Warfarin and systemic calcification?

[Nocturne]

Oh, I'll link to something that those with an interest in CAC might find interesting.

WARNING! This is easily the most positive and hopeful study regarding my personal situation that I have ever found on the web or anywhere else. It is the ONLY one that specifically tried to look at the average number of years of life lost due to different CAC scores at different ages. There is a lot of material out there that does NOT look this rosy (and honestly, even this doesn't look rosy for anyone who isn't White -- but I am White, so it's upbeat for me).

http://www.sciencedirect.com/science/article/pii/S0735109707019328

Pay special attention to the graphs about halfway down concerning "Predicted life expectancy by CAC scores in ethnic subsets" (you may have to download them to see them properly -- oddly, they looked fine on my iPhone!)

"The predicted changes in life expectancy for ethnic subsets by CAC score are shown in Figure 5.In each case across ethnic subsets, younger patients with CAC scores ≥100 to ≥1,000 had a reduced life expectancy. For 40-year-old NHW, life expectancy declined 2.0 to 5.9 years for CAC scores ≥100 to ≥1,000."

For some reason, Whites seem somehow resistant to the lifespan-reduction associated with high CAC scores. They are still associated for sure, but from what I'm reading, an African-American, Asian, or Hispanic person who has a CAC score of 1000+ at the age of 40 can expect to live 15 years less than average, while a similar White person loses only about 5 years on average.

For a guy like me, White and in his early 40s with a score of 156, it looks like I lose about 2-3 years. Which is a lot less deadly than I had thought.

It's also got to be based on mathematic supposition more than actual human data, because I can't imagine where they'd have found a significant number of actual 40 year olds with CAC scores higher than 400, let alone higher than 1000. So I'm not sure how legit it really is. But those graphs DO have a permanent home on my iPhone, and give me something positive to look at when things feel bad.

Another fun "nomogram" dealing with CAC and other factors is this one:

http://content.onlinejacc.org/article.aspx?articleid=2198998&resultClick=3

It took me a little while to figure out the "nomogram" these guys came up with, but it makes it look like my lifespan might not be as short as I had feared, even if CAC progresses relentlessly (not that it shouldn't be fought every step of the way!).

Even if my CAC hits 1000 by age 60, which it would at a modest progression rate of 10% per year, I still have a roughly 75% chance of making it to 75 if I can keep all other risk factors under control. Of course, the aortic stenosis will complicate that... But still, it doesn't seem as hopeless as I had feared.

My current CAC level, if you look at the graph, seems to present a risk of death just slightly higher than being diabetic -- but remember, it grows. It grows.

 

[cldlhd]

The chicken analogy is called humour and i, at least, won't be up all night praying that I don't get Calcification because I chose to go on Warfarin. Objective people don't pick and choose studies to suit their own personal needs. And I have read hundreds of studies.

Did you know that over half the people that ever ate tomatoes are dead? Seriously, they're that bad for you. Read it on a blog somewhere.

I believe the study nocturne mentioned was cited by ncbi, not exactly comparable to a blog. I got the joke just didn't find it funny or applicable as I wasn't buying or creating hype. Dismissing any study that shows a possible link between warfarin and calcification as 'hype' isn't objective. I'm not sold on the connection but I entertain the possibility that its true just as the benefits of coq10 and fish/krill oil are probably contested in numerous studies but I take them also along with my k2 .

 

[LondonAndy]

Even if my CAC hits 1000 by age 60, which it would at a modest progression rate of 10% per year, I still have a roughly 75% chance of making it to 75 if I can keep all other risk factors under control.

Now you just need to watch out for the proverbial bus, Nocturne - a bigger issue for me in London perhaps!

 

[dick0236]

This is one of those threads where I don't know much about what yall are talking about......but since my name was mentioned twice, I'll add my experience.
Calcium: My CMP(Comprehensive metabolic Panel) 6/26/2016 value was 9.8 and the Referance Range was 8.4-10.2 mg/dL.
CoQ10 and fish oil: Tried them both a few years ago(not sure why). Stopped after a little while(not sure why).
Cholesterol meds: Tried statins for a few years and stopped them because of muscle aches and screwed up INR readings. BTW, just read a newspaper article that a "study" has found that a higher LDL or HDL(can't remember which) is good for seniors.......go figure.

I agree with LondonAndey......watch out for the bus.

 

[cldlhd]

You might be surprised about that Nocturne ! That's not to say it might not be gene-dependent to a degree, but my HDL used to be a regular 2 (77 in US numbers). Then nine years ago I started to eat extremely low carb Paleo way of eating due to being diagnosed with diabetes (I’m very slim btw, underweight, the diabetes is atypical). Steadily my HDL has risen, first into the upper 2’s, then the 3’s - I even reached 3.9 once - that is 150 in US numbers ! My HDL now holds around 3.5 (135 US). That is eating lots of meat, fish, eggs, non-starchy veggies, nuts, and saturated fats as in coconut oil. No grain foods, starches or sugars, and obviously no foods made with them. I cook everything from scratch, doesn’t take much effort - think steak and sautéed broccoli which we had for dinner yesterday. We eat extremely well Tad expensive. Of course I’m just anecdotal but I’ve read of plenty of others who have done likewise and got similar results. Interesting eh ?

So never any pasta with some bread? Or an ice cream on a hot summer night? No beer? The horror.....

 

[Paleowoman]

BTW, just read a newspaper article that a "study" has found that a higher LDL or HDL(can't remember which) is good for seniors.......go figure..

From the British Medical Journal: 'Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review’: http://bmjopen.bmj.com/content/6/6/e...0-374451e8cbb1 By elderly they mean people over the age of 60.

 

[Agian]

Be careful with your health. Read carefully and critically, and I'll say it again: 'Don't believe the hype' See a specialist, see another one and even a third one. Find the answers to your questions. By the way, testing for Calcium in your vessels is dead easy. All it involves is an ultrasound of your Carotids. Do one now, take Warfarin, check again in two years. If there's an increase, there's an issue. There are answers to the questions you're looking for.

 

[Agian]

From the British Medical Journal: 'Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review’: http://bmjopen.bmj.com/content/6/6/e...0-374451e8cbb1 By elderly they mean people over the age of 60.

I think what they're trying to say is that if you've hit old age with a high Cholestrerol and done ok, then it may not be as big a risk factor as it might be for a younger person with established disease. Note that they've gone out of their way to differentiate total cholesterol from LDL. We also know that sickness, malnourishment and cancer cause low cholesterol. That doesn't mean that low Cholesterol is bad for you. It's like saying we got a bunch of elderly smokers and found they're doing better than the middle aged ones with lung cancer, so maybe smoking is ok in the elderly.

PS And hell, why not? You've hit 90 and you've smoked all your life with no problems. It happens!
Not everyone with high Cholesterol gets heart disease, that's why they call it a 'risk factor'.
Statins haven't been around that long anyways.

 

[Protimenow]

I don't know if I've seen this much activity so quickly on any other threads.
A lot of issues were brought up. I'll comment on a few.

Doctors seem, in many cases, to be strongly influenced (owned?) by the pharmaceutical companies. These companies have an impact on the teaching curricula, they have reps (referred to in the United States as 'detail' persons) who visit doctors in their offices, or on company sponsored dinners, golf excursions, junkets - where they pitch their latest essential new drugs.

I've been taking warfarin for nearly 25 years. I just had a carotid ultrasound with essentially negative findings (yes, the carotids are still there, but only one insignificant area of possible plaque).

I'm strongly considering taking K2 - the body needs vitamin K, and as others have said, I can adjust my warfarin dose to accommodate any coagulation effects (although K2 is not supposed to have an effect on INR).

I had a TIA a few years ago because I trusted my meter too much - the meter said 2.6 - the hospital said 1.7. Since then, I've done testing of a variety of meters, comparing them to each other and to lab tests. I've decided which meters I trust, and the one that I prefer, and I've posted extensively about this. My point here is not about the meter -- it's about response to the TIA.

The wizards at UCLA discharged me, after diagnosing the TIA, on a 'stroke protocol.' This protocol included Lipitor (a statin) because a study showed that this particular statin reduced the risk of a stroke recurring. What they DIDN'T look at, from what I recall, is the cause of the stroke - was this a cholesterol plaque, or a clot that resulted from a low INR? Assuming that ALL strokes were caused by cholesterol-related problems, they really didn't include someone with my issue in their recommendations. BUT MY DOCTORS DIDN'T EVEN CONSIDER THIS.

I've been reducing my dose of Atorvastatin (generic Lipitor) over the past few months - it's gone from 80 mg, to 40 mg for about five or six months, and now I'm taking 20 mg. While I've reduced the statin, my INR has also dropped, so I have to increase my warfarin dose. (It'll be interesting to see if there are any correlations between INR and statin dosage). I'll continue to wean myself off statins, switch doctors, and get another lipid study. I'll also continue to adjust warfarin dosage, as required, while I drop the statins (and possibly start the K2).

One other weird thing about my clinic, and probably doctors in general -- on my chart they recorded a diagnosis based on my medications, rather than the other way around. My chart says that I have hyperlipidema - although my blood tests don't show this and they have no evidence for this, other than the medication that I take and may not need.

If I was taking progesterone, they may say that this man is also menopausal, for all I know.

Sometimes you have to hold your doctor's feet to the fire. They're not infallible. A lot of times you may even wonder how they got through medical school.

 

[Agian]

I agree with you 1000% mate.
I'm also going to look a little bit more into Vitamin K2.

Drug reps visit doctors and basically tell them how wonderful their new drug will be for their patients. The valve guys do exactly the same thing. They're like used car salesmen.

Get an On-x and you too can have an INR of 1.5. Only your 1.5 is 1.2 and you have a stroke.

I'm evolving into a grumpy old bastard.

 

[tigerlily]

Wow, I've only had time to scan all the comments but I thought this thread would be lucky to get one or two responses. I'll come back and read more carefully later. I do have a couple of questions that come to mind. Is it true that K2 has no effect on coagulation? In other words, is it true that K1 and K2 are different animals in terms of their purpose? Can warfarin distinguish between the two forms of vitamin K or would it suppress or inhibit the function of K2 as much as K1? I think Paleogirl said that K2 does not effect INR which makes me think that Warfarin would not inhibit the function of K2. I hope that's true. My concern has been that if you take K2 and have to go up on warfarin as a result, then the increase in warfarin would cancel out the positive effects of K2. I hope I'm making some sense here. Anyway, all your responses give me lots to think about. BTW, I've been known to overthink things a bit. LOL.

 

[Agian]

My concern has been that if you take K2 and have to go up on warfarin as a result, then the increase in warfarin would cancel out the positive effects of K2. I hope I'm making some sense here. Anyway, all your responses give me lots to think about. BTW, I've been known to overthink things a bit. LOL.

You are making total sense. I'd like to know the answer to that myself. My question is 'if it's harmless, is it worth taking?'
Pellicle mentioned another old member called 'Gym Guy' who was doing exactly that, but I haven't been able to find any relevant old posts. We may have to rely on Pelmeister's memory (face slap).

 

[Paleowoman]

I think Paleogirl said that K2 does not effect NRI which makes me think that Warfarin would not inhibit the function of K2. .

No I never said that. On another thread I wrote there are no known toxic effects of vitamin K, either K1 or K2, and I posted a link to the information about that. But on every container of vitamin K2 you'll find a warning to consult your doctor if you are on anticoagulant therapy. Here is what it says on a website about supplemental vitamins regarding K: "There is no known toxicity associated with high doses of phylloquinone (vitamin K1), menaquinone (vitamin K2), or menadione (vitamin K3) and its derivatives. High intake of vitamin K is not recommended for individuals taking anticoagulant medications such as Warfarin (coumadin)": http://www.vitamins-supplements.org/vitamin-K.php I would guess that anyone on anticoagulants wanting to take K2 shoud ask their doctor but it's highly unlikely that they'd find a doctor who knows about K2. Doctors know something about K1 but few know about K2.

 

[Protimenow]

One of the things that used to be said about warfarin dosing is 'consistency.' If you take a certain dose of K2 (or even K1, for that matter), and do it daily, you can test your INR and slowly adjust your dosage so that the INR is still in range.
Sometimes I have to remember this because I take a vitamin packet with five or six pills in it -- and I think it has a small dosage of Vitamin K. If I adjust my warfarin dosage so that it compensates for the effects of the Vitamin K in my vitamins, that should be fine. BUT, if I skip these vitamins for a day or two, in theory, my INR would go up because there's no K to help bring it down.

I don't know that K2 will have an effect on INR -- but to play it safe, the makers of K2 put that warning just to keep themselves out of potential liability if a person's INR actually DOES drop and no adjustment for it is made.

 

[Agian]

The issue is it might mess up your INR, placing you at risk. I suspect you could still take it though and adjust the Warfarin dose.
The question, I think, someone asked was that if you take Vitamin K and then something that essentially neutralises it, then what's the point?
A valid question.

 

[cldlhd]

I don't know if I've seen this much activity so quickly on any other threads.
A lot of issues were brought up. I'll comment on a few.

Doctors seem, in many cases, to be strongly influenced (owned?) by the pharmaceutical companies. These companies have an impact on the teaching curricula, they have reps (referred to in the United States as 'detail' persons) who visit doctors in their offices, or on company sponsored dinners, golf excursions, junkets - where they pitch their latest essential new drugs.

I've been taking warfarin for nearly 25 years. I just had a carotid ultrasound with essentially negative findings (yes, the carotids are still there, but only one insignificant area of possible plaque).

I'm strongly considering taking K2 - the body needs vitamin K, and as others have said, I can adjust my warfarin dose to accommodate any coagulation effects (although K2 is not supposed to have an effect on INR).

I had a TIA a few years ago because I trusted my meter too much - the meter said 2.6 - the hospital said 1.7. Since then, I've done testing of a variety of meters, comparing them to each other and to lab tests. I've decided which meters I trust, and the one that I prefer, and I've posted extensively about this. My point here is not about the meter -- it's about response to the TIA.

The wizards at UCLA discharged me, after diagnosing the TIA, on a 'stroke protocol.' This protocol included Lipitor (a statin) because a study showed that this particular statin reduced the risk of a stroke recurring. What they DIDN'T look at, from what I recall, is the cause of the stroke - was this a cholesterol plaque, or a clot that resulted from a low INR? Assuming that ALL strokes were caused by cholesterol-related problems, they really didn't include someone with my issue in their recommendations. BUT MY DOCTORS DIDN'T EVEN CONSIDER THIS.

I've been reducing my dose of Atorvastatin (generic Lipitor) over the past few months - it's gone from 80 mg, to 40 mg for about five or six months, and now I'm taking 20 mg. While I've reduced the statin, my INR has also dropped, so I have to increase my warfarin dose. (It'll be interesting to see if there are any correlations between INR and statin dosage). I'll continue to wean myself off statins, switch doctors, and get another lipid study. I'll also continue to adjust warfarin dosage, as required, while I drop the statins (and possibly start the K2).

One other weird thing about my clinic, and probably doctors in general -- on my chart they recorded a diagnosis based on my medications, rather than the other way around. My chart says that I have hyperlipidema - although my blood tests don't show this and they have no evidence for this, other than the medication that I take and may not need.

If I was taking progesterone, they may say that this man is also menopausal, for all I know.

Sometimes you have to hold your doctor's feet to the fire. They're not infallible. A lot of times you may even wonder how they got through medical school.

Same here, even though its not represented in my lipid / cholesterol results my cardiologist has me listed as having hyperlipidema.

 

[Agian]

Yep, and if someone had put you on an antidepressant, you'd have depression listed as a diagnosis. I'm taking fishoil, so that makes me hypofishaemic.

 

[cldlhd]

Well the pharma companies do take good care of the doctors. A buddy of mine owns a restaurant and he told me how once a week a bunch of doctors would come in and eat like a drunken John Belushi , take a load of food home and the whole thing was on a pharmaceutical companies dime.

 

[Protimenow]

The question about 'if you take warfarin and something that neutralizes it, what's the point?' is not really the question. It's not like adding acid to neutralize a base. Vitamin K has other benefits in addition to merely improving coagulation. It's the OTHER benefits of Vitamin K that make taking it worthwhile. Warfarin and Vitamin K just balance each other out -- the more Vitamin K that you take, the lower the INR will go - the more Warfarin you take, the higher your INR will become.

To me, it makes sense to take Vitamin K, and just adjust the warfarin dose to balance out the effects that Vitamin K has on the INR.

 

[pellicle]

The question about 'if you take warfarin and something that neutralizes it, what's the point?'
...
To me, it makes sense to take Vitamin K, and just adjust the warfarin dose to balance out the effects that Vitamin K has on the INR.

I tend towards your view, and to me adding Vitamin K to the mix just complicates things. If you don't take your K the INR may spike. So its just another pill to need to take daily. And for an unknown benefit.