G
Guest
I would increase by the equivalent of one day's dose spread over the week. Round up to a whole tablet if you need to.
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The doctors office just called me at work. My husband definantly needs to find another doctor. He is still at 1.5 and the doctor wanted to make sure he was eating enough greens. After 4 1/2 years of this he still doesn't understand managing coumadin at all. I am so frustrated I want to cry and hit someone.
K
Karlynn
I tend to agree that cutting out the greens in order to get the INR up is not the best way to go. We do need greens and if they are a consistant part of his regular diet, then it would be reflected in his dose. Cutting them out now to raise the INR will just mean that the INR could drop again once he puts them back in his diet.
It's not so much the things we know contain K that are the problem, but the things that contain K that we don't know about. When I was consistently drawing a low INR, we were raising my dose and doing all that was logical. Then I found out that the protein bars I was eating had a lot of K in them. I didn't need the bars in my diet (it was a lazy way of eating) so I dropped them like a hot skillet.
Has anything new been added to your husband's (or in Jeanne's case -son's) diet? Protein shakes, V-8 juice, Instant Breakfast, Ensure, something rich in soy????? Soy is a huge nutritional suppliment now and is being used as a major protein source.
It's not so much the things we know contain K that are the problem, but the things that contain K that we don't know about. When I was consistently drawing a low INR, we were raising my dose and doing all that was logical. Then I found out that the protein bars I was eating had a lot of K in them. I didn't need the bars in my diet (it was a lazy way of eating) so I dropped them like a hot skillet.
Has anything new been added to your husband's (or in Jeanne's case -son's) diet? Protein shakes, V-8 juice, Instant Breakfast, Ensure, something rich in soy????? Soy is a huge nutritional suppliment now and is being used as a major protein source.
Karlynn,My husband was put on the South beach diet because he is pre-diabetic. I went home Friday and got out all the prepackaged South Beach meals I had bought for him. The first 4 ingredients on the Breakfast bars were Soy based and the cookies and frozen meals all contained some form of soy.
So,we got rid of all those foods. And we are doing what AL suggested and raising his dose by one days coumadin spread over 7 days and we are finding another doctor to manage his coumadin. He has been at 1.5 for about three weeks now and that is just too scary.
So,we got rid of all those foods. And we are doing what AL suggested and raising his dose by one days coumadin spread over 7 days and we are finding another doctor to manage his coumadin. He has been at 1.5 for about three weeks now and that is just too scary.
G
Guest
I tell people that advertising for something that goes in your mouth does not apply to you. You absolutely must find the hidden sources of vitamin K. I had one young woman patient who caused a TIA by eating a whole case of Luna bars over a week.
K
Karlynn
I'm glad you found the source. I have some of the South Beach Breakfast Bars too. I only eat them if I haven't left enough time for breakfast and I'm running out the door. Soy in moderation shouldn't hurt, but as you found out, many of the new diets are very rich in soy. I just got George Stella's Low-Carb cookbooks. Any of his recipes that call for a flour product use soy flour
. So much for his low-carb pizza crust.
. So much for his low-carb pizza crust.
I spent over an hour and a half at the grocery store reading labels. There were some baked products that sound great for a diet but they are full of soy. Does anyone know if macadamia nuts have vitamin k? I have been buying them for him to eat as a snack. I told him I could easily kill him and no-one would know I did it. I could just feed him all these foods he shouldn't eat.
I did feel guilty for buying him all the South Beach foods thinking I was doing good. Hopefully his INR will be up this week. He will retest on Thursday or Friday.
I did feel guilty for buying him all the South Beach foods thinking I was doing good. Hopefully his INR will be up this week. He will retest on Thursday or Friday.
K
Karlynn
Gosh, I hope not! I eat them too. Here's the nutritional ingredients I found. On one site I clicked on the Extended Information and they had Vitamin K listed as ~mcg, which means not enough to measure - if any present. So they should be okay.
Macadamia Nuts - Raw kernel.........per 100g serve
Energy..........................................3040kj
Protein..........................................9.27g
Fat (total oils)................................76.4g
Mono Unsaturates..............59.6g
Poly Unsaturates................3.1g
Saturated.........................13.6g
Carbohydrates Total........................10.0g
Sugars.............................10.0g
Dietary Fibre..................................1.4g
Cholesterol.....................................Nil
Phosphorus....................................241mg
Calcium.........................................53mg
Sodium.........................................3mg
Potassium.....................................409mg
Thiamine (B1)................................0.22mg
Riboflavin (B2)...............................0.12mg
Niacin..........................................1.60mg
Iron.............................................2.00mg
Macadamia Nuts - Raw kernel.........per 100g serve
Energy..........................................3040kj
Protein..........................................9.27g
Fat (total oils)................................76.4g
Mono Unsaturates..............59.6g
Poly Unsaturates................3.1g
Saturated.........................13.6g
Carbohydrates Total........................10.0g
Sugars.............................10.0g
Dietary Fibre..................................1.4g
Cholesterol.....................................Nil
Phosphorus....................................241mg
Calcium.........................................53mg
Sodium.........................................3mg
Potassium.....................................409mg
Thiamine (B1)................................0.22mg
Riboflavin (B2)...............................0.12mg
Niacin..........................................1.60mg
Iron.............................................2.00mg
K
Karlynn
I should add that the reason I'm glad macadamia nuts don't appear to have K in them is that I don't eat them regularly. I buy them occasionally and then eat a lot of them . If I did eat them regularly and they did have some K in it, that would be reflected in my warfarin dose.
. If I did eat them regularly and they did have some K in it, that would be reflected in my warfarin dose.
KristyW
Well-known member
Don't throw out the baby with the bathwater
Don't throw out the baby with the bathwater
Terry,
Just because a food has a lot of soy isn't a reason to avoid it. I have been on the South Beach way of eating for over 2 years. I do eat edamamme (soybeans) on my salads. I'm just pretty consistent at how often I eat the edamamme (Usually 2-3 times a week.)..I eat leafy green salads everyday for lunch and for dinner I have broccoli and/or spinach 5x/week. My warfarin has been adjusted to my diet. That said....I DO NOT buy any of the South Beach packaged foods as they contain waaayyyy too much sodium, and you still need to supplement those meals with fresh veggies to make them fit into the South Beach framework.
I believe that the biggest culprit is the added exercise. I experienced 2 significant drops in my INR over the past 2 years...The first and lesser of the 2 was when I started South Beach, but the biggest drop and the hardest one to recover from was when I started exercising regularly.
Hope some of this helps.
Don't throw out the baby with the bathwater
terryj said:
Terry,
Just because a food has a lot of soy isn't a reason to avoid it. I have been on the South Beach way of eating for over 2 years. I do eat edamamme (soybeans) on my salads. I'm just pretty consistent at how often I eat the edamamme (Usually 2-3 times a week.)..I eat leafy green salads everyday for lunch and for dinner I have broccoli and/or spinach 5x/week. My warfarin has been adjusted to my diet. That said....I DO NOT buy any of the South Beach packaged foods as they contain waaayyyy too much sodium, and you still need to supplement those meals with fresh veggies to make them fit into the South Beach framework.
I believe that the biggest culprit is the added exercise. I experienced 2 significant drops in my INR over the past 2 years...The first and lesser of the 2 was when I started South Beach, but the biggest drop and the hardest one to recover from was when I started exercising regularly.
Hope some of this helps.
Kristy, I also think the exercise helped cause the large drop plus he has ben working 12 hours a day and 8 hours on Saturday because of a big project at his work. He had committed on the large amount of sodium in the meals and we were adding more fresh foods and less processed foods. I just got concerned because he was 1.5 and we adjusted his dose up by 20% and he retested in a week and was still at 1.5. Also, his PCP is not doing a very good job of managing his dose when he has a problem. I really rely on this site for information. He is still doing the South Beach diet just with me cooking more of the foods he can have and controlling some of the sodium and watching the soy.
Ross
Well-known member
Terry I don't think I'd worry so much about the diet. Something is not right if you increased the dose by 20% and INR didn't change at all. I think I'd want another lab to test me if this was the case.
We are in the process of finding another place to test now. We have to change our PCP through my husbands insurance and get that approved first though. I questioned the doctors office twice about the INR being 1.5 after the 20% increase. I think they are wrong. You can barely get them to call you back. I left 3 messages last week and then when they called they gave me the reading and no suggestion of what to do. It took them 4 days and me calling them 3 times to get the results.
Ross
Well-known member
Yeah, that is totally unacceptable. Time to shop for a new one.
K
Karlynn
If the South Beach prepackaged foods have soy listed in their first ingredients, then there is enough soy in the meal to make a change in your INR if you are eating them daily. I know I have had to be very careful that the protein shakes I buy are whey and not soy, as well as any bars. The South Beach diet itself isn't a soy-rich diet when you prepare your own meals. I'm sure they use soy in their prepackaged foods because it contains less fat and allows them to keep the fat grams down while keeping the protein component up.
Kristy is right, if it's a diet that he will be consistant with, then the dose can be adjusted accordingly. I don't eliminate Vitamin K containing foods. I also eat edema on occasion (love it raw! shelling it like peanuts - mmmm) but something that is made from soy flour or a processed soy, is going to contain much more K than edema. Much like it's better to eat the fruit, than drink a cup of the juice you get from it. Orange juice (because it take a lot of fruit to make a cup of juice) contains much more sugar than just eating the orange.
Terry, I think your husband is having his low INR from a few factors. It sounds like he's begun his "get healthy" plan all at once, so the soy product and the exercise are both playing a part. I started exercising regularly a few years ago. I experienced a drop in my INR, but not a severe drop. I just get the feeling that the soy protein (because it's in concentrated form) is the bigger culprit.
And all that being said - Ross has a point. He most likely should have seen a change in his INR with a 20% increase. But I will say that when I had my protein bar debacle that was causing my low INR, we were raising my dose regularly and my INR was not moving and didn't move until I figured out it was the bars causing it and I stopped eating them.
Kristy is right, if it's a diet that he will be consistant with, then the dose can be adjusted accordingly. I don't eliminate Vitamin K containing foods. I also eat edema on occasion (love it raw! shelling it like peanuts - mmmm) but something that is made from soy flour or a processed soy, is going to contain much more K than edema. Much like it's better to eat the fruit, than drink a cup of the juice you get from it. Orange juice (because it take a lot of fruit to make a cup of juice) contains much more sugar than just eating the orange.
Terry, I think your husband is having his low INR from a few factors. It sounds like he's begun his "get healthy" plan all at once, so the soy product and the exercise are both playing a part. I started exercising regularly a few years ago. I experienced a drop in my INR, but not a severe drop. I just get the feeling that the soy protein (because it's in concentrated form) is the bigger culprit.
And all that being said - Ross has a point. He most likely should have seen a change in his INR with a 20% increase. But I will say that when I had my protein bar debacle that was causing my low INR, we were raising my dose regularly and my INR was not moving and didn't move until I figured out it was the bars causing it and I stopped eating them.
J
JeanneImp
Matt's INR is 2.6 today. That is with 5mgs. every night. I would like to get him closer to the 3.5 range. I am not comfortable with his lower INR.
I think I should keep him 5 mg instead of going back to 4.5 or maybe 5.5???
Thanks so much for helping me!!!
I think I should keep him 5 mg instead of going back to 4.5 or maybe 5.5???
Thanks so much for helping me!!!
Ross
Well-known member
Leave it go one more week and if it's still around 2.5, then maybe 10% more.
J
JeanneImp
Thanks Ross! We are keeping you busy, eh???
Ross
Well-known member
Yeah I'm busting up another forum and trying to figure out why a part of it won't work.
