Deep Vein Thrombosis (DVT) Support Group

Hi Danielle,
I can relate to this has my INR is up and down like a yoyo too.
When I was diagnosed with DVT on the 1st September I had Clexane injections for about aweek and half while the Walfarin kicked in.
When I came out of hospital I had to go back every other day it was a pain. But now Im off the injections and just take Warfarin. I go to Warfin Clinic every week.
I know some people who,s INR is very stable they go every 3 months. But everyones different
.
Has you said family and friends dont understand the importance of our INR and its understanding we get a little anxious worrying about how levels.
But try not to worry to much, it will just become the run of the mill.

PS/ My father,s a joke he thinks DVT is like having a headache, gone the next day, but some people are just pig ignorant. lol. Take Care Maggie x

Hi again, you probably already know this but certain food, herbs, alcohol ,medication and flu injection can interfere with you INR levels.
Maggie x

When I was first put on warfarin last year I was also given the 'yellow book' which tells you what you can safely eat and what to avoid as regards interaction or neutralisation of the blood thinning effect. I followed the instructions to the letter as I reasoned it would be just for six months even though it meant not having my favourite cabbage, broccoli and lettuce. Even so I still had quite marked ups and downs in my INR level and it seemed a bit of a lottery as to arriving at the correct dosage but it did eventually settle down at around the optimal 2.5 level.

The second time around I queried the dietary considerations with the INR nurse since I didn't relish going 'cold turkey' on green veg and he said that it didn't really matter if I ate green veg or not and indeed it was better if I did since I should aim to eat a balanced diet. Well I wish I had known that first time around. Obviously I still have to avoid cranberries and grapefruit, but then I have never liked cranberries and grapefruit - and any citrus fruit come to that - gives me joint pain. So that is no great sacrifice.

From initial second diagnosis (after the clexane injections ceased) to as recently as four weeks ago my INR levels ranged as high as 3.3, whereas now it has stabilised at 2.6. Now that the INR has stabilised I have it checked every three weeks and on occasion when it varies unexpectedly the interval drops accordingly. The time it spiked to 3.3 I couldn't think of anything I had eaten differently so all I can think of is that maybe the level is affected by indeterminate factors such as the amount of exercise taken (?). Currently I take 6mg five days a week and 7mg on Fridays and Sundays.

I tend to be a creature of habit as far as eating goes and I think if you can eat sensibly, without making meal times boring of course, then I think that goes a long way to stabilising the INR levels.

As for your family and friends I would suggest that they read up on DVTs so that they realise how very lucky they are that you are being treated for this condition.

Take care.

Hi danielle. First if all warfarin is in it's nature very unstable in INRs. Like others here have explained sometimes what you eat can affect the INR. Oh by the way INR is just a standardized number system that correlates to how long your blood is taking to clot. So, it is and isn't a huge deal if the numbers are not too far apart week to week. But it could be if you clot un oh! Serious consequences could result. I ate some chopped liver last week. My number went to 1.2! I didn't stress. It goes back up takes 4-6,7 days of consistent diet. Then I was drinking a fiber drink every morning. Well that also interfered with the warfarin absorbtion and metabolism. My INR went down. Personally I can't tolerate too high INR. I get very tired and my brain doesn't function, I get like I'm in suspended animation! So I'm very sensitive to my level of INR. Without and/or before testing I can tell you what my INR is within .4. I'm good. I'm very sensitive to the warfarin. Well also try taking at night or ask your doctor to adjust your dosage.

Hey guys, thanks for the replies. When I was put on the Coumadin I was fortunate enough to have already been seeing a nutritionist who explained to me the importance of stable diet while on the medication. She never said I absolutely couldn't eat anything, just not to go overboard with things high in Vitamin K and then not eat them for 5 days, and to stay away from the grapefruit and cranberries. I have been pretty good with that. I too am a creature of habit and maintain a pretty stable diet. I do still eat some of the green stuff, but normally and on a very regular basis which my doctor said is just perfectly fine! Thank goodness!

What is frustrating me is that I have been on this Coumadin only since August 2nd and am now on LOVENOX injections for the third time because my INR and PT keep going down, even though they increase my Coumadin dosage. I went from 1, 2, 3, in the beginning to start then 10, to spike my INR, was at 5 and 7.5 alternating, up to 7.5, then 8, then 8 and 9, then 9, then 10, now 10 and 11. It gets stable for about a day when they increase it and then shoots down to about a 1.1-1.5 AS SOON as I go off the LOVENOX. I just got back from the lab and it was back down to 1.3 The other day it was 1.5 and they increased it this weekend. I know the meds are sensative but you'd think that if they are increasing it constantly and consistantly it would have an affect or atleast stay stable?!?! Its just frustrating I guess, and overwhelming, makes me worry too... Hopefully only have to be on these shots for a few days. We will see. Has anyone else done lovenox or any other injection multiple times?? I was told in the hospital just in the beginning!

You know it sounds to me danielle like you may be eating something or taking a multivitamin or something that binds up or counteracts the warfarin. Look closely at what you take in. INRs do jump around but yours shouldn't like that considering your dosage. Examine closely what you're injesting including any supplements or fiber.

The only medication I take is prescribed and hasn't been changed since I've been on the coumadin, and they know about those medications-- Lamicatal and Topomax. Other than that, I hardly ever even take Tylenol or OTC pain medication. My doctor has perscribed me Vicodin for my wisdom teeth that cannot be removed and are impacted, but I rarely take them either. And if I do I only take one in the morning which seems to work throughout the entire day. Also, no fiber suplements... never ever. As for food... ? I don't know. I eat chicken, iceberg salads with cheese and crutons and a meat with some dressing, sandwhiches for lunch, a banana or yogurt, egg whites for breakfast, little pretzels, coffee in the AM, water to drink, juice... see why I am frustrated????

Yes Danielle I see why now. Maybe you got a liver that is doing something that keeps the warfarin from blocking the factors it needs to. Check online about lamictal and topamax sometimes the Drs don't know. But not much you can do if you need it. I get really tired from warfarin so I know it's working almost instantly. I maybe hypersensitive. You may have a super liver that metabolizes it quickly ands sends it out of your system. I don't know. You're doctor "should" know. The INR. Does jump around but not totally eratically. I know when I'm not healing little cuts I'm in the 2s. I know it intuitively.

The only thing anyone has said about the topomax or lamictal was that the coumadin would affact the topomax, but that the topomax would not affect that coumadin. They said that the topomax affects would be stronger because and to watch for common side effects from it, which we have noticed none.

Funny you mention Liver. I have been seeing a specialist at for about 3 years now at a nutritionist/eating disorder clinic, which I have been in recovery for since then and no longer struggle with (I say that to make a point that it shouldn't play a part in the following...) and they randomly do blood work on me, such as a complete blood count. Every time they do they say that my liver function comes back abnormally LOW which they don't really see, that when they see issues with the liver it comes back HIGH usually... I wonder if this is something that needs to be looked ino further...has anyone ever heard of this??