Am a grandmother with questions

[K_a_t_y]

Does a a low INR cause mood swings? I am a grandson living with me and he has mood swings and says it is caused by low INR. They are having a difficult time balancing his medicine dosage. I know with health problems - ( in am in my 70's and have some of my own.) - but can not find data on connection between low INR and moods?

[JulieRoberts]

Hi...Ive been on warfarin for nearly 18 years but I have never had any mood swings due to low I.N.R or high I.N.R either! Maybe Im just one of the lucky ones but I have never heard anyone mention this before either. Is it possible that the mood swings to be caused by something else? Good luck getting answers to this...I wish I could help! ☺

[daisyd]

Morning I have Hughes syndrome and have to have an INR of about 3.5 I can tell when it is out out range, too high I feel anxious, like when I have too much caffeine, low and I feel depressed and have even less energy I test my own INR and 9 times out of 10 I am right

Perhaps he should ask the Haematologist about this

[Smythian]

To my knowledge there is no correlation between a low INR and mood swings. Not even sure if this is a side effect of any anticoagulant. I do hope that things settle for your grandson. Good luck!

[maejane]

Hi Katy I haven't heard anyone on here mention mood swings, but can we ask why he is on blood thinners ? How old is he, maybe there is more to this and depending on why he is on them. I was only 24 when I had my first pe just 7 weeks after giving birth and I got very moody and depressed about the impact a pe has on you and your life, and couldn't wait to get off warfarin to get "back to normal" but it wasn't due to my Inr it was me myself that other problems relating to the episode at the time. I am now in my 40s and had another pe and stroke and on life long blood thinners my attitude is a hell of a lot different. I hope you get to the bottom of the problem good luck to you both

[Lexby]

Hi Katy,

I have been on Warfarin for 20 years and I agree with daisyd.

I have also seen a similar discussion somewhere on these forums where some people were saying they felt better when in their target range. In fact, it was searching the very same subject that lead me here.

We are told to listen to our body in Cardio Rehab. I'd say your grandson is doing that. Exercise with quality sleep and a healthy balanced diet would naturally help, but so is being taken seriously (which you clearly are by researching the subject). My partner is a veterinary surgeon, thankfully she understood when I felt down. She also saw the test results, and I was right 8 or 9 times out of 10. After all, thinner blood will flow through vessels more quickly and thicker more slowly. So it makes sense that it could affect oxygen delivery and then mood.

My target INR is 3.5... too high, and I feel manic and lightheaded, too low, and I feel fatigued and that in turn can make me feel depressed. It reminds me of the period before I had the valve replacement - I was misdiagnosed as suffering from depression when I had a bicuspid Aortic Valve that was leaking for several years. However, it was many years after the operation, and starting warfarin, before I recognised these feelings. Initially, I put the length of time down to my body adapting to the INR range I spent the most time. But it could also be because I felt so much better after the operation that it took me longer to learn the subtle differences (maybe my body adapted sooner). However, I was in my 30's and very active so was probably too busy enjoying life to notice if I was manic or fatigued when my INR was out of range.

I used to have my INR tested and managed at the hospital. But now I test at home, and self-manage, I don't notice it so much, even when I am out of range. The symptoms are still there when my INR is out of range, but I don't think about them. What tends to happen now is, I test, and if my INR is out I'll think back and sometimes I'll realise I had been slightly manic or slower than normal, but not every time. It could be that my diet is better these days. But it could also be that in knowing I have control and do the tests more frequently I don't worry and look for the symptoms (and then home in on them and then feel depressed). When the hospital was managing my INR, it would often be outside of the target range and on occasions go above 7 and below 2... often because they would try too hard, with a large dosage change, to get me back in range and overshoot... I noticed the extremes most of all!

PS. While writing the above, I thought about how I was feeling now... which is a little fatigued (but not depressed). I was due a test today, so I just tested, and my INR is 2.8, a little below my target range (3-4). However, I could have easily put it down to a busy few days (rock climbing, gardening, swimming and a sauna) and I'm sure others would. ​

I hope that knowing he isn't the only one that gets these mood swings helps your grandson. It helped me when I found out there were others. As with what daisyd said, it may be worth discussing it with the Haematologist too.

[nossib in reply to Lexby]

Dear Lexby, agree with your very well presented response and so many factors in life can alter or effect us, including our INR levels , including our diets & particular attention to some things whilst on anti coagulants.

This certainly is an excellent forum for learning so much more here from one another, than even our busy Health Practioners.

[Lexby in reply to Lexby]

Thank you nossib,

I just noticed that I meant to say that with my partner being a veterinary surgeon, and that science being evidence based, she kept an open mind and didn't dismiss my feelings the first time I was wrong. In fact, she kept asking me how I felt and what result I was expecting, before a test, and it was eventually proved that I was right most of the time (I'm happy with that lol).

[suzen]

Well maybe just health problems in general can cause anyone some mood swings! Its yhe stress : )

[Tipper]

"After all, thinner blood will flow through vessels more quickly and thicker more slowly." - says Lexby

It's not thinner or thicker...just takes more or less time to coagulate!!! You should understand this surely?

[Lexby in reply to Tipper]

Hi Tipper, thank you for your comment about my post.

I could be wrong, but my understanding was that raising the INR made blood less sticky and allowed it to flow more freely.

Maybe it is all in my mind, but when I test myself, I find it easier to balance blood on the tip of my finger when my INR is low than when it is high (boy, it's frustrating when it's very high - I've wasted a few test strips when the blood has run off my finger before I can get enough on the right spot). Also, when I cut myself shaving, if my INR is high, my blood looks very watery and behaves very differently to when it is low. Bruising is also worse when it is high - presumably because it seeps through the damaged blood vessels more easily.

BTY, there are three factors that come into play to stop bleeding. The ability of blood vessels to constrict after an injury. The number of blood platelets to plug the hole. And the ability of blood to clot. Minor bleeds will eventually stop even if one of those factors is diminished. Furthermore, the latter two affect the blood stickiness and so making it thicker and less watery when normal.

OK, I may be a bit rusty on this and I have not checked to see if there more recent thinking, but if you have better information, then I would be interested to know. After all, we are constantly learning and I remain open minded.

PS. I just found the following on MedicineNet.com, but there are other similar references to thinner blood on the net: Warfarin is commonly called a "blood thinner," but the more correct term is "anticoagulant." It helps to keep blood flowing smoothly in your body by decreasing the ​amount of certain substances (clotting proteins) in your blood.

Anyway, my point was that I feel sluggish when my INR is low and elated when it is high. Also, I'm not the only one to notice this and as I said, it makes sense that thinner/thicker blood flows more/less freely (no doubt we will get a better explanation in time).

[AnneTS in reply to Lexby]

I think we might be getting confused about terminology here. Sticky blood is a distinct term for those of us who have either Hughes Syndrome or APS (antiphospholipid syndrome) where clotting is a major problem.Often daily injections with Heparin can leave some of us feeling much better health-wise than taking Warfarin; so Warfarin must have some overall effect on some people. warfarin acts soley to slow down the speed at which the blood clots or "coagulates". I know it might look as if I am splitting hairs but "sticky blood" has a different pathway. I do sympathise with your grandson and it is good that he is aware of his body's reaction to Warfarin. If he has a Haemotologist he might like to find out if research has been done on this reaction to Warfarin and then enlighten the rest of us who have come to this amateur conclusion. Thanks for your interesting post. Anne.

[Smythian]

I agree with Tipper. The reference to 'blood thinners' is misleading. The blood is never affected by anticoagulants to make it 'thinner' - the impact is upon the time taken for the blood to coagulate.

[Lexby in reply to Smythian]

Perhaps. Maybe, by removing some of the clotting proteins, there is more room for red blood cells, which in turn gives the feeling of being on a caffeine high (as dasyd put it) or at least carry more oxygen. Anyway, it's certainly less sticky and runs off my finger more easily and I notice a difference in my ability to do things when at the extremes.