DVT deep vein thrombosis forum

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INR Changes
Started by Helen
Posted: November 18, 2009 at 19:10
Hi I had a clot in my left thigh when I was 29 weeks pregnant. Since having my baby in June I have been on warfarin and was told I would be on it for 6 months. My INR levels have been stable around 2 for most of the time I've been on it. In the last month my INR level dropped to 1.9 and now to 1.7 so I've had to increase my dosage. I don't know what may have caused this as I have not changed my diet. Can feeling stressed or an increase in exercise affect your INR. I was really hoping that I would be able to stop the warfarin next month but now I'm not so sure. Just wondered if anyone else had a similar experience and if they have any advice?

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Re: INR Changes
Reply #1 by Cittycat
Posted: November 18, 2009 at 20:13
Hiya Helen,
Don't worry about them changing your dose - for lots of reasons INR levels dip and rise. Too much green veg, alcohol, not drinking enough water during the day, stress - the list is endless!
I'm a lifelong user of warfarin following multiple DVTs brought on after being in plaster following a sprained ankle in 2001. In this time my warfarin dose has altered so many times I can't count!
I'm sure you will come off the warfarin as planned by your doctor if this is your first DVT.
Just be aware though that once you have one clot, you are loads more likely to get another at some point in future so make sure any aches or pains get checked out pronto.
This is what happened to me - first clot was treated for six months with warfarin and then another one came totally out of the blue about six months later - which is why I'm now a lifelong user. Was totally scared out of my head and then super angry. Still pretty peed off when I think about it too much but hey! At least we are alive eh!
All the best,
Cittycat x
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Re: INR Changes
Reply #2 by Helen
Posted: November 18, 2009 at 22:25
Hi
Thank you for your reply. It's really helpful to hear other people's experiences and reassuring to know that it is normal for INR levels to change so much. I'm sorry to hear that you are a life long user of warfarin but as you say we are lucky to be alive. I don't know about you but I would consider myself to be a fit and healthy person and do feel angry at times that this has happened to me (although I know it was pregnancy related). I am quite conscious about my leg and how it feels so I will take your advice and go to the dr if there is any change. I will keep my fingers crossed about the warfarin but if I have to stay on it, I will accept it xx
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Re: INR Changes
Reply #3 by Audrey
Posted: November 21, 2009 at 12:46
Helen:

Anything that increases your metabolism, such as exercise or stress, can lower your INR because the body is also metabolizing Coumadin/warfarin faster.

I've been on Coumadin for the same length of time as you and have not been so fortunate with stable results. I have had to have my blood tested 27 times in 5 months, and only once have I had two consecutive readings within the target range of 2.0 to 3.0. I've tested within the range 7 times, below 9 times and over 9 times, with a low reading of 1.3 and a high reading of 6.2. Even the hematologist is confounded by the way they cannot get me stablized.

Some of my highest readings may be explained by Tylenol, catching a cold and getting stung by a wasp twice. We can't make sense of the lower readings and some of the other high readings.

I get to go for another blood test today; the fourth since last Saturday! Oh boy.
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Re: INR Changes
Reply #4 by Helen
Posted: November 22, 2009 at 11:17
Hi Audrey

Thank you for your post. I'm sorry to hear that things have been so uncertain for you. It must be really frustrating having such unstable INR and not really knowing the cause. So many things can affect your INR levels and it is really difficult to pinpoint one thing. It sounds a bit stupid but I didn't really think about it until my INR dropped. I had just been carrying on my life as normal. I really hope that they can sort your INR out soon so you don't have to keep going for blood tests.


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Re: INR Changes
Reply #5 by dave hale
Posted: June 2, 2010 at 15:40
my inr is normally stable but has suddenly increased from 2.5 to 3.1,this is using my
coagucheck at home,the only change i have made is that i have had 2 glasses of wine
which i dont normally have as i do not drink,could this have an effect
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Re: INR Changes
Reply #6 by claire
Posted: June 2, 2010 at 17:02
Yes, alcohol will raise your inr x
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Re: INR Changes
Reply #7 by Carl
Posted: June 4, 2010 at 11:33
My INR was stable at 2.5 after 3 weeks on Warfarin. Then I had 3 evenings of alcohol drinking and my next blood test revealed my INR had shot up to 3.5! So that's my personal proof that I should stay off the booze. Drat!
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Re: INR Changes
Reply #8 by Claire
Posted: June 4, 2010 at 15:55
Carl
I went for drinks with friends on Monday night, I had 2 small glasses of white
Zinfandel and had the hangover from hell the next day !! soooo not worth it as I've
been feeling great for the last 6 months.

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Re: INR Changes
Reply #9 by Robin Allison
Posted: September 10, 2010 at 12:48
My INR has been stable at 3.0 for the past 30 months now it is all over the place ranging from 2.0 to 3.9, why?
My local INR Clinc has reduced by Warfarin dose to 2.75 and within 2 weeks the INR reduces to 2.0.
The INR clinic increases the Warfarin dose to 3.0 and again within 2 weeks the INR returns to 3.3.
My eating and drinking habits have not changed for 3 years and the INR clinic can not advise me why this happening.
Can anyone advise me?
Thank you.
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Re: INR Changes
Reply #10 by CAROL TAYLOR
Posted: September 28, 2010 at 04:24
Hi I had a prosthetic aortic valve 2006 when I was 48 and since then my inr has only been stable for 2 consecutive months.I am so tired of being asked "have you missed a dose/s" when I know I haven't, luckily I only have to get my finger pricked as the needles played havoc with my veins but that also has it's down side.I have been on 6-6-7 for months with extra added when it drops, very rarely has mine increased above 3.2 but it can drop to 1.1 as it has now.Why does this happen? I am on a number of other drugs and know that some even paracetamol can have an effect usually the opposite from the norm. Can any one help? My doctor is very good but she doesn't understand why it drops either.
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Re: INR Changes
Reply #11 by Connie from Wisconsin
Posted: December 2, 2010 at 01:32
Hi!

It has been very useful reading everyone's threads! I have been taking Warfarin for 3 years now after having an "ascending aortic aneurysm" repaired which resulted in a faulty aortic heart valve, which they replaced with a mechanical valve. My target range is 2.5-3.5. I really haven't been able to be "consistant" thus far on a regular basis....not terrible, but I find myself going almost weekly most times because I am "just out of range". I am 45 years old so my "daily routine" is not consistant as it would be if I were an older person. I was taking 4.0 mg per day most recently. I just joined a Gym in which I have been participating in various cardio and toning classes. Last week my numbers were too low at 2.2. They increased my dose to 4.5.....but when I went for my blood test today....I was all the way down to 1.4. The only change that I have meade recently was my rigorous excercising. No one ever told me that increasing your excercise would make your numbers plummet!! I am not complaining......I feel fantastic working out....and would not change that!!! I don't care if I have to bump it up to 10 mg per day. I just wanted to make people aware that incresing your excercise DOES impact your INR/Protime......it lowers it considerably!! Any other people's experiences would be greatly appreciated if shared!!!
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Re: INR Changes
Reply #12 by PharmKid
Posted: December 16, 2010 at 02:12
Yes, exercising will increase the metabolic capacity of your liver and
drop your INR by two mechanisms: 1. increased breakdown of warfarin 2.
increased production of clotting factors. Don't stop your working
towards your health improvement goals unless there is some other
contraindication, but ensure your health care providers are aware of
the change (starting or stopping your exercise regime)and get more
frequent INR lab work until it stabilizes. As far as overall
cardiovascular health goes, there are very few reasons not to be
active... just increase in moderate increments to allow body and mind
to adjust to the stress. It will also increase the likelihood of your
new activity becoming a permanent lifestyle change.
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Re: INR Changes
Reply #13 by Gabe in SD
Posted: January 4, 2011 at 19:09
thanks for all of your comments about your fluctuating INR levels. I unfortunately think I have one of the most bizarre situations. I have had a stable INR reading between 2 and 3 for about 2 years or more, but recently I passed a kidney stone and my level shot up to 10. So the clinic advised several skipped doses and then a lesser regiment to bring it back down in range. Unfortunately we are going on three months now where it seems something has changed metabolically because they can't seem to bring me back down below 3.8. Kinda scarey. Anyone have something like this happen to them, and what was the solution?
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Reply #14 by Patartsy in VA
Posted: January 15, 2011 at 05:18
My sisters inr levels are being checked on a weekly basis. Her INR test is usually on Tuesday and sometimes she does not hear back for 2 days-however, this week the doctors office never called so she called just before the weekend and after much inquiring found out her level dropped all the way down to 1.2. If she had not called I am not sure they would have called. She feels insecure about the docotrs staff and follow through. If she had not called by Friday afternoon she would have gone for three days (long weekend) on the too low dosage and who knows what may have happened. Do any of you have a problem not feeling secure with the doctor and staff keeping you informed?
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Reply #15 by Gillett
Posted: March 15, 2011 at 18:33
My INR tests have been normal for years. Two weeks ago it was high, so I had to have it tested again. It had doubled in two weeks. I am not doing anything different. What would of happened?
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Reply #16 by Bailey's grandma
Posted: April 5, 2011 at 20:45
I've been on Warfarin for blood clots (DVT) for 2 1/2 yrs. It has never been stable in all that time. Two weeks ago it was 3.4; today it is 1.7. I watch carefully what I eat and do not consume alcohol because of the effect on the INR count. I am on 7.5 mg daily when they try to adjust it, the count just goes all over the place. I came off of the Warfarin for 3 months a year ago and developed new clots, so I'm now a lifer. I've come to realize that this just happens and I can't worry about it as long as I don't develop clots, its o.k.
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Reply #17 by Crystie
Posted: April 28, 2011
I had two blood clots go tomy lungs about five years ago...i did my
coumdin thing, i was fine,i had my blood checked and my inr is 4.5? what
caused it to spike up?
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Re: INR Changes
Reply #18 by Yuri
Posted: May 1, 2011 at 21:14
Dear All, after consulting with doctors and reading many articles,
there are really many things that can affect INR even if you take
stable dose of warfarin. Warfarin's impact can be increased or reduced
by other medicine you are taking, volume of water you drink, food,
sport, stress, alcohol, condition of various systems of your body,
which has something to do with blood condition, and dozens of other
factors... It is hardly possible to understand why INR changes when
everything else seems to be unchanged. Just check it more often when
it starts jumping - I use INRatio device for that at home - very
useful and convenient. Also do not be afraid if INR goes beyond the
target range. Nothing will happen in 2-3 days (doctors confirmed to me
that with my target INR range of 2.5-3.0, I should not worry to see
INR getting close to 5.0 or down to 1.0 in some days - dose should be
adjusted and the level should be back to range in 2-3, maximum 4
days). Naturally, if you get higher than 5.0 it is better to call
doctor urgently - may be they will prescribe to eat some vitamin K
pills to reduce INR (or just skip warfarin for 1-2 days)
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Reply #19 by Nikki
Posted: June 10, 2011 at 10:07
Hi i was diagnosed with a dvt and multiple PE's in both my lungs in March 2011. Starte on clexane injections and warfarin. when my INR is in range they stop the clexane. I have ended up back in hospital on 3 occasions since being diagnosed as my inr drops below 2 and i develop chest pain. So they restart the above regime.

My target rang is 3-3.5 i went to clinic yesterday and my level is 1.6 so started me on clexane for 3 days 12mg of warfarin for 2 days then 8mg and i also have pain in my leg again and slight pain in my chest. This is really getting me down they do not know why i developed the clots i am 25 years of age. Why does my level keep dropping and the pain returning. Is there any advice anyone can give me.
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