Very high dosage

[charlieecho]

Had bentall procedure back in May 2013 and did well. I'm a 31 yr old male in good health and no other medications. I'm currently taking 16 mg of warfarin and have been for 3 months now. I know everyone is different but from everything I've read this is abnormally high to have a therapeutic range between 2.0-3.0 and @ 16 mg i'm still on the lower side of that. Usually around 2.3 give or take. I don't eat any different probably than any other person. I don't' eat anything consistently. I enjoy a steak with mash potatoes one day and the next a salad.

I know there are many who believe that dosage is not important it's keeping inside you're INR that is. I'm just not a believer in that though @ 31 I will have to take this for the rest of my life. Hopefully a new drug will be available at some point between now and then. The government wants us all to believe that most medications cause no harm to us, but anything synthetic has adverse effects over time (hence all the side effects your read that people have on various meds). Most websites won't mention it but warfarin has shown to increase calcium build-up in the arteries and narrowing of the aortic valve that goes from the heart and carries oxygen to the body. Now I have a mechanical valve so I know it can't narrow but my arteries still can.

I've always tried to take the holistic approach towards anything but with a mechanical valve I don't know if it's possible. I listen to a lot of The Duke and The Doctor on the radio and she talks about weening her patients off of warfarin onto a more natural remedy, but how she monitors that I don't know.

Anyone ever took an alternate approach to blood thinning?

Thanks for your time,
Charlie

 

[KristyW]

Charlie...warfarin has been around since the 1950s. I know of a patient who had valve replacement in the 50s as a child. He has been on warfarin all this time. Truly, this is a medication with few side effects when taken and monitored properly. As far as your high dosage, if you're active and eat very healthily, it's not abnormal to have a fairly high dosage. To date, there is not a more effective drug with fewer side effects. All the new anticoagulants are not readily reversible, therefore in an emergency, there's no way to stop the bleeding. I hear you about not wanting to take synthetic drugs, but with a mechanical valve, I really don't see any alternative. As for the calcium buildup...is it actually the warfarin, or the crazy..."Don't eat any green vegetables or anything high in Vitamin K" that has caused the increase in calcium and artery narrowing? I really don't think we know.

 

[dick0236]

I have taken as much as 10mg/day as a young man with a very active lifestyle. That dosage has steadily decreased to my current 5+mg/day. I have never been told of any "calcium" build-up problems after routine lab testing that have been part of my physical exams. My experience is that I need to be careful about adding dietary supplements and some Rx's(especially Statins) as they can dramatically increase my INR. Let someone else experiment with a holistic non-warfarin "blood thinner".....you DO NOT want to be a guinea pig on warfarin.

 

[njean]

I too am a long-term user of Coumadin. Had double-valve surgery in 1975 when I was 24 and I'm 62 years old now. I can remember taking 14mg, 13mg for extended periods of time after my first surgery until my INR was brought into range. I had to test weekly, then bi-weekly until I was in range. After I got in range, I tested at the clinic once a month for many, many years.

In the last 7 years, I alternate between 7.5 and 10mg of Coumadin and check my INR once a week, sometimes every other week. My range is 2.5 - 3.5 and I have my own home monitor which makes testing so much easier. I eat what I want and always have, without worrying about the "greens", blah, blah, blah!

I've never been told that I show a calcium build-up in my arteries and I've had several caths throughout the years. In fact, the doctors always comment as to how clear my arteries are.

Life is too short to spend it worrying about the "what if's".....take your meds as prescribed, stay as consistent in your diet as you can and if you indulge every now and then, don't worry about it.

Stay well!

 

[pellicle]

Hi

firstly I'd say the answers from those above should be a Q.E.D. on the issue, but

Had bentall procedure back in May 2013 and did well.

excellent .. glad to hear the good news.

I know everyone is different

they are ...

but from everything I've read this is abnormally high to have a therapeutic range between 2.0-3.0 and @ 16 mg i'm still on the lower side of that.

I've read of MUCH higher (660 mg per day) ... what happened to believing everyone was different?

You may like to read this thread:
http://www.valvereplacement.org/forums/archive/index.php/t-25929.html

I know there are many who believe that dosage is not important it's keeping inside you're INR that is.

yeah, like pharmacologists, biochemists ... you know, trained people who have spent their lives learning about drugs and drug body interactions ...

Hopefully a new drug will be available at some point between now and then.

hopefully. But hopefully one which is as safe, as reversible and with as few side effects. Give it 50 years after such a drug is introduced and you'll know it as well as as know warfarin now. So far what I have seen of the replacements (dabigatran , xarelto) is that they are numerous issues with them (including inability to quickly reverse and return to coagulation).

Its old tech, but sometimes the wheel still works.

The government wants us all to believe that most medications cause no harm to us,

err ... pardon? your not a conspiracy theorist are you? Try reading the literature from scientific publications. These are world wide and (I know this is hard to believe) independent from governments.

but anything synthetic has adverse effects over time (hence all the side effects your read that people have on various meds).

... and the new drug you're hoping for would be 'natural' right?

Most websites won't mention it but warfarin

You need to be careful with what you read and where. Many well meaning sites are written by people who just don't understand or worse simply cut and paste from some other site. Many sites exist only to market a product. if you want information, stop reading websites - start reading Peer Reviewed Journals

Anyone ever took an alternate approach to blood thinning?

Well as a person with a biochem background I can start by suggesting that all drugs we have are obtained by starting with study of natural products. Its no pun to say that drugs are 'cooked' just as food is cooked.

You eat bread right? You know its been chemically altered from the wheat it started from right? Yeast (a kind of mold) digest it and we then eat the broken down sugars that they produce from the harder to digest starches stored in the seeds.

I guess that you know that Warfarin was discovered by accident in "spoiled" sweet clover. Which is to say it was produced by molds (Penicillium nigricans, P. jensi, and the Aspergilli).

Best wishes for a good recovery and please don't sweat the stuff.

 

[charlieecho]

Thanks for the info guys and reassurance. I'm just always suspicious of any prescription drug. I don't expect the guy who's a biochemist to understand that lol. Where you know studies on drug types I on the other hand have read many natural/holistic approaches to life in general not just blood thinning (which has been done). I did much research before the surgery mainly on warfarin. It's hard to find anything bad about other than bleeding problems which I really wasn't concerned with being as young as I am. I have heard about the increase of calcification in the arteries due to warfarin use but it's not widely spread news.Like Pellicle mentioned it's hard to trust everything that you read. Hence why I'm asking questions here as well as doing my own research in the meantime Always good to hear it from the horses mouth so to speak though right?

I feel better about being on warfarin now and will try not to fret about it as much. Really appreciate all the info and support.

 

[pellicle]

Hi

Thanks for the info guys and reassurance. I'm just always suspicious of any prescription drug.

and some amount of suspicion is a good thing .. I encourage it

I don't expect the guy who's a biochemist to understand that lol.

well oddly I do. But just in case it is of value to either you or anyone else reading this in the future, the question to ask yourself is about precision in herbal preparations.

You see Warfarin (Coumadin, Marevan ....) is a very narrow therapeutic range drug. Like everything its good in the right amount and will kill you in taking too much.

The range is quite tight (depending on the person) and so even a 4mg excess per day could send your INR whistling into high numbers putting you at a significant risk of a bleed.

Any good herbalist (and remember, that's where biochemistry came from) will tell you that there are good and bad sources for stuff. Good quality herbs, vs poorly grown ones. A good herbalist will charge heaps for 'the right stuff'.

So in contrast the (nasty) pharmaceutical companies make a concoction of the drug we (mechanical valvers) need in highly accurate does. When you take a 1mg tablet it won't have 2mg or 1.5mg in it. Should you find that you could actually sue them.

In contrast if you were taking your aspirin from natural sources (such as Willow bark) the amounts of salcylic acid you get could vary considerably (particularly if you drank a second cup of tea or didn't let the tea draw properly).

Pharmaceuticals are simply the result of attempting to get precision in dose.

Next time you have surgery you should be thankful of this as the anesthetist in particular is quite important at keeping you alive. Their attention to precision is really important.

But as to mistrusting companies ... keep the *******s honest is my view.

on the subject of

.Like Pellicle mentioned it's hard to trust everything that you read. Hence why I'm asking questions here as well as doing my own research in the meantime

that's exactly the approach!! Always question, always cross reference and if you get it from the horses mouth - take a good look inside to see what may be hiding under the tongue ;-)

keywords for any reading of things are: veracity and authenticity.
This is in theory the reason for peer reviewed journals. However sadly many journal articles make reading their ideas an impenetrable fog. When I did my masters thesis I tried to make my writing more comprehensible to joe average. I had to fight a few battles for that.

Merry Christmas

 

[BarbATS]

Good morning and Merry Christmas/Happy Holidays to you, Charlieecho!

So glad for you that you put your thoughts out there and got lots of sound advice from the experienced valvers!
As a 13-year warfarin user after mitral-valve replacement with a mechanical valve, I can add my best wishes to you and encourage you
to enjoy yourself and calm your thoughts. I look forward to reading update posts from you down the road!

 

[charlieecho]

Hi



and some amount of suspicion is a good thing .. I encourage it



well oddly I do. But just in case it is of value to either you or anyone else reading this in the future, the question to ask yourself is about precision in herbal preparations.

You see Warfarin (Coumadin, Marevan ....) is a very narrow therapeutic range drug. Like everything its good in the right amount and will kill you in taking too much.

The range is quite tight (depending on the person) and so even a 4mg excess per day could send your INR whistling into high numbers putting you at a significant risk of a bleed.

Any good herbalist (and remember, that's where biochemistry came from) will tell you that there are good and bad sources for stuff. Good quality herbs, vs poorly grown ones. A good herbalist will charge heaps for 'the right stuff'.

So in contrast the (nasty) pharmaceutical companies make a concoction of the drug we (mechanical valvers) need in highly accurate does. When you take a 1mg tablet it won't have 2mg or 1.5mg in it. Should you find that you could actually sue them.

In contrast if you were taking your aspirin from natural sources (such as Willow bark) the amounts of salcylic acid you get could vary considerably (particularly if you drank a second cup of tea or didn't let the tea draw properly).

Pharmaceuticals are simply the result of attempting to get precision in dose.

Next time you have surgery you should be thankful of this as the anesthetist in particular is quite important at keeping you alive. Their attention to precision is really important.

But as to mistrusting companies ... keep the *******s honest is my view.

on the subject of


that's exactly the approach!! Always question, always cross reference and if you get it from the horses mouth - take a good look inside to see what may be hiding under the tongue ;-)

keywords for any reading of things are: veracity and authenticity.
This is in theory the reason for peer reviewed journals. However sadly many journal articles make reading their ideas an impenetrable fog. When I did my masters thesis I tried to make my writing more comprehensible to joe average. I had to fight a few battles for that.

Merry Christmas

Very true and you hit on a lot of good points. Herbal remedies are no where near the exact science of a drug created in a lab, and believe me, I'm not someone who thinks all natural remedies are the way.

It's just the thought of taking any drug over that period of time could have some adverse effects.

Thank you for the responses. I enjoy hearing it from all sides. Your views on warfarin are somewhat relieving pellicle.

 

[TheGymGuy]

Pellicle, love reading your posts. You like to take a post apart to provide feedback to each and every sentence, and while it's almost obnoxious at times, I know that you always mean well and it really does help.

I am posting for 2 reasons. Firstly, I am on 11mg doze per day and this has kept me stable for quite some time, INR around 2.3 (self-test weekly). Honestly, I started out at 6mg doze, then 8 and now 11mg. As seasons change and my diet changes or body-weight changes things change, and honestly it does not matter. So long as I am within my range of 2.0-2.5 or even under 3.5, but over 2.0, I know I am fine.
Secondly, I was going to make several points that Pellicle beat me to, so I am just posting my agreement with things that he said in hopes that this helps you.

 

[pellicle]

Pellicle, love reading your posts. You like to take a post apart to provide feedback to each and every sentence, and while it's almost obnoxious at times, I know that you always mean well and it really does help.

Thanks for the feedback. I guess its because
- I want to answer each question asked as best I can
- I have a CDO nature (which is OCD corrected into proper alphabetical order
- being a science trained person who has worked for 12 years in Data administration I get anal

 

[Midpack]

(...)I get anal(...)

Pellicle, please keep your sexual preferences out of this forum :cool2:

 

[pellicle]

Pellicle, please keep your sexual preferences out of this forum :cool2:

ahh, I see ... misunderstanding

I was meaning this

The term anal retentive (also anally retentive), commonly abbreviated to anal,[1] is used to describe a person who pays such attention to detail that the obsession becomes an annoyance to others, potentially to the detriment of the anal-retentive person. The term derives from Freudian psychoanalysis.

rather than that ;-)

Freudian slip (when you want to say one thing, but say your mother)
;-)

 

[Agian]

That was like a comedy routine. LOL.

 

[mom2angel]

I, also like to take the holistic approach towards medicines, so I completely understand. However, Coumadin is the one medicine I don't mind taking. I've been on it for almost 32 years and never had any side effects, that I know of. I am 33, healthy and active. I enjoy running, lifting weights, etc. I have never had any major illnesses, aside from the endocarditis. I choose to believe that Coumadin is safe since it's been around for so long and has such a good track record. I chose to believe this a long time ago, since I am supposed to take it.
I just wanted to let you see that I have been on it for 32 years and am doing great. I take 14mg daily, and keep an INR between 3.0 and 3.5. 14mg works great for me. I was up to 16 1/2mg during my last pregnancy. I know there are also a few other long-time Coumadin takers on here too. Best of luck

 

[Jason]

I understand your concern and myself was fretting over the amount of warfarin I was on directly after my surgery. However, after some consulation with docs and the good people here on this board, I finally convinced myself that it isn't the number that is important, but the INR. Understanding that, and having Dick point out to me that while warfarin seems daunting, the alternative was much worse, my thoughts changed and my outlook became much better. I am currently on 10-12.5 mg/day and have been for a few years. It varies up and down with activity level, and I try to stay fairly active for all the health benefits of that. You have got some great advice here, which is why I love this board!