hot weather, INR goes up??

[Gail in Ca]

I recently returned from vacationing in Florida with my sister and family. It was very hot and humid compared to Ca.
I tested my blood while there and my INR was only 1.7.
Took more coumadin and tested 5 days later and it was still only 1.9.
I was concerned to say the least.
When I returned my inr has been 2.5 , 2.9.
Of course I had to up my dose but I think I will be able to return to my normal dose soon.
Why does the INR go up in hot weather?
Just a coincidence?
Anyone have this problem while traveling?
Gail

 

[LUVMyBirman]

Hi Gail

In early June we spent a few weeks in FL. My INR went down. Last year same time it went higher with the heat.

Live in the heat and humidity as it is. We will top 100 today, yikes. Anyway...just returned from Hawaii recently and my INR was way up. 6.5!LLeft my Coaguchek at home this time. Probably not a good idea, but it made me feel free for once. Thought back to all the times that I traveled without one and I survived.

You had stated that your INR went up? 1.7 in on the downside. Did it go up upon leaving the humidity?

have so many more concerns with my INR in the summer. The heat being the main factor. It usually increases it. Others here have found the heat to decrease it. It all boils down to individualization.

Take your test kit with you and be happy and enjoy.

 

[LUVMyBirman]

If you make mine Corona Light with a lime....I will be all over that one

Honestly, my INR usually increases in the heat and humidity. Guess it depends on the person.....just like the individual doses.

Got to figure what works best for you as everyone reacts differently to the stuff:mad

PS, Janie.....go have yourself a nice crisp salad with your cool breezes. Yep, I am missing Chicago just about now!

 

[Guest]

I am not a valve replacement person but a pharmacist who monitors warfarin. I also run the website www.warfarinfo.com. There is no doubt in my mind that the two major factors for getting the INR out of line are going on vacation and having company. I am convinced that it is because you get out of your routine. Just look at the comments this forum. You eat differently - sometimes better sometimes worse, you have time changes, you lose many of the clues that you get at home about taking your medications, your alcohol intake varies. Almost every INR that is below 1.5 or above 5.0 (excluding illness) is associated with vacation or guests. Summer, Thanksgiving and Christmas are the peak times.

 

[LUVMyBirman]

Hi Al

Have checked out your site in the past and let me say that you have contributed a wonderful source of information for the 'novice' Coumadin patient. Certainly hope you continue to share your findings with us.

Have been at it myself for a little over two years with the assistance of my trusty Coaguchek for the past six months. I do have a medical background so my cardiologist feels comfortable with self regulation.

What is your take on heat and the INR in your patients? As I stated mine will rise with the heat. With the exception of one time.....ate a salad. So that explains the fluctuation.

 

[Guest]

I think that we had 6 weeks of no day below 90 degrees. I find that INRs tend to go down slightly in the summer. However, we are in the Arkansas River valley and some of the best vegetable crops in the country are grown around here. I think it is attributed to that as much as hot weather. But there are too many confounding factors to truly sort it all out.

 

[LUVMyBirman]

Agree, think about the heat..... people eat and or crave more high K vegetables.

I don't indulge myself to the disapproval of my doctor from a nutritional standpoint. But, at this point my INR is more important than a salad.

I am supplemented with Chromagen RX Iron and One a day's Woman formula which is Vit. k free.

 

[LUVMyBirman]

Hi Janie

Geeze....what a drop in just 24 hours! 3.5 is a perfect number.

Usually do not test within 24 when I am off...so who knows how far I drop?? Give it 48 hours. Few weeks back went from 6.5 to 3. something in that time frame. Using the cutting my daily dose in half theroy for one night.

When patients are only tested once a month at the direction of their MD's they are obviously not under tight control. Having the home testing method gives you the upper hand.

On the heat subject...have been out in it myself sunning, swimming, walking the pup. Humidity is horrendous. Tested this AM and I am up again. 3.2 last week 4.0 today. Heat obviously has an increasing effect on me.

Oh well, better 4.0 than 1. something. Gonna leave it alone and eat a small salad. Test again in a week.

Let's keep the heat comparisons on the INR going people. It is interesting to see the differences between us all!

Have a nice day

 

[Christina]

Janie, I don't think Houston is any hotter than Arizona, maybe more humidity, but don't feel bad. You just never know with INR. It can change from day to day.
Me being an outdoorsy person and being in the Arizona heat all the time, my INR was 4.2 last week, and this week I tested at 3.4. Still at 19mg a day! I think that was great, and am feeling good.
Not changed anything in my diet. Am eating pretty much the same boring stuff!
My new doctor is not afraid of a higher INR, and lets me do the testing. I pray he'll stay this way and not change his mind.
I still have to take the time to go to his office and show them that I am proficient with the Protime machine and am able to get an INR result, so I can fax the form to QAS... Just haven't taken the time. Sorry Lance! Will get it done one day I promise!

Christina:

 

[Guest]

I didn't want to jump in and be too pushy with my ideas, but since some have sent nice comments, I'll share some things I've learned with you.
I had a statistician analyze 2,500 visits to my clinic. We found that there was no statistically significant increase in the risk of bleeding with any INR below 5.0. I monitor most people about once per month, so that is a factor too. Therefore, I rarely hold a dose if a person has an INR below 5.0. What I usually do is reduce (or increase) the dose by about 1 tablet per week. This usually works out to about a 15% change. Then I check them again in about one week. Southern Colorado is sparsely populated, so many people come over 100 miles to my clinic. It is not too practical for them to return too often. The average age is about 70, so many do not have the dexterity to manipulate self-testing.
From what I read, you each have worked out your own procedures and they all seem to work for you. What you are proving to me is that making small changes is the right direction is the secret of warfarin management.
Dr. Cathy Hassel, a hematologist at U of Colo Health Sciences Center, says better to have a high INR an than a low one. If you bleed you can put pressure on it, ice it, cauterize it, stitch it, give vitamin K, give fresh frozen plasma or even more blood. If you have a stroke what are you going to do. Maybe give TPA (the clot buster) but what is the side effect BLEEDING.
I like the It's Never Right for INR, I had never heard that one before.