Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 > I have been reading the summaries for several weeks and find them > very useful. I have been told that I will need to be on Coumadin for > life. I have two questions about Coumadin. My internist says that > there is new information that a maintenance INR level should be > between 1.5 and 2.0. Has anyone heard this? Also since there is > some evidence that Vitamin K is essential for strong bones, does > taking Coumadin contribute to the development of osteoporosis? > Thanks. Hi , you might want to do a few searches at Pub Med Age, race and medical history all play a part in deciding what an individuals levels should be at. I think the jury is still out on whether current numbers should be lowered a little but I confess I don't follow the subject as much as I probably should. Here's your starter for 10 http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=PureSearch & db=PubMed & detail\ s_term=%28%22atrial%20fibrillation%22%20AND%20INR%5BText%20Word%5D%20AND%201.5%2\ 9%5BAll%20Fields%5D As to your vitamin K question, changes in the amount of Vitamin K that you eat may affect the way warfarin works but this is different from saying you should reduce your intake of it. My understanding is that people on warfarin should try to keep their vitamin K intake reasonably constant. Again I don't know enough about this either - Warfarin blocks the re-use of vitamin K in the liver but I have no idea if this affects bones in anyway. Hopefully someone else will be forthcoming with a more confident/accurate reply. -- D Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 , I just started coumadin. If you have AFIB then your INR numbers have to be between 2 and 3. 1.5 is too low. Also stay away from Vitamin K. It decreases the effectiveness of Coumadin. Re: coumadin > I have been reading the summaries for several weeks and find them > very useful. I have been told that I will need to be on Coumadin for > life. I have two questions about Coumadin. My internist says that > there is new information that a maintenance INR level should be > between 1.5 and 2.0. Has anyone heard this? Also since there is > some evidence that Vitamin K is essential for strong bones, does > taking Coumadin contribute to the development of osteoporosis? > Thanks. Hi , you might want to do a few searches at Pub Med Age, race and medical history all play a part in deciding what an individuals levels should be at. I think the jury is still out on whether current numbers should be lowered a little but I confess I don't follow the subject as much as I probably should. Here's your starter for 10 http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=PureSearch & db=PubMed & detail\ s_term=%28%22atrial%20fibrillation%22%20AND%20INR%5BText%20Word%5D%20AND%201.5%2\ 9%5BAll%20Fields%5D As to your vitamin K question, changes in the amount of Vitamin K that you eat may affect the way warfarin works but this is different from saying you should reduce your intake of it. My understanding is that people on warfarin should try to keep their vitamin K intake reasonably constant. Again I don't know enough about this either - Warfarin blocks the re-use of vitamin K in the liver but I have no idea if this affects bones in anyway. Hopefully someone else will be forthcoming with a more confident/accurate reply. -- D Backup web page - http://afibsupport.proboards23.com List owner: AFIBsupport-owner For help on how to use the group, including how to drive it via email, send a blank email to AFIBsupport-help Nothing in this message should be considered as medical advice, or should be acted upon without consultation with one's physician. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 > , [snip - some things I've already commented on too many times ] > Also stay away from Vitamin K. It decreases the effectiveness of Coumadin. Hi Michele, whilst vitamin K might mean you have to take a higher dose of warfarin to maintain the required INR this option may be preferable to avoiding vitamin K. Again I, don't know enough about this but I think it my be wise to confirm your understanding with your doctor or pharmacist.... I just did a quick search at http://stroke.ahajournals.org/ and found this, which may be of interest... Long-term Oral Anticoagulation Reduces Bone Mass in Patients with Previous Hemispheric Infarction and Nonrheumatic Atrial Fibrillation http://stroke.ahajournals.org/cgi/content/full/28/12/2390?maxtoshow= & eaf but what do I know -- D Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 I was told that I can eat things with Vit K and that they would adjust the coumadin. Since I don't care for green vegetables and I never drink, I really don't have to worry about that. But yes, they will adjust it for you. Re: coumadin > , [snip - some things I've already commented on too many times ] > Also stay away from Vitamin K. It decreases the effectiveness of Coumadin. Hi Michele, whilst vitamin K might mean you have to take a higher dose of warfarin to maintain the required INR this option may be preferable to avoiding vitamin K. Again I, don't know enough about this but I think it my be wise to confirm your understanding with your doctor or pharmacist.... I just did a quick search at http://stroke.ahajournals.org/ and found this, which may be of interest... Long-term Oral Anticoagulation Reduces Bone Mass in Patients with Previous Hemispheric Infarction and Nonrheumatic Atrial Fibrillation http://stroke.ahajournals.org/cgi/content/full/28/12/2390?maxtoshow= & eaf but what do I know -- D Backup web page - http://afibsupport.proboards23.com List owner: AFIBsupport-owner For help on how to use the group, including how to drive it via email, send a blank email to AFIBsupport-help Nothing in this message should be considered as medical advice, or should be acted upon without consultation with one's physician. ------------------------------------------------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 I have not heard that the INR should be between 1.5 and 2.0. I get my blood work done every week or two and the EP, Cardiologist and my General Practitioner have all told me I have to maintain an INR between 2.0 and 3.0. As far as the Vitamin K goes the nurses that manage the Comedian Clinic told me to just try to be consistent. For instance if I eat green veggies 3 times a day or three times a week then just try to keep the same amount every day or week. P ............................................ > I have been reading the summaries for several weeks and find them > very useful. I have been told that I will need to be on Coumadin for > life. I have two questions about Coumadin. My internist says that > there is new information that a maintenance INR level should be > between 1.5 and 2.0. Has anyone heard this? Also since there is > some evidence that Vitamin K is essential for strong bones, does > taking Coumadin contribute to the development of osteoporosis? > Thanks. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 I have not heard that the INR should be between 1.5 and 2.0. I get my blood work done every week or two and the EP, Cardiologist and my General Practitioner have all told me I have to maintain an INR between 2.0 and 3.0. As far as the Vitamin K goes the nurses that manage the Comedian Clinic told me to just try to be consistent. For instance if I eat green veggies 3 times a day or three times a week then just try to keep the same amount every day or week. P ............................................ > I have been reading the summaries for several weeks and find them > very useful. I have been told that I will need to be on Coumadin for > life. I have two questions about Coumadin. My internist says that > there is new information that a maintenance INR level should be > between 1.5 and 2.0. Has anyone heard this? Also since there is > some evidence that Vitamin K is essential for strong bones, does > taking Coumadin contribute to the development of osteoporosis? > Thanks. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 _______I too have been told the same exact thing . INR numbers between 2 and 3 ___________________________________________________________________________- Re: coumadin I have not heard that the INR should be between 1.5 and 2.0. I get my blood work done every week or two and the EP, Cardiologist and my General Practitioner have all told me I have to maintain an INR between 2.0 and 3.0. As far as the Vitamin K goes the nurses that manage the Comedian Clinic told me to just try to be consistent. For instance if I eat green veggies 3 times a day or three times a week then just try to keep the same amount every day or week. P ........................................... > I have been reading the summaries for several weeks and find them > very useful. I have been told that I will need to be on Coumadin for > life. I have two questions about Coumadin. My internist says that > there is new information that a maintenance INR level should be > between 1.5 and 2.0. Has anyone heard this? Also since there is > some evidence that Vitamin K is essential for strong bones, does > taking Coumadin contribute to the development of osteoporosis? > Thanks. Backup web page - http://afibsupport.proboards23.com List owner: AFIBsupport-owner For help on how to use the group, including how to drive it via email, send a blank email to AFIBsupport-help Nothing in this message should be considered as medical advice, or should be acted upon without consultation with one's physician. ------------------------------------------------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 Hi , These are all good questions, the same I investigated when starting out on Coumadin. My initial reaction to Coumadin was somewhat eratic as were my eating habits. Keeping records and comparing INR #'s with foods comsumed that week, helped me understand the interaction. Now I am on a much more balanced diet with fairly constant INR #'s. My preferred range is somewhere between 2.0 and 2.3. Coumadin falls short of protecting when it enters lower numbers. I seem to recall at 1.7 or 1.6 it will no longer protect from clotting. This too is somewhat individual, but I consider it too risky to venture below 2.0. Even when my test comes in at 2.0 there is a chance that at one point it had dropped below, so for me that is the cut off. What Coumadin does to our bones is also being investigated. Several thousand Coumadin patients are participating in a study to see what, if any, negative effects there are. However, it will be a couple of years before we will know the results. The good news is, that within a couple of years we will have a new blood thinner - not affected by vitamin K - and not requiring blood tests. good luck / > I have been reading the summaries for several weeks and find them > very useful. I have been told that I will need to be on Coumadin for life. I have two questions about Coumadin. My internist says that there is new information that a maintenance INR level should be > between 1.5 and 2.0. Has anyone heard this? Also since there is > some evidence that Vitamin K is essential for strong bones, does > taking Coumadin contribute to the development of osteoporosis? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 My doctor also tells me coumadin levels should be between 3-5. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 Excuse me, a typo.......levels should be betweein 2-3. Sorry. > My doctor also tells me coumadin levels should be between 3-5. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2004 Report Share Posted January 31, 2004 No way levels above 3 can cause fainting and severe bleeding. The blood would be way too thin at level 5. Please ask your doctor again. Re: coumadin My doctor also tells me coumadin levels should be between 3-5. Backup web page - http://afibsupport.proboards23.com List owner: AFIBsupport-owner For help on how to use the group, including how to drive it via email, send a blank email to AFIBsupport-help Nothing in this message should be considered as medical advice, or should be acted upon without consultation with one's physician. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2004 Report Share Posted February 1, 2004 > No way levels above 3 can cause fainting and severe bleeding. The blood would be way too thin at level 5. Hi Michele, whilst the original post was a typo you'll find quite a few people here whose target is higher than 3 (for example I believe people with a mechanical mitral valve are likely to have higher ranges). Deciding what an individuals target should be (or even if they should be taking warfarin at all) is all about balancing risk and benefit for that individual... So although higher INR levels will introduce more risk on the bleeding side your comment of " No way " may have missed the mark. Similarly, because of the increased risk of bleeding for the very elderly it's common for their range to be lower than 2-3. but don't take my word for it see " Class 1 5 a " under " Recommendations for Antithrombotic Therapy in Patients With AF " here http://www.acc.org/clinical/guidelines/atrial_fib/VIII_management.htm#VIII_Greco\ mmendation and a little higher up on that page you'll find " A target INR of 2.0 (target range 1.6 to 2.5) is recommended for primary prevention in patients more than 75 years old. " but I recommend reading the text in context. -- D Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2004 Report Share Posted February 1, 2004 Hi , Yes I see your point. I was not thinking outside my afib situation. Coumadin is used for a variety of heart disorders. Thanks for the info. Re: Re: coumadin > No way levels above 3 can cause fainting and severe bleeding. The blood would be way too thin at level 5. Hi Michele, whilst the original post was a typo you'll find quite a few people here whose target is higher than 3 (for example I believe people with a mechanical mitral valve are likely to have higher ranges). Deciding what an individuals target should be (or even if they should be taking warfarin at all) is all about balancing risk and benefit for that individual... So although higher INR levels will introduce more risk on the bleeding side your comment of " No way " may have missed the mark. Similarly, because of the increased risk of bleeding for the very elderly it's common for their range to be lower than 2-3. but don't take my word for it see " Class 1 5 a " under " Recommendations for Antithrombotic Therapy in Patients With AF " here http://www.acc.org/clinical/guidelines/atrial_fib/VIII_management.htm#VIII_Greco\ mmendation and a little higher up on that page you'll find " A target INR of 2.0 (target range 1.6 to 2.5) is recommended for primary prevention in patients more than 75 years old. " but I recommend reading the text in context. -- D Backup web page - http://afibsupport.proboards23.com List owner: AFIBsupport-owner For help on how to use the group, including how to drive it via email, send a blank email to AFIBsupport-help Nothing in this message should be considered as medical advice, or should be acted upon without consultation with one's physician. ------------------------------------------------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2004 Report Share Posted February 1, 2004 In a message dated 2/1/2004 12:08:30 AM Central Standard Time, mpignalosa@... writes: No way levels above 3 can cause fainting and severe bleeding. The blood would be way too thin at level 5. Please ask your doctor again. Re: coumadin My doctor also tells me coumadin levels should be between 3-5. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX Isn't there a comma missing after " way " ? The first sentence above says that an INR of 3 cannot cause fainting and severe bleeding while I think the intent of the sentence was that it can. Several responses and responses to the responses spoke of a typo, was that it? (sorry about all the responses). Guy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2004 Report Share Posted February 1, 2004 Thank you very much for reiterating that the first post was a typo!!! Your information on coumadin is very informative and I appreciate you posting the info. Debbi, OU Alum, in OKC Hi Michele, whilst the original post was a typo you'll find quite a few people here whose target is higher than 3 (for example I believe people with a mechanical mitral valve are likely to have higher ranges). Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2004 Report Share Posted February 1, 2004 Guy, I originally type INR level should be 3-5 according to my doctor, which was a typo, should have been 2-3. Hope that clears things up. Debbi, OU Alum in OKC ==================================================================== .. Several responses and responses to the > responses spoke of a typo, was that it? (sorry about all the responses). > Guy Quote Link to comment Share on other sites More sharing options...
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