Exercise and Coumadin/INR

[William]

I had my replacement in December. I was in the hospital 8 days, part of which was due to get my INR reading up. After I got out it seemed stable, even a bit high (4.9 at one reading), but now has been going steadly down. It was at 1.7,1.9,2.7,2.4 with dosage changed to meet. No change in the diet but as I recover I exercise more. Could that exercise have that much effect on the INR? Will

 

[Guest]

Exercise has a huge effect on the INR. The more you increase your heart rate, the more that the blood carrying the warfarin will go through the liver and be metabolized. This causes the INR to go down. I had a letter to the editor published in the American Journal of Cardiology about this.

People think I am nuts when I tell them, "Oh, you're feeling better? Then I will have to jack your dose up." But that is the way it is.

 

[Karlynn]

People think I am nuts when I tell them, "Oh, you're feeling better? Then I will have to jack your dose up." But that is the way it is.

No, you're the Wonderful Wizard of Warfarin!

 

[tommy]

Will,

My INR wasn't very stable until about 6 months post op. When I started vigorous exercise, my INR dropped a some, but not as much as you describe. I was also 2 1/2 years post op when I started exercising. Since you are only 3-4 months post op, I would attribute some of your drop the healing/recovery process.

Sounds like you are doing great. Just monitor the INR more often and make the adjustments until it stabilizes. Keep exercising. Congratulations!

Al, you're not nuts. Of course,we're are biased. We need you.

 

[jenny]

I don't get this Coumadin.

I don't get this Coumadin.

Hi everyone , I had a valve replacement done this fall for my mitrol valve. I have switched Cardio guys and my last doctor said I should be in the range of 2.5 to 3.5. Now I have a new doctor, and he said I should be in the range of 2.0 to 3.0. My last blood count was 2.08 . Is this to low? The new lab people say no, it is not to low, but I am kind of nervous about it, just because the opinion changed from the old doc. to the new one.

Also, I know, I dumb question, but does your blood count go up with more vitamin k or down? As you can see, I should have asked questions on this. Thank you. It is tough to get old for me

 

[Rich]

Hi Jenny,
Vit K will make your INR go down.
As far as the range goes, it would seem each doctor has his/her own opinion.
For my aortic valve my range according to my doctor should be 2.5-3.5.
I have heard that for a mitral valve the range should be higher due to increased risk of clotting.
I am sure Al and those with MVR can answer better than me.
Rich

 

[Rich]

Will,
My INR was steady as a rock for over six years.
Then I retired and went absolutely crazy remodeling our house.
That huge increase in activity dropped my INR like a rock.
Thanks to Al I got right back on track within a short time.
Rich

 

[geebee]

Jenny,

The accepted INR range for a mechanical mitral valve is 2.5 - 3.5. Mine is actually 3.0- 4.0 because of afib.

Because of blood flow, the mitral valve tends to produce more clotting which is why the range is higher.

You should talk to your doctor about your concerns. Bring in some articles to show him so he understands 2.08 is too low.

 

[William]

Thanks Folks! Your responses are words of wisdom. Will

 

[Guest]

Jenny,
2-3 is not the range for a mitral valve. The only exception would be if you have had some serious bleeding problem. This would be a bleed that required you to be given blood or a bleed into the brain.

 

[Raverlaw]

I'll just chime in to say that I have been exercising pretty heavily and regularly for the last 8-9 months, and it is a constant struggle to keep my INR up in the range - it has been slipping down ever since I started to exercise. It has gotten to the point where I can predict how much more warfarin I need to take in a given week based upon how many hours of exercise I get. When I hurt my leg and couldn't exercise for about 6 weeks, my INR shot up like a rocket, and I had to adjust my dose downward.

 

[jenny]

Coumadin question again

Coumadin question again

Thank you all for anwering my questions...I called the doctor today and he said that he keeps his patients with a mitral valve between 2.0 and 3.0. Ugh, this is the second cardio doc that I have had since my OHS. I have also had the Maze with the St Jude Valve......I am now so very nervous about having a stroke. What would you all do? Do I try and find another doctor? Thanks again .

 

[Guest]

Call your insurance company's customer service number - on your membership card and explain the problem and ask for another cardiologist in your area. They will give you the names of those who are taking new patients and your insurance.

This has to be your top priority tomorrow. This doctor is incompetent. It's not like you live in some wilderness area and have only one doctor to choose from.

This doctor hasn't even bothered to read the guidelines. You are at risk for a stroke and the doc is at risk for a big lawsuit. Read warrenr's story about his dad.

 

[jenny]

Al.......Coumadin

Al.......Coumadin

Thank you , Al, I will look for another doctor. You probably are saving my life.. What an asset you are here. Thank you again. Jenny

 

[Don Giaquinto]

Don Giaquinto

Don Giaquinto

Exercise has a huge effect on the INR. The more you increase your heart rate, the more that the blood carrying the warfarin will go through the liver and be metabolized. This causes the INR to go down. I had a letter to the editor published in the American Journal of Cardiology about this.

People think I am nuts when I tell them, "Oh, you're feeling better? Then I will have to jack your dose up." But that is the way it is.

I am new to this sight and have already learned something. Apparently, excerise lowers your INR? I am only 4 weeks {almost} post op but I am antisipating getting back to heavy excerise.

I guess I have to antisipate problems with the INR and excerise? I was looking into a home test kit and will talk to my Dr. about it. Right now they are still tweeking by dose. Just yesterday I was adjusted to a 2.5mg one day and a 5mg the next.

I look forward to the feedback from this sight and apparently people trust your opinion.

Don G

 

[geebee]

Don,

Welcome to the family. You have come to the right place for assistance.

Yes, exercise lowers INR. Having a home INR monitor will definitely help you to keep track of how your INR will change as your exercise increases.

Best of luck and don't be shy.

 

[Guest]

Almost everyone's warfarin requirement increases as they recover and become more active. It may take a little longer to get your adjusted because you are probably going to increase your activity level more than most people, but that is good.

Valvereplacement has more people who are serious about looking into the facts than others that I have been associated with.

 

[McCln]

William

William

It will have an affect on the INR. I exercise five days a week. On each day I am do from 30 to 60 minutes a day workout, on bicycle and treadmill. The main deal on exercise is consistancy. Be consistant on your exerise regiment. Try to keep it the same every week. It make a difference. When you are adjusted, the INR wil stablized also. When you cut back, it will effect the INR. Mine was affected by antibotic, 3.8. But I am mostly consistant in my exerise and walk alot on the weekends. Good luck and build up slowly on the exericise. Do what you feel doing. Take care.