INR change with exercise

[jeffp]

How much change in INR do you see with increased exercise? I'm just at the point where I'm walking at an almost brisk pace (vs the slow stroll I'd barely been able to do a few weeks ago). Currently up to 1 1/2 miles each day. Not scheduled for blood draw until next week (last was 3 weeks ago while I was at the stroll stage - dread the venipuncture - almost always get woozy or pass out - yeah, I'm a wuss). Have gradually upped the coumadin from 52mg per week to 56 over the last 2 weeks with exercise increase. Would like to get some others input on how they changed as they got up and about more.

 

[Rich]

Jeff,
When I was recovering I walked about a mile twice a day, every day.
It did not affect my INR.
However after I retired several years ago I went a little crazy with home remodeling.
I was an engineer sitting behind a desk for many, many years, I was not in the remodeling business.
The huge increase in hard physical activity dropped my INR like a rock.
Thanks to Al I got back on track.
I have been getting that poke in the arm for almost nine years now.
You will get used to it, the best thing to do is not look at the needle going into your arm.
If the person drawing it is pretty good you shouldn't even feel it.

 

[ccrawford]

Jeff - I don't know that anyone has ever quantified the relationship between exercise and INR, although it is well known that it happens. Anytime you start pumping more blood thru the liver, it will cause the INR to go down. As a side issue, have you tried to find a Coumadin clinic in your area that uses a finger-stick method of testing ? Sure beat the blood draw.

 

[William]

I posted the same question weeks ago because I like to exercise and it seems that it will make your INR go down. How much depends on a number of things. As I recovered from my replacement and did more, my INR lowered. Will

 

[bvdr]

Jeff, what was your INR before you increased your activity level? Three weeks seems a little long between blood draws at this stage of your recovery.

My highest weekly warfarin dose was 49 mg and that was during a time when I was feeling good and very active. Now I am on only 30mg a week and am in range. I check weekly and add or shave a mg or two a week when needed. I am usually in range. I know that for me exercise makes a big difference. The only other period of time my requirements for warfarin was suddenly greater was when taking a prev-pak for a bleeding ulcer. I was taken off my daily aspirin but not my warfarin. My INR dropped to 1.6 and it took a couple of weeks to get it back in range. I was on Lovenox in the meantime.

I do hope you are going to home test?

 

[tommy]

When I went from couch to heavy running, my dose increased 10%.

 

[jeffp]

Jeff, what was your INR before you increased your activity level? Three weeks seems a little long between blood draws at this stage of your recovery.

My highest weekly warfarin dose was 49 mg and that was during a time when I was feeling good and very active. Now I am on only 30mg a week and am in range. I check weekly and add or shave a mg or two a week when needed. I am usually in range. I know that for me exercise makes a big difference. The only other period of time my requirements for warfarin was suddenly greater was when taking a prev-pak for a bleeding ulcer. I was taken off my daily aspirin but not my warfarin. My INR dropped to 1.6 and it took a couple of weeks to get it back in range. I was on Lovenox in the meantime.

I do hope you are going to home test?

INR has been in the 2.6-3.0 range since my discharge. Was getting tested 2-3 times a week for the first 2 weeks, then once a week for the next 2. I will be doing home testing but my cardio wants to have me testing on venipuncture for 3 months before he has me go over (I think its an insurance issue as Medicare has that guideline and where Medicare goes, so the rest of the industry seems to go). I really just want to get stable, get my strength and stamina back, and get back to some assemblance of a normal life. (yeah, I want it all, don't I!)

 

[danielgilboa]

Hi Jeff,

Going the right way - don't give up or slow down the walking.
It seems like many of us experienced drop in INR when raising the physical activity (me too), but we all reach this drop 4-10 weeks post, so who knows, maybe it is part of the stabilizing process. I found my INR stabled out after about 3-4 months. Now I can pretty well predict what will happen to it as a result of changes in life style and diet.
I think you should still be testing every week until it evens out aspecialy since you are still going through the recovery process. Things are changing, probably also your eating habbits, maybe weight, activities etc.
There is no technical reason not to begin home testing the day you get back from the hospital. If you can handle a cell phone (well, depends which one...) you can handle a self tester. I don't know about insurance and doctor's reimbursment considerations. I needed to buy mine so I got it a week after I got back from the hospital.