INR Ups and downs

[LUVMyBirman]

I have been logging my weekly INR results for the past four years. Every summer I go on the ride of my life.

AL's new study showed weather does not have much to do with INR fluctuations. Seems to be an issue here though.

Here are my results from the past month. Have been on 6-1/2 mg straight. Usually end up right back on my 6-1/2 daily.
4.2, 4.3, 4.6, dose change down 10% for four days 2.5.
Was hesitant to change my dose. But after going the three weeks high.....it appeared it was time. I did do a dose decrease to bring it down. I can never ever hold a day. When I am under 4.5 subtact 2mg for one day have a salad and end up right back where I should be.

Back up to 6-1/2 now. I was even eating high K foods on the
6-1/2 and still came out high

 

[Ross]

I've come to the conclusion that we are plants. The more sunlight we receive, the more photosynthesizing we carry out, hence increases in our INR's.
Is there any other explanation?

P.S. I can't blame it Rains dog all the time or she's going to get mad at me.

 

[Perrster]

I'm photosynthesizing, throw some fertilizer on me!

I'm photosynthesizing, throw some fertilizer on me!

Great analogy Ross. Although we've heard the "scientific" explanation from Al, we've also heard many a "witch-doctor" answer to the fact that Coumadin is a beast that we all have to learn to control. While I respect scientific opinions, I believe this beast is indeed affected by weather.

Every darn time a storm front goes through, I feel like my nose could bleed any time. I spend a lot of time in the sun (with the golf Gods) and can sense problems when they arise. I'm in a "catch-22" situation as my dose was increased a few months ago because of my increased activity, exercise and obvious photosynthesization.

Gina, do you have any symptoms to know your INR is running high, or is it purely because you can self-test more often? (FYI: I was denied insurance help again, so I have truly thrown in the towel and just thankful that my Cardio has a Coaguchek). But I won't test more than once a month-the cost is crazy.

Perry the plant.

 

[carbomedic]

yah, that's it, photosynthesization.

That's gotta be the reason for my INR ride too!

Ohmygod, I think I finally ate too much brocolli!

carbo

 

[LeoLillac]

INr ride the wave

INr ride the wave

HI , I was not aware that temperature effect's the INr
learn something new every week on this wonderfull forum .
My inr was 5.o a few week's ago for no reason ( no ididnot drink
mimosas I do not have any symptom's .
I am sure whe ni retrun from vacation my inr will be
higher happened last 2 vacations .
It must be to many full moon and solar eclipses
Enjoy the summer .
Dara
tricuspid valve replacement Feb9th2001
DR Fuster ( my angel)
Dr griepp ( surgeon)

 

[ccrawford]

Gina - The Pharm D at my former Coumadin clinic told me that there is usually a cause for a changing INR, so don't forget to mention it to your cardio next visit. I wouldn't have a clue, but a good question/answer session can sometimes pull the culprit out of the hat - so to speak. Chris

 

[Lisa in Katy]

Like a lot of things in our bodies, I think the INR fluctuates daily. For us women who still have fluctuating hormones, it's probably worse. I figure that as long as I'm taking my Coumadin and watching my diet, my INR won't be extremely low (which is my biggest worry). My extreme changes have always been on the high side, and I can tell those because of bruising/bleeding. I've been steady for 7 months now - 6 1/2 mg per day. With teaching, it has become more difficult to have blood tests, so I only go every other month. Though I won't recommend this to everyone, it seems to be working for me. When I was an elevator ride away from the lab, I was always fighting the fluctuating numbers. One test would be high, so I would adjust my dose and the next test would be low, etc.

I do think that checking the INR too often doesn't help. I think it can give you "false" highs or lows that would come back under control with a steady dose and diet.

My opinion, of course!

 

[DickV]

Lisa, I could not agree more. I believe changing coumadin dosage too often can cause problems in keeping INR's stable. I just averaged my last 36 tests going back a few years and it is 2.88 and my doseage during this period has either been 8.0, 8.5 or 9.0. I stay at 8.5 and bump up or down .5 mg. if I get above a 3.5 or below a 2.5 which is rare. Diet and exercise plus an occasional martini/cigar combination works for me. I test at least monthly but I have a machine which makes it easy.

 

[JimL]

I had a veinous draw yesterday, INR at 5.64. What to do?

I had some cysts removed last Friday, which meant anesthesia (does that affect INR? I sure had a nice nap...), antibiotics (which seems always to affect the INR one way or another), Darvocet (I don't remember if that affects INR), and a general decrease in activity (which raises INR).

Of those factors, only the darvocet continues for a while. I go for another INR check on 7-11, since my clinic is closed 7-4. So how much should I decrease? Should I go for another veinous draw before 7-11?

These are not serious questions, just part of the ongoing struggle with coumadin. My routine varies every day....

 

[ccrawford]

Jim - I can't give you an official reply, but Darvocet affected me by raising my INR. I questioned my former Coumadin Clinic and they verified that Darvocet can indeed do this. I don't think it affects it drastically, but if you are on a regimen, then, I bet you'll have problems. Hope this helps. Chris

 

[JimL]

Thanks, Chris, it does, as I try to weigh the various factors and decide how much to cut my dosage. I'll probably end up baring my arm for another needle on Friday, to get a fresh INR reading after cutting back.

 

[ccrawford]

Jim - I don't know if you have a dosing table/decision tree or not ? The one my clinic uses indicates that if the INR is over 4.0, then: Hold the daily dose for one or two days AND reduce the weekly dose by 10-20%, then check INR again in a week. I also checked Al's book - darvocet will affect the INR if more than 19 extra strength (500 mg each) are taken or if more than 26 regular strength (325 mg) are taken. Chris

 

[Lisa in Katy]

Antibiotics have always affected my INR by spiking it high - that's my excuse for not having my teeth cleaned (lol).

 

[JimL]

Many have reported the dramatic drop in INR from holding coumadin even one day; I've noticed the same.

Therefore, I took half a pill Monday, and the other half Tuesday. The end result is the same as if I had skipped Monday and took a whole pill on Tuesday, but the effect is a more even drop in the INR, at least I hope. It works out to a little more than a 10% reduction in the weekly coumadin dosage.

I haven't yet decided what to take today. I'll take 5 or 6 mg today and tomorrow, and then test again Friday.

 

[Rain]

Jim, I?m glad to hear you are retesting... I know I sure would.

Jim, I?m glad to hear you are retesting... I know I sure would.

Nah....Ross, I don?t mind you blaming the rotten dog.... but boy does it make Sara mad! She just cannot understand what the dog sleeping in the flower bed has to do with my INR. lol Al says its not the weather... so I've decided it must just be that we are more active when the weather is nice.

Perry, I know when my INR is high. I get these little red spots that start around my ankles and bruises pop up all over my legs. My gums begin to bleed easy and I have blood in my nose. And besides all that..... I can just ?feel? it. Thankfully none of those things happen at an irritating level until it reaches about 4.0 I certainly agree with Dick and Lisa about not changing the dose unless you absolutely have to. I've never liked rollercoasters.

 

[Guest]

I like the photosynthesis idea. Check the garage sales for copies of Kermit singing, "It's Not Easy Being Green"

I have a set of dosing algorithms available for those of you who want guidelines. Look at
http://www.warfarinfo.com/publications.htm

 

[Christine]

well,here's my two cents worth.. when i was living in dallas, my INR would shoot up once we hit the triple H's.. (hazy, hot and humid).. 90-100 dgrs... now that i'm in philly, my coumadin nurse actually agreed with my nurses down in dallas that heat makes the blood thinner thus higher readings.. it's been a month now since i moved and finally becoming stable again.. YEA...

so now i just got to keep informing my re-aquainted friends that i can go out with them, but can not drink like them.. which i really don't want to do anyway, but having to say no to a shot of snapps when i'm already having a few beers, sometimes is not a fun thing to do.. but it beats the alternative..

have fun...

Christine

 

[Ross]

So forget the beers and have a schnaps! hehe

 

[Guest]

Ask them where they got their information about heat thinning the blood. I could find nothing in any medical jorunal that the National Library of Medicine had going back to the 1960s. The only other study published was by Brian Gage and he found no change by looking at the INRs reported at their clinic in St. Louis over one year. Every month the average came out exactly the same.

Could you have consumed more alcohol during the hot summer months? That has a known effect.

Remember than warfarin does not thin the blood. It only slows the ability of the blood to form a clot.

Whe they talk about thinning the blood, do they mean the actual viscosity of the blood or are they talking about the ability to form a clot?

 

[sharon]

Weather and Blood

Weather and Blood

Well, I'll add my 2 cents. In upstate NY where the winters are really cold (dreary and long too) people are told not to go out and shovel snow if they have a heart condition because the blood is much thicker during the winter and the extra exertion could lead to too much of a strain on the heart. So, if it gets thicker in the winter it stands to reason that it gets thinner in the summer. Why else do people who have lived in northern climates and then move down south always say that their blood has thinned so much that they can't take winter temperatures anymore?