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Determining Signs of Low INR

Learn Life-Saving Information Now! All About Anticoagulation Therapy and Determining Signs of Low INR.

One of the key factors to successful anticoagulation therapy is patient education.  You need to know about diet restrictions, basic drug interactions, and most important of all, you need to know what signs and symptoms to look for if your warfarin is not working properly.

Very few patients test their INR at home. It is therefore difficult to determine if your INR is dangerously high or low without going to a Coumadin Clinic.  Unfortunately, a high or low INR can be fatal.  So what can you do? Just assume your doctor got your dose right and it is out of your hands? NO! You can learn the signs and symptoms of high and low INR and take immediate action if any of them appear.

Signs of Low INR

A low INR means your anticoagulation dose is too low and your blood is clotting too quickly.  Some people might say your blood is “too thick.” This puts you at risk of developing conditions caused by a blood clot.

low INR can be far more dangerous than a high INR because the signs and symptoms are more difficult to recognize. A high INR will likely present as unusual bleeding or bruising before turning into a life-threatening condition, giving a patient time to seek medical attention. Conversely, a person will usually be unaware that their INR is too low until they develop a DVT, PE or stroke.  Unfortunately, these three conditions caused by a low INR frequently cause permanent life-changing injuries or death.

If any of the following symptoms occur, it could be because your INR is too low:  

  • Deep Venous Thrombosis (DVT): a blood clot deep within a vein, usually in the legs. Symptoms may include swelling, redness, tenderness and/or warmth in one leg or one area of one leg and generalized leg pain.
  • Pulmonary Embolism (PE): a blood clot that has traveled from somewhere in the body, usually the legs, into the lungs.  Symptoms may include difficulty breathing, chest pain, shortness of breath, breathing quickly, dizziness, increased heart rate or low blood pressure
  • Stroke: a blood clot that has traveled from somewhere in the body and lodged itself in a blood vessel around the brain.  Symptoms may include partial or total paralysis, inability to speak or swallow, sudden and severe headache, vision changes, loss of coordination or difficulty walking, confusion, facial drooping, dizziness, nausea or vomiting.  Patients with atrial fibrillation (A. Fib) have an especially high risk of stroke and are given anticoagulant medications to decrease that risk.

All patients on anticoagulants should be familiar with the signs and symptoms of a low INR.  If any of these symptoms occur, call your doctor or seek emergency medical attention.

Common causes of a low INR, or of a blood clot in general, include:

  • Taking too low of a dose of an anticoagulant medication
  • Missing a dose of anticoagulant medication or cutting back on the dose without doctor approval
  • Consuming too much vitamin K or other nutrients known to interfere with anticoagulant medications
  • Taking a supplement that has vitamin K or other nutrients known to decrease INR after starting anticoagulation therapy
  • Prolonged sitting such as on an airplane, long car ride or even seeing a long movie
  • Being bedridden
  • Various other health conditions such as obesity, smoking, high blood pressure, diabetes, high cholesterol, pregnancy, age (over 65 yeas), history of blood clots or a clotting disorders, heart failure or atrial fibrillation

Ways to decrease the chances of having a blood clot when taking anticoagulants:

  • Take your anticoagulation medication exactly as prescribed by your doctor
  • Eat a consistent amount of vitamin K every day
  • Avoid foods and supplements with high concentrations of ingredients known to decrease INR
  • Talk to your doctor or pharmacist before taking any new prescription or OTC medications
  • If your INR is stable, do not start a supplement that has vitamin K or other ingredients known to interfere with anticoagulation medications unless your doctor approves
  • Avoid sitting for long periods (periodically walk the isle of an airplane or movie theater during long engagements; take frequent pit stops during road trips)
  • Exercise daily, even if it’s something as simple as pushing a vacuum around the house or taking a walk around the neighborhood
  • Quit smoking
  • Gain control over health conditions that increase the risk of a blood clot including high blood pressure, high cholesterol, diabetes and obesity

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