INR rollercoaster question

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S

srbouska

Hey there you helpful buncha people:)
I am having some issues with A) balancing my coumadin and B) understanding what exactly effects my INR

I have been jumping up and down constantly in the past month. I've balanced all my meals with vitamin K (rather my wife has) and nothing has changed, I havent drank any alcohol/smoked any cigarettes and i've still managed to have a INR thats worse then the rollar coaster at disney land.

I had a great balance of 2.7 (my tween values are 2.5 3.5, mechanical valve)
for about 4 months. I have now dropped down to 1.8 on my last check so my doc put me on alternating doses. ( my regular dose for 4 months was 3.5 mg now up to 4 and varying 5mg every second day) I was put on some antibiotics AFTER my last check due to something called folicolitice (pardon the spelling) so I'm sure that as well will now effect my levels.

I'm now going in weekly to get blood tests once again after a nice 4 month spree of monthly blood work so at least its being checked however i'm wondering if there is something that i may have done to affect my levels in the first place.
The only thign that has changed in 5 months since post surgery is i gained roughly about 30 pounds, have been walking a lot more regularly and thats all that has changed.
Here are my questions hehe
1. Does weight affect INR levels regarding coumadin?
2. Does Antibiotics RAISE or LOWER my INR level?
3. Is there anything other then Vitamin K that can affect my INR levels?
4. If my INR goes horribly low for any reason, if i drink alchol will it thin my blood immediately? (stupid question, not like i'd do it but i am curious if thats how alchol works)

5. Is there any site that has a lot of information regarding what affects my coumadin and INR levels?
Thanks!!!
 
It's not unusual to have to mess with dosing for fluctuating INR's for a while after surgery. First of all, forget about trying to not eat vitamin K. What we eat really has very little, if no, effect on our INR. And studies have shown that people that include Vitamin K in their diets tend to have more stable INR's. Don't go taking a vitamin K supplement, but I wouldn't worry about Vit. K in your food. The reality is, we are creatures of habit when it comes to our eating, so if you're a salad lover - keep having salads etc.

Your body is also going to require more Coumadin as it heals and functions better. Surgery knocks it for a loop, so your metabolism probably slowed down quite a bit. Now that you are feeling better, you're probably more active.

Yes- antibiotics do mess with the INR so you probably will be adjusting your dose again. Most often they make it go up.

Alcohol effects the INR because it dehydrates you and the concentration of warfarin is stronger in your blood (your blood does not actually "thin"), but many of us enjoy regular adult beverages in moderation without any effect. Just don't go on a post-St. Paddy's day bender.

It's best to keep track of your dose changes by telling us your weekly totals. You adjust your dose by a % of your weekly total. So what have your weekly doses been?
 
I might be able to answer a couple of your questions.

Some (maybe most) antibiotics can lower your INR.

With me......I found that the more walking/exercising I did - did cause my INR to drop

It was suggested by my surgeon to have one drink a day - I don't (wish I would) he said "it will help with the blood flow"

Like you, I was always worried about my INR. Worse after having antibiotics, but I've learned to wait 2 weeks after taking antibiotics to get my INR checked. Just so my body could re-adjust.

When was you last dosage of antibiotics?
 
just to add to Freddie`s very good explanation, I believe level of exercise has a lot to do with it, too. The more you move, the more you burn it up.

Have you checked out the stickies at the top of this thread - there is a ton of information there.
 
I can't remember (for sure) who posted this so I will not use his name....his statement...."if I am between 2 and 5 I don't worry"......That post changed my way of looking at my INR and my life on ATC......Eat what you want, adjust dose when needed and enjoy your life.
 
I'm not sure if weight gain has any bearing on it.
Increased activity level will cause your INR to go down.
Anti-biotics usually will increase your INR but it can go the other way sometimes.
Have you added any other medications recently?
Lastly go to Al's website for tons of valuable info. He is our expert when it comes to Coumadin. That site is www.warfarininfo.com.
Rich
 
Welcome. It's good to have you here. If you want a site with the most info on anticoagulation (and the most people in one place with understanding and experience with anticoagulation) your search is over. Here we are.

To begin, you should read the stickys at the top of the Anticoagulation Forum, especially the "Discovery Health Anticoagulation Program." Almost everything else you want to know about Coumadin management is right there. And, it is a film clip, so all you have to do is look, listen, and be happy that you found so much information in one place.

The panel of three doctors who discuss the topic of "Anticoagulation Management," are all recognized experts in anticoagulation and all three are associated with large hospitals. They cover many of the important topics that interest you.

You might also check the web site,www.warfarinfo.com, which is a site run by Dr. Al Lodwick, who managed a large anticoagulation clinic for 10 years in Colorado. He is now traveling the country providing a series of seminars for doctors and medical persons involved in anticoagulation management. Al is a member of this board and visits us still.

I hope you will post again soon.

Blanche
 
Hi Blanche,
I had the same problem for two and half months.
I had just got out of the hospital Dec 24th and thats when it started to go like a roller coaster also. Just last week it started to go up to 2.4 and now this week is 2.7 and had went down to as low as 1.4.
I thought exercise had a lot to do with it (which I was'nt doing hardly any)
When before the hospital I was doing everyday workouts.
Then I thought it was the food i was eating but that did'nt matter to much either. I had lost alot of weight in the hospital also thought that might have something to do with it. Then thought maybe the cold ( like its cold here in AZ)
The clinic thought maybe i was skipping doses or forgetting to take.
Well we never found a reason. But its doing much better now.
So I don't think there always has to be a reason. I thought maybe STRESS.
Well I don't know if I help ease things up alittle or not. But I hope hubbys INR comes within range soon.
I hated having to go to the clinic every week and be poked.:eek:
 
As a newbie to warafrin/comaudin I can say that when i began exercising again, it caused my INR to drop.

Haven't taken any anti-biotics.

Alcohol has had little or no effect, and unfortunately I had quite a few on
a couple of occasions since starting the warafrin :eek:

The dose I take suits the food I consume.

Of course, Home Testing makes it much easier to stay within my range.
 
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