INR

[darceynjo]

Hiya since I asked my last question I just wondered if anybody could tell me what the symptoms are for low INR levels. My target range is 2.5 which I have never reached, the highest I have ever had is 2.2. On tuesday it was 1.7 the reason for me asking this is that I am so tired all the time and slightly confused. thanks for any help give Julia xxx sorry if I am asking too many questions but I am new to this and dont understand any of it xx

[daisyd]

Hi do you know the resson why you had a pulmonary embolism, the reason I ask is because I have Hughes syndrome, sticky blood Antiphopholipid syndrome, all the same condition but needing to have a higher inr of 3.5, otherwise symptoms as you describe .

Have a look at the Hughes foundation web site where it tells you more, their is also a site on here

Good luck hope you feel better soon

[darceynjo in reply to daisyd]

Hi I broke my foot on xmas eve, but somebody else has said that the other symptoms I have could be the one that you said thankyou for this Julia xx

[Hidden]

Hi darceynjo

The question should be "How do you know if the warfarin is working". Well dareynio, you will not be able to tell if your warfarin is working by how you feel and will not feel any different. You need to discuss your symptoms with your GP or anticoagulant provider.

The amount of warfarin therapy needed to prevent blood clots varies from person to person.

So in my opinion and many experts, you need to have regular INR tests (unless stable) to see if your warfarin is working but this test don't tell how well the warfarin is working over the period between tests and can only do this by working out your therapeutic time range but the INR is used to tell how much warfarin is needed.

In my opinion dareynio, you need to work out how well your warfarin is working by working out the percentage of times your INR is within your therapeutic range (TR). I have made an excel spreadsheet that can work out how well the warfarin is working between tests called the therapeutic time range. Can you work out how many times you are within range? Should you need help to do this please let me know your INR results with the dates.

Hope the information helps but please discuss your concerns with your GP and anticoagulant provider. It is very important to maintain your INR within your therapeutic range and being too low means the warfarin therapy is not working.

[darceynjo in reply to Hidden]

Hi Firemansam, Thankyou for that but I am still confused all I can tell you is that when I was in hospital they wanted my INR to be 2.0 before they would let me home. Then 7 days later I had to go to the clinic where I was told that my target range would be 2.5, when he did my blood test it came back at 2.0, 7 days later it was 2.2, then this last time again 7 days later it was 1.7 and I was told to increase my warfarin to 10mgs that day and then 8mgs for the rest of the week until I go for my next blood test. Sorry to be such a pest and Thankyou Julia xx

[Hidden in reply to darceynjo]

Hi Julia, first of all you are not a pest and we are here to support you while you come to terms with your illness and your warfarin therapy. If you supply me with the dates of all your tests, I will enter them in my excel spreadsheet and explain how your well your warfarin therapy is working. It is my understanding that your therapeutic range is 2 -3 and they would like to maintain your INR at 2.5. Once you provide the test dates and INR readings, I will be in a better postion to explain more about warfarin therapy but of course you should always discuss this with the anticoagulant provider. Julia, please feel free to contact me at any time. Are you a member of ACE and do you have their latest magazine, if not I can arrange a free copy and my home telephone number is in there, so that you can talk to more freely.

[darceynjo in reply to Hidden]

Hi Firemansam, Thankyou for your kind words of support. I am not a member of ACE but I would be grateful of a copy of there latest magazine. When you ask for the dates of my tests do you mean when I have to visit the hospital for the INR blood tests ?Also yesterday I received a letter from the Haemophilia & Thrombosis Centre with a appointment, I thought that I was to be on warfarin for 6mths and then back to see the Chest Doctor nobody said anything about having to see anybody else, so what could this mean. Thankyou once again Julia xx

[Hidden in reply to darceynjo]

Hi Julia,

Would you and any other member who wants to contact me please email me at: [e-mail]. Julia would you be able to contact ACE on 020 8289 6875 and request a free INReview magazine and please let me know if you don't receive it.

I only need your INR test dates and INR results after you were discharged from the hospital, as they only require you to be at least 2.0 on discharge as it does take 3/4 days for the warfarin to work, so reading at the start can be erratic and 7/14 days testing is required.

It's normal to have checkups after discharge especially during the first 6 months of warfarin therapy and nothing to worry about, so don't read too much into the appointment. This is your opportunity to discuss how the warfarin therapy is working and they will look at your test results in the yellow book and will ask how you feel since starting th warfarin.

Please let us know how you got on Julia, as your experience helps other members who are also going through similar experience on warfarin therapy.

[darceynjo in reply to Hidden]

Hi Firemansam, sorry not got back to you but not been too well this weekend. I go for my weekly INR tests tomorrow so I will forward on the dates and results that you require. Thanks once again Julia xx

[Hidden in reply to darceynjo]

Sorry to here you have been unwell and hope you are feeling a little better.

[willowgirl]

hi julia, my range is 2.5, it could be anything thats altering your readings , i have factor v leiden so am on it for life, even a face cream, shampoo etc can alter readings, i cant have anything with vit e, aloe vera, numerous different things, its personal to your body,my dad has the same but can use things i cant, my last reading yesterday was 3.0 but not done anything different, as long as you within your range 2.0 / 3.0 you are fine, just make sure you have regular inr tests dawn xx

[ELCgirl in reply to willowgirl]

Hi willowgirl,

I have factor v leiden too. I never thought about face creams, shampoos, etc affecting INR readings? I am on a high dose rate of warfarin at the moment, 10.9gm/day. I have been up to 12mg/day before. I do eat lots of veg (I grow in my garden), and I know my diet affects my INR. Also, I moderately drink alcohol. As long as I do not make any changes to diet, my INR is within range.

I have regular tests and if I am at all worried, my GP will fit in extra tests.

[gel1]

HI Julia

my range is 2.5 to 3.5 following a bi lateral PE. Initially I had headaches on Warfarin, but I put that down to the whole stress thing of being ill, now I have no symptoms, I followed firemansam's advice and monitor the time I am in therapeutic range which at the moment is 55%. Just before Xmas my INR dropped down to 2,1.9 and then 1.8, (for no apparent reason) and now I take 12/13 mg Warfarin on alternate days. Like you I am relatively new to this treatment , but its so good to have a website where you can ask these questions, and people who have had these experiences can offer you their own practical advice.

[Lynneiow]

Hi Julia, my range is 2.5 too, and l am on Warfarin for life. It can take a long time to stabilise your INR, l have had readings between 1.9 and 3.2. Generally l don't feel any different regarding my readings, although l often feel very tired and run down. As has been said before, so many things can affect your INR and it is difficult to pin down what could be causing the changes. It will take time for you to realise what does affect you personally, but you will get there eventually. When l was first diagnosed with a DVT due to a clotting disorder, l thought l would never get my Warfarin right, but you do stabilise given time. Try not to worry as this can make it worse as l know to my cost!! Good luck. Lynne

[Oggie]

Hi darceynjo,

I have had similar concerns too being new to all this. My range is 2-3 although the INR nurse wants to see it above 2.5. Similar causes by the sounds of it, I fractured my ankle 12th Dec but the DVT wasn't found till New Years Eve. I have reached 2.3 at its peak but seems to go up and down for no apparent reason. I was really panicking as I saw this as a sign of the clot not dissolving. My INR nurse wasn't very good and I then came across this site which I found really helped me. Since then had 2 more tests and it's started to creep back up, although slowly, with the latest being 2.1 so definitely think worrying does not help.

Firemansam I would be interested in your spreadsheet if you could let me have more information.

Keep reading posts on here, sure they will re-assure you more and good luck

[Hidden in reply to Oggie]

Hi darceynjo

Yes, please to send you a copy. It might be better if you let me have all your INR test dates and INR Readings to date since leaving hospital and I will setup the excel spreadsheet for you initially if that's OK with you! Please email them to: [e-mail].

I have been working on a new excel spreadsheet that take into account the warning from PBrit that Dentist will want a printout from the self-test monitor. The new spreadsheet allows you to enter your warfarin dose everyday so it's like your yellow book but does much more. I send a copy of my excel spreadsheet to my GP every 6 months, so that he can be assured that I am looking after my wellbeing and taking my warfarin therapy and he's been more than happy with me self-testing and self-dosing.

[Oggie in reply to Hidden]

Hi Firemansam, I know this is cheeky but would you be kind enough to do a spreadsheet for me too? I am also new to this and very wary that I haven't yet reached my target although am within therapeutic range, I think.

If I email my dosage and readings would you be able to set it up for me? I would be extremely grateful.

Many thanks

[Hidden]

Hi Oggie, more than happy