Warfarin & Hot Tubs

[Jenrc]

Hi there, have not posted in a loooooooong time, but coming up on my 3year anniversary of aortic valve replacement (mechanical). Am happy to report things have been a-OK since then.

Back on point. I am taking a vacation in a few weeks and will have the opportunity to go in a hot spring or two in the Eastern Sierras. I can't find anything conclusive out there about the risk involved as I take warfarin. I seem to remember being told: no saunas, hot tubs or tattoos. Unless my memory is confused.

Anyone have experience with this? Going to call my INR management clinic and also shoot an email to my cardiologist.

Thanks!

 

[dick0236]

I've been in a few saunas and hot tubs over the years with no problem and I can't see why there would be a problem. Tattoos might present a problem since it could be a little messy and the risk of infection might be a little greater.....after all, we take antibiotics just to get out teeth cleaned. It'll be interesting to hear what your cardio says. I'm not sure I would trust the INR lab to give a knowledgeable answer.

 

[pellicle]

Hey Jen

I'm going to go out on a limb here and say that if one considers
- warfarin as an anticoagulant, and
- considers that the INR is a measure of how long it takes blood to clot
- that you don't want blood to clot inside you body (and it normally doesn't)

and remembers that anticoagulants do not cause you to bleed, they just slow down the clotting (coagulation) of blood..

that the answer is it won't have any effect.

If anyone told you to avoid hot tubs they were either worried about you falling and smacking your head or they were parrots repeating instructions which they had memorized but not understood.

Have a good time in the Sauna (after being married to a Finn for some years I've come to like saunas and still have them)

Best Wishes

 

[almost_hectic]

I would consider this, there may in fact be a big difference between hot tubs and hot springs. Hot tubs I should think would be no big deal. Hot springs however I might see cause for concern and if It were me I would hesitate to jump right in without somehow investigating further. Hot springs can often contain high concentrations of minerals. Those high concentrations of minerals can be absorbed into the body directly through the skin especially during a long hot soak. I don't know this for certain but I would think those concentrations of minerals introduced into your body might potentially effect your INR directly or temporarily alter your body's ability to metabolism warfarin. I tend to err on the side of caution...

 

[pellicle]

I too err on theside of caurion. But with a biochem degree i guess what seems obvious to me may not to others.

Unless you drink lots of that water your skin is designed as a barrier to most things , it does mot facilitate absorption like a plants roots.

Vitamin K is not a mineral and not found in springs. There is a popularized myth that the minerals get into you. Despite many studies nothing can be shown that our bodies absorb anything this way (through the skin).

If you are concerned, bottom line is test and adjust if required. This works for EVERYTHING.

 

[almost_hectic]

I too err on theside of caurion. But with a biochem degree i guess what seems obvious to me may not to others.

Unless you drink lots of that water your skin is designed as a barrier to most things , it does mot facilitate absorption like a plants roots.

Vitamin K is not a mineral and not found in springs. There is a popularized myth that the minerals get into you. Despite many studies nothing can be shown that our bodies absorb anything this way (through the skin).

If you are concerned, bottom line is test and adjust if required. This works for EVERYTHING.

So all those salt bath, mineral bath things are a bunch of snake oil? I knew there wouldn't be any vitamin k risk, but I sorta thought things like calcium or magnesium may interfere with how your body handles warfarin?... I know if I take magnesium I'm told to take it opposite the time I take my warfarin otherwise it interferes. I didn't know what other minerals may do, but if they can't get into your skin I guess they can't do anything...

 

[pellicle]

Hi

So all those salt bath, mineral bath things are a bunch of snake oil?

depending on what you expect from them. If you expect an altered PH and an altered feeling on your skin when you get out of it, not at all. If you were after observable changes to your inner workings yes.

Adding salts to baths can alter the way your skin feels by not having it feel water soaked (you know, when say your finger tipss go wrinkly). This is related to osmosis.

https://en.wikipedia.org/wiki/Osmosis

I knew there wouldn't be any vitamin k risk, but I sorta thought things like calcium or magnesium may interfere with how your body handles warfarin?

my bottom line is that there is theory and there is reality. We do our best to make theory match reality, But its the observation of reality that guides theory. So if you wonder : test and see. Preferably on more than one occasion so you can be sure of the readings. Even if one does not home test /dose being comfortable with self testing provides great confidence in how it works and removes the fears.

The first year of a science degree is all about getting people out of "being told" and into "testing" ... then we introduce understanding how to evaluate what you've seen in your tests. Such as "is that change related to the thing or is it not" (IE I had a cold, someone gave me their secret Tea, 2 days later I got better. Was I going to get better or was it the tea?)

... I know if I take magnesium I'm told to take it opposite the time I take my warfarin otherwise it interferes. I didn't know what other minerals may do, but if they can't get into your skin I guess they can't do anything...

exactly

Our gut is like the roots of the tree ... put it where it will get in.

Oil of Ulan (and many cosmetic companies) makes a fortune selling stuff at outrageous prices based on the uncertainty if it will help or not ... plus it smells nice.


PS: I personally can't see any interaction with magnesium tablets, but it may depend on the "carrier" in the pill. This topic here seems a good anecdote to that question

http://www.valvereplacement.org/foru...m-and-coumadin

 

[Jenrc]

Thank you all for your feedback. Still waiting on info from my cardiologist. New medical messaging system in the health network has them all scrambling!

 

[yotphix]

Nothing to do with taking a salt bath, but from Livestrong the following: (mind you, in the previous paragraph they refer to warfarin as a 'blood thinner', so...grain of salt, as it were)
"Typically, 99 percent of the Coumadin you take is bound to proteins within your bloodstream, according to the article in “American Family Physician.” When bound to protein, Coumadin is unable to function. This means that only 1 percent of your dose of Coumadin is biologically active. Though this seems small, 1 percent of a Coumadin dose is more than enough to prevent blood clots. However, when magnesium levels are elevated, less Coumadin is bound to proteins. Only 92 percent of the Coumadin dose binds to protein when magnesium levels are high, according to an article published in the March 1999 issue of “Magnesium Research.” With that much unbound Coumadin, you are at risk of excess bleeding and other complications of Coumadin overdose."
Odd, I've never once seen a mention of magnesium having so much effect on warfarin, and never been warned. Presumably, when magnesium levels drop, the opposite is true? As in, too much exercise without good electrolyte replacement should result in poor anticoagulation?

Getting back to the question though, I haven't noticed a problem from hot tubs. I don't spend a lot of time in them, but there are a couple of places in the world were I visited them regularly, and have never noted a change in INR, even when I was still testing weekly.

 

[almost_hectic]

magnesium is higher in certain foods, if it were a factor you'd think without some measure of it, it would wreak havoc on maintaining INR?...