inexplicable inr

[Kirsti67]

I live in Norway and every winter i have to incrase my warfarin dose. I travel a lot to Spain (flight time 4 h 45 min) and every time I Get there my Inr goes from 3,5 to 4,5..5.. and eaven higher. And the oposite when I go back to Norway. My doctor can not explane why this happends. IT can not be food or drinks because it happends from day 1. So now I have one dose in Norway and another in Spain. The difference in tab in one week is 22.

I take warfarin 2,5 mg. Norway weekly dose 34.

Spain weekly dose 22 pills.

I like to understande why things happend, so if anyone have a suggestion I really wood appriciate it .

[Lure2]

Hi Kirsti 67,

My name is Kerstin and I live in Stockholm. Glad to hear from some Scaninavian member even if the reason could be better of course.

First of all I must congratulate for your excellent skiing. I have followed the WM in Östersund with Interest.

I am also on Warfarin with a therapeutic level of 3.5 - 4.0. What is your level set at?

Are you Lupus Anticoagulant positive as that can make if more difficult to stay in range. I suppose you selftest when you fly and also when in Spain. Sometimes we do not know why there is a change. Do you have trouble with erratic INR during your stay after your arrival? Do you stay all winter in Spain?

[Kirsti67 in reply to Lure2]

Hello Kerstin.

Thank you for the reply and gratulations. I must admitt that Im not a sportsfan 😄 my therapeutic level is the same.

And Im Lupus Anticoagulant positive.

I havet coagucheque, but Im not allowed to medicate only by using that. My Inr has never been stable over long time. But Im lucky because I have my doctor on speed dial 😄I travel bak and forth to Spain. We have a house there. But my friends and family are in Norway.

My body feels so much better when im in Spain. Less pains.

Im wondering if sun (vitamine D) and the air (very salt caused by two saltlakes) can infect on the Inr?!?

[Lure2]

Hi again,

A lot of things can make the INR erratic. Sun perhaps, exercise, low and high pressure in weather etc etc.

You have been with us since 2012 so I guess you know that CONSTANTY with everything is very important.

I guess you know that other autoimmun illnesses like Sjögrens, Thyroid-issues, SLE and RA may go hand in hand with APS and therefor important to have a Specialist of autoimmun illnesses like a Rheumatologist who knows to take the necessary blood-tests.

You say you feel better in Spain. You also have a higher INR there and that can perhaps make you fell better. Hope you test in the vein there also.

I can tell you I test at home every second or third day and go to the lab to do a double vein-test within a 4 hours time from the test at home. I am triple-positive with persistantly high titres and therefor difficult to be in range.

Have a nice trip next time......!

Kerstin

[MaryF Administrator]

HI, does your INR settle down after a few days? It is good that you are able to have swift communication with your specialist, as I am sure they will be keen to try and sort this out for you. It is very important with this condition to make sure your levels of B12, D, Folate and Ferritin get tested regularly plus your Thyroid. Hopefully some more people who fly regularly will reply to you, if they have similar reactions or not? MaryF

[Kirsti67 in reply to MaryF]

Hello

Can you tell me what the levels on this should be? I think Norway have a very low and wide range. And I have problems with explaining the importens of vitamine when I am within the range.

[MaryF Administrator in reply to Kirsti67]

Your doctor will need to look at your TSH for your Thyroid plus your antibodies, I enclose this test as an example/guide for your GP: medichecks.com/thyroid-func...

Ferritin I like mine at around 110, D mine last came in at 120, and my B12, I can't remember the exact figure, but I was mid of the top range. However your country may have a different style of testing and reference ranges, my Folate was also much better last round of testing. I do supplement for everything and it is all monitored and checked against my own readings, by various doctors involved in my care. MaryF

[GinaD]

I have found that sun exposure raises my INR.

[Kirsti67 in reply to GinaD]

Thats good to know. GinaD😄 so despite what my doctor say Im not alone 😄

[Kirsti67]

Well...Im not a good patient. 😄im not constanty. I try new things to improve my helth. But ofcourse I self test often. I know I have rheumatic problems. But I Dont have a diagnoses. And that is because there is no threat for it, and I dont need more diagnoses 😄 But I think that is why I feel better in Spain and better in the summer in Norway