Okay, what is wrong??

Christina L · Jan 6, 2004

another thing

another thing

The nurse said GREEN tea is a BIG no-no when on Coumadin - it can be drank the day before blood is drawn and really affect the INR in just one day!

Come to think of it, I told her, I had had ONE cup of de-caf green tea on Sunday afternoon (the first cup of green tea I have had - thinking it was healthy).

Regular tea is okay to drink.

Christina L.

Harpoon · Jan 6, 2004

On teas...

(I was reminded of this while shopping at an herbal remedy type place here that has a brand of dar jeeling I like)

Avoid, ginko biloba (I mentioned that) echinacia, ginsing, guarana, and a number of other herbals that claim to be stimulants and such...

There are green teas that are out there that don't have these things, but they're few and far between and you have to be real careful to read labels. If you can, write down ingredients of the tea you're interested in (most seem to have websites on the boxes so you could look them up on-line without buying a box that you end up not being able to drink) and check it against coumadin reactants...

The other trick is to use have your herbal tea "once in a while" rather than every night or maybe a few times a day.

I have one maybe, once a week, if that, and I'm pretty selective over what I'll drink. At the coffee shop here they have a herbal remedy book that lists all kinds of drug interactions, it's VERY helpful when sorting out what you can and can not drink, maybe they have it on Amazon???

Guest · Jan 6, 2004

Chistine - you also have to be consistent with your spittin tobacco. Changing from Skoal to Copenhagen will lower the INR. Copenhagen has more vitamin K.

One lady came in for the first time and said, "I'm 92 years old. See that little bulge? (Points to her lower lip) That is Garret's Snuff and I have had a plug there for 86 years so don't go telling me that I've got to quit." Yep, her older brothers got her hooked when she was 6 years old.

The dose of warfarin is immaterial - only the INR matters.

My guess is the cardiac rehab is making the INR low. I had a letter to the editor published about this in American Journal of Cardiology. My clinic was in the cardiac rehab gym for 5 years, so I have seen a lot of this. As you improve you exercise more and more up to your tolerance level. When you were a -fib, your heart was not pumping blood efficiently. As you went out of it and your heart pumps blood through the liver more times, you metabolize the warfarin more efficiently. When you finish the rehab, if you do not continue to exercise, your INR will probably go above the desired range.

All of the advice looked good, but I think Jim came the closest to the cause. I agree with eating what you want and adjusting the warfarin around it. I have lots of people who drink some green tea. The other thing was mentioned is that eating the leaves is not good.

Christina L · Jan 6, 2004

Consistent with my spitten tobaccy!! Never!!

I will give up my herbal teas, my vitamins and supplements, and even my beloved brussel's sprouts, but I won't change my brand of chew!! Hee.

You could have a point about the exercise, but truly I don't think I am exercising all that much - about one mile on the treadmill every day - compared with others, they are walking miles and miles a day!!

Who knows what is causing this, but I just hope the INR is improved by next Monday.

Thanks for your help - as always!

Christina L.

Guest · Jan 7, 2004

It is not how much you walk in relationship to others but in relationship to how much you were able to walk at the time you were started on warfarin that matters.

We had a 1/20th of a mile track in the clinic. I saw onw woman who could not go around it once when she started. By the time she got to 1 mile, her INR had dropped to 1.0 - the same as no warfarin.

Christina L · Jan 7, 2004

Interesting about the walking. If my INR does not go up by next Monday, I will definitely bring up that subject. BUT they will just increase my dose of Coumadn.

Thanks for the info!
Christina L.