is it common to have erratic inr's during menopause?

[kathyD64]

hi guys i dont drink any alcohol any more to remove that variant to affecting my inr's. am eating healthily following slimming world plan am exercising taking y warfarin correctly yet my inrs are all over the place!! only thing different is perimenopausal - is there a link? kathy xxx

[Hidden]

Everything affects warfarin. Increasing activity when you are normally less active will require more warfarin. What you eat, how much you eat, stress levels, sweating, etc, etc. It’s like an insulin dependent diabetic. Any change is eating habits or activity will require modification of how much insulin you need.

The is not an APS related issue but way warfarin metabolizes in the body.

[Jade]

I too have posed this question. I am 50 and peri at present and my INR is crazy. It remains stable for a couple of days the without a clue why I find it has fallen well below my target. I was pretty stable upto the last year so I am also assuming it is hormones messing with it.

[Manofmendip]

Hi Kathy

There are many dietary factors that affect INR and being as consistant as you can is an important; alcohol tends to increase INR and foods rich in Vit K will reduce INR. So, there is no need to avoid alcohol if you enjoy a drink - and APS sufferers have precious little to enjoy sometimes - but if you do drink alcohol then you should try to drink about the same number of units each day, not abstain for several days then have a binge; that way you can have a fighting chance to adjust your Warfarin dose to balance the alcohol units.

Similarly, certain foods are very high in Vit K, which is a Warafrin antagonist, so you need to try to eat about the same amount of Vit K each day. This is, of course, harder than drinking the same number of units of alcohol per day as booze, in the UK, comes marked with the number of units, if it is in a bottle, whereas food does not give you the Vit K content. Certainly, for me, Brussels Sprouts and Cabbage knock my INR way way down.

I believe that there was a trial iin the USA where they gave Warfarin users a base dose of Vit K, 150mg by injection, so that Warfarin dose could be balance against this base load and any dietary flucuations had less effect; i don't know the outcome.

I hope that this helps.

Best wishes.

Dave

[kathyD64]

Thanks Dave & Jim & jade for your replies. I stopped alcohol as my inr are going to 8.5 7.7 then 2.2 but years of taking warfarin I did have a happy medium with diet and drink and exercise. Ive done many diets in the past without affecting my inrs. As you pointed out Dave I enjoy a glass of wine but because the lab said well its alcohol related I took that out of the equation to prove its not!

I have had recent Tia's also started aspirin but choose not to take when inr raised as it always affect my stomach & head when high then I need omeprazole so vicious circle.

The main change to my body is hormonal so that's what I am wandering is the cause - unless recent Tia's but these occurred when my inr r was theraupeutic so all a bit of a puzzle & I am feeling more vulnerable as keen to self test but still guided by lab at mo .. but even though they said wait 2 weeks for next level I've book after a week whilst my body feels so vulnerable - i would like some say after all when stable I do the opposite leave it longer before checks Kathy x wishing you all a happy & safe weekend

[Lili1881 in reply to kathyD64]

Im surprised you test so frequently i get tested weekly even when my inr is outside my range, i have been on warfarin since 2014 when i had my first stroke and tia. recently my inr has been up and down but ive realised i am peri menopausal, i also generally follow a slimming world diet, i dont drink, omeprazole can affect warfarin which is why i dont take it, i have gastritis, i uded to find the omeprazole caused me the same signs as the gastritis, then after my 2nd stroke i was told omeprazole and the family affect my warfarin so couldnt have them. But many things in our body chemistry change how we metabolize medication, when i started warfarin in 2013 i had to take 15-17 mg of warfarin to stay in my 2-3 range. Now i only need6-7 mg. Yet i take much the same medication except since this stroke i take more nerve medication.

[daisyd]

Hi Kathy

Sorry have I got this right do you only take Omeprazole when you have problems. It should be taken regularly everyday.

I am having problems with the menopause at the moment, but as Dave says vit K in food is important.

If I have a meal without green veg, I try and eat a kewi or pickled Gurkin or two mmmmmmmm to keep the vit the same.

High INR is horrible when its high, I have only had one about 7.6 felt awful.

Self testing is wonderful so reasuring, I had a terrible headache the other day self tested ,reasured my INR was normal for me, wish everyone had a machine

Karen xx

[daisyd]

Sorry Kathy I should have said hot flushes etc had made no difference to my INR

Karen xx

[kathyD64]

Thanks Karen, i only take omeprazole for a few days when inr high and causing me gastric problem once inr below 5 my stomach usually settles and can go months with no problem. (omeprazole does affect inr as well i cant remember if it increases it or reduces it!)

I will look more carefully at my diet because of using rocket salad alot, ? that may have a high vit k property also am eating lots of fruit have reduced sproats and leafy green veg. my inr is 5.4 felt unwell yesterday getting better so thats reasurring - when it was 8.5 i felt brill am thinking it was a false high but im with you on self testing just waiting for pct to say i can get strips on prescription.

My gp has advised with peri menopause, the oestrogen varies so that can affect the amount of warfarin needed. When levels are low you need less warfarin, when high the opposite hence the pill causes increased clotting risks.

kathy xx

[daisyd]

Hi Kathy

You need to check with your Doctor about the Omprazole or pharmacist

I am almost 100% sure that it should be taken daily, problems or not.

I was informed by someone on the Hughes web site of a list of foods with vit K in them, its not that you can't eat them just the same amount every day.

Good luck about the strips I get mine on the NHS

Web site Vit K is

Alere Home Monitoring Welllife Vitamin K registry

Good Luck

Please let us how you get on

Karen xx

[daisyd]

ptinr.com/cafe-ptinr/vitami...

This is the link their is full pages as well as a printable version

Karen xx

[kathyD64]

Thanks karen I have saved it on my I pad to refer to quickly xx