Active lifestyle and Warfarin

[acr]

Hi All, a general question. Does an active lifestyle equal a higher Warfarin dose ? I've been on 5mg since surgery, and my INR has always been in range. Now that I'm up and about, walking miles instead of staying indoors, I'm finding my INR dropping and dose has been upped to 6 and 5 on alternate days. Just wondering if your body gets rid of Warfarin faster if your metabolism increases ?

 

[tex]

Hi,
I havent noticed it making a difference, when i first started on it my levels were up and down, they seem to have settled i have 11 for 4 days then 10 for 3. What ever i do now it doesnt seem to affect the level, hope this helps.
How things going since your operation?
Take Care
Jane

 

[Ross]

Yes it does. The more your heart pumps the blood through the liver, the more filtering the liver is doing, therefore, INR will decrease requiring adjustment upward.

 

[acr]

Thanks, that makes perfect sense.

Tex - going well cheers, Cardio rehab starts next week, plus I'm itching to get back on the bike (pedal type), so more dose adjustments to come methinks.

 

[dick0236]

Yep, the higher the activity level....the lower the INR....hence, the greater the Warfarin dose. As an old man, I take half the dose I took as a young man.....70mg then, 35mg now. The only "real" change has been in my type and level of physical activity

 

[suerose]

Same exercise induced drop here too.

Same exercise induced drop here too.

I'm 9 weeks post op and last week really started walking alot: 45 - 60 minutes a day. Finally felt up to it. My INR went from 2.9 to 1.4. Not sure how quickly it dropped due to exercise, because there was 3 weeks between testing. Too long in my book!

One gal in cardiologist office said increased metabolism could indeed be the cause. Dr. himself didn't think so! Interesting contradiction.

Was stable INR for couple weeks at 7.5 mg...now I'm up to 10 mg. Sounds like a lot to me, but the INR doesn't lie.

Am frustrated.

 

[catwoman]

I'm 9 weeks post op and last week really started walking alot: 45 - 60 minutes a day. Finally felt up to it. My INR went from 2.9 to 1.4. Not sure how quickly it dropped due to exercise, because there was 3 weeks between testing. Too long in my book!

One gal in cardiologist office said increased metabolism could indeed be the cause. Dr. himself didn't think so! Interesting contradiction.

Was stable INR for couple weeks at 7.5 mg...now I'm up to 10 mg. Sounds like a lot to me, but the INR doesn't lie.

Am frustrated.

Increased metabolism does decrease the INR.
In a nutshell, the more times your blood goes through the liver, the more quickly particles are metabolized and removed from your blood, reducing the amount of warfarin available to bind with the clotting factors in your blood.

That's one of the reasons people on warfarin are advised to tell their doctors when starting an exercise program. I found several such suggestions on line just now.

 

[Ross]

I'm 9 weeks post op and last week really started walking alot: 45 - 60 minutes a day. Finally felt up to it. My INR went from 2.9 to 1.4. Not sure how quickly it dropped due to exercise, because there was 3 weeks between testing. Too long in my book!

One gal in cardiologist office said increased metabolism could indeed be the cause. Dr. himself didn't think so! Interesting contradiction.

Was stable INR for couple weeks at 7.5 mg...now I'm up to 10 mg. Sounds like a lot to me, but the INR doesn't lie.

Am frustrated.

Stick with us and you'll see just how bad the medical community is at dosing and agreeing on anything Coumadin related! What your doctor said simply shows his ignorance of how the drug works.

Another thing, the amount of Warfarin/Coumadin you take has nothing to do with such things as too much. The correct amount for you, is the amount that keeps you in range. For some, it's 2mg a day, for others it's 20mg a day, but for each of those folks, that it the correct amount.

Don't be frustrated (Yet). If they had you in range, then your Coumadin clinic might be one of the few that actually know what they're doing. Yes, it's that bad out here. You'll be in range again soon. Would home testing be an option for you to consider?

 

[suerose]

Much calmer today...and Vitamin K Diary ?

Much calmer today...and Vitamin K Diary ?

Thanks to you all and to the one woman in the cardio office that DOES give me concrete advice, I'm 90% sure it's the exercise that's the cause this time.

I'm also feeling better about the amount of MY daily dose. I'm learning to stop comparing myself to others and what they're taking. Lesson beginners all need to learn I guess.

I'll have my INR tested Sat. a.m....hopefully I'll be moving up closer to 2.5 by then.

Yes I would consider self testing...I'd like to know weekly, not monthly! But don't want to broach the topic with cardio until I get a bit more seasoned with this and they more confident in me that I've gotten into consistent diet, exercise regimine.

SPEAKING OF DIET...trying to understand that Vitamin K diary. Looks tedious to calculate everything I eat ...quantities into micrograms. I wrote in a question to QAS and it was a lip service answer. ANY TIPS?

Striving to master this....Susie

 

[suerose]

How at risk am I?

How at risk am I?

Another question.

When I'm low like this...under 2.0....how at risk am I to develop a clot / stroke?

Feeling like a walking time bomb!

 

[Ross]

SPEAKING OF DIET...trying to understand that Vitamin K diary. Looks tedious to calculate everything I eat ...quantities into micrograms. I wrote in a question to QAS and it was a lip service answer. ANY TIPS?

Striving to master this....Susie

Yeah, throw that dumb list out the window and do it right. Eat what you always have eaten in the past, but try to be as consistent as possible. Dose the diet you eat, don't diet the dose of the drug. Most of us like to be on the higher end of our range so we can enjoy pigging on our greens and not worry about falling too low. Diet plays a very very small role in INR. None of us give an inkling of thought about our Vit K intake when it comes to food.

The problem comes when you suddenly change the amount of what you eat. You cannot sit down and pig down a bag of spinich and not expect your INR not to drop. I mean alot of spinich too, not just a little bit. These people have got to knock it off with this watch the Vit K intake thing. Now another thing that might pose problems are hidden sources of Vit k such as Carnation instant breakfasts, Ensure, Boost, energy drinks and bars(They are loaded BIG TIME with Vit K), and that sort of stuff. If your doing them now, continue to do them in the same amounts, otherwise suddenly stopping them will cause your INR to rise.

 

[Ross]

Another question.

When I'm low like this...under 2.0....how at risk am I to develop a clot / stroke?

Feeling like a walking time bomb!

If your under 2 for more then a 2 or 3 days, you need to have Lovenox shots until your in range again. What is the risk? Depends on you. Some peoples blood clots really fast and others seem to be able to go forever. There is no real answer, but when I asked my Cardio, because I was forced to go unprotected for a while, he said the risk is very low, but a risk nonetheless.

 

[suerose]

She did mention Lovenox...if I don't get over 2.0 tomorrow, I'll ask about that. Is that a once and done thing? Or ongoing?

Not drinking any Carnation or Boost etc. Have laid off any greens until I get my numbers up.

Good to know I don't have to get out my sliderule to figure those micrograms! Egads! That was freaking me out.

I'll just get consistent on the greens...like a serving a day of broc, spinach, asparagus ....right?

 

[Ross]

She did mention Lovenox...if I don't get over 2.0 tomorrow, I'll ask about that. Is that a once and done thing? Or ongoing?

Not drinking any Carnation or Boost etc. Have laid off any greens until I get my numbers up.

Good to know I don't have to get out my sliderule to figure those micrograms! Egads! That was freaking me out.

I'll just get consistent on the greens...like a serving a day of broc, spinach, asparagus ....right?

Lovenox is dosed at 1mg per kilogram of body weight and injected every 12 hours.

Don't lay off your greens, eat them like you always do or your setting yourself up for teeter tottering. A serviing a day if that's what you normally do. I usually have a boat load of brussel sprouts or something at least twice a week, sometimes 3 times a week. The main thing is to eat like you always have so that that diet is what is dosed for.

 

[catwoman]

Not drinking any Carnation or Boost etc. Have laid off any greens until I get my numbers up.

Good to know I don't have to get out my sliderule to figure those micrograms! Egads! That was freaking me out.

I'll just get consistent on the greens...like a serving a day of broc, spinach, asparagus ....right?

Greens aren't the only food that has vitamin K. It's also found in fats and oils. It would drive you crazy trying to log all your vitamin K-laced foods and what-not. Just eat a normal diet, consistent in a variety of foods.

 

[suerose]

Results from Saturday's blood work - YAY! I'm in range again at 3.0 !!!
They've put me on alternating days of 7.5 mg and 10 mg
Blood draw again on Wed 5/13

I'm 100% convinced it was the daily hour walks that triggered the drop in INR.

Now to get consistent w/ my diet---I am eating greens again, and had a couple glasses of wine over weekend.
Am going to make my own salad dressing (recipe from a coumadin cookbook...where they recommended putting your oil in the sunlight to lessen the Vit K attributes.)

Feeling much more at peace with this new warfarin life of mine...dropping frustration w/ Doctor (he can't help himself!!!!!! and am more confident of my dietary decisions. Was way to stressed over the INR last week.

Thanks VR.com!

 

[Ross]

Results from Saturday's blood work - YAY! I'm in range again at 3.0 !!!
They've put me on alternating days of 7.5 mg and 10 mg
Blood draw again on Wed 5/13

I'm 100% convinced it was the daily hour walks that triggered the drop in INR.

Now to get consistent w/ my diet---I am eating greens again, and had a couple glasses of wine over weekend.
Am going to make my own salad dressing (recipe from a coumadin cookbook...where they recommended putting your oil in the sunlight to lessen the Vit K attributes.)

Feeling much more at peace with this new warfarin life of mine...dropping frustration w/ Doctor (he can't help himself!!!!!! and am more confident of my dietary decisions. Was way to stressed over the INR last week.

Thanks VR.com!

Put that cook book away! It's only going to cause you to yo yo. Just do your thing as you normally would. I'm not kidding. Forget about even hearing that Vit K thing.

 

[catwoman]

Now to get consistent w/ my diet---I am eating greens again, and had a couple glasses of wine over weekend.
Am going to make my own salad dressing (recipe from a coumadin cookbook...where they recommended putting your oil in the sunlight to lessen the Vit K attributes.)

Ditch that cookbook! Just eat like anyone else......
Exposing oils to sunlight may destroy vitamin K, but it also destroys quality of the oil at a much faster rate. Oils are meant to be stored out of the sun.

I make dressings with mostly olive oil. I occasionally use safflower oil, I think. No corn oil, vegetable or soybean oil.

A trick I picked up from Weight Watchers: Put your dressing in a container on the side; dip your fork in the dressing, then sprear your salad greens. I thought it bizarre when I first heard of it, but I'm still doing it 5 years later.
This is great with thick dressings like blue cheese, thousand island, etc. You get enough of the flavor without pigging out on just the dressing.

 

[suerose]

Honestly...the ONLY recipes I even looked at were the dressings as the others seemed like overkill! ...

Wow.....Okay...I trust you two....keep beating me over the head...I think I"m getting this....you're making my life SIMPLER and that, I like!

Vitamin K? I don't know that word anymore! Nyaaaahhhh!!!!!
Susie

 

[Ross]

Honestly...the ONLY recipes I even looked at were the dressings as the others seemed like overkill! ...

Wow.....Okay...I trust you two....keep beating me over the head...I think I"m getting this....you're making my life SIMPLER and that, I like!

Vitamin K? I don't know that word anymore! Nyaaaahhhh!!!!!
Susie

Hon the vit k in oil is so negligible that it's not worth the time to sit it in the sunlight. Those crazy people make it sound like if you have the slightest bit of K, your INR is going to go crazy and it's just not true. You'd have to really really pig on something high in vit k to do much to your INR. So long as you eat a normal healthy diet, just as you always have, the dose will be adjusted for your diet. By following all these silly Vit K writings, your dieting the dose, which is completely backwards from the way it should be.