Pulmonary Embolism Support Group

By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.

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Vitamin K and PT/INR numbers

Vitamin K in our foods, mainly greens can cause our PT/INR numbers to drop.

Normal daily allowance of Vit. K is 80mcg. I decided to watch my intake keeping the Vit.K I consume between 20-40 mcg.

Foods high in Vitamin K are spinach,broccoli, etc. Here is a site with a comprehensive list of Vitamin K foods and their mcgs. I find this one very useful and keep it in a kitchen drawer.
http://www.drgourmet.com/md/warfarincomprehensive.pdf

My doctor and nurse both agree if one keeps their intake of Vit. K mcgs. about the same every day then the dosage of Coumadin should stabilize.

Also there are antibiotics that will play havoc with our numbers. Levaquin is one.

I hope this will help anyone who is not familiar with this aspect of our disease.

Hugs to all,
Nan

Replies

rmb
rmb

My pharmacist told me that almost all drugs, over the counter and prescription, can interact with coumadin in some way, meaning it can mess with your INR. I have low INR all the time so I always ask the pharmacist how something is going to interact. I was buying over the counter sleep aids recently and some of them interact with coumadin and some don't, but I wouldnt have known that had I not asked the pharmacist. I think we forget about all the over the counter stuff we take without even thinking.
deleted_user
deleted_user

RMB,
Yes medications can interact with Coumadin. Some more than others. I am told if I add, stop or change dosage of any medication to let them know. Also not to use OTC meds before talking to the nurse. I am monitored to keep my levels between 2-3 and not below 2. Here is a site that has a feature "drug interactions" where one can list all their meds including OTC to see what reactions they have with Coumadin and other meds.
How low is your INR? My last one was 1.8 after taking antibiotics. I have to come in every week now to make sure I stabilize again on 5mg of Coumadin.
It is all so tricky but so darn important to stay above the 2.0.
Doctors differ on this level I know. A rheumatologist thinks I should be between 3.0-3.5 INR? This is recent so when he talks to my doctor things may change?
deleted_user
deleted_user

My INR has been all over the place since September when I started Coumadin. It has been in the 1's for about 3 of the last 4 weeks. I went to the ER with severe dizziness and low blood pressure last week at which time my INR was 1.3. They admitted me and it took 7 days to bring my INR to a 2.0 on 15 mg of Coumadin, along with a Heparin drip. I try to be consistant about vitamin K. Once, a while ago, my INR was 6.7...
rmb
rmb

Yeah, I have problems with low INR too. It hasnt been above a 2 since I was discharged from the hospital, which was just over 3 months ago. It has been everything from 1.2 to 1.8 and everything in between. The last few weeks, its been hovering around 1.6. Im up to 12.5mgs and 15mgs of warfarin, alternating every other day. I get tested every other week or ever week, depending on my numbers and my dosage. I get tested again on the 31st. I am going to assume its going to be low. Then if its not, I can be pleasantly surprised!

I used to flip out that my INR was low, but I know that even if its low, Im still not clotting like I had been. Ive eliminated the likely cause of the clots (birth control pills) and I have the vena cava filter so that if I do develop DVTs again, they arent going to go to my lungs. While they tell you the most important thing is to not vary your diet, just eat the same thing all the time, that doesnt seem to matter in my case. So, Ive eliminated tea, most supplements, green vegetables, anything that Ive read about that can increase clotting. Makes for a crappy diet, but what are you going to do? It took forever to get my INR up above 2 when I was in the hospital with the PE. My doc says that some people are just resistant to blood thinners. I have a booklet from my doctor that rates common foods in terms of vitamin K. It rates them whether they are low, medium and high in vitamin K. Its a really helpful little guide and it also lists supplements and herbs that can be a problem.

Im tentatively going off the warfarin in March. A little scary but I am really excited about it. It will be nice to not have to get tested all the time and to be able to eat normally.

Rachelle
rmb
rmb

My drs office just gave me a really handy book called The Coumadin Cookbook: A Guide to Health Meals when Taking Coumadin. Its a great reference book with recipes for folks on coumadin. The recipes take into account the amount of vitamin K and it contains facts regarding coumadin and the impact of food. While I received pretty good info regarding coumadin while I was in the hospital, this book is much more inclusive.

For instance, the amount of vitamin K in vegetables can vary depending on where they are grown. Dried herbs like parsley and oregano contain higher amounts of vitamin K than fresh versions of these herbs. Oil is a huge culprit in large amounts of vitamin K, including salad dressings, mayo, etc, and that exposure of oils to sunlight or fluorescent light destroys 85% if the vitamin K.

Anyway, if anyone is interested in ordering the book, its published by Marsh Publishing Company. Looks like the list price is $16.95.

Rachelle