Stress and INR

Does anyone else feel that stress affects their INR? I am 27 and have been on Warfarin for over 12 months now - I am a lifer, with homozygous Factor V Leiden.

I have an incredibly stressful, draining job which I find difficult enough (since I am always very tired from the Warfarin), but I also feel like the stress is affecting my INR, because it is very unstable. Just wondered if anyone else had found the same thing.

Thanks!

Yes, I am having that experience right now.
It is making my INR low. You can't make people at jobs understand how there being inconsiderate to these issues affects you and your health. Feel free to send me a message back. I am 44 and have a mechanical heart valve of ten years. Thank you.

Donna44 wrote:

Yes, I am having that experience right now.
It is making my INR low. You can't make people at jobs understand how there being inconsiderate to these issues affects you and your health. Feel free to send me a message back. I am 44 and have a mechanical heart valve of ten years. Thank you.

Russ 48, Hello Donna Not sure if I'm having the same problem with my INR as you but I do feel like I'm loosing it at times.I've been on it for 2.5 years and this past month was the first time I went a whole month with just one test. I normally take 2.5 2.5 5.0 three day cycle. I too have a mechanical valve. Does your valve keep you awake at night?

Peter 41, I have an artifical valve and have been on Warfarin for 22 months now. I find that with stress my INR levels drop rapidly. I am presently going through a very stressful period and my INR as dropped from 2.8 to 1.7 in 4 days without change in dose or diet,

I have had a mechanical valve for a lil over a year now and yes it does keep me up sometimes. I have a bad habit of tapping my foot to the ticking noise. I dont even notice I am doing it until my wife says to stop.

Russ wrote:

<quoted text>Russ 48, Hello Donna Not sure if I'm having the same problem with my INR as you but I do feel like I'm loosing it at times.I've been on it for 2.5 years and this past month was the first time I went a whole month with just one test. I normally take 2.5 2.5 5.0 three day cycle. I too have a mechanical valve. Does your valve keep you awake at night?

Donna44 wrote:

Yes, I am having that experience right now.
It is making my INR low. You can't make people at jobs understand how there being inconsiderate to these issues affects you and your health. Feel free to send me a message back. I am 44 and have a mechanical heart valve of ten years. Thank you.

I'm really struggling with it at the moment - particularly the tiredness, feeling cranky and having a lot of stress! It's really great to hear from people who have been surviving on warfarin long-term, because it helps me feel a bit less isolated... Donna44, have you got any tips for lowering stress or communicating to colleagues that you need help? I feel like I am always letting the team down, everyone works late and I can only just manage to make it to 5pm before I have to go home. I get home and just collapse, I'm so tired - it shouldn't be this way at only 27 years old! Can people on warfarin take any medication to help fight fatigue?

I have been taking 4 warfrin aday for the past 14 years have no side effects

Stress definitely affects INR. It doesn't affect it any one way either; some people came in with an INR of 6 and others with an INR of 1.3. As a medical professional who runs an anticoagulation clinic, I see it all the time, especially this time of year when everybody is stressed out. Hardly anyone’s INR is at goal. I don’t recommend starting any “stress-relieving” supplements or medications without consulting whoever is managing your INR. Some products are safe, but may require some dose adjustment. Some products should absolutely never be taken with warfarin. Be especially wary of over-the-counter and “natural” supplements; those products can really interfere with your body’s metabolism of warfarin. Also, think hard about your diet during times of stress. Many people eat differently in response to stress without even thinking about it. Combining emotional eating with stress is a sure-fire way to get really unusual INRs. My only advice is to attempt to relax when you can, take time out for yourself, and make sure to keep your regular visits for checking INR. Report any unusual symptoms suggestive of a clot or bleed immediately.

I was in hospital. Internal bleeding. But not from INR. Probably from vein breakage in intestine = AV Malformaations VS Diverticulitis. I am taking Warfarin because I have an artifical mitral valve. I usually take 7.5MG. The took me off my Warfarin for 3 days. After I was discharged from the Hosptial 3 days ago they told me to resume my normal amount of Warfarin. When I went in my INR was 3.1. When I was discharged, my INR was 2.0. But today when I went to get my INR checked it is now at 1.2. My question is..isn't 1.2 a dangerous amount for a person with an artificial mitral valve? Should the nurse had talked to my doctor about it? They are in the same clinic. Should they have told me I should go to hospital and get heparin until I get back up to 2.0?

No Becky - you are right - many times patients are discharged without the consultation of the managing doctor - I always used to tell my patients to always call me if someone gave them instructions on their Coumadin besides me - Alot of times, you are discharged and never told to even have the PT/INR checked again in a couple of days - the problem is when you are in the hospital - you are given different doses daily because they check your blood work daily - I would definately always consult your doctor and demand to have your blood work checked at least every other day until you are back into range.

As far as being tired: I would encourage you to start an exercise program - exercise will give you more energy - it is not really that you are tired because of the Coumadin - that doesnt normally happen - the cold weather months are more of a culprit than the Coumadin. Hope this is helpful

janekc wrote:

Does anyone else feel that stress affects their INR? I am 27 and have been on Warfarin for over 12 months now - I am a lifer, with homozygous Factor V Leiden.
I have an incredibly stressful, draining job which I find difficult enough (since I am always very tired from the Warfarin), but I also feel like the stress is affecting my INR, because it is very unstable. Just wondered if anyone else had found the same thing.
Thanks!

I am briefly transpanted from California to The Haague and it was fifty degrees and now it is below zero. I am stressed to go up twisty, steep stairs( fractured a year ago) and I left home without really knowing how I can tell I am out of INS range.I wonder if someone knows what the symptoms are of being out of wack with the diet and coumadin dosage

Elaine, the only way to know if you are out of your normal range is to have blood work - there are no signs or symptoms. A late sign is that you may have blood in your urine or your stool - but sometimes your INR is very high at that point and the risks of falling or cutting yourself are serious. I would recommend you simply go and have bloodwork done soon.

I have just started taking coumadin. What does INA stand for.

I never heard of INA -- do you mean INR? Are you referring to the blood test? The name of the test is a PT/INR.

In Nov I was found to have plumonary embolis in both my lungs. Since then max been stabile is 3 weeks. End of Jan my INR went from 2.6 to 1.4 in 2 weeks the longest stretch between blood tests. My dosage went from 7mg to 9.5.which seems really high.Week later still the same on same dose. I ended up back in hospital where they have managed to regulate my INR to 3. However I been home less than 1 week and I see a steady drop 2.8,2.6 now 2.2 The Dr at the hospital even suggested I wasnt taking my correct dose which is totally wrong as my mother died from this I am so careful. The only thing different is at home I am under extreme stress. From what I am reading this sounds like the cause.

I personally think stress affects everything - my INR has been fine for months between 2-3, and then for no reason down to 1.5, up to 1.8, and then down again. It was the holidays, I got married on New Years Eve, and then my mother has been ill, and of course I worry about my condition.

Like everyone else, no missed doses, no greens to cause the problem, just a change in the INR. My dose was raised last week, and I find out this Tuesday what it is now. I think it is because I am exercising more and flushing the medication out of my system, the clinic thinks that also.

If you don't already, I still write down everything I eat/drink/etc.(for 6 months now) so I can always go back and check if something may have affected it.

Good luck to everyone -
Shana

Does anyone know what would cause and INR of 2.8 to jump to 4.1 by the next day? Mine is going nuts. It was stabilized at around 2.7 then shot up quite far. They have not decreased the amount of rat poison yet. This stuff is so deadly I can hardly believe it. What a horrible drug and my heart goes out to anyone/everyone who is taking this product. Why can't the docs accept Nattokinise and some of the other blood thinning substances? Red Yeast Rice is something I am checking out right now but will not take it while under Warfarin. It seems the FDA wants people to suffer under this drug protocal.

I know I will get the stuffings beatin out of me for some of my comments, but someone needs to fight back against this hideous scenario. Reading most of the commentary on this blog is enough to make a person weep. There must be a better way. Even some of my doc friends dread this Warfarin stuff. Apparently there is a movement in the medical/research community to have this stuff taken off the market. Surely with all our brilliant young research scientists/docs, we can come up with a better system for anti-coag. Even the anti-coag pharmacists running my program, fear this drug.

God Bless you all for your suffering,

The bad boy in Colorado - getting ready to get my head kicked in for my "out of the box' comments.

Hello Colorado bad boy,

No, I am not going to kick your head (hey you are on coumdin, you can't get hit in the head, right :) for your comments. this is a free country and you are entitled to your opinions and even make them public.

Incidentally, I had something very similar happen not too long ago, although a little lower on the scale. My INR tends to go low for no appearant reason and was at 1.9 one day and at 3.7 a couple days later. There wasn't really anything I changed...maybe stress, not sure, but nothing drastically different.

I understand your frustration with coumadin. I have had my days.....

However, every time I think I am ready to get off it and maybe I can try without, something happens and I praise God for letting the medical world discover coumadin. Some people just plain and simply need it.

I don't know you and I don't know your medical history (and even if I did - I am not a doctor or nurse) so I don't know what is best for you.

But I do know that if your doctor prescribed it for you, there is probably a pretty good reason for it. If you arent' sure, you might want to get a second and even third opinion. It's your health and it's great to see you are taking control of it rather than handing it over to just one single doctor.

Keep up your research and just maybe you'll be the one to find something that might work great. You won't know unless your pursue it.

I for myself pretty much know that I need the coumadin. I tried without it and it simply didn't work. I am glad I went through it and tried, and I am even more glad I am back on the coumadin and most of the time problem free.

I still have issues with travel and have posted questions about it on another thread. I am still looking for some answers ...but meanwhile I am trying to be good and follow "doctors orders"....knowing it's my decision...

Good luck and I hope you are having a fantastic weekend....

All the best to us all and may God bless us

Kazza, bilateral DVTs and multiple bilateral lung clots beginning of feb 08. I've been put on a therapeutic range of warfarin of 2.5-3.5 but dr wants 3.0 ideally. All has been going OK since leaving hospital and although the INR has bounced around between 2.7 and 3.7 it has stayed in the 'zone'. Now got latest test result on Friday and in one week my INR has gone from 3.2 to 1.9. I haven't missed a dose although the dr did quiz me on that and didn't seemed to believe me when I said no! I'm on 6mg/7mg at present and the dr doesn't want to increase my dose. I've been eating exactly the same stuff but I have been getting a lot of chest pain the last month and I wonder if the stress of that is affecting my levels? I have a repeat INR test tomorrow. Hopefully it will have increased but if it hasn't or has gone down I'm not sure what the dr is planning to do. If stress does affect the INR levels then it seems to be a bit of a downward spiral - low INR makes you more worried about recurrence of clots so your INR drops with the stress etc. What happens if it is too low? Does the Dr start you on injections to get you back into the range quickly? Hope everyone is keeping well.