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@MdaPA

My wife is also ruled by emotion , Many find a daily vitamin K1 supplement can smooth out fluctuations

Just a thought you may consider
 
Here is my wife's experience with mechanical aortic and mitral valves after 4 years:

1) The clicking still drives her crazy, especially at night.

2) She gets anxiety and stresses over taking warfarin and self-testing each week.

3) Bridging and managing INR for 3 minor surgeries was painful and was not fun.

4) She hates planning and keeping a mindful watch on the amount of high vitamin K foods she eats.

There. I said a few things negative above mechanical valves. Let's see who gangs up on me.

I will add that being on warfarin severely restricts pharmaceutical treatment options for arthritis. It also complicates spinal surgery and other spinal treatments for stenosis. There is also the obvious complication that any injury whether it be a shaving cut or going through a windshield results in 2-3.5 times more bleeding before coagulation. Mechanical valves have an increased risk of endocarditis although it is rare.

However, tissue valves have their own set of worries...unknown valve life expectancy, slowly decreasing valve performance (just like those with a BAV experience), another 2-6 month life disruption for a replacement valve, additional cost of cardio care and routine echos plus the big Kahuna - cost of replacement valve surgery when the bio one fails.

Two paths to life. "If a choice is difficult, that's often because both paths are of equal merit."
 
How/why does a daily vitamin K1 supplement smooth out fluctuations in INR?

Random numbers, but if you’re at 50 and add 25, thats not as much of a change vs being at 0 and adding 25. Your daily warfarin dose is already factoring in a certain level of vitamin k in your diet if you take a supplement.

Commonly referred to as dosing the diet.

Remember, there’s no such thing as too much warfarin. It’s just the dose that keeps you in range.
 
Random numbers, but if you’re at 50 and add 25, thats not as much of a change vs being at 0 and adding 25. Your daily warfarin dose is already factoring in a certain level of vitamin k in your diet if you take a supplement.
OK, thanks, that makes some sense. I'll check into this further.
 
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