Warfarin and vitamin supplements.

[Cavalierrubie]

Morning to all. Haven't posted for sometime, but best wishes to all during this second lockdown. I am feeling a bit "run down" after an ear infection and strong antibiotics. I was thinking of taking Vit. B complex and fish oils. I already take magnesium and Vit. D and they are OK. I asked my healthcare team, and they said to take them and see what happens to my INR. I am not convinced that this is safe, after reading information on the internet. Can anyone advise please? Many thanks.

[CDreamer]

I am wondering, after asking your healthcare team, who I think gave you an excellent answer, why you would think we are more qualified?

It implies that you have doubts and seek reassurance that all will be well when there will be mixed opinions and every person will metabolise very differently and so have different results.

Dr Google can be very helpful but you do need to be discerning and trust what you think, feel and intuit is right for you.

Personally I take Fish Oils daily, have done for years but am on Apixaban which works very differently to Wafarin and one of it’s advantages is that you don’t need to worry about interactions nearly as much.

Best wishes.

[Cavalierrubie in reply to CDreamer]

Yes, unfortunately I cannot take the new anticoagulants, so you have an advantage in that respect. I don't think you are more qualified than my healthcare team in the least, and was merely enquiring of everyone's experience and knowledge, which I thought was what this forum was intended to do. Sometimes, we need a second opinion if things are worrying us and there is nothing like asking people who are having the same problems. We are all different and unique - thank goodness.

[BobD Volunteer]

As a warfarin user of 16 years myself I can tell you that many drugs etc can affect INR readings, particularly antibiotics. I have never noticed any change in INR related to supplements but then again if you take them consistently then your INR will be stable even if your dose needs to increase or decrease.

It is always good practise to have an extra INR test post any antibiotics as we know that many increase INR. Leave three or four days after last dose would be my advice.

[Cavalierrubie in reply to BobD]

Thanks for replying Bob. Yes, my INR went way down low after antibiotics, and they have had to increase dosage. They are on it so to speak. I never get on well with antibiotics anyway. I read somewhere that fish oil is not so good. Maybe try one at a time. I just feel I need a tonic! Always getting colds and chills. Thanks for always helping and being so reliable in your experience and knowledge. I am very grateful.

[BobD Volunteer in reply to Cavalierrubie]

Vit D helps as does zinc and CoQ10 all of which I take.

[MarkS]

Yes those are all safe. I take Vit D and magnesium and eat quite a bit of oily fish. I've also taken Vit B complex in the past.

Do you have a Coaguchek? I think it's really good for those of us on warfarin. I also take Vit K2 which is excellent for warfarin (and other) users. It helps stabilise your INR, improve bone strength and reduce atherosclerosis. However it will reduce INR a little so will require a slight increase in warfarin. I don't mention that to health professionals as they are still wedded to old fashioned ideas and will tut-tut!

[Cavalierrubie in reply to MarkS]

Hello Mark. Thanks for taking time to reply. That's very helpful thanks. I have an INR check regularly, do you mean that, or a different kind of check up? Interesting about the vitamin K2 you take - didn't know about that. This is where this forum is brilliant. It keeps you fully up-to-date with what's going on, and certain things we need to know to make life easier and worry free. We don't always get all information from health professionals. Stay well and safe.

[Auriculaire in reply to Cavalierrubie]

Vitamin K2 is recommended if you take vit D and have a high calcium intake especially if you take supplements as vit D increases calcium absorption from the gut. K2 directs calcium to where it should go ie bones and teeth rather than into tissues where it does not belong ie artery walls.

[Offcut]

I was told when on Warfarin that I should avoid Vits and supplements unless advised by Doctor. My INR was not the most stable anyway ! I have moved over now to Apixaban I do now also take vit D, Calcium and was on Iron as one of my tablets reduced that. While I am on apixaban I have found my veins are either collapsing or causing them to blow? ( I have also been treated Recently for Temporal Arteritis) I was also given Magnesium while in A&E due to my AF/Tachycardia Going a little berserk.

[Cavalierrubie in reply to Offcut]

Thanks for reply. Can I ask who told you not to take supplements? Take care of yourself. Sorry to hear you are having problems and hope things soon get better for you.

[Offcut in reply to Cavalierrubie]

It was the Warfarin Clinic that told me to lay off the vits! I am still weaning off a high dose Steroids. They have doubled my Nebravlol and added Digoxin which has now got to a near normal heart rate but O2 still going low?

Be Well

[MarkS]

Hi Calalierrubie, the Coagucheck tests your INR. The advantage is that you can do it from home and then just send the result in. You can also do it as often as you like, e.g. once every week or so, and that results in much better INR control. Get 70% of the time in range and that's equivalent to the NOACs. Get 99% in range, as I do, and that's better than the NOACs. The Coaguchek costs £299 in the UK but the test strips should be free on the NHS.

Mark

[Cavalierrubie in reply to MarkS]

Thanks Mark. Yes, I have been thinking of doing this, and it's beginning to look more likely that I will be. It must be much less stressful when you are in control of yourself, and worth the cost if you have to be on Warfarin life-long. Thanks for all the help - much appreciated.

[jwsonoma in reply to Cavalierrubie]

I bought a used Coaguchek on eBay and also buy my INR test strips from there. I test every 4 days as I'm plant based and my INR jumps around a lot. Kaiser in California gave me a free Coaguchek and 1 test strip a week but I broke the Coaguchek and test more often. I can get my INR down close to 2.0 before before I do anything that may result in a fall like snow boarding or mountain biking and let it drift up to mid 2s other wise. It is very helpful when traveling. I usually have 50g of frozen kale in a smoothie every morning for my K.

[Lomcevak]

Tell your INR clinic what you want to do and ask for extra blood tests to monitor your INR levels. In a short time you should see some benefit from your vitamins and be in control of your Warfarin intake too if it is affected.

[Cavalierrubie in reply to Lomcevak]

Bless you for being so positive and helpful. I have decided to go ahead with taking supplements. I did before I got AF and certainly felt a lot better than this. I eat well but this doesn't seem adequate at the moment. Keep well and best wishes.

[annlynne]

Hi Cavalierrubie, I'm so sorry you are low and I hope your ear infection is cleared up. I took warafin for 8 years or more before the cardios put me on Apixoban which is apparently targetted for AFib. I was contantly having toe infections because of my affected foot clawing and causing an ingrowing toenail and it was the antibiotic caused my INR to go up and down. During lockdown I had bloodtests that showed I was low iron (and high sugar) I referred to my other drugs and Phenytoin can cause enlarged red blood cells and sugar spikes. Neverthless the GP diagnosed diabetes and I am now on medication for that as well. (probably just as well -I've now stopped eating liquorice allsorts). Because of this I have spoken on the phone with the GPs . they do recommend I take Vit D as 80% of Covid patients admitted to hospital were vit D deficient. When I asked aboyt VitB complex they answered "well it won't do any harm "and I have to continue with folic acid (just in case I want to start a family !!tee hee -I'm 74 so I'd be in the news ). sorry to be flippant, I'm afraid it's what gets me through the minefield that is my life Do keep well and ask me again when I'm more compus mentus it's this crazy world just now that is playing havoc with my sanity. Basically what I'm saying is that my GP's have told me to take D, B and folic acid. I've upped my consumption of those lovely little easypeeler mandarin type oranges to give me Vit C and I;m taking Omega 3 for my elderley joints. I should have made it clear I had a major stroke when I was waiting to go on Warfarin, that was 11 years ago. So keep on the blood thinners and keep safe there is such a thing as an AFib related stroke. best wishes Annlynne

[Cavalierrubie in reply to annlynne]

Thank you for taking the time to reply to me it's really appreciated. Sorry to hear of your health problems - which make mine look insignificant. Sorry you got the sugar! My daughter's husband has diabetes, and I know this can make you depressed, and lower the immune system, so you are in my opinion doing right in looking after yourself well. Yes, the world is crazy right now - but this too will pass. You are not alone. My daughter suffers with anxiety and depression, and has had to seek help recently , and it's all down to this awful virus playing havoc with our lives. We have been used to so much freedom. Years - many years ago ! it would'nt have been such a hardship to stay at home. People were more content, and accepted their little lot. I remember the days..........................!!!! Probably sounding old and grumpy ha! Anyway, hope this will soon all be a memory. Next year this time we will be millionaires as Del Boy would say. All the best and love to you.