Newbie -- Introduction -- INR's not budging

TickTickTicking · Jul 30, 2002

Hi all,

I'm new to this group ... referred from a WebMD poster. I have two questions and I'll give you a brief background. I have an artifical mitral valve (St. Jude) which was replaced in Mar'96. My INR has been off for the past month. I'm staying in the 1.9-2.2 range. This week, my doctor told me to take 12 mg of coumadin ... and to test weekly now (I have a home tester so that's no problem). This is the most coumadin I've been on since my surgery. I've always been in the 2.7-3.1 range with minor adjustments here and there. My question is do any of you have any idea as to what could be causing the low INR? I haven't changed my diet nor routine in any way and it seems like no matter how much coumadin I take, it ain't budging. Doctor wanted to make sure my machine was working correctly so we tested with a regular draw and the results are consistent.

Second question ... have any of you ever experienced any problem with high altitudes? I live in the Piedmont part of NC which is smack dab in between the coast and the mountains. My daughter is going to school in the mountains and on a recent orientation weekend I had an awful time breathing and experienced slight queasiness and felt like I was burning up ... couldn't get the air conditioner cold enough.

A little personal info ... I'm 40 years old, mother of one 18-year old, divorced but boyfriend has been a prince through all of this. I picked the name TickTickTicking because my daughter used to tease me when I came home about how my valve sounded.

I look forward to participating further.

LUVMyBirman · Jul 30, 2002

Welcome,

Any changes in medication? Additions or subtractions?

Trying not to be too here....but, are you maybe going through some hormonal changes? This can certainly effect the INR. Estrogen replacement patches caused my INR to take a dive. I have since decided to take a pass for that reason. Seems it is not a bad idea given the current controversies.

If you have been spending a lot of time outside in the sun, bathing or sitting in the heat your INR can also be effected. I recently moved from a very warm climate to a cooler one. Well, a bit cooler lately. My INR has never been better. I have been getting the same reading, week after week.

Guest · Jul 31, 2002

You have to look for something that is different. Think about vitamins, herbs, natural products, activity level, liver function, weight gain or loss, pain medications, any medications stopped or started. People tend to forget that stopping something is just as important as stopping something. I've even seen stopping or starting chewing tobacco throw it off.

You might find a clue on my website www.warfarinfo.com

Nancy · Jul 31, 2002

Hi Tick, Tick-

Nice to see you posting here, and welcome to this wonderful site. You've got lots of kindred spirits here.

My husband has been on Coumadin for 25 years. It's always changing, just like Gina said. That's why most people have to be tested frequently.

Eating things with Vitamin K in them can make the INR lower. Exercising more can also. There are so many things in your daily life that can make the INR change, that it's sometimes impossible to figure out what is doing it. The best approach is what your doctor is doing. Right now, you'll need frequent testing until you get stabilized, then the testing will probably stretch out. It takes 3 days for any changes made to your Coumadin to register in your testing. It's not an immediate thing.

We are very fortunate that we have a wonderful member who is a Coumadin expert, his name is allodwick and he runs a Coumadin clinic. He peeks in from time to time to answer questions. He also has a website with oodles of info.

Here's the link for that:

http://www.warfarinfo.com/

Hope to see you here often.

TickTickTicking · Jul 31, 2002

Thanks for the replys

Thanks for the replys

and the welcomes. I hope the INR level moves soon. I never thought of hormones affecting INR but it makes sense given they affect everything else (LOL). I'll try to recall the past few weeks for any changes to my routine.

Guest · Jul 31, 2002

I just saw a new reason for the INR drop today. The guy had been stable on 10 mg per day for months and now we have moved the dose up to 15 mg per day. I asked every question i could think of over the last few visits. Finally I asked if he had changed brands of chewing tobacco. He said, "Yeah. I changed fron Skoal to Copenhagen, just before you started increasing my warfarin dose." Tobacco is a green, leafy vegetable. When you chew it you swallow the vitamin K. They might standardize it for the dose of nicotine but I bet they don't do anything about the vitamin K content. I'd heard that this could happen but never actually saw it before.