Natto and INR

[slipkid]

Amoxicillin takes care of Infection not swelling. Aspirin or other aspirin like helps the swelling.

True but I suspect maybe it was the infection that was causing his tissue to swell (with all the bugs and immune system junk that piles up when your body fights that) thus the antibiotic killed the bugs such that the swelling due to the infection cleared up as he healed.

 

[Protimenow]

I'm probably taking too low a dose of K2 to make any difference to my INR,

I take it daily, so if there WAS an effect, I've already compensated for it by dosing for any changes.

Sorry, Pellicle - I missed the part about Natto being high in K2.

 

[Chuck C]

I'm probably taking too low a dose of K2 to make any difference to my INR,

I take it daily, so if there WAS an effect, I've already compensated for it by dosing for any changes.

Sorry, Pellicle - I missed the part about Natto being high in K2.

How much do you take daily? I take 2 x 100mcg capsules. As mentione earlier, I took an extra 500 mcg recently, with no noticed effect. I did take 25 capsules, with guidance from the coumadin clinic, when my INR went to 9.7, with the intent to lower it significantly, which I have reason to believe that it did, although there were some confounding factors.

I do have an interest in finding the dosage which lowers my INR 0.2 to 0.4, as I do martial arts and on days when I have significant physical contact, I would prefer to be at the lower end of my range. I'll be doing some n=1 trials (meaning me being the one participant) and inching my dosage up to see at what point I see movement of my INR). I'll be sure to update the forum with my results.

 

[pellicle]

Oops

 

[Dana]

K2 drops INR. In fact, in Japan it is used often to bring INR down when a patient's INR has gone dangerously high.

When my INR went to 9.7, due to the Amiodarone, the first thing that the coumadin clinic did was to ask me if I had vitamin k or k2 on hand. As I just had k2 they had me take 25 x 100mcg capsules. It takes a lot of the over the counter capsules, typically of 100mcg each, to drop INR.

To give you an idea of how much K2 Bionic Orange ate, it was 2 packages of 100grams of natto, two days in a row. 100 grams of natto has about 1,000mcg of K2. So, he ingested 2,000mcg of k2, two days in a row. That is the equivalent of taking 20 of your 100mcg capsules, two days in a row. Much different than taking 2 or 3 capsules. 2 or 3, or even 4 or 5, probably not enough to drop your INR. Taking significantly more than that, at some point, will move INR downward.

I take 200mcg of k2 per day. That is not enough to move INR much, and since I am consistent with taking it daily, it would not even move my INR a little. On Friday night I did an experiment, taking an additional 5 capsules of k2, or an extra 500mcg. That was not enough to change my INR. But, I am going to try increasing it gradually, until I get to the point where I get a noticeable drop. I'll let the forum know if I find the leverl of k2 which moves INR.

Don't forget that there are different forms of K2. Over the counter supplements are available typically for MK-4 and MK-7 forms. MK-4 does nothing to my INR but MK-7 acts just like K1 in me. I would be interested to know what kind you take. Check your bottle to see what kind of K2 you are using. Thanks.

 

[Chuck C]

Don't forget that there are different forms of K2. Over the counter supplements are available typically for MK-4 and MK-7 forms. MK-4 does nothing to my INR but MK-7 acts just like K1 in me. I would be interested to know what kind you take. Check your bottle to see what kind of K2 you are using.

The form of K2 that I take is Mk-7.

 

[Protimenow]

You may try a supplement with a low dose of K1. K1 is known to reduce INR, and may have a more predictable (and possibly faster) effect on INR than K2. You may be able to adjust the dose to bring your INR to your target range.

One other question: Was your 9.7 INR the result of a lab test? If so, did the lab rerun the test using the same blood sample? Did they have you return for a retest? It's possible that the lab screwed up the handling of the blood draw. I've had some crazy results from some of the labs that I used - and testing using a meter or other labs confirmed that the FIRST lab results were long.

I don't think the XS can even give you a number that high.

 

[Chuck C]

One other question: Was your 9.7 INR the result of a lab test?

Yes, it was at the lab.

Given the well documented effect of amiodarone on INR and especially given the high dosage of amiodarone that I was placed on, it was not surprising that my INR went to 9.7. It was something that was overlooked by the pharmacist and also the coumadin clinic. Given that I was on a high dose of amiodarone, my INR should have been tested daily for at least a few days.

I will link a study below, which actually suggests proactively reducing warfarin dosage at the time of of administering amiodarone. At 400mg/day of amiodarone, they recommend a 40% reduction in warfarin(see quote below). I was on 800mg/day upon release- twice as high as the 400mg/day, for which they suggest a 40% reduction in warfarin. The study did not even contemplate a dose as high as mine, but the effect on INR is dose dependent. I can tell you that I sure wish that I had my Coaguchek self testing device upon my release, so that I could have checked myself. To be clear, I am just quoting the study linked and not advocating that anyone proactively reduce their warfarin if they go on amiodarone. That is something to be discussed with your cardiologist, but I would bring the studies on amiodarone and INR to his attention, to facilitate the discussion about the need to monitor INR very closely, upon administration of amiodarone. For those who are not familiar with amiodarone, it is often prescribed for irregular heart rhythms, such as afib. As valve patients, with a higher risk of developing afib than the general population, I would suggest that we should have amiodarone on our radar.


"The study found that the impact of amiodarone on the INR was directly related to the maintenance dosage of this medication. The authors state that with amiodarone dosages of 400, 300, 200, or 100 mg per day, the warfarin dosage should be reduced by 40, 35, 30, or 25 percent, respectively. "

https://www.aafp.org/pubs/afp/issues/2002/0415/p1669.html

 

[pellicle]

Don't forget that there are different forms of K2.

Indeed, just to throw this out there there are two basic forms

1. Phylloquinone - the form in plants
2. Menaquinone - the form in animals

K2 is often written as MK-n where  n Is the integer for the type
Eg MK-7 would be Vitamin K2-7

Some reading for those who are interested

https://en.wikipedia.org/wiki/Vitamin_K

https://pubmed.ncbi.nlm.nih.gov/23590754/

 

[Protimenow]

I'd forgotten that you were taking Amiodarone. That's a mean drug. It contains Iodine, which is no favorite for your body.


I was taking it briefly after my heart rhythm started doing the polka, a waltz, and the Freddy (are any of you old enough to remember the Freddy?) all at once. That medication stopped my intestines from running, and after taking that sheeit for a week, my abdomen turned to stone, and I was readmitted because I had severe constipation (caused by Amiodarone), and my rhythm hadn't resolved (okay, it was Fox Trot instead of Freddy, but still wasn't right).

 

[Joseph]

Always late to the party, and coming back to natto, there's something similar in Korean cuisine called cheonggukjang (청국장). I'm not a fan but having a Korean spouse am familiar with it along with doenjang (된장) which is its fermented cousin. I eat plenty of doenjang (mostly in traditional stews) without seeing large swings in my INR. Neither are ingredients I would be eating by the spoonful on their own.

 

[Protimenow]

Doesn't your cousin mind being fermented?

 

[Bionic Orange]

Normally I take one teaspoon which provides about 115 mcg of vitamin K2 MK-7. If my INR is on low end of my therapeutic range I don't take any but never more than one tsp.

I have developed a taste for it and wish I could eat more but I don't.

Delucadana, this is like eating 1 blueberry in a bowl of blueberries, or 1 chip from a bag of chips, or 1 peanut from a bag of peanuts. You, my natto-friend have more restraint and willpower than I will ever have. I love natto but I've learned to leave it alone as I do not have the willpower for just 1 tsp. At least I now know there is one other person on this forum with sophisticated and well-developed tastebuds.

 

[Dana]

Somehow I have two different log-in IDs. Delucadana and Dana are one and the same.
Haha, one teaspoon is still a treat for me, though. I sometimes wonder if I allowed myself to eat as much natto as I want, if I would get sick of it. For a while I made my own natto in a pressure cooker but my wife didn't like the stink of the kitchen during the process. Good to know there are fans as I have never met one except for the person who introduced it to me. More typically the reaction is closer to what Anthony Bourdain said on his show:

…The Japanese love natto, an unbelievably foul, rank, slimy,
glutenous, and stringy goop of fermented soybeans. It’s the Vegemite
of Japan, dearly loved by everyone there, for reasons no outsider can
understand. If the taste wasn’t bad enough, there’s the texture. There’s just no way to
eat the stuff. I dug in my chopsticks and dragged a small bit to my
mouth. Viscous long strands of mucouslike material followed, leaving
numerous ugly and unmanageable strands running from my lips to the
bowl. I tried severing the strands with my chopsticks, but to no
avail. I tried rolling them around my sticks like recalcitrant angel
hair pasta. I tried slurping them in. But there was no way. I sat
there, these horrible looking strings extending from mouth to table
like a spider’s web, doing my best to choke them down…

I love that description.

 

[pellicle]

It’s the Vegemite
of Japan, dearly loved by everyone there, for reasons no outsider can
understand. If the taste wasn’t bad enough, there’s the texture. There’s just no way to

as an Australian I found living in Japan intresting, they have a food there (based on seaweed) which tastes remarkably like Vegemite. The trick with Vegemite is to spread it thin and over buttered bread, otherwise it's too strong a taste for the uninitiated. However that's the thing we do, encourage them to slaver it all over the bread and then sit back and watch the entertainment reaction.

Having said that I've not actually bought Vegemite in decades.

I tried severing the strands with my chopsticks, but to no
avail. I tried rolling them around my sticks like recalcitrant angel
hair pasta. I tried slurping them in. But there was no way. I sat
there

While living in Japan I saw a program on TV (probably NHK) where they did a test on how long these strands could be made. They ended up having a table on the ground and the person sat on a platform held on a forklift. They tested varoius Natto makes. The "winner" reached the maximum lift of the fork lift and was eleven (11) meters.

If the taste doesn't put you off and that didn't then I guess you're good to go.