Low dose Vit k to stabilze swinging INR?

[Ross]

Al have you read up on or heard of news of this?

http://www.clotcare.com/clotcare/vitaminkstabilizesinr.aspx

 

[DrAllan]

I'e copied my note in a previous replay to a similar question: I personally plan on starting increased vitamin K once my atrial ablation at the Cleveland Clinic is well healed and I am off of oral steroids for some other problems. Once i have some rsults,i will post
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The closest I have come to anything that approaches your question is a patent application about mixing high dose vitamin K with warfarin. The premise is that the dietary fluctuations are a small percentage of the total oral intake under these circumstances and there is less fluctution in the INR. Althought the patent alludes to this, there are no studies in themedical literature to support it. Attached is the abstract of the patent. If you wish to read the entire patent, then go to the patent office website at www. Uspto.gov and do a search on the patent number in the published application section.

Best to you

Allan

United States Patent Application 20050215625
Kind Code A9
Nesselroad, James M. III September 29, 2005

Combination therapy for anticoagulation

Abstract
A combination anticoagulation medicament including vitamin K with warfarin in an oral form is described. Between 50 and 5000 micrograms of vitamin K are combined in a single oral medication with 0.5 to 15 milligrams of warfarin for administration. The combination of vitamin K with warfarin in a single orally dosed form is a novel approach to improving the effectiveness of anticoagulation. The combination allows for broader application of warfarin in medical anticoagulation and reduces the variability of anticoagulation due to the influences of diet, additional medications, nutritional status, changes in physical condition, and potentially other factors. Use of the combination therapy improves the safety of warfarin as an appropriate anticoagulant for many medical conditions.
__________________

 

[Karlynn]

The article, at the least, is a justification for our "Dose the diet, don't diet the dose" mantra.

It would be interesting to do a poll asking warfarin members if they do or do not intentionally limit Vit. K intake, and if they consider their INR stable.

 

[Ross]

It would be interesting to do a poll asking warfarin members if they do or do not intentionally limit Vit. K intake, and if they consider their INR stable.

Make it so, but I think the results of members would be that they do not. Now new people that are coming in........Well we've heard the same old blah blah for so long that it makes me want to correct all the crap they've heard before going any further.

 

[jwilliamsr]

Do Not Attempt This At Home......

Do Not Attempt This At Home......

.... WITHOUT THE BLESSING AND SUPERVISION OF YOUR CARDIOLOGIST AND/OR WARFARIN MANAGER.

Ross,

I had previously read the article in Pharmacotherapy referenced in the bibliography as #1. (Low-dose vitamin K to augment anticoagulation control)

Small group of patients. Needs a larger study, but is very interesting. Apparently the theory is that fluctuations in dietery intake of vitamin K become small (as a percentage of total vitamin K intake) if you take a small dose of vitamin K daily in tablet form. Therefore dietery vitamin K intake might have a smaller influence on INR. I don't think the Pharmacotherapy article mentioned the warfarin dosages administered to the study patients, but I would think the patients receiving the vitamin K would require higher warfarin doses.

I mentioned it to the manager of my Coumadin Clinic and she had not heard of it before. I plan to take her a copy of the article.

I am anxious to here Al's opinion too!

jimmy

 

[Guest]

I thought that we had discussed this before. Dr. Kathy Hassel, a hematologist at the University of Colorado, says that she uses it.

The idea is the same turning on a 3-way light.

If you go from 0 to 50 watts, you have made an infinite jump and your eyes might hurt from the contraction of the pupils.

When you go from 50 too 100 watts, you have made a 100% increase and it is very noticable.

When you go from 100 to 150 watts, you have only made a 50% jump and the change is noticable less.

You can plug in mcg of vitamin K for watts.

The main difference is that as you increase the vitamin K, you will need larger doses of warfarin.

Henry Bussey's ClotCare site should always be a trusted source. He is the only pharmacist on the Chest Guidelines committee. He brings in so much money from drug company grants that his daughter Marie's full time job is managing the site.

 

[Ross]

I thought that we had discussed this before. Dr. Kathy Hassel, a hematologist at the University of Colorado, says that she uses it.

The idea is the same turning on a 3-way light.

If you go from 0 to 50 watts, you have made an infinite jump and your eyes might hurt from the contraction of the pupils.

When you go from 50 too 100 watts, you have made a 100% increase and it is very noticable.

When you go from 100 to 150 watts, you have only made a 50% jump and the change is noticable less.

You can plug in mcg of vitamin K for watts.

The main difference is that as you increase the vitamin K, you will need larger doses of warfarin.

Henry Bussey's ClotCare site should always be a trusted source. He is the only pharmacist on the Chest Guidelines committee. He brings in so much money from drug company grants that his daughter Marie's full time job is managing the site.

I guess we did, but my failing memory or pumphead just didn't get it sunk in.

 

[Guest]

I wasn't sure that I didn't write it for somewhere else either.

 

[Randy & Robyn]

My inr has been incredibly stable since my surgery in February...always between 2.6 and 3.0.

I take a multivitamin that contains vitamin k every day with meticulous consistency.

Randy

 

[jwilliamsr]

My inr has been incredibly stable since my surgery in February...always between 2.6 and 3.0.

I take a multivitamin that contains vitamin k every day with meticulous consistency.

Randy,
If you don't mind my asking, how much vitamin K is in that multi-vitamin?
Thanks,
jimmy

 

[aussigal]

I can see the logic in the article ...
I went off on a web-search and found others recommending the same thing both in tablet &/or "real food" forms...
it makes perfect sense to me too...

Yay for green vegies!

 

[Cris N]

I take a daily multivitamin - Walgreens Super Aytinal vitamins with 80 mcg Vit K. It has greatly improved my INR in-range readings. 80 mcg is the RDA.

 

[Guest]

It seems to me that amounts above 20 mcg per day will cause an increased dose of warfarin to be needed. 80 mcg is a rather hefty amount. It should stabilize the INR very well.

 

[Ross]

I may have to try this. I hesistate because when I do eat things with K, I eat alot of them, but on the other hand, I have a crappy diet.

 

[Randy & Robyn]

Randy,
If you don't mind my asking, how much vitamin K is in that multi-vitamin?
Thanks,
jimmy

It's a one a day men's health formula and has 20 mcg of k in it.

 

[Cris N]

It seems to me that amounts above 20 mcg per day will cause an increased dose of warfarin to be needed. 80 mcg is a rather hefty amount. It should stabilize the INR very well.

Yes, it did increase the warfarin dosage but happily stable.