you KNOW that your diarrhea is not a result of some OTHER medication you are taking? For some reason, you seem averse to seeking medical evaluation from Doctors who could actually diagnose your issues.

2 - Could you be more specific about the "horrible side effects" from drugs that "work on stomach acid" and provide the Names of the Drugs you are concerned about? Several of our members take such drugs and I'm sure they would be interested in what you have learned about them.

BTW, INR testing "every couple of days" is WAY Too Often.
Testing and dosing should NOT be done more than Twice a Week, preferably no more often than every 4 days. For stable patients, most Coumadin Clinics recommend 4 weeks between tests. Concerned patients may find every other week works well.

'AL Capshaw'

thanks Al, I'm glad you asked specifics. I'm pretty much here for life on VR.com (thankfully), and I'm glad there are supportive people are yourself.
1. When I take my 2.5 dose my stools are more soft, closer to diarrhea, but when I take 5 mg,it's all over the bowl (sorry for the graPHIC) I'm also taking Lopressor. before the surgery, I wasn't taking anything so it could be the Lopressor, but I'm assuming it's from the Coumadin because of the first statement. I am guessing. My Doc claims that it isn't from the Coumadin. maybe he's right.
2. I read that an effect on one of the stomach acid drugs is discoloration of teeth. I'm still only in my 40's and want my young looks to last. Will it happen to me? I don't want to take a chance.
I think in the beginning I'd like to test every other day just to see how I eat and exercise effect the Coumadin. I would like to eat protein bars when I get back into working out etc. etc.
Overall, I'm still young and so much has hit me in such a short time, although I'm so fortunate to have the surgery. My heart is extremely strong. When I had the catheter performed the doc said that my valve opening was smaller then a pinhole and it was leaking. I saw it on the screen. There wasn't a steady flow of blood coming out. that's why I felt like I wasn't getting oxygen to my head. that was the scariest part for me. Most likely, I'll listen to the more experienced people, but I also like to play devil's advocate. I have learned a lot on the forums. I am very thankful also.

 

[witzkeyman]

Witzkeyman, I think you mentioned that you are taking SAMe. I found this. It could explain your rash and diarrhea. The part about blood in the stool is also very scary for those of us on Warfarin.

Side Effects and Safety Concerns
The most common side effects of SAMe are digestive complaints, particularly nausea. Other side effects include skin rash, lowered blood sugar, dry mouth, blood in the stool, thirst, increased urination, headache, hyperactivity, anxiety and insomnia.


Again, I repeat, supplements should be avoided at least until your INR is stable.

thanks Lisa,
I'm not taking Sam-E yet. thanks for the info.

 

[witzkeyman]

Hey Witzkeyman,

You've probably realized from the number and passion of the replies to your initial post that you're worrying us.

There is a lot of good advice in these replies. I believe Lisa is right on target with her comments about getting your INR stabalized and working with professionals to get it stabalized. It sounds like you're struggling with the INR-coumadin issue and doing the home monitoring thing is probably not a good option until you reach the point where you are very comfortable with INR and coumadin issues.

If the diarrhea you are experiencing is a side effect of coumadin, it may not be a long term effect. Your body may simply need more time to make adjustments which allow you to tolerate the drug. Is the diarrhea a result of the coumadin you are taking or the result of something else like worrying too much or some kind of herbal supplement?

I find my INR fluctuates more as a result of my activity level rather than as a result of diet. My INR fluctuates quite abit within my zone depending on how my level of activity affects my metabolism. I'm usually on the high end or the low end of my zone. I also find that excessive stress tends result in diarrhea and an occasional skin rash.

It would really be nice if there was a herbal substitute for coumadin or if one could simply manage INR with diet. Several members have noted very accurately that these options are not viable. I hope you are taking their words of wisdom to heart.

We really hate to see you struggling with these issues and hope the decisions and choices you make will result in you being with us for a long time. Please find yourself a doctor whom you have confidence in and work with him/her to positively resolve your issues. Good luck.

-Philip

It would really be nice if there was a herbal substitute for coumadin or if one could simply manage INR with diet. OH, HOW I WISH PHILLIP, OH HOW I WISH!

 

[Ross]

If you want help, we'll give it. Playing devils advocate for others reading this thread could be dangerous for them. Closing this one down. Your doing or talking of doing far too many dangerous things with Coumadin. This is not a drug to be played with.