I am new to the forum having recently being diagnosed with AF but am not in it 24/7 it comes and goes and normally doesn't last too long, thankfully,( never the less it is still a' pain' when I get an attack)- following discovery of Hyperthyroidism last summer. I have also had high blood pressure for a fair while but have only been on Meds. for 10 months, this has thankfully come down to normal levels recently after cutting down considerably on caffeine and wine. I currently take 80mg Propranolol & 200mg of Propylthiouracil for the overactive Thyroid, 20mg Lisinopril & 5mg Amlodipine for the Hypertension and have just had my Warfarin increased to 5mg as from today. I started the Warfarin 19 days ago, it has been increased from 2 to 3 to 4 and now 5mg, my INR is still 1.0. I realise that getting the levels right will take a while but though I would have responded at least a little by now. I hate taking so much medication and am determined to be as proactive as possible in managing my health problems, hopefully reducing the Meds over time. I eat a diet pretty rich in Vit K loaded foods so presume this may have something to do with the INR reading? I am 51 and very active and generally fit. My GP is excellent in everyway and I am currently getting checked bi weekly for both INR & BP. I can question on my next visit, but was interested to hear you comments.
Thanks in advance
WB61
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wb61
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Welcome....it sounds as if you are getting good care, as they are watching your INR so closely I would not be too concerned it will go up. I am 56 and only been diagnosed for about a year. I too drink everything caffeine free now and like you only have intermittent problems. Drug regime is really not so bad when all settles down and you get used to it. You are not alone x
Thanks for your reply. The caffeine appears to have been a big trigger factor for me and white wine, cutting out both has made a huge difference, so far at least.
The health care here in the Highlands has been exceptionally good in our experience. The GP's really can do their job, no 5 minute time slots here, thankfully! Only had to wait 5 weeks for an Echo and it would have been sooner had my GP requested it.
It frightening how many people are suffering for years without a diagnosis, I feel fortunate to have such a great GP who listens, asks lots of questions and is keen that patients are proactive with their care regime.
INR does take a while to settle down, they will want to get you between 2 and 3 as quickly as possible, but some of us are just difficult.
Don't change your diet, it's changes of diet that can throw out the INR quickest when you are starting especially, if you are eating Vit K Foods now then keep eating them, this will be taken into account when the warfarin dosage is worked out.
And don't get hooked up on the mgs you are taking, doesn't really matter if it is 9mg or 2mg, the only thing that matters is the INR getting to the right point, and everyone will be different in the dosage they take to get there.
Hi and thanks for replying to my question. The volume of Vit K rich food I eat is almost definitely keeping my INR low at the moment but was still hoping it would settle sooner so that I am not down at the surgery twice a week!. I will definitely be sticking to a strict (ish) diet with similar quantities of the same types of food, as the benefits of a healthy diet out weigh the minor inconvenience in the meantime :). I am a tad impatient that s' all !
I agree with beancounter keep your veg intake but if anything keep to the same amounts each time then it should be easier to stablise. I never get the same reading but as long as it within range not a worry.
Hi and thanks for the reply :). I won't repeat myself but must jus say how interesting this forum is and it's great how responsive everyone is. Thanks.
As stated above don't worry to much about the dosage you are taking. I take 5mg a day and have been stable on it for a long time. I know others that only take 2mg and some who take 10mg. It just depends on how your body handles it. And now they tend to take the slow approach while raising the dosages. Since it will take 2 to 3 days to see the true outcome of a dosage change, increasing the dosage to much could cause your INR to jump and overshoot your desired level. Then bringing it back down will also take a while. So most have started raising it slowly. The normal reading for INR on someone not taking warfarin is between .75 and 1.1 so you may have started on the low end.
About the diet mentioned above. We have seen many who think that they can not eat green veggies and other things because of the warfarin. Foods such as kale, spinach, Brussels sprouts, parsley, collard greens, mustard greens, chard, cabbage, endive and turnip green are high in Vit K and have the effect of lowering your INR. Since your dosage is dependent on your INR it can be adjusted to keep the proper level as long as your diet remains stable. If you eat 5 servings of green veggies during the week then try to eat about the same amount each week and it is easy to stabilize your dosage. Two thing they want you to either stay away from or really limit are cranberry juice and alcohol . Cranberry juice (studies are still checking this) causes the warfarin to remain in your system longer which can really raise the INR level as does alcohol. Here is a link to a popular food list for those on warfarin:
Hi and thanks for the link. . I have been a chef for 30 years mainly organic and healthy recipes with some Raw stuff, so have a broad knowledge of food and what's in what etc; but I found some really good things on the Dr Gourmet site, you never stop learning! Thanks. I will definitely be staying away from edible trigger factors in future, so glad that I managed to identify mine quickly. I will keep my eye on 'cranberry' news as it is my favourite drink after wine !
As has been already said , the actual dose of warfarin is not important as we all metabolise drugs differently. I have been stable on 4.5mg for years (Don';t like green veg much anyway) and INR between 2.2 and 3 usually. It is strange how fashion changes. When I started they put me on 10mg for two days and then started checking, so I was up there pretty quickly but now they don;t seem to do this which I find odd. as it worked fine for me.
As far as drug regimes go I would suggest a 7 day pill box if you haven't already got one. Load it up at start of the week and then all you have to do is open the correct day at the same time each day and pop them in. Most pharmacies will sell you one.
Hi and thanks for replying . I suppose most Docs er on the side of safety with the dosage because of the bleeding risk, but as every one's said it will eventually reach the correct level. I'm just one of those impatient sorts and I hate taking meds! I will definitely get a pill box as it is easy to miss some medication. There's no wonder some people get confused and
struggle with taking meds at the right time and the correct dose. Many of the pills for related illnesses actually look very similar particularly for older folk.
Good to know that you have been steady on 4.5mg, long may that continue
hi i was diagnosed just over 5 weeks ago with af at the age of 41. i also eat a very healthy diet and are on lots of meds for high blood pressure and diabetes. my INR levels are still 1.0 they have increased my warafarin to 6 mg this week and have told me to stick to the same diet it will take abit longer to get my levels right because of my diet. i have been worried also because of the risk of clots as i am having lots of palpation's everyday but only lasting up to a few minutes each time. thankfully not like the first time which lasted 17 hours. hope fully we will both be sorted in a few more weeks and get piece of mind. good luck and remember to stick to the same diet.
Hi Sheffieldlass and thanks for your reply. I must be more patient!
I hope you get settled with the warfarin, it's not easy when you're taking meds for other conditions. I have been fortunate thus far as my palpitations have lessened considerably (as mentioned above) since I cut out wine & caffeine , also my thyroid drugs may well be starting to kick in which was most probably the cause of my AF.
All the best with your on going treatment I hope you get to your INR target soon.
I am also a Sheffield lass but moved to Scotland 8 years ago, I am from the Meadowhead area!
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