INR is low

[NascarfanMary]

I am at 2.2 this week, first time in about 3 weeks. I am having a hard time understanding this. They have my range at 3.0 to 3.5 and I was within in the range for about 3 weeks.

I was wondering what I could have done to cause it to go low? I haven't changed any of my diet, I am not on any new meds, and my exercise has increased more. I try to exercise everyday even on days I dont have rehab.

My Cardio has incresed my coumadin to 8mgs. I am goin to be retested next week. I haven't been at this high of dose since surgery. After OHS I was taking 10 mg in the hospital but I have been @ 7.5 mgs or 7 mg and have stayed stable since I have been home.

One more question: Does Vitamin k foods cause the INR to be too low or does it cause it to be high? My Dr. asked me after telling me my results, if I had eaten alot of greens. I havent changed anything that I have been eating. I just don't know what happened.

The only thing I really have to complain about is I have been feeling extremely tired. I do feel better. I am not as short of breath as I have been. I am just so TIRED! Could this have something to do with the coumadin? If any one could help, I would appericate it. Thanks!

 

[McCln]

You should have had a pamplet when you got on the coumadin. But here is goes. Yes, green, leafy vegatibales will lower your inr levels. I had a small salad within the three days and on the third day, took my inr and it was low. Another time, ate green beans, less than a cup and it was low again. There are a lot of foods with vitamin k, but it tends to be green, leafy, vegetables that is higher in vitamin K content. Just go over your diet, look at what foods you are taking in and how much green you are eating. Good luck in bringing you inr up I know how frustrating things are. Take care.

Caroline
09-11-03
Aortic valve replacement
St. Jude's valve

 

[Nancy]

More exercise will also make you metabolize Coumadin more. That might be it.

 

[Johnny Stephens]

and my exercise has increased more. I try to exercise everyday even on days I dont have rehab.

I agree with Nancy. Increased bloodflow from exercise will cause you to metabolize it more quickly. This is actually fairly common when people start to really recover.

 

[Guest]

Do not worry about how high your warfarin dose is, only the INR counts. I have seen people who needed as little as 4 mg per week to as high as 160mg/wk. It depends mainly on the variations in your liver enzymes that metabolize the warfarin.

You are on the right course. There has been at least one study published showing that as people recover from valve surgery they need more warfarin.

 

[NascarfanMary]

INR is within range

INR is within range

My cardiologist has me taking 8mgs of coumadin and I will be restested in 2 weeks. I am concerned about it getting low during that time. It seems that if I am tested weekly, I feel more comfortable. I have read about the way the body metablizes the medication when you are more active. Could someone explain how the liver abosrbs the coumadin? Last week I was worried about the high dose, and praying the this week I wouldnt have to hold a dose. But it was at 3.1 and I dont have to change dosage. I am trying to learn as much as I can about the vitamin K foods. Sometime feeling guilty for eating a small portion. I know that the Dr. told me to watch the greens and if I eat the same amount each week, then they would have to adjust the dosage according to how much I eat. I keep a diary of my diet and look back on the weeks that I have been low. I am consitant. So it must be the activity and more exercise that makes it go low. I read alot of posts from AL and it is a big help to me and anything I can find about coumadin on the web. When I began taking coumadin, I had little information given to me. My pharmacist is one of my closest freinds, and she has help lot with my questions. With her help and the site, I have learned alot in the past few months. Thanks for your help.

 

[Guest]

If you came to my clinic and had been taking a warfarin dose for one week and your INR was in range, then I would lengthen the interval between appointments to 2 weeks.

The liver contains enzynes that metabolize foods drugs etc. When the blood is pumped into the liver, these enzymes get rid of a tiny amount of warfarin. Each pass gets rid of more warfarin.

There are some drugs that get entirely metabolized the first time that they pass through the liver. This is why some medications can be given only by injection.

 

[NascarfanMary]

Bruises

Bruises

I am finding more bruises on my legs and arms. I do have one that is a little painful on my lower leg. I have been watching it carefully, since i have had several blood clots before. I know that when my INR is low, there is a chance for clots to form. I had one in Dec. in the upper right arm near the shoulder and it took a while for thr dr. to get is dissolved. Is it more common for people on coumadin to bruise more? I was just concerned that I am bruising more lately. Wondering what could be going on. Thanks.

 

[Dee]

I too have had a hard time keeping my INR levels in range. I take 7.5 everyday and eat a little greens everyday. It's seems to get a little easier as time goes on (I'm 5 mths post op). The other thing that has helped me is that I have a home test kit, CoaguChek. Then I can test anytime I want if I feel like maybe it's off for some reason. My insurace paid 100% for it, you might want to check into that.

Have you visited Al's website yet??? It has some great info on there.
It's www.warfarinfo.com
I also found out that there are other things besides greens that contain vitamin K. Mayo is one of them and cauliflower......check out his website and it gives you a list of things.

Good luck on the warfarin war!

~DeeDee~

 

[tommy]

A reading of 2.2 with a target range of 3.0-3.5? I would prefer to be tested again in a week. 2 weeks is a long time, especially with a history of clots.

If you are excercising in addition to rehab, you could be over doing it -that could be why you are tired, but frankly doesn't explain "extremely" tired.

Diet constency is the key. Live your life and adjust the dose.

 

[catwoman]

Dee:

Mayo (7 Tbsp) is HIGH in vitamin K; cauliflower (1 cup) is LOW in vitamin K, according to the trifold info Coumadin from Bristol-Myers Squibb.
I tried to print out the list on vitamin K from the USDA. It's a pdf file and keeps stalling on p4 of 5. It lists specific vit. K content in a variety of foods.

Al:
Odd thing: Cabbage (1 1/2 cups) is HIGH in vit. K; 1/2 cup of canned sauerkraut is LOW. What is sauerkraut made from? Cabbage. Read somewhere that acid kills/counteracts the vit. K.
Is this true? Does that mean we can use a vinegary oil on salad and eat all the greens we want?

 

[nascar08]

Prayers

Prayers

well i hope your inr level gets better. i think you should get one of those inr machines. also i think you should have dr. rosenthau have you call him for any problems or concerns about your inr level. well hope you get better.

 

[Guest]

I'm not a sauerkraut expert.

 

[McCln]

Eveyone

Eveyone

Hi everyone, here I go again myself. My INR was a low 1.8 this week. We think it was my week of fried eggs in vegitable oil. I will change this very quickly. I found a olive oil cooking spray Always Save brand. I will get it this weekend. I just can't give up vegitable oil or fried eggs completely. The other day, I gave in to eating three eggs, which probably lowered the INR. I will do better on my changes in my daily diet. Just be kind to me. Take care all.

Caroline
09-13-01
Aortic valvereplacement
St. Jude's valve

 

[JimChicago]

The coumadin cookbook says olive oil has about 13.7 mcg/oz vit k and treated (exposed to sunlight fot 48 hrs) olive oil has about 2.1 mcg/oz

In contrast they say corn oil has .8 mcg/oz

But many say olive oil is better for one's arteries. It pays to test often with any changes.

 

[Peacebella]

Hi,

I took some excedrin one day, and then 2 days later I had a large bruise, figured my INR was too high so, I held one dose. Went and had my PT/INR done 2 days later and ended up in the hospital 2 days as my INR went down to 1.7. Just recently I had my teeth cleand and took the usual amoxicillin prior to cleaning. Went for lab next day and it had dropped. So there are so many things to watch. Good Luck. My doc won't give me a script for the at home pt/inr machine, as I had a mitral and aortic valve replacement. Thinks I might adjust my dosages...not me.

Peace and Love,
Kathie

 

[cinda575]

my Inr last week was a 2.02 and this week was a 1.8 my dr. is freaking out and it is a new dr. in a different state and cannot refer me to anyone because of all the red tape on insurance. I was supposed to get it taken yesterday again but it takes 4 days for me to get the results, so i do not know what to do, i dont want blood clots .I have been doing nothing differently but i have been taking metro-gel . that was 2 weeks ago , a week before the 2.02 reading. then last week it was down lower. who knows ...I am just sick with this INR s***. So he has me on 10 mg t,th,sat and sun. and 7.5 on m,w,f. And i cant seem to get rid of a problem i have so i am taking another weeks worth or medicine. should i go to hospital? when i was in there after surgery they wouldnt lwt me go until they got me to at least a 2.4 and i was at 1.8 then for 4 days ....please let me know what to do.

 

[bvdr]

It is dangerous for your INR to be that low. Lovenox can be used to hopefully offer you another method of protection while your coumadin dosage is being adjusted. Waiting four days for an INR result is preposterous! I think you may need to really push this issue........your health is being risked each day your INR remains low.

 

[Guest]

Cinda,
You should seek a clinic where you can get the results while you wait. Look at www.acforum.org and click on clinic locations. Taking 4 days to get results of an INR in way, way below the standard of care. There is absolutely no reason why you cannot get them the same day.

How long have you been on warfarin?

If you have an INR of 1.8 and you need to be at least 2.0, you should be getting about a 20% dose increase.

 

[Peacebella]

low INR

low INR

Hi Again,

Since being hospitalized 3 weeks ago, my INR is finally up to a 3 today. When I was in the hospital, i had several injections of lovenox and 10 mg of coumadin one day and 15 the next. The 3rd day my iNR was 3.25 and they released me from the hospital. I get my INR's checked at my cardiologist and worked out a deal to pay only my copay. Finally I can wait 2 weeks for my next INR. Good luck, and def. go somewhere where you can get results the same day.