Hemochromatosis

[Eowyn Rose]

Need some help,

My INR level is still not maintainable. My dose has to get higher and higher. At this time ca. 4 months after op. I am on 9 mg and and the reading fell from 2.8 to 2.2. in a week. I think I most be a super Rat. As soon as I am on a dose for a around 14 days my body seems to be able to be more effecient in metobolasing the warfarin. I am also very carefully what I eat, no alcolhol etc. I am trying very hard. I have Gallstones which do me hardly any harm. So I think that might not be the reason to be unable to stabilize my INR. But what about my hemochromatosis. Could that affect it all?
If anybody got some answers?
Thanks
Eowyn Rose

 

[Ross]

I have Hemosiderosis which is a very close relative to Hemochromatosis. I'm not having that particular problem and I've been on Coumadin nearly 3 years now. I do have some wild swings, but seem to stay within range on a steady dose. Since our stuff involves Iron metabolism, I can't see where it would play a part, but perhaps Al can shed more light on it.

What is your diet like? Could you possibly be getting hidden Vit k that you don't know about? Many times being too careful of what you eat is what does you in.

 

[Guest]

Does your INR ever go too high? If so the dose may be related to gallstones.

There are also variations in the enzymes that metabolize warfarin that are somewhat related to ethnicity.

I think that Ross is correct that hemochromatosis should not be a factor, unless you are testing with one of the home testers. These require the blood to flow up a channel in the test strip. If your hematocrit (the percentage of red blood cells in your blood) gets too high it can stop the test from running. I'm not sure that this happens in hemochromatosis, but it might be a factor. Don't worry about it making the test inaccurate - it just won't run at all if the hematocrit is too high. You get an error message, not a false reading.

When you consider that they make warfarin in a 10 mg tablet, then you realize that 9 mg per day is not really an unusual dose. Four months after surgery means that you are still recovering. This means that you can expect your warfarin dose to still need upward adjusting.

 

[Eowyn Rose]

Thanks for your replays. My INR was never higher then 3.2. I am getting once a week tested by taking blood and sending it to the lab.
I am glad I can eliminate the possibility that Hemochromatosis is not afactor in my INR getting to low. I usually take the tablets after dinner before I go to bed. Would it be better if I take the dose in the morning on a empty stomach so Warfarin gets not carried or attached to food and eliminated much quicker? Al I do refer to your site a lot and it is a great help to me. I also read most of your responses on this forum, and learn heaps.
Thanks Ross an Al.
By for now
Eowyn Rose

 

[Guest]

Warfarin is a very slow-acting drug. The time of day that you take it makes little difference. The test is probably most dependent on what you took 3 days ago.

Food does not affect the absorption of warfarin very much. Just avoid taking it with a high-fiber laxative.