I started out stabilized on 12mg of warfarin --- per week. Yep, 1.5mg/day except 3 mg one day per week. INR between 2 and 3. Over the 3 years I've been on warfarin, I've had a couple of small upward adjustments to keep my INR between 2 and 3, and until recently I was on 15mg per week (1.5mg Su, Tu, Th, Sa and 3mg Mo, We, Fr). My INR had been gradually drifting down over the last several months from 2.5 and finally dropped to just below 2 (1.9). My caog nurse and I agreed to change my dose to 3mg on Thurdays, raising my total weekly dose from 15 to 16.5mg, and increase of 10%. Two weeks later my INR was 2.9, and increase of 50%. We'll check again in another 2 weeks. If it's not over 3, great, I'll stay on it.
Parenthetically, I'll note I'm not a big salad/greens eater. I suspect my vitamin K intake is low. However, during the past couple of weeks, I went on a binge, eating one good sized salad almost every day, and a few times twice a day. These were iceberg lettuce primarily but some romaine and other lettuces and "greens". This just points out that you can eat just about all the salad you want without significantly counteracting warfarin because most lettuces have very little vitmain K. Iceberg has about 100 mcg PER HEAD (over one pound). That's barely the RDA. If you go through the USDA charts you'll see that only spinach, kale, collard greens and a few other very dark green leafy vegetables have amounts of vitmain K that are significant in any usual portion size, even if eaten daily.
Anyway, despite being extremely sensitive to warfarin, I've over all been remarkably stable with just a slow drift down in INR over 3 years. Some very sensitive people are quite unstable and benefit from vitamin K supplementation, as has been cited here before. My cardiologist and I discussed that, but I'm leaving well enough alone for now, although I may change my mind based on some of the health issues being at least theoretically connected to vitmain K antagonist use. Anyway, I'm enjoying my new found interest in salads without ill effect. I may even add some additional spinach - I do eat some occasionally- if my INR stays up around 3.
Parenthetically, I'll note I'm not a big salad/greens eater. I suspect my vitamin K intake is low. However, during the past couple of weeks, I went on a binge, eating one good sized salad almost every day, and a few times twice a day. These were iceberg lettuce primarily but some romaine and other lettuces and "greens". This just points out that you can eat just about all the salad you want without significantly counteracting warfarin because most lettuces have very little vitmain K. Iceberg has about 100 mcg PER HEAD (over one pound). That's barely the RDA. If you go through the USDA charts you'll see that only spinach, kale, collard greens and a few other very dark green leafy vegetables have amounts of vitmain K that are significant in any usual portion size, even if eaten daily.
Anyway, despite being extremely sensitive to warfarin, I've over all been remarkably stable with just a slow drift down in INR over 3 years. Some very sensitive people are quite unstable and benefit from vitamin K supplementation, as has been cited here before. My cardiologist and I discussed that, but I'm leaving well enough alone for now, although I may change my mind based on some of the health issues being at least theoretically connected to vitmain K antagonist use. Anyway, I'm enjoying my new found interest in salads without ill effect. I may even add some additional spinach - I do eat some occasionally- if my INR stays up around 3.
