I have not but I don't drink daily. I usually have 2-4 drinks on the weekend.

I would just consider that overconsumption of alcohol, even beer, can irritate the lining of your stomach which can lead to ulcers, which can bleed, so warfarin could make that worse.

For those on warfarin then the risk of bleeding does not increase until its above 4. Elderly (>70 years) are at much more risk of bleeding that younger people), basically as the veins are in worse state than among younger people.

I think there is a real danger of being drunk while on warfarin. If you are drunk, then you are at more risk of falling down and injure your self. Further, as you are sedated with alcohol, when you injure yourself, you may be less aware of the risk of the injury, and instead of going to ER, one may continue partying or go to sleep. So it is good idea not become drunk while on warfarin, and it is good that you are avoiding that.

Alcoholics have lower platelet counts than non-aloholics but platelets are important for clotting. Lower platelet count means that they have longer prothrombin time and thus higher INR, i.e they bleed more easily because due to lower platelet counts it is more difficult for the blood to clot. Have you done any blood samples to check the number of platelets? However, I have not seen any information regarding how much alcohol is needed to raise the INR above four following a single drinking session for people that go partying e.g. once or twice a month. I guess this varies with lots of factors such as gender, body weight, liver status and many more factors. Also, Im not sure whether the INR response to alcohol is linear (e.g. 1 drink changes INR from 2.1.-2.2) or whether it has some different relationship e.g. exponential, which means that your INR can spike after the alcohol levels are above some limit. If you have a INR measuring kit, you can check it out yourself, i.e. drink alcohol and se how your INR changes, and there you got some benchmark. This alcohol dose a day (4-10 beers) probably contributes to the thinning of the blood. However, from what you say then your INR is unstable, and perhaps this can be partly due to variability in your alcohol intake (i.e. ranging form 4-10)

However, the fact that you are drinking 4-10 beers every day then that is a high consumption and is likely to affect your general health. I have seen guidelines of one beer (355 ml) for women in a day and two beers for men to be within a safe limit. From your profile I can see that you are dealing with number of mental disorders and you are also dealing with alcoholism, and I can see that you are seeking for help for these issues. I can only recommend to reduce you alcohol intake to perhaps 1-2 beers at night, if that is possible. It may well be that you can sustain drinking 4-10 beers at night without having any bleeding incident, and without having any accident for some time, but this a bit of a Russian roulette. I would think that drinking 4-10 beers every night must have impact on the all aspects of your overall health, including your venous system. Heavy alcohol drinking can actually cause DVT. My advice would be to take any measure to try to reduce this alcohol intake.

"For those on warfarin then the risk of bleeding does not increase until its above 4."

That's not entiry accurate.

Being on warfarin alone increases the risk of bleeding. Being on any anticoagulant increases the risk for bleeding.So it's a matter of managing other risks for bleeding since we are already at an increased for bleeding.

The risk of bleeding when INR is between 2-3 it is relatively small (for most people anyway, apart from elderly), but increases greatly when the INR becomes greater than 4. Heavy alcohol consumption in addition to warfarin can however increase the bleeding risk.

So I should rephrase the sentence as;
"For those on warfarin then the risk of bleeding does not increase markedly until its above 4."

I can find literature to support this...

There is an article on ClotConnect about the interaction of alchohol and anticoagulants. You can find it here...

http://patientblog.clotconnect.org/2011/10/26/alcohol-and-warfarin/

I'm not debating that a high INR doesn't increase the risk for bleeds, just that we're already at an increased risk being on anticoagulants. jThat's why they make you come of anticoagulants when you have a procedure.

Thanks for the link TossNTurn, it seems to be that the interaction between alcohol and warfarin is poorly studied and is actually quite complex.

Dear rmb- yes, the risk is elevated while we are on anticoagulation but the bleeding risk is relatively small when within theurapeutic range (INR 2-3), but increases markedly when INR is above 4. That was my point.

Yes, it is important to stop anticoagulant before surgical operations. Also, following injuries, the bleeding risk becomes greater when at INR 2-3 than compared to someone that is not antcoagulated (INR around 1). However, statistically speaking, the bleeding icidence of patients that are within therapeutic range, INR 2-3) is low, apart from very old people (>70).

A paper on bleeding incidence for patients recieviing warfarin, but sample size was relatively low (321). Risk of bleeding for serious bleeding was 3.8 per 100 patient years. The risk of bleeding was greater among patients with underlying illnesses (e.g. renal or hepatic), old age and alcohol abuse. It should be noted that the mean age of patients in this study was 69 years. Risk of bleeding should be less if younger patients would have been selected. Alcohol is widely mentioned as a risk factor for patients taking warfarin.
http://onlinelibrary.wiley.com/doi/10.1111/jth.12352/pdf

Findings from recent studies indicate that the risk of bleeding for patients on the new anticoagulants, e.g, Rivarobaxan (xarelto) is lower than for warfarin.