reducing coumadin intake with fish oils?

[sunonwaves]

Considering the damaging long term effects that coumadin has on the liver bones and arteries, I really want to reduce my dose, and am wondering if this can be done safely with fish oil (same amount taken everyday)
At the moment Im on 5mg (now 7mg as my INR is at 1.8 due I think to being on antibiotics)
Anyhow Id love to know if anyone has had experience with taking fish oil or natural blood thinners to reduce their coumadin intake.
Thanks in advance

 

[Bina]

As far as I know only Coumadin/warfarin will affect and control coagulation and INR readings. Other herbals
and/or supplements can affect the level of platelets in the blood but without the control that Coumadin gives.
We have members who have been taking Coumadin daily for over 30 years so I am not going to worry about it
for now. A reduced dose won't make any difference, we take the dose needed to keep us as safe as possible
from stroke or hemorrage.
Really, there isn't any diff whether you take 5mg daily or 3mg daily.

 

[Michellemar]

I have a question. What is INR? I'll be getting a bovine valve probably, but when I had a stent put in in '04 (RCA, 91-93% blocked-from radiation damage) I had to give myself lovanox shots in the stomach, and take plavix... And I think it was the plavix...but I was getting hematomas(?)big blowout bumps on my arm veins that scared me silly ... And one nosebleed that lasted for about 12 hrs. I may, even with the bovine aortic rep valve, have to take warfarin... Are some people just not candidates for it.? My Irish skin is so thin I'm practically an anatomical Model...veins, here, arteries, there, tendons, etc... Just thinking fragile anything linings... I'm 62..... Just wondering .... Michelle

 

[Bina]

Michelle--- INR is International Normalization Ratio which is the method used to measure the coagulation time of the
blood while taking Coumadin.
Lovenox, Heparin, and Plavix affect the blood differently and are measured differently.
(I'm thin skinned and delicate also and have no problems taking Coumadin).

 

[dick0236]

Considering the damaging long term effects that coumadin has on the liver bones and arteries, I really want to reduce my dose, and am wondering if this can be done safely with fish oil Thanks in advance

I have taken fish oil in the past to reduce colesterol, but have never read, or heard, that it has any value as an anti-coagulant.
Nor have I ever heard of, or experienced, any of damage you mention and I have been on it almost 44 years(10mgs daily as a young man and 5mg now). Talk with your doctor before experimenting with this.

 

[Protimenow]

International Normalized Ratio is a standardized number that takes into account the actual prothrombin time (clotting time) and the reagent used to induce the clotting. Depending on the reagent and test method used, the same sample of blood can take vastly different amounts of time to clot. The INR adjusts for these differences and gives a standard number. (My meters all give prothrombin times and INRs. It's interesting to see that the prothrombin time with a ProTime meter is much longer than that with an InRatio -- but the INRs are about the same).

I've been taking Warfarin for nearly 20 years, and haven't had the bone loss or liver damage you mentioned.

It seems as if there may be some very rare individuals who can't take coumadin.

Also - as noted previously - Fish Oil may have a different effect on clotting than does warfarin. Its effect may not show up in INR. Years ago, I asked my doctor about using Aspirin instead of warfarin -- not knowing that they had different modes of operation. As Dick mentioned - you should talk to a doctor before making any changes. (If Fish Oil actually worked, and had a measurable result, it probably would have replaced coumadin long ago.)

 

[Bill B]

Considering the damaging long term effects that coumadin has on the liver bones and arteries

I'm puzzled as to where these concerns are coming from. Warfarin does not "damage" the liver and the effects on arteries and bones are not established but are based on laboratory observations that warfarin inhibits some proteins involved in bone metabolism and handling of calcium.

 

[LeakyUK]

My readings on Warfarin from UK NHS sources suggest that there should not be any problems provided the dosage routing is correctly followed and INR is controlled. There are, interestingly, warnings AGAINST aspirin and ibuprofen although some here do take aspirin as well. Family members have taken Warfarin with no trouble over the years.

 

[sunonwaves]

Thanks so much for all the replies, this site has truly been a massive support for me and my fiance. I typed out the above post for him, as hes still not up to reading to much or going online.
We were told about the liver damage by the woman employed at the hospital to give you the info on how to take the drug and what it does. She said when taken in the long term it has shown to cause liver damage.
It is really nice to hear that so many of you have been on it for 20 years or more and feel fine. My fiance is only 33 and when he asked her how long he can expect to live on it, she said " oh you should have another 28 years or so" as though that was good news! he said he would like to live for longer than 28 years, have grandkids etc, and she just didn't know what to say, and just stumbled along saying that he should be fine and changed the subject.
Hence why we have been quite concerned and trying to find out as much as we can about the effects of the drug and how we can reduce them.
Re the fish oil, we have looked in to a few alternative cardiologists that use fish oil to reduce coumudin intake. Though for mechanical valves I do feel it would be risky to stop the drug all together.
I honestly believe that "if" there was a natural alternative to coumudin we wouldn't know about it, as the pharma industry is all about patents and profit, and it cant be done with something like fish oil (just as an example)
Thanks again for the responses, its really appreciated!

 

[catwoman]

We were told about the liver damage by the woman employed at the hospital to give you the info on how to take the drug and what it does. She said when taken in the long term it has shown to cause liver damage.

Shame someone so misinformed is propagating that misinformation to others...

One thing to note: Warfarin is metabolized in the liver, as are many other drugs. IF you have any liver damage (hepatitis or cirrhosis, for example), your liver is less able to metabolize the warfarin. And that will affect your INR.

But, no, warfarin does not damage the liver.

 

[dick0236]

We were told about the liver damage by the woman employed at the hospital to give you the info on how to take the drug and what it does. She said when taken in the long term it has shown to cause liver damage.
It is really nice to hear that so many of you have been on it for 20 years or more and feel fine. My fiance is only 33 and when he asked her how long he can expect to live on it, she said " oh you should have another 28 years or so"

Your fiance should speak to his surgeon about the advice this person is giving out. I am sure he would be interested in her "medical mis-information". She really needs to be retrained....or better yet, removed from her job as an anti-coagulant adviser.

 

[Protimenow]

The medical-legal crap may be the reason you were told about the liver damage. They want to cover ANY POSSIBLE outcome - and if some idiot somewhere claimed that warfarin damaged his liver, to protect themselves from any legal liability - no matter how slight - some hypersensitive clinics or medical providers will state that this is a possible reaction to warfarin. They probably said that if your fiance takes warfarin he could die. They probably said that if he takes too much or too little, he can also die. This is all to protect their rear ends from any possible suit - for any possible claim, no matter how little factual background there is.

I think there's miniscule risk of liver damage from long term warfarin usage. I haven't looked for studies that support this theory, but I'm sure that MILLIONS of people are taking it without negative liver consequences.

Your comment about the pharmaceutical industry stifling any other anticoagulants may have been true years ago, when the patents were in effect and there were no generics, but today, with daily doses costing as little as a nickel a day (half of a generic that costs about a dime at many pharmacies), there is no reason for the drug companies trying to protect this drug. In fact, they're working hard at developing other drugs that can be taken without the required INR testing -- and that can sell for many dollars each.

Warfarin is a proven medication. It's taken by millions of people worldwide. It DOES require monitoring while you're taking it so that your INR stays within range -- but it does what it's supposed to do, and is well tolerated by a large majority of users.

Looking at fish oil, aspirin, and other materials to avoid having to take this safe (if used correctly and monitored regularly) is not a good idea.

The manufacturers of some of the mechanical valves say they can last as much as 75 years -- your fiance dying as a result of liver damage caused by warfarin use is probably less likely than him being hit by a kid on a skateboard.

 

[Duff Man]

I think there's some merit in the desire to safeguard the liver, although I've never read anything about anyone having liver problems directly from warfarin. Even though there might be some merit, it would be foolhardy to take aspirin or fish oil in warfarin's stead without having some specific study that proves your valve specifically will tolerate such an anti-thrombotic regimen. To even reduce your inr to below a valve specific theraputic level without some empirical evidence that it won't put you at risk is not wise. As far as I know, there aren't any studies that take a serious look at fish oil supplements and mechanical valves... and you'd want one before you risked a stroke over it.

Sometimes there are varying opinions on what a safe lower limit INR is for that particular valve. That might be a good place to start.

 

[yotphix]

"I honestly believe that "if" there was a natural alternative to coumudin we wouldn't know about it, as the pharma industry is all about patents and profit, and it cant be done with something like fish oil (just as an example)"
Warfarin Sodium is long since off patent and is available from several makers of generics. I am paying no more for a day's dose of warfarin (and I take 11mg/day) than I would for a single fish oil capsule. If the pharma folks could make money from fda approval for fish oil capsules as reliable, controllable anti-coagulation therapy, you know they'd be selling it already. Just because something is 'natural', doesn't mean it can't be either patented, or packaged and sold as medicine.
" oh you should have another 28 years or so"
That was a ridiculous statement, and never should have been made. We all say stupid stuff sometimes but when medical professionals say stupid stuff they scare people. Ignore that off the cuff remark and listen to the evidence.

 

[Protimenow]

If your fiance is 90 years old, perhaps the 28 year comment would be fairly accurate. Or, perhaps the person who said it was joking and you took her seriously.

Warfarin IS derived from nature -- the discovery was related to fermented clover - something in it was causing animals to bleed to death. Once the agent was found, it was isolated, refined, and is now in the pills that many of us take daily.

 

[sunonwaves]

Thanks so much for all the wonderful replies we are taking in all your adice / thoughts on the issue, It really has made us both feel SO MUCH more confident with this rather tricky little green pill (well our green 5mg coumudin is green anyhow )

 

[Jkm7]

What that coumadin manager said to you and your fiance is disgraceful and ignorant to the max. She is just plain wrong. All other things being equal, there is no reason your fiance can't expect to live a good long life while taking coumadin but he must take it appropriately. That means you both must educate yourselves about this drug which is exactly what you are doing. GOOD for you to take control of his healthcare so you won't be 'victim' to such poor coumadin advice in the future.

Best wishes.

 

[dick0236]

Thanks so much for all the wonderful replies we are taking in all your adice / thoughts on the issue, It really has made us both feel SO MUCH more confident with this rather tricky little green pill (well our green 5mg coumudin is green anyhow )

If you are taking a "green" pill, it is NOT 5mg. Coumadin/Warfarin tablets are color coded per an internationally accepted color system. "Peach" is the color for 5mg. "Green" is 2.5mg. 6mg is "teal"(close to green). You may want to verify your Rx with your doc and pharmacist to be sure you are taking the proper dose.

 

[ALCapshaw2]

sunonwaves -

The usual response to taking antibiotics is for your INR to increase (or stay the same), depending on which antibiotic you take.

For an INR below 2.0, the Risk of Stroke increases. Typically, an increase in your WEEKLY Dose of 10%+/- a bit is recommended for an INR below 2.0. If you went from 5 mg/day for 7 days to 7 mg/day for 7 days, that is a 40% increase which is HUGE and will most likely cause your INR to to Too High at which point your manager may advise that you HOLD a dose or two which will cause your INR to Drop Like a Rock and you will be in the Dreaded Roller-Coaster Effect. You need to know that SMALL CHANGES followed by retesting in a week or so is the Best Way to maintain a Stable INR.

Out of curiosity, who is managing your Coumadin testing and dosing?
Do you know what training they have had and what Dosing Guideline they use?

'AL Capshaw'

 

[catwoman]

If you are taking a "green" pill, it is NOT 5mg. Coumadin/Warfarin tablets are color coded per an internationally accepted color system. "Peach" is the color for 5mg. "Green" is 2.5mg. 6mg is "teal"(close to green). You may want to verify your Rx with your doc and pharmacist to be sure you are taking the proper dose.

I agree with Dick.
Obviously, you are not in the U.S., because all generic and trademarked forms of warfarin are identical in color, and 5's are a peach.

I googled for colors in the U.K. and found 3 sizes listed -- 3 mg (blue), 5 mg (pink) and 1 mg (brown) warfarin tablets (UK colours).

Not sure what colors. sizes are available elsewhere.