The Occasional Splurge - Dose Adjustment?

Taylor · May 9, 2008

Hi - I've been on warfarin since my surgery in March 2007 and have been consistently in range eating pretty much what I want but avoiding large amounts of vitamin k. It's really been great and after some initial overreactions (removing romaine lettuce from sandwiches etc) it has really been easy. And so far I haven't felt the urge to eat an entire large bowl of broccoli or spinach. My question is whether people ever adjust their dose if they do want to occasionally splurge on an amount of vitamin k that would have an effect on your INR. And if people do adjust, how do you do it? Do you take a little more your next dose after the big splurge or right before? Then the next question is if I do want to splurge once a in a while, is it really a good idea to adjust my dose for that one time splurge? I think what prompted my interest in this is that I recently received an Inratio (love it) and now have the ability to test whenever I want and really see the effects (if any) of variations in diet, exercise, dose adjustments, small amounts of alcohol etc. I also tend to hover in the mid to lower portion of my range so if I ever were to want to splurge I'd prefer to find myself at the higher end of my range instead of falling below.

Any insights would be great!

Thanks, Taylor

Karlynn · May 9, 2008

Hi Taylor,
I really don't give a second thought to what I eat and my INR, as long as I'm not incorporating a soy-based product on a regular basis. But I don't worry if I go out and get a spinach salad one night - or if I have a big serving of broccoli, like I did last night.

I do prefer to stay on the higher end of my range and this is why I don't think too much about it.

When I started on Coumadin many years ago I was also very careful. But like diets are want to do - it didn't succeed in keeping me on the low-K straight and narrow.

Eat what you want - test regularly and then make dosing adjustments if needed. I wouldn't recommend taking an extra amount for having a large field greens salad in an evening.

JimL · May 9, 2008

My asparagus needs cutting, and I may have some tonight. Since that is very seasonal -- I wouldn't want to splurge on something out of a can or on something picked last week somewhere else -- I have on occasion added a mg or two of coumadin. I won't tonight, since I tested on the high end yesterday at 3.4.

Cooker · May 9, 2008

I don?t home test so I don?t adjust my dose without instruction from my cardio?..I prefer the high side and if I am between 2.5 and 4.5 I?m happy?..I am consistently between 3.2 and 4.2 and have been for over two years??I eat what I want, when I want it?I eat a salad of some type every day and greens and broccoli and asparagus?..you get the picture?.I would not worry over it.

The problem I have with being on Warfarin is dealing with a medical community that wants to stop it for every little procedure

?..I would hope that they get it right someday but it most likely will not be in this chimps lifetime.(no highjack intended

)

aussigal · May 10, 2008

Same here as Cooker and Karlynn...I eat what I want when I want and if I feel like a bowl of Broccoli I will enjoy every mouthful. I tend to keep my INR at the high-end of my range and have been on the same dose for ages. I only change my dose if I add or take-away a med that interferes with the Coumadin.

Ross · May 10, 2008

Just keep your INR at the higher end of your range and don't worry about your splurges. You'll start chasing your tail if you go monkeying with the dose for the splurge.