New Member

[billD]

My tricuspid valve was replaced with a mechanical heart valve in late 2020. I am fairly active and am interested in how people on warfarin mange their Vitamin K intake especially when they are away from home.

 

[tom in MO]

Welcome to the forums.

I take along my home tester and check my INR once a week and adjust as needed. The last time it went up since I wasn't eating as much vegetation as usual

 

[ValveAdmin]

Hello Bill, welcome to the forum.

 

[pellicle]

My tricuspid valve was replaced with a mechanical heart valve in late 2020. I am fairly active and am interested in how people on warfarin mange their Vitamin K intake especially when they are away from home.

Hey bill ... wow .. a tricuspid!

I manage my warfarin based on what I've written here:
http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html
and here:
http://cjeastwd.blogspot.com/2015/10/managing-my-inr-example.html
I don't manage my vitamin K, and indeed I prefer to just eat a good diet. There is very little actual evidence that a good healthy diet does anything more than increase your health and perhaps even stabilise your INR

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4998867/

In conclusion, the available evidence does not support current advice to modify dietary habits when starting therapy with VKAs. Restriction of dietary vitamin K intake does not seem to be a valid strategy to improve anticoagulation quality with VKAs. It would be, perhaps, more relevant to maintain stable dietary habit, thus avoiding wide changes in the intake of vitamin K. Based on this, until controlled prospective studies provide firm evidence that dietary vitamin K intake interferes with anticoagulation by VKAs, the putative interaction between food and VKAs should be eliminated from international guidelines.​

Best Wishes and Welcome Aboard

 

[LondonAndy]

Welcome, billD. I shall join the bandwagon for self-testing. Whilst some people react differently to diet changes, I have generally found my INR remains pretty stable. The greatest effects on my INR are when I have a cold (a significant drop in INR even preceding symptoms), or when I am on antibiotics, when INR goes up a lot. I eat random amounts of foods containing vitamin K. However, when on holiday with a very different diet and a significant increase in alcohol consumption, I do see more variation in INR, and have sufficient experience now to adjust my own dose as needed.

I use a CoaguChek XS meter and test my INR weekly. The UK's National Institute of Clinical Excellence, which advises our NHS on best practice, produced this report that shows how beneficial it is to use a home meter. Only the CoaguChek products are approved here, to meet necessary accuracy standards.

 

[billD]

Hey bill ... wow .. a tricuspid!

I manage my warfarin based on what I've written here:
http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html
and here:
http://cjeastwd.blogspot.com/2015/10/managing-my-inr-example.html
I don't manage my vitamin K, and indeed I prefer to just eat a good diet. There is very little actual evidence that a good healthy diet does anything more than increase your health and perhaps even stabilise your INR

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4998867/

In conclusion, the available evidence does not support current advice to modify dietary habits when starting therapy with VKAs. Restriction of dietary vitamin K intake does not seem to be a valid strategy to improve anticoagulation quality with VKAs. It would be, perhaps, more relevant to maintain stable dietary habit, thus avoiding wide changes in the intake of vitamin K. Based on this, until controlled prospective studies provide firm evidence that dietary vitamin K intake interferes with anticoagulation by VKAs, the putative interaction between food and VKAs should be eliminated from international guidelines.​

Best Wishes and Welcome Aboard

Thanks for all the information.

I was diagnosed with Levo Transformation of the Great Arteries two years ago. In simple terms, the functions of the left and right sides of the heart are swapped and the tricuspid valve was leaking because the right side is pumping blood around the body instead of just to the lungs.
I have been monitoring my vitamin K intake (daily intake around 120mg) very closely but my INR has varied a bit sometimes going up or down by 0.8 or more (e.g. 3.1 to 3.9 in 12 days) without significant dietary changes. I know that there is a bit a variability in the INR results from different pathology labs. I was trying to work out which factor was having more of an impact on my INR results, the different pathology labs, the variability of my Vitamin K intake due to doing a fair amount of guessing on serving sizes or changes in activity levels when I am not at home.
The best path forward is to start self-testing and I will discuss this with my GP.

 

[pellicle]

Hi Bill

I have been monitoring my vitamin K intake (daily intake around 120mg) very closely

not particularly needed, and really you're much more benefited by monitoring your INR more ... as 12 days is a bit much IMO

but my INR has varied a bit sometimes going up or down by 0.8 or more (e.g. 3.1 to 3.9 in 12 days) without significant dietary changes.

if you like I can allocate some time to work with you when you want to start and set you up with some basic understandings and some formatted spreadsheet which will see you on your way to making a better fist of it.

Its not uncommon that INR varies around a point, its a lot like shooting a target in many ways, and getting a tight grouping is as much about genetics (or the rifle or the ammo) than you may think.

If you look into how much Vitamin K is needed to shift INR in any significant manner you'll soon see why its a bit pointless tracking it.

Tap me on the shoulder via a direct message (called "conversations here) when you're ready to start and we can chat about it.

As you probably saw on my blog my INR and dose does a little dance and I keep my INR in the range fairly well.

Some examples

PS, I see you're an Aussie too, sorry we flogged ya the other night mate.

 

[billD]

Thanks, I will contact you when I return home.
The maroons outplayed the blues again....

 

[pellicle]

The maroons outplayed the blues again....

flog us back next time mate ... keeps the whole thing interesting