I think they just have not dialed into the right dosage for your body. Also, I can tell you what affects my INR more than vitamin k is if I'm not eating as much food as I normally do. If I am not eating as much as I usually do, my INR will go up. Also, what could be affecting your increase in INR is that you seem to be really tyring to over-limit your vitamin K, to the point where you sort of become vitamin K deficient and that can mess with things too. I would give yourself a chance, like several weeks, to just settle back into your normal diet pre warfarin, and see what happens.

My INR was coasting along between 2-3 for months and then last month, it shot up to 3.9 out of no where. Who knows.

Also, I don't mean don't test for several weeks. I mean, just allowing time to see therapeutic results once your diet is more normalized.

I agree with rmb. Although my INR became therapeutic in a week when I first started warfarin I continued to have swings for a few months. I think the key for me to eventually maintain stability was to stop over compensating with my diet. I had an incident in July when I wasn't eating or sleeping as much and my INR went up over 4, very rare for me. I suspected it was high and went to the lab. In the end, all I had to do was skip a couple doses and everything went back to normal. You'll get there.

Thanks everyone for your responses and your support!

Rmb...it totally is too much! But that is how they do it, and I would really prefer to just do it myself, and not have to go to the hospital anymore.

Ah, ok so the company that provides your home monitor makes you test weekly? I suppose they do that for liability purposes. Kind of ridiculous. I mean, diabetics test at home all the time with no oversight, although home testing glucose monitors for diabetics have been around for quite some time so their liability is more substantiated than home INR testing at this point. Plus, it's a health risk for real if they can't monitor their glucose at home.

Anyway sorry for the tangent!

With regard to home testing, Medicare rules allow you to test once a week. I suppose if you went nuts and tested daily, they would only pay for once a week.
They allow once a week but nothing says you have to test once a week.

Yeah, it is through the hospital, and they have you test weekly. I assume it is a liability thing.

Having a home tester would be a great thing to have. If you are starting a new medication, exercising more, making dietary changes, or if you get an infection/flu/cold, you can see if your INR is being affected. I don't think testing once a week is too much. The monthly INR test only gives you a snap shot of your average INR level. It doesn't tell you when there are deadly fluctuations. Most everyone who has blood clots while on warfarin has a temporary drop in their INR.

I have a friend on the Hughes Syndrome website who tests her INR every three days. She has regulating her INR down to a science. She knows how much Warfarin to take to raise it back up again and how many Brussel Sprouts to eat to drop it back down to normal range. She has APS like me with high antibody levels so her target INR is 3.0 to 3.5. Some people have to have higher INR levels to stave off the symptoms of APS.

I would be happy testing once a week just for added peace of mind. I test now every 4 weeks, even went 6 weeks this last time and my two latest INR's were 2.7. I do however have some panic attacks in between getting my monthly INR checks. It would be nice to be able to spot test just have peace of mind.

I don't worry if my INR goes above 3. My hematologists wants it above 3 because I am a high risk for more clots. I start to worry when it goes over 4. I have had an INR of 3.4 before and my bleeding still stops right away. If I prick my finger tips and wait for a minute or two to check my blood, it will clot right up solid on my finger. My blood is really thick.

That is if I prick my finger tips to test my blood sugar. If I wait too long the blood clots up in one big huge ball. If you have an INR above three isn't a paper cut supposed to be deadly? Maybe not. Any how, there is no right or wrong way to do this. It is all about what you feel comfortable with.

Haha, Jeremy! I've had an INR as high as 8 (which I wouldn't recommend). Even at that level, I don't think a papercut would be deadly.

Yep, I've been like 6.2 and didn't bleed to death from shaving. The thing with warfarin is that you can have problems with controlling bleeding even with a therapeutic INR. It's the same with any anticoagulant. That's why you come off warfarin for so many procedures. I just had needle biopsies done on my thyroid and my doc wanted me off warfarin for three days before the procedure, and those were just fine needle biopsies. I think there was no reason to be off but it was the doc's call. I have a colonoscopy in a few weed and will be coming off again, 5 days before the procedure.

Of course high INRs are not ideal but I don't think checking your INR so frequently, if your INR is proven to be relatively stable for an extended period of time, really solves for much except to make you think about your INR all the time.

My brother has been on warfarin, the same exact dosage, for a few years now. His INR has is always between 2.3 - 2.5 the entire time he has been in it. So now he tests every couple of months. I think he's an extreme case of stability. My INR has been tricker but after a while most people lock into a range and a dosage, give or take some occasional adjustments.

I test every two months now. I'm coming up on my 5 year PE anniversary so have had plenty of time to stabilize. I have a standing order though and can stop by for a test any time I think I need to. So, if I start a new med, get sick or am heading out for a risky adventure, I get tested. If antibiotics or something throws me out of range, I test more frequently until I'm stable again. The time between tests that is appropriate for you will depend on a lot of things. The article at the link talks about a few of them.

http://www.consultant360.com/articles/when-can-intervals-between-inr-checks-be-extended

If you are trying to stabilize an erratic INR you have to find out how your body responds to dosage changes. For me, I have to make very small changes. Early on if I went high and the protocol said hold a day I would. Then my INR would go too low. I came up with protocols that work for me and now my nurse just asks what my plan is. If I'm slightly out of range, I do nothing. If it stays out of range, then I add or subtract a couple of mg in my weekly dose.

That's exactly how I am with adjustments too.

So, Thanksgiving is not so far away and my son-in-law does the cooking. He is a fantastic cook. He makes some of the foods that I have cut way back on. How do I handle gorging myself on his creamed spinach and home made cranberry sauce?