Concerned about my INR

[Mark Wagner]

For what will be 4 years on January 19, (surgery anniversary date) I have had very little problem with my coumadin, outside of a drug interaction that put me in intensive care with internal bleeding. All of the sudden my tests results have been down the last two months. I am supposed to be between 2.5 - 3.5.
A month ago I was 2.3, and now have dropped to 1.6. The clinic has really up-ed my dosage, so hopefully that will do the trick. I cannot see any difference in diet, or activity level to speak of. Diet... I probably don't eat enough because I am always on the go with my work and all; but that is really nothing new. I took another test today. My dosage has been increased from 5 mg 3 days a week and 7.5 4 days a week to, ... 7.5 6 days a week and 5 mg once a week. Maybe that will do the trick. As far as I know, I have not missed a dosage.
4 year now. It is hard for me to believe it has been that long.

Talk at you later ... Mark

PS Coumadin has been such a breeze for me. Maybe it is just my turn now.

 

[Ross]

Your body must be doing something behind the scenes. I know I don't eat right (close to not at all) and when I don't, my INR is high. I'm living off of the Coumadin then. Are you watching for hidden sources of Vitamin K? Your not doing the Carnation Instant Breakfast Plan are ya?

It's hard to say Mark. Sometimes we do these things for no apparent reason. Watch, your next test will be high.

 

[Guest]

Did you start vitamins, or some kind of a supplement that may have vitamin K in it?

 

[Karlynn]

Check everything you eat carefully. My story was that I was having a very hard time getting my INR up above 1.8 in August. I couldn't think of anything I'd been eating or taking that had changed in the last year. Same vitamins, same staple foods, same protein shake. To make a long story short, I had switched from one protein bar to another. I didn't look at the content, because the one I had been using had no K in it. The new one I'd been eating (about 3 a week) had 33% RDA of Vit. K. Not all food is created equal - or so I found out. I was swearing to my doctor that nothing had changed - and I thought nothing had, except for my brand of protein bar.

I hope you find your answer soon.
Karlynn

 

[Mark Wagner]

Still low

Still low

My results from Friday are still low. A little better but only up from 1.6 to 1.9. Now they have me at 7.5 mg every day. I'll test again next week. Thanks for the advice Ross, Al and Karlynn. My vitamin supplements have not changed. I don't see where I am getting any more vitamin K than ususal. The coumadin clinic talked to my wife today on my diet, but everything is pretty normal. I was on some heavy duty anti-biotics a few weeks ago, but my last anti-biotic pill was about a week and a half ago. See, I turned 44 and it all falls apart.

Mark

 

[Nancy]

Hi Mark-

A little while ago, didn't you have some exhaustion issues? Perhaps that combined with the antibiotics have upset your system for a while. If that's the case, it might take a little while for things to get back to normal. There is obviously something going on and the fact that your INR is heading in the right direction is good.

I bet in a couple of weeks it'll be a non-issue.

Merry Christmas.

 

[Christina L]

So glad I read this post!! I am on Coumadin because of my bout of a-fib several weeks ago and hopefully will be taken off of it in January or February but "we" have had a time getting my INR in the therapeutic range. Read about the vitamin K in your protein bar, Karlynn.

I have been drinking a LOT of Ensure and Boost w/extra protein because I thought it was good for me - giving me extra calories. Went immediately and checked the label, and saw the Boost has 40% vitamin K in it!!!!

I am stopping these drinks immediately!! I will stick to getting my protein from meat plain and simple.

Thank goodness for this web site!! Ya live and learn!

Christina L.

 

[Nancy]

I'm glad you checked that out Christina. Ensure and Boost are BIG problems, mainly because the hospitals push them so much. They don't even realize the huge amount of Vitamin K in these drinks. Then the doctors wonder why their Coumadin patients can't get their INR up.

Why they don't know this is a mystery to me.

Watch out for Luna bars and other ilk also. I think Luna bars have 100 percent Vitamin K.

V-8 juice also has Vitamin K, but it isn't shown on the label.

 

[Ross]

Ensure and Boost is good for you. It's the overload of Vitamin K that isn't. I don't know how you've been drinking them, whether one a day or what, but to just stop now will likely result in INR climbing rapidly. How many did you drink in one day anyhow? Carnation Instant Breakfasts are just as bad Vit K wise.

What I'm getting at here is to remain consistent, but if your drinking 2 or 3 of those things a day, trim it to one.

 

[Nancy]

It would help everyone tremendously if some of the medical professionals who monitor the board, get on Ensure and Boost manufacturer's cases and request a product w/o Vitamin K, for their Coumadin patients.

As Ross said, they're good for patients who cannot eat properly, or who cannot stomach hospital food, but not at the expense of having their INR plummet.

So, guys and gals, how about helping all the Coumadiners out???

It'll keep you from scratching your head wondering why the patient cannot get therapeutic.

 

[Christina L]

You're right, I shouldn't stop cold turkey. Thanks Ross. I have only been drinking one a day with a banana first thing in the morning.

I haven't had a taste for green vegetables (especially salads) since the surgery and have craved protein and carbs, so it is not like I have been taking in a lot of vitamin K - only in the Ensure/Boost.

I have my INR checked again tomorrow. I has never gotten above 2 since I started the Coumadin about four weeks ago. I am on 7.5 mg every day except T and Th, and on those days 10 mg.

So, you think I am okay with one can a day???

Thanks everyone!

Christina L.

 

[Ross]

I'm sure you are, but you could cut it to just 3 or 4 for the week. What your doing now is consistent, so I wouldn't want to throw that out of whack at this point.

 

[LUVMyBirman]

Ahhhhh, my culprit "Ensure"

Ahhhhh, my culprit "Ensure"

After my second surgery for my percardial window three weeks post op. Was extremely malnourished....l..did not eat much for the week prior.

Anyway, in the hospital they decided I needed Ensure. Sounded logical under the circumstances. Well, after 10 days of my INR not budging (reason why I was still sitting in the hospital on Heparin) Got really really board. As I was drinking my Ensure...took a peak at the back of the can. Vitiamin K. Hummmm. At that point I was aware that was an antagonist to the Coumadin. Informed the nurse I would no loger be drinking the Ensure. Dr. came in and said "so I hear you don't want to drink my Ensure".?

Darn right I said. Would like to get home sometime this month! It has Vitamin K in it and my INR is not budging! She said

"Oh...I had no idea". That was my doctor. Scary days.......