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Warfarin doseages

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In a message dated 3/7/2006 4:34:37 P.M. Central Standard Time,

sjphdoc@... writes:

Another question: I am having trouble getting my INR PT to between 2-3

where the doctor wants it. I have been on it for almost two months now

and all I registered was 1.1 yesterday. I am taking 5 mg four times a

week and 7.5 mg three times a week.

I am 58 and slightly overweight, if that has anything to do with it.

Even so how long does it take to get enough Warfarin in your system to

register?

INR can be difficult to stabilize. One thing to keep in mind is to eat foods

that give you a fairly stable source of vitamin K. Vitamin K affects your

clotting factor so needs to be stable. Somewhere on our web site there is a

list of vegetables and their Vitamin K content. I expect someone will tell you

exactly where it is.

I started taking coumadin when I was first diagnosed with afib. A few years

later a nurse called in a refill order for me but called out warfarin, I was

having a terrible time stabilizing and when the cardiologist's primary nurse

found out I was on warfarin, she was somewhat upset and switched me back to

coumadin. My INR immediately stabilized.

Guy

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Thanks to all who wrote recently RE: Scare in France started my A-fib.

Another question: I am having trouble getting my INR PT to between 2-3

where the doctor wants it. I have been on it for almost two months now

and all I registered was 1.1 yesterday. I am taking 5 mg four times a

week and 7.5 mg three times a week.

I am 58 and slightly overweight, if that has anything to do with it.

Even so how long does it take to get enough Warfarin in your system to

register?

Thanks again for all your answers and comments,

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Never mind; I found it.

U.S. Dept. of Agriculture (USDA) listing on vitamin K in food, sorted

alphabetically or by nutrient content:

http://www.ars.usda.gov/Services/docs.htm?docid=9673 (from Jo Anne)

******But i still would like to know about dose amounts and time it

takes to get the stuff to stabilize at a therapeutic dose.****

Thanks,

> >

> > _http://atrialfribilation.myfreeforum.org/index.php_

> > (http://atrialfribilation.myfreeforum.org/index.php)

> >

> >

> >

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Hi, .

I've been on warfarin for 8 months, have been avoiding all the vitamin K

foods, and still am not stabilized as far as my INR readings.

Warfarin doseages

Thanks to all who wrote recently RE: Scare in France started my A-fib.

Another question: I am having trouble getting my INR PT to between 2-3

where the doctor wants it. I have been on it for almost two months now

and all I registered was 1.1 yesterday. I am taking 5 mg four times a

week and 7.5 mg three times a week.

I am 58 and slightly overweight, if that has anything to do with it.

Even so how long does it take to get enough Warfarin in your system to

register?

Thanks again for all your answers and comments,

Web Page - http://www.afibsupport.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.

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Hello :

So sorry about your scare in France and the consequent afib.

Three and a half years ago, it took me three months before I could

get my INR in the therapeutic range of 2-3. It was not until I

started eating salmon 2-3 times per week that it made a difference.

I also have ginger, garlic, celery almost daily and I have been

known to eat spinach at about 9-10PM when I realize that I haven't

had enough vitamin K during the day. My portion of red meat is only

1-2oz, but I do eat larger portions of chicken or fish.

If you are eating a lot of bread, cake and fat it may interfere with

your INR because of the high content of vitamin K in flour and flour

products...One cup of flour contains about 550mcg of vitamin K.

Canola oil, mayonnaise, salad dressings often have a medium to high

content of vitamin K. Olive oil has a medium content of vitamin K,

Sesame Oil has none or has a negligible amount?

If you want less absorption of vitamin K (you can still eat veggies

in a good size portion, good for your eyes, regulating the viscosity

of blood, osteoporosis, etc) put some lemon juice or vinegar on your

veggies. If you want to enhance absorption of vitamin K put a

little olive or sesame oil on them and no acidic stuff.

If you are taking a multi- vitamin do not buy it with vitamin K,

iron or large doses of vitamin C...the latter two will increase

your hemoglobin and that will lower your INR. The higher your

hemoglobin the harder it will be to regulate your INR...that has

been my experience. So a hemoglobin or 14 is advised to reduce

incidents of blood clots for both men and women. A lower hemoglobin

is beneficial in that way.

In addition, have a low iron count dinner the evening before you

go for your INR. That is how I have been able to maintain a pretty

good range of my INR. Be calm before you have your INR because

emotions can affect it....Try doing the blood test after a fast of 6

to 12 hours......

I am 69 years old and for about 3 years, I have been on Coumadin

10mg per day except Wednesdays when it is 5mg. I am overweight and

inactive. I also have an iron overload condition which gets treated

with periodic blood draws of 250ml....this also helps my INR by

lowering my hemoglobin. I absorb iron more efficiently than 6 out

of seven people worldwide. So my hemoglobin is always veering to

15..

Isabelle

PS A deficiency state occurs for three weeks,after taking

antibiotics. So, eating plain low fat yogurt with active cultures

for a month or so, is useful in re-initiating synthesis of vitamin K

in our gut.

snip.........> Even so how long does it take to get enough Warfarin

in your system to register?>

>

>

>

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-:

I really have a bone to pick with anyone who told you to avoid

vitamin K veggies....This will not help you regulate your INR and in

the long run could cause problems for you.

Please be aware that not having any vitamin K veggies will set you

up for osteoporosis. Vitamin K is a great regulator of blood

viscosity. It will both prevent blood clots as well as bleeding and

plays a role in calcium metabolism, helping to form stronger bones.

In addition, the veggies that you need to eat in consistent daily

portions are also needed for eye health.

If you have been unable to stabilize your INR I would have the

following blood tests to check my CBC, ferritin, tibc/uibc and the

transferrin saturation percentage. If they are all elevated except

the tibc/uibc that would give you a clue for not getting your INR in

the therapeutic range.

These are the guidelines. A hemaglobin 0f 14 for men and women; a

ferritin of about 50, and a transferrin saturation percentage of 44%

or below. If the tibc/uibc are below normal range for your lab,

than your ts% will be elevated, indicating iron overload. Ferritin

are sometimes borderline in people with sugar imbalences.

In my opinion and experience, people with an iron overload condition

will have greater difficulty in reaching and maintaining a

therapeutic INR range.

So, what to do?.....It is important to eat smaller portions of

meat, reduce your intake of products fortified with iron above 4%

and ascorbic acid in cereal and sodas. (Some bagels are fortified

with iron 25%) Both of these additives will enhance absorption and

storage of iron....as well as raise your hemoglobin...the higher

your hemoglobin the harder it will be to get to the INR therapeutic

range...

If you will look at my reply to on dosage, you may find some

additional information that may help you. Everyone should do a

yearly check up that includes the above 5 blood values in order to

to postpone or prevent the five major diseases. We should know

these blood values just like we know our cholesteral, HDL and LDL

levels.

I have only one gene(AH) for Hemochromatosis but I have all the

symptoms of someone with two genes (HH) So, I go for periodic blood

draws of 250ml and that also helps my INR stay in the therapeutic

range. I go for the smaller blood draws because I have afib and

this smaller phleb is less of a strain on the heart. I drink lots

of fluids before, during and after the phleb.

It is unfortunate that most physicians as well as hematologists do

not advise having these tests until someone has cirrhosis or

diabetes or some other condition or disease. One of the symptoms of

an iod is Afib. The higher the ferritin the more likely you will be

susceptible to a major diseases....because you will rust from the

inside out.

I share this with you to inform you and I hope I did the right thing

in making you think and do these blood tests.

Isabelle

In AFIBsupport , " Moskowitz "

wrote:>

> Hi, .>

> I've been on warfarin for 8 months, have been avoiding all the

vitamin K

> foods, and still am not stabilized as far as my INR readings.

>

>

>

>

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> Hi, .

>

> I've been on warfarin for 8 months, have been avoiding all the vitamin K

> foods, and still am not stabilized as far as my INR readings.

>

>

>

Hi , this abstract might interest you....

Patients with unstable control have a poorer dietary intake of vitamin K

compared to patients with stable control of anticoagulation.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra\

ct&list_uids=15886802&query_hl=3

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Guest guest

My mom has just started taking Warfarin and is on an iron tablet a day

and was also told to avoid vitamin K veggies.

She had a major GI bleed in January and had to have 4 pints of blood and

was in the hospital for 4 days; she almost died. Her hemoglobin was not

quite 1.

She was back in the hospital this past weekend; the doctor thinks she

had a TIA. A Carotid Artery study was done on Monday and shows she has

70% blockage on the right side and clear on the left. The cardiologist

has started her on the Warfarin plus an enteric aspirin every day and

her GP put her back on the iron tablet.

Do you think it is ok for her to be taking the iron along with the

Warfarin?

The cardiologist is trying to get her prepped for a Cardioversion and

Catherization, but she has to take the Warfarin for 3-4 weeks first.

Thanks,

Angi

Re: Warfarin doseages

-:

I really have a bone to pick with anyone who told you to avoid

vitamin K veggies....This will not help you regulate your INR and in

the long run could cause problems for you.

Please be aware that not having any vitamin K veggies will set you

up for osteoporosis. Vitamin K is a great regulator of blood

viscosity. It will both prevent blood clots as well as bleeding and

plays a role in calcium metabolism, helping to form stronger bones.

In addition, the veggies that you need to eat in consistent daily

portions are also needed for eye health.

If you have been unable to stabilize your INR I would have the

following blood tests to check my CBC, ferritin, tibc/uibc and the

transferrin saturation percentage. If they are all elevated except

the tibc/uibc that would give you a clue for not getting your INR in

the therapeutic range.

These are the guidelines. A hemaglobin 0f 14 for men and women; a

ferritin of about 50, and a transferrin saturation percentage of 44%

or below. If the tibc/uibc are below normal range for your lab,

than your ts% will be elevated, indicating iron overload. Ferritin

are sometimes borderline in people with sugar imbalences.

In my opinion and experience, people with an iron overload condition

will have greater difficulty in reaching and maintaining a

therapeutic INR range.

So, what to do?.....It is important to eat smaller portions of

meat, reduce your intake of products fortified with iron above 4%

and ascorbic acid in cereal and sodas. (Some bagels are fortified

with iron 25%) Both of these additives will enhance absorption and

storage of iron....as well as raise your hemoglobin...the higher

your hemoglobin the harder it will be to get to the INR therapeutic

range...

If you will look at my reply to on dosage, you may find some

additional information that may help you. Everyone should do a

yearly check up that includes the above 5 blood values in order to

to postpone or prevent the five major diseases. We should know

these blood values just like we know our cholesteral, HDL and LDL

levels.

I have only one gene(AH) for Hemochromatosis but I have all the

symptoms of someone with two genes (HH) So, I go for periodic blood

draws of 250ml and that also helps my INR stay in the therapeutic

range. I go for the smaller blood draws because I have afib and

this smaller phleb is less of a strain on the heart. I drink lots

of fluids before, during and after the phleb.

It is unfortunate that most physicians as well as hematologists do

not advise having these tests until someone has cirrhosis or

diabetes or some other condition or disease. One of the symptoms of

an iod is Afib. The higher the ferritin the more likely you will be

susceptible to a major diseases....because you will rust from the

inside out.

I share this with you to inform you and I hope I did the right thing

in making you think and do these blood tests.

Isabelle

In AFIBsupport , " Moskowitz "

wrote:>

> Hi, .>

> I've been on warfarin for 8 months, have been avoiding all the

vitamin K

> foods, and still am not stabilized as far as my INR readings.

>

>

>

>

Web Page - http://www.afibsupport.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.

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Guest guest

> My mom has just started taking Warfarin and is on an iron tablet a

day and was also told to avoid vitamin K veggies.

Hello Angi:

I am sorry your mother and you are going through so much.

My answer is simple.

I am not a doctor but in my opinion your mother should not be

taking iron and Coumadin at the same time. They are antagonistic.

Coumadin thins the blood and iron thickens the blood. Iron in

pill form could be partially responsible for her many problems as

well as the lack of vitamin K in her diet.

Whether on Coumadin or not, no one should ever avoid the vitamin K

veggies since they provide such an essential vitamin and is vital in

controlling both blood clots and internal bleeding and plays a role

in calcium metabolism.

When taking coumadin the vitamin K vegetable portion has to be

eaten in a daily consistent portion. 85mcg is neede daily...but

only some of the vitamin K gets absorbed...Absorption is enhanced by

adding a little olive oil or other fat. As mentioned above vitamin

K also plays a role in calcium metabolism and helps to make stronger

bones and the other vitamins or minerals in the veggies also are

necessary for eye health.

Iron is toxic and should never be taken unless the five tests I

mentioned are done and interpreted......All norms are set too high

in our labs. With or without symptoms, one in seven persons may have

some problem with iron metabolism....and absorb more dietary iron

than their " normal " counterparts. Only yearly blood tests mentioned

can help to postpone or prevent the 5 major diseases in the US.

When taking iron, we are increasing the chance of developing a

disease because we are rusting from the inside out. Vitamin B

complex(small dose) and vitamin C from fresh fruit and veggies(and

not in pill form) will accomplish the same thing without causing

these serious problems, but it may take a little longer. Eating

daily plain low fat yogurt with active cultures and with a little

honey is helpful in helping to raise the Hemoglobin indirectly.

Also, after antibiotic usage, a vitamin K deficiency has been found

to occur for up to 3 to 4 weeks. So, perhaps at that time we should

increase(?) our intake of vitamin K from veggies....... only...not

in pill form and increase the yogurt.

This is not medical advice it is to be interpreted as just for

educational purposes.

>

>snip........... >

Do you think it is ok for her to be taking the iron along with the

> Warfarin?

>

> > Angi

>

> -

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Interesting... my INR, since surgery has been 1.3, 1.2 and 1.4 after a

week on 7.5mg warfarin... this mornings was the 1.4, and that was after

10mg on Monday night. The only thing that has changed is that s

Hopkins said to take Vit C in larger doses to assist with proper healing

after my PVI. I've been taking 2000mg per day for a few weeks now.

I'll mention this to the INR nurse, since at this point I'd rather up

the warfarin and keep the Vit C level steady...

If you are taking a multi- vitamin do not buy it with vitamin K,

iron or large doses of vitamin C...the latter two will increase

your hemoglobin and that will lower your INR. The higher your

hemoglobin the harder it will be to regulate your INR...that has

been my experience. So a hemoglobin or 14 is advised to reduce

incidents of blood clots for both men and women. A lower hemoglobin

is beneficial in that way.

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phdoc91 sjphdoc@...> wrote:

Even so how long does it take to get enough Warfarin in your system to

register?

,

Every person is different. It took me 5 mos. to get stabilized. I am 65 and

overweight. Because I am a rather large person they started me out @ 7.5mg/day

which had little effect for 2 weeks. Then my INR went to 5.8. They rapidly

dropped my dosage and played games adjusting the dosage for the next 4+ mos.

while my INR went up & down like a yo-yo. I finally stabilized at 2.5-2.8 taking

only 1.25mg/day.

On the other hand, my wife stabilized within a few weeks, and despite losing

40lbs (on purpose)over the last couple of years has remained very stable, with

only an occasional switch from 2.5 & 3mg/day and back, over the last 5yrs to

stay within the desired INR range.

Web Page - http://www.afibsupport.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.

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Guest guest

Hi

It is worth remembering that it is not the amount of warferin you take

but the amount you need to get to between 2-3 we all take different

amounts. It does depend on your meds your diet intake particularly Vit

K (green leafy veg) It is best to stick to your normal diet and meds and

allow the professionals to get your dose right. I have been on warfarin

for 3.5 years and still have problems with the rate going up or down,

that is why regular testing is necessary.

Hope this helps, and good luck

ine

Warfarin doseages

Thanks to all who wrote recently RE: Scare in France started my A-fib.

Another question: I am having trouble getting my INR PT to between 2-3

where the doctor wants it. I have been on it for almost two months now

and all I registered was 1.1 yesterday. I am taking 5 mg four times a

week and 7.5 mg three times a week.

I am 58 and slightly overweight, if that has anything to do with it.

Even so how long does it take to get enough Warfarin in your system to

register?

Thanks again for all your answers and comments,

Web Page - http://www.afibsupport.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.

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Share on other sites

Guest guest

My husband was told at his first appointment were he was prescribed Warfarin,

that he should stop taking all vitamin E medication. He was also given more

than a 100 other instructions.

We both didn't think about his cutting out his multivitamins. I caught up with

it about 10 days later. So it is extremely important to check other

vitamins/medications for vitamin E.

You can check out the foods (with their quantities) that increase vitamin K

here: http://www.ars.usda.gov/Services/docs.htm?docid=9673

My husband's doctor told him to eat the same total of vitamin K foods every

week.

An assistant at my doctor's office told me that the amount of the vitamin K

increases in the blood in summer due to more plentiful, cheaper vitamin K foods

(broccoli, spinach, brussel sprouts, etc.), and then goes down in the winter.

Jo Anne

Warfarin doseages

Thanks to all who wrote recently RE: Scare in France started my A-fib.

Another question: I am having trouble getting my INR PT to between 2-3

where the doctor wants it. I have been on it for almost two months now

and all I registered was 1.1 yesterday. I am taking 5 mg four times a

week and 7.5 mg three times a week.

I am 58 and slightly overweight, if that has anything to do with it.

Even so how long does it take to get enough Warfarin in your system to

register?

Thanks again for all your answers and comments,

Web Page - http://www.afibsupport.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.

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Share on other sites

Guest guest

Hi, Just to point out that Vitamins that are bought in a normal shop

compared with a health shop are very low in dose and would not warrant any

concerns.

The warfarin clinic I belonged to had a vast range of ages for the patients

most of which had little problems keeping with in there INR ranges.

I never had a problem with the exception of changes of drugs. I did bear in

mind that I was only 45 at the time and the dr there did comment that the

some senior patients did have problems trying to keep with in their INR

limits but this was rare.

C UK

My husband was told at his first appointment were he was prescribed

Warfarin, that he should stop taking all vitamin E medication. He was also

given more than a 100 other instructions.

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Guest guest

, the vitamins we bought were recommended by Doris Rapp, M.D. for people

with allergies.

Further, with them, my husband's INR was 1.7, and without them, my husband's INR

is 2.2.

Jo Anne

RE: Warfarin doseages

Hi, Just to point out that Vitamins that are bought in a normal shop

compared with a health shop are very low in dose and would not warrant any

concerns.

The warfarin clinic I belonged to had a vast range of ages for the patients

most of which had little problems keeping with in there INR ranges.

I never had a problem with the exception of changes of drugs. I did bear in

mind that I was only 45 at the time and the dr there did comment that the

some senior patients did have problems trying to keep with in their INR

limits but this was rare.

C UK

My husband was told at his first appointment were he was prescribed

Warfarin, that he should stop taking all vitamin E medication. He was also

given more than a 100 other instructions.

Web Page - http://www.afibsupport.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.

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