Question:

How can I help regulate my INR with my diet?

Hello I am a person who has done the operation of the heart valve now since 6 months ago. I have the mechanical bileaflet heart valve. I am having a problem now with my INR. I am using WARFARIN. Since the operation now for 20 days, I am using 10 mg per day, but only one time my INR went to 1.91 and then starting to go down it goes until 1.30, then goes until 1.70 and then again down. Please help me by telling me what should I do and what should I eat/not eat and what kind of diet I should use? I want to have the INR 2.50. I weigh 110 kg and I am 34 years old. Please help if you can. Best greetings.

Submitted by Glauk Zhara from Kosovo on 11/15/2014

Answer:
by Scott R. Sherron, MD

The amount of vitamin K in your diet will play a role in the correct dose of warfarin. It is not as important to limit vitamin K as it is to ensure a relatively stable weekly intake. You have undoubtedly been given a list of foods that are high in vitamin K, so you should carefully review this list and evaluate your intake. There is some variation in the strength of generic warfarin from company to company & from batch to batch, although this has been less of an issue in recent years. Also, some people seem to have a variable metabolism of either the drug (warfarin) or of vitamin K. Therefore, fluctuations can occur that are not predictable or controllable.

All in all, adjustment of warfarin dose can be challenging and confusing, but if you work carefully with an experienced clinician, you should be able to control it reasonably.

Thanks.