why does my inr levels keep going up? is it normal to feel tired when it is high?

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i had a mechanical heart valve fitted last year, didnt go to well , end being open three times then got MRSA in hospital for three months. i feel cold a lot of the time , and im picking up every virus thats goes around. my level should be 2.3 to 2.5 but at the mo it 4.9 , i feel so tired , been put of work with another virus . just want some advice as i dont go to any clinic , my GP dose my tablets, so is there anything im doing wrong or is this normal .

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  • Posted

    There are a number of things which can affect INR, particularly medicines including herbal preparations and increased alcohol intake. Have you had any changes regarding these recently ?

    Tarun (hospital pharmacist)

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  • Posted

    When you are unwell it can raise the inr, it it wise to have regular monitoring esp when feeling ill so the gp or nurse can adjust the warfarin dose according to your inr.

    If your range is 2-3 then 4.9 is high and you are at risk of unwanted bleeding or bruising, get an inr done this week.

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  • Posted

    Poor you Joanne,

    I had a mechanical heart valve fitted 16 years ago.  Unfortunately after a short while I was informed that it was leaking slightly.  However, each year I see the consultant at the hospital and usually have an echo.  I have had several problems (the last being that the heart kept going out of rhthym so eventually had a pacemaker fitted.  Anyway, have been on Warfarin since my first op and like everyone else my INR goes up and down.  My scale is 2.5-3.5 (30 being the target).  Very rarely do I manage this regardless of trying to eat and drink the right things.  Do not eat very dark greens or drink much alcohol,  Never drink Cranberry juice, and Grapefruit juice is also a no no.  What I can't understand is that you say you do not visit any Clinic, but presumably you go to your doctors to have your INR taken regularly and the blood is then sent to hospital to be analyised.  As long as you do this you should be OK.  Yes, I also seem to pick up anything that is going the rounds. Like someone else said, antibiotics or some medicines will affect your INR and it can take quite a while to settle down again.  Keep strong, it will work out in the end for you I am sure.

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  • Posted

    Hi Betty, Angela and Joanne. I am on anticoagulants for almost one year now, after three episodes of thrombosys and a pulmonary embolism.  I can manage my Warfarin doses with the coagucheck, a device from Roche diagnostics that uses small lancets to collect a drop of blood and calculates the INR. It should cost around US$500. You need also the test strips at around US$10 each and lancets.  It worths the price, since, with a short training, you can test your INR anywhere at any time, without having to visit a hospital or healthcare provider. My usual Warfarin intake is a three day scheme: 5, 5 and 3.75. This allows for an ajusted range for the INR between 2.5 and 3. Remember that gp or nurse doesn't have any technique for finding the ideal intake scheme, besides trial and error. Just like us. However be careful while increasing or decreasing doses, since there is a delay on INR response. You can also get early detection of departures from adequate range due to eventual food or medicine interaction. 
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