If you eat or drink something you know will raise your INR, can you eat something on the same day that would lower it to cancel out the affects? and can you do vise-versa with something that would normally lower it?
For example...I am mot a big consumer of alcohol, but do enjoy a couple glasses of wine now and then or a mixed drink when having dinner or visiting with friends. Coumadin clinic tells me that alcohol will raise my INR. If I ate asparagus or greens on the same day, would it somewhat keep my INR within range?
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mylafont
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Hi - I'm sure others more qualified will post better replies but please take care on this topic. I have a home test machine and use that if I think there is a reason the INR has gone dodgy. I'd phone my gp if an issue and not self medicate.
Saying that I consider wafarin / INR interactions with everything I eat and drink and do try to balance. It's not as simple as cancelling out. Some foods inhibit warfarin and for me at least exercise makes a difference as does how much water I'm drinking. I would think for example saying 3 Brussels sprouts counteracting a small glass of Rioja is going to be different between people as well as some will have warfarin levels based on their normal level of vitamin K. I'd love to know if there is a well written paper on this topic if anyone could share it. It seems to work for me as my INR levels are only out when I travel to China or am on antibiotics both of which are rare.
The thing with Warfarin & INR levels, regarding food and drink is consistency. So, when I was on it, I used to try to eat a similar amount of Vitamin K rich foods each day and have a similar intake of alcohol each day too. I used a self testing meter and calculated my own dose, with my GP's blessing, and this did help.
Two instances that I remember causing me issues was:
1. Having too much to drink on my 50th birthday in Italy, which caused my INR to rise to 6.5; and
2. having a Brussels Sprout rich risotto in a restaurant, which dropped INR, overnight, from 4.0 to 3.2.
So, try for consistency in what you eat and drink and in changes to the amount of Warfarin you take, certainly don't make large adjustments to the dose as there is a delay in dose changes affecting INR, so it is easy to over or under shoot your target.
I Think you told me you were Lupus Anticoagulant like me. Then it can be more difficult to keep the INR steady. I am selftesting but you are not.
I never taste alcohol after my diagnose of APS. I drink a glass of red wine for dinner every day. Only one glass and constantly.
It is easier to get your INR down than to get it up. Gets faster. Actually I do not know what to eat to get it up more than to increase the warfarin-dose. Perhaps alcohol but I never drink that. To increase it with your warfarin it can take up to 3 Days.
Yesterday I had to get it down as it was too high and I eat 10 brusselsprouts and also some broccoli. In 24 hours my INR had droped 1.3. But we are all different!!!
Sorry Kerstin, I just now seee this is three years ago, but I’m still trying to study INR instability ... I have a major issue right now. I’ll post my question/ doctors finding on it very soon- as soon as I feel better- I have a factor chromogenic X ( CFX) that I now found out I have to subtract one full point off from of my vein value.
I had never heard of this. It “ replaces “ the PT - but serves to act as the New INR for me.
But it’s a 3 day turn around...
it’s a nightmare. So if I’m 5.7
on finger prick, my true CFX is 16, or Actual adjusted vein value 3.8!!!
This has been my problem! ( we Think...) now I’m just bridging... guessing what the discrepancy is on Finger prick to vein value is because it was a weekend...( averaging my norm of .5) then taking an additional one full point off from that...
I know you mentioned it already, but when you parallel test with machine vs. Lab, are the differences in your INRs numbers between the two consistent? it that simple?
I still have much to learn and it would be ideal for me to self test, but there is much controversy over self testing... especially with positive L.A.
If the INR is high the difference is greater than if the INR is low. Differ perhaps 2 - 3.
Do not forget we are all different!! I am trippelpositive and have high numbers of antibodies. I am a bit unique that way. That fact may mean nothing perhaps as to the sensitiveness of warfarin. Nobody knows.
I believe it is good for us to eat K-vit rich vegetables to get the INR more stable. I have also read about that.
If I did not have my machine and was able to test every second day it would be impossible to keep my INR in the therapeutic range.
Thanks everyone. I don't self test. It's not widely accepted here in the USA. I am also lupus anticoagulant positive, which keeps the machines from being accurate. So, I don't self adjust my dose. With that said, I won't know if something I ate or drank affect my INR unless I happen to go lab the next day.
I'm pretty consistent with my Vitamin K foods, but the few things that cause INR to go up I don't partake in regularly, such as crawfish and alcohol (both make it high).
I have noticed when it's high, it is easier to bring it down.
I was wondering if I have some wine or go to a crawfish boil, if I should eat vitamin k also later on in the day.
One hematologist I have seen called it "voodoo blood chemistry." He made it clear he would prefer it if I never ate any of the Vitamin K rich foods. Another doctor advised me at the onset of my warfarin journey, that those patients who practise "voodoo blood chemistry" by memorizeing relative Vitamin K content of food and trying to be consistent in amount of "thickening" and "thinning" foods consumed daily tend to, paradoxically, have more stable INRs. I chose to follow that second doctor's recommendation. And I've remained fairly consistent -- but there is a learning curve. We're all different, and I strongly suspect part of this individuality has to do with our gut flora. Research is only just beginning to chart the strong influence those friendly (usually) bugs in our guts have on our metabolism. So, while eating a bit of ginger may lower my INR within a few hours, it may not have the same effect on you.
And, as Dave pointed out, amount of water consumption, exercise level (and kind -- cardiovascular? or strengthing?) as well as stress levels all can effect INR. THis is why some people are more successful and happy ditching the warfarin thing and just going with the shots -- which are based on body size and are not nearly as subject to metabolism vagueries.
I strongly recommend keeping a chart of INR numbers, foods, activities, sleep habits -- details which will convince your family you are a nutter! -- as you may discern in your records patterns which will help you integrate warfarin more successfullly into your life.
I have been remarkably steady for the most of the 15 years + I've been on warfarin. There was once when I was reading a fascinatingly complex novel when my INR unexpectedly rose; it made me wonder if amount of brain activity influenced the metabolism of Vitamin K. (Just kidding. I think?)
I'm having a broken wisdom tooth extracted on May 11. I will bridge from and back to warfarin before and after. I'm looking forward to having some liver-rich pate or (one of my favorite dishes) liver and onions on the days preceeding my procedure. ( Liver is so high in K that i will not risk the chance that eating it.)
I seem to be a little better since adding vitK back to my diet rather than eliminating it all together.
I do keep a diary of INR numbers and about a month ago started adding episodes and how I'm feeling on a given day. I have yet to see a pattern with my INR level. But my INR is all over the place since being on warfarin.
The shots sound interesting. Can you direct me where to go for more info?
The shots are fragmin, heparin, clexane, lovanox, and must be prescribed by your treating doctor. many of us on this site use these, but, as I read member stories, those who take the injectable anticoagulants do so because the warfarin did not work out. There are pluses and minuses which you must discuss with your doctor.
more warfarin but the warfarin can't be changed or adjusted ever 3 days because of the 1/2 life of the warfarin. we test because of my ability to plummet or sky rocket out of control.
but if i drop to low under 2.0 them he may put me on the Enox { Lovenox } - to protect me --BUT with my feet problems the Enox causes my feet to split open as it's doing it's job but it's a double edge sword at that point . did my blood today @ 11:0 I needed to fix my feet bandages , trying to keep them dry . so anyways the lab won't result the INR till most likely 4:00 and it's 1:40 PM now -- I bleed a little so my guess it's where on my arm that they had drawn the blood . they have to alternate because i get stabbed so much .I will let you know where the INR is last time it was 3.9 and we tried a 6 day test . -
Dressing change tomorrow on feet @ wound care to evaluate progress - it in't getting to much worse BUT it isn't healing either - then i go to therapy for migraines and get my needles on shoulders and spine and lower lumbar .
Medicare took away my narcotic cream for my neck , back , and legs --NOW my back shots - so migraines started and so that's why i am getting the needles in neck. back down spine and across the lower lumbar region-- the needles ,they will only last maybe till next month if i am lucky so i am working with the federal Government to try to get them reinstated-- but this has to happen before the needles stop the beging of next month --
now my blood plummeted from 3.9 -it is now 2.7 and 2.0 thy will want to give me lovenox shots that will mess up the healing of my feet !!!
they wanted to keep me on the same warfarin schedule -- but i said NO we have to be more aggressive or i will drop below the 2.0 INR and then the lovenox shots - i have to give myself !!
GRRRRR---
well re evaluation for back needles tomorrow-- then dressings changed on feet and see what Wound Care wants to do next ???.
Thanks my friend -- Noticed yesterday when nurse changed dressing {suppose to be air and water tight seal } had leaked and medicated pad that is put into wound that is actually soaking up any discharge had come out of position and the Tegra-derm seal had torn ???? -- I can't see that -- discharge was not bad nurse said - GOOD news -- I see Wound Care this morning @ 8:45 to see just where we are going to be and where we are going with this
Right foot healing slow - but going in the correct direction any ways. will let you know what i find out
O well Kerstin-- left foot wound progressing further up along heel !!
This would be along the edge of the out side of the foot o the Right
Right foot doing better but still needs to be treated
got doc. info from Hughes center -- and also going to give her APS action paper work -- she will look at it -- she is nice pleasant and a good listener which is vital to our Dc patient relationship
so next dressing change should be Friday @ the Dc's office where my PCP is -
told you I would let you know
ALSO I almost forgot they are finally going to either X ray or ultra sound my calves as they are swollen and painful --the wound DC is doing this which is great. don't know when my appointment is yet but i will let you know .
Thank You for your concern ---- Casey sends a wag and me just a big but gentle hug my Buddy
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