excercise and INR

[psalmist]

I have started a light work out routine now that all of the festivities are over (except for new years). Just some jump'n jacks, half push-ups (too hard for the real thing ), and some crunches. Nothing major just a light routine. I was wondering if I should expect a drop in my INR and what you guys would recommend for the first couple of weeks of adjusting to my routine. Thanks Seth.

 

[geebee]

Yes, you can expect to see a drop. It may not be much and might not even require a dosage adjustment but I would test at least weekly for the next few weeks until you know for sure.

 

[Ross]

It will drop, but only testing is going to tell how much. Maybe you'll have to adjust, maybe not.

 

[Jamboesque]

Hi Guys not posted in a while, but then never had a problem for ages.

However I had my INR today and it came back @ 5.3 normally 2.5 -3.3

I am a bit concerned, obviously. Even given the fact that there over the festive period things can go a little awry, this seems a bit excessive, and the only thing that has changed is the fact that I'm no longer going to the Gym, due to its unplanned closure. I had decided not to rejoin another gym until I came back from a skiing holiday in mid January. My last gym visit was 18th December. (I usually do 20min CV work, 20 mins Weights & 20mins Abs & stretching roughly 10 times amonth).

Could the lack of excersize be a contributory factor in this INR result.

I have been advised by my PC doctor to with-hold Warfarin for 2 days and then restart 6mg then 7 daily & recheck in a week) I'm not sure about this, especilly with my holiday coming up (It's one weeks cross country skiing as opposed to downhill)

Thanks in advance for any useful replies

Jack

 

[ALCapshaw2]

I have also noticed a correlation between exercise and INR, although not as great as your recent result.

OTOH, I have also had some ERRONEOUS INR readings from the Finger Stick instruments used at my Coumadin Clinic. They have a policy of double checking any reading over 5.0 (and now 4.5) by a Lab Draw. Two such readings (5.3 and 4.9) both came back as 3.2 when tested by veinous draw and sent to the hospital lab.

SO, my recommendation would be to confirm the reading. IF it is confirmed, I would be tempted to hold only ONE dose, or if you have a high metabolism (i.e. take a high dose of Coumadin, say 5 to 10 mg), drop back by 1/2 dose for 2 days. Again this is my NON-profossessional guess.

Hopefully some of our more experienced self dosers will chime in with their sage advice.

Do you have a Dosing Guide?
If not, I highly recommend AL Lodwick's Dosing Guide (see www.warfarinfo.com) for only $5 U.S.
OR, browse or search through the Anti-Coagulation Forum for the guidelines from one of the Family Practice Journals.

'AL Capshaw'

 

[Bina]

Jack your INR of 5.3 is nothing to freak out about. Have you rechecked this test?
Your clinic wants you to hold off your dose for 2 days......Sorry I disagree.
If it was me, I would only hold off for 1 day and then next day take half a dose.

 

[Blanche]

Jack:
Just a short time ago my husband's INR was 7.5. He had been taking 6.0 daily. My husband took 3.0 for two days, then changed his daily intake to 5.5 and 6.0 on alternate days. Six days later his INR was 2.3.

In 2000, Al had several strokes, with one being debilitating. His INR was between 1.5 and 1.7 when he had these strokes. Doctors said the strokes were caused by a Coumadin failure. Recently I received records going back to 2000 from the Cardiologist's office. Prior to his strokes, he had an INR of 4.3. He was told to hold for 3 days. He did that. Now, I think that might just have been the thing that caused his strokes. The materials I received did not show that he was told to recheck at any given time.

I believe that holding for two days for an INR of 5.3, with no symptoms of problems, can be very dangerous.

Blanche

 

[Jamboesque]

Hi Guys,

Thanks for the replies.

After a bit of circumspection I think I kind went a bit overboard. I've had one other blip like this but not a week before a long waited for skiing holiday.

I'm a bit more relaxed now.

Here is the guidelines as used (probably, I can't find a more up to date version online) by the GP (PCP) informing me of what I should use (see my post above for his/her recommendation). Having said that the message was relaid by the practice secretary with whom it is pointless to discuss/argue.

http://www.refhelp.scot.nhs.uk/index.php?option=com_docman&task=doc_view&gid=105

The source is Lothian NHS which I suppose is equivelant to your State Health Board. But as far as I can see I have been given the wrong info with an INR of 5.3 and a target INR of 3.5 +/- 0.5(standard in the UK for Mech. AVR) it should be omit one day decrease weekly dose by 10-20% then divide by 7 & retest in 4-5 days (OK it'll be a week in my case ho-hum) so I should be taking 6mg instead of the 7mg I'm taking at present.

I'm still interested that Xmas & New Year considered, the only change to my lifestyle is my lack of physical exersize in the gym.

The blood test is a venous draw with the sample sent of to a central lab, in general the service is very good with the results and updated therapeutic levels advised within 5-6 hours.

If it turns out that my INR is still high then I'll just have to miss out those black trails, phoooie I'm not letting a small thing like that ruin a good holiday.

I will have to monitor my INR closely when I restart my gym work when I come back and rejoin a new gym...

Jack

 

[njean]

Okay, I know that many of us have been told that if our level of exercise increases, so does our INR. However, after being on coumadin 30 years +, it has always worked the opposite for me. I know I have been called an "odd ball" but I can prove that right now:

All summer long, I was on 11 mg for 5 days & 10 mg for 2 days & my INR was between 2.5 - 3.0, the desired range. Because the weather was warm & agreeable, I was walking about a mile a day plus doing some light gardening & what nots around the house. As soon as winter came in, & my walking & level of activity decreased outside due to inclement weather, I am now having to take 10mg for 4 days & 7.5 for 3 days. I have tested weekly since I got my machine because of the fact that my INR has never been stable since my last OHS in 2006. In fact, for the past 10 days, I did not test because I wanted to see if I could get away from testing every week due to the fact that we will be going on a 2-week vacation in May & I did not want to have to take my monitor with me. So I tested this past Thursday, & my INR was 5.3! Plus, I knew something was not right, because I had had a recurrent nose bleed for the past few days & more aches & pains than usual & that's what prompted me to test & there it was! So, I skipped a dose altogether Thursday night, & Friday I took 7.5 & tonight I will take 7.5 & re-test tomorrow to see where it's at.

So, you see, some of us are affected differently by some of the same medications we take & I am living proof of that!

 

[Philip B]

INR & Exercise

INR & Exercise

If my understanding of INR and coumadin dosage is correct, engagement in a good, regular exercise routine speeds up one's metabolism. A higher metabolic rate typically results in lower INR as the body metabolizes coumadin at a faster rate. In short, a faster metabolic rate will require more coumadin to stay in the zone.

As noted in previous posts concerning this thread, how much one's exercise program affects his/her INR and how much of a change in coumadin dosage will be required to stay within the preferred zone is an individual thing. Again, theres's sound advice in previous responses here...monitor, monitor, monitor and make adjustments when necessary.

Since I broke my foot a few weeks ago I haven't been able to do much exercise and I've had to lower my coumadin dosage as my metabolic rate has slowed. I had been taking 7.5 mg daily; now I do 5 mg. When my foot heals and I start skiing and doing my bicycle trainer thing again my metaboic rate will speed up and I'll have to increase my dosage.

Monitoring will give you the information you need to make adjustments in your dosage.

-Philip

 

[njean]

Update on INR Reading

Update on INR Reading

In reference to my previous post to Seth on Exercise & INR readings:

I checked my INR today & it back to the desired level of 2.5. Thursday when I checked it, it was 5.3. So what I did, was skip Thursdays dose altogether, took 7.5 on Friday, 7.5 on Saturday & checked today. I had been on 5 days of 10mg & 7.5 for 2 days & then checking, however, now it seems that I will have to do 10mg for 4 days & 7.5 for 3 days & see where I am next Sunday.

As I have mentioned before, when my level of activity or exercise decreases so does my coumadin doses. I know this goes against everything doctors, medical professionals tell us, but I'm just the opposite & perhaps Seth & others out there, react the same!

And since my INR has been so erratic since my OHS in 2006, I definitely believe that it is because of my still malfunctioning Mitral valve & until that issue is resolved or I die, my INR's will continue to be erratic & I'll have to check my INR at the end of every week.

But, it could always be worse....... so you do what you have to do & keep going!