I know infections infections affect the INR , but I can't remember which direction or by how much. ( I'm sure it's person to person dependent.)
I went from slight below target INR of 3.5 on Thursday to suddenly 4.5 this morning. ( spinach for breakfast!) Hematologist raised my Wafarin from 16mg every day to 17 mg every day starting Thursday morning. I am to self check Tuesday ( tomorrow) and report in with INR. I decided to check this morning. I've just switched a week ago today from LMW Heparin to Wafarin so we are trying to establish my dose.
I feel great with INR this high! ( I am leery to even report it to hematologist I feel so well! But that would not be fair to him... I'm about to call.)
However, I'm realizing in the last hour I very well may have a UTI. This may account for the higher INR.
Or, it could be both. I might have a slightly too high dose AND the onset of a UTI. I just don't want to lower my dose of Warfarin unnecessarily and reclot with a DVT the way I did last month...
So, which is it? Does an infectious raise the INR, or make it drop?
And... if I just ate about 1/2 cup of spinach, how long does it take for that to show effect on the INR?
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KellyInTexas
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Also, Don't forget it takes warfarin a couple of days post dose to do it's job. If you call I would tell hematologist about poss UTI. I can't comment on if it raises or lowers because I honestly do not know. Good luck, please educate me, thanks, Cindy
Yes. It takes three days for max . A few more for steady state. Yes I told the RN Belia I had an Appointment with onbyn at at 1:30pm this afternoon and she might call Holahan if indeed it is a UTI.
Update: I just called my hematologist's office. ( my hematologist is Dr. Joseph Holahan in San Antonio, Texas for Reference. His nurse is a RN. I called her and reported. She said infections NEVER affect the INR in and of themselves. It's only the antibiotics that do. I had her repeat it to make sure I was understanding it correctly.
Is this correct.
Can any of Dr Beverly Hunts Patients weigh in on this please? Or any one here who actually and a true APS hematologist?
If I breathe my INR changes haha! I'm not sure what Drs generally think about whether infections change inr or not but I had a UTI last October and my inr went to 5.2 I think it was.
However today I have no infection and I'm 5.4 - like I say most things I do seem to change mine!!
You're not bothering me! I hadn't started the antibiotics- it was high the day I went to see dr about UTI. But I can't be sure it was the infection, as I say I'm high today with an infection. I've got a very unpredictable inr x
Hope they did not lower it too much- that razors edge we live on is too sharp to be comfortable sometimes. The problem is often it's the doctors comfort level he's/she's worried about...
U r so right Kelly, a good analogy I'm going to use it! 😂
My inr had dropped to 3.6 so that explains the headaches.
I had a struggle but finally he agreed to raise my warfarin dose!!! He wanted to leave it the same! I explained that it would have dropped more by next week and under 4 I feel terrible. Finally he agreed to raise it!!!
How r u feeling? I hope the infection is sorted and inr stable. 💋
The initial urine sample run showed no infection. It's being sent off for a 3 day culture. I suspect it will be fine/ no infection. I did this once before- in January. I thought it was UTI- all clear. Then a couple of weeks later started spotting a little blood ( tiny amount) with urinating- thought maybe bladder? ) then a week later it was a little heavier- evident it was vaginal! I was totally confused because three years ago t had a hysterectomy, ecterocele, cystocele, ,and rectocele all at the same time. As it turns out I was " spitting a stitch" from the vaginal cuff. It did tear on out / come through in its entirety- one single permanent stitch. My gyno said very very unusual. The integrity of my tissue is just not right. I suspect APS and blood flow issues to tissues is to blame.
I think perhaps I'm doing this again. Cramps, etc. it can feel confusingly like the bladder.
I have had 18 episodes of bronchitis/ pneumonia in last 3 years due to the immune deficiency I have along with APS. For me, the infections did not affect my INR. However, most antibiotics, the ones I tolerate anyway, run my INR sky high. When on antibiotics I've learned to cut my Coumadin by 1/2 and check INR a day or two later. Immune deficiency (CVID) now being treated with IVIG so have not needed antibiotics for almost 5 months!
Another odd problem that wreaks havoc on INR is diarrhea. It has caused my INR to jump to 7. But, even at 7 I cannot totally stop Coumadin even for one night cause my INR drops like a rock. My hematologist stopped my Coumadin for one night when my INR was 7 and the next morning my INR was 2.3 and my blood clotted in tube before it reached the lab. ( I was hospitalized when this happened). Needed emergency injection of lovenox.
Now I know if I get a really high reading on INR, especially with diarrhea, I cut my usual dose in half.
Thank you so much for this feed back. I was left winging it on my own the evening my INR was high. ( this is the first time it has ever been too high. Usually it just keeps tanking. )
My hematologists nurse never called me back with instructions Monday. ( she still hasn't I might add- even though I took my INR again yesterday with my coagucheck I have at home and it was down from 4.5 to 3.4, and this morning it's slightly low with 3.0)
So my dose was 17 mg daily- I had just begun that from 16 mg daily for 4 days and was 2.7 I think so he upped it to 17 every day and it shot me to 4.5. ( target 3.5 " at least" per Professor Hughes.)
I didn't know what to do so I just took 6 mg that night.
Called nurse yesterday ( with updated Inr of 3.4) and told her what I had done the previous evening for dosing since I hadn't heard back, explained I didn't think it was wise to play the part of my own hematologist, and could I please have guidance moving forward on re- establishing doseing.
I have had 3 bouts with Dehydration And Diarrhea , little to no urination ,I was hospitalized and received 2 large IV bags every time and and INR shot up- This may very well be because of the dehydration from severe diarrhea.I had Dia. 17 times is 12 hour what ever i drank ran right thru me . So Dia. and low hydration with me made my INR go up 2 .0 points.
My goodness. 17 times in one hour. That'll keep a guy busy...
Before my diagnosis I kept going into paralytic ileus. ( now we know it was micro clotting into bowels.) In and out of multiple surguries looking for adhesions... but appendix was chronically infected- it had to go. Gall bladder quit squeezing. No stones- just quit working. It had to go. Likely all the ileuses just took their toll on these various systems. organs and glands don't like to be infected/ sluggish/ from being in paralytic ileus. Lots and lots of diarrhea and vomiting. Lots of hospitalizations for being waaaay too thin. I totally get it. No fun. Very dehydrated.
Thanks for letting me know. Now I will have a heads up on this.
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My INR is too high !
Warfarin not raising inr....why?
