INR and Fasting

[bahlvarun]

Hi,

I am from a religious background, where in Fasting is part of rituals in our day to day life. I am not sure with the INR issues, is it fine if I have to fast.

Fast generally involves eating once a day/not eating/eating fruits once a day/ only fruits etc. It depends on the type of fast you are on.

Just wanted to check, if its OK to do these types of Fast. Got my AVR done only last year on Oct. 12, 2010.

Please advise.

Regards,
Varun Bahl

 

[chaconne]

I think it can largely depends on how much Vitamin K is in your diet (leafy greens, brokkoli etc...) and how consistent that is. If you have 1 day a week where you eat only vitamin K rich foods, that could cause a weekly INR fluctuation.

 

[bahlvarun]

I think it can largely depends on how much Vitamin K is in your diet (leafy greens, brokkoli etc...) and how consistent that is. If you have 1 day a week where you eat only vitamin K rich foods, that could cause a weekly INR fluctuation.

Chaconne,

I don't take any leafy greens, broccoli etc, its better to avoid then to keep a track of these ;-)

 

[AgilityDog]

You need to have your INR checked far more often than once per year. Once a month at minimum, every week to 2 weeks is better.

Yes, fasting will affect your INR. No, you should not eliminate all vitamin K rich foods from your diet because you are on coumadin. That's a myth.

Your religion should probably exempt you from fasting for medical purposes, or at least permit you to break your fast to the extent of making sure you continue to eat your normal amount of vitamin k rich foods daily during the fasting period.

 

[bahlvarun]

Laurie,

I get my INR checked every week, was just curious if one day or may be couple of days fasting will have an impact on INR, even though I do fast its during the day, I eat at night.

Just wanted to correct myself if I am on the wrong side.

Regards,
Varun Bahl

 

[Lynlw]

Can you take extra vitamens,( or if you normally dont take vitamins take them) on the days you fast?

 

[scott.eitman]

Laurie,

I get my INR checked every week, was just curious if one day or may be couple of days fasting will have an impact on INR, even though I do fast its during the day, I eat at night.

Just wanted to correct myself if I am on the wrong side.

Regards,
Varun Bahl

I suggest discussing your diet with the person who checks your INR.

I am glad you asked this as I had not thought about this question as the Jewish holiday of Yom Kippur approaches this weekend.

 

[AgilityDog]

Scott, I am pretty sure Judaism exempts young children, pregnant women, nursing mothers, and those who are ill from fasting on Yom Kippur. I'm not actually Jewish, but have many friends, co-workers, and courtesy relatives who are.

I got the impression from the OP's first post that he only had his INR tested once a year. That worried me more than his fasting.

That said, if he wants to fast, and is otherwise healthy, yes, it's likely to affect his INR but one day should not make a huge difference, unless that day falls a day or two prior to the INR test, or he tends to swing widely in his INR even without changing dosage.

Ditto for Yom Kippur. Does one day of not eating any greens usually affect you? ('cause I don't know any perfect people who eat just like they should every day. I hit a 4.0 last week, but realized I hadn't had any veggies for 2 days-ooops. I reduced one day's dose by 1mg to get back in line, maintained my current dosing otherwise, and was a perfect 3.0 this weekend. But that's ME.)

I you usually have a problem with INR if you skip your greens one day of the week, then consider a modified fast or no fast on Yom Kippur. If it doesn't normally bother your INR if you skip eating your greens one day, then the fast should be fine, IMHO.

Now that I know the OP is testing weekly, then yes, he should discuss fasting with his coumadin manager.

 

[Bina]

Hello Varun, how are you doing ?
Since you don't normally eat many greens that are high in Vitamin K, you can probably do a brief fast without
a big effect on your INR. Most important is to keep a steady intake of fluids and keep checking your INR.
Best wishes !

 

[scott.eitman]

Thanks. It also excludes the Goy (non-jew) Father/Husband in a jewish family, but I like to participate with the family.

 

[Bill B]

I can't see a day or two of fasting having any noticeable effect on your INR and response to warfarin. Know that warfarin is for most people a very slow-acting drug. It takes a week or so for any change to be fully realized, sans perhaps the reversal of warfarin by high-dose vitamin K administration. My diet is not consistent day-to-day. Some days I get busy and may eat nothing or have only one meal. Other days I pig out. Missing greens for a couple of days is not going to make any measureable difference. It just doesn't happen that fast. It all works out on average. If warfarin was that sensitive and immediately responsive to food intake variations, it would be a far more dangerous drug. For most of us, INRs are stable for many months at a time despite all kinds of variations in life activities. Although warfarin needs to be taken with care, there is too much paranoia about it that has spawned all kinds of folklore about things that might affect warfarin and INR but don't, cranberry juice among them. I got "hooked" on the stuff because it was the first thing they gave me after I got out of bed in the morning after my surgery, and I associate it with my glorious survival. I might drink a half gallon some days then go a week with none. Glad it has no effect!

Bill B (retired pharmacist)

 

[bahlvarun]

I was on fast monday, checked my INR it was stable at 2.46 infact last week it was at 2.73, I guess just as Bina said, since I am not having food loaded with Vit. K, its not gonna have a major impact if I fast during the day.

But I guess if I had gone for a Fast on fruits, it would have had an impact, for now since its single meal a day that to Vegan (only Potatos), it didn't make a big difference.

Thanks for your comments all.

 

[Bina]

Varun, thanks for the update