INR drops with excercise

[gerrychuck]

I definitely see a correlation between exercise and INR over the 7 years I've been self-managing. Specifically, with moderate or higher intensity exercise; brisk walks and being generally active doesn't have the same effect. My theory has been that exercising turns up my metabolism, and that increases the rate at which my body processes and eliminates the warfarin. The metabolic theory also seems to hold in that I have had to adjust my dosage down incrementally over time as I age, and as my overall stress and activity levels have declined (i.e with retirement). I started out with 8 mg/day, and currently I take 6, or less when the various factors that affect me are in play (alcohol, exercise, illness, acetaminophen). But for me, exercise is definitely a significant factor.

 

[pellicle]

Hi

I definitely see a correlation between exercise and INR over the 7 years I've been self-managing. Specifically, with moderate or higher intensity exercise; brisk walks and being generally active doesn't have the same effect.

indeed, I see it too in the short term, but (for myself) once my (lets say winter skiing training) starts by a few weeks I'm sort of back to where I was. So for me its transient, and once my fitness levels are up higher that effect drops away. I suppose I could keep pushing the envelope and that may keep it happening.

So to be more accurate (rather than general) I find that I see it, but eventually it diminishes. Once I remain consistently active it returns to within 0.5mg of what I needed before (my dose varies between 6.5 and up to 8mg FWIW). If I do sporadic exersize I see the effect again at the start (quite reliably, indeed at first I thought I was onto something). I have been unable to make any predictions about "how much" I'll need, so while I'm aware of it measure and dose accordingly is still my go to.

We are each a bit different however so one should determine how one responds for ones self.

 

[user 15848]

Agree, it makes sense, since warfarin is processed by the Liver and stress, exercise and others may influence
liver functions at some level; at least for me that is the explanation for when the doctors rise their eyes
and say "whe dont know why sometimes inr goes up or down", just a thought

 

[dick0236]

.........that is the explanation for when the doctors rise their eyes
and say "we dont know why sometimes inr goes up or down", just a thought

I agree with your docs. I gave up trying to figure warfarin out a long time ago. I simply try to keep my INR within my range, 2.5-3.5 and don't sweat the occasional 2.2 or 3.8 INR which I occasionally get......on a consistent daily dose, 5mg. That said, I do think that age and activity have played a role in my dosing.....when I was young it took 10mg/day warfarin that gradually reduced to my current 5mg/day.

 

[tom in MO]

Well the probably the biggest general effect of exercise is probably dehydration or if you consciously try to combat this, over hydration. My brother-in-law has sent himself to the hospital twice due to triathalon dehydration episodes. He's 62 but thinks he's 40. Think of what that would do to your warfarin/vitamin K equilibrium...

When it comes to warfarin metabolism, exercise helps your bowels work better, dehydration makes your bowels work less efficiently and slower, while hydration helps affects your colon process what enters your stomach. Travel makes some drink less water. Travel also makes some constipated or gives them loose bowels if they have any one of a number of bowel disorders (e.g. IBD, IBS or Crohns) effected by changes in diet, mood, stress, etc.

There's a lot of variables before the biggest variable...each of us is different yet alike. That's why we dose the diet not diet the dose