Prothrombin Time
Greetings to the board…..I am diagnosed with Permanent Lone A-fib, am a non-anticoagulated patient, and have a PT INR of 1.0 within the 0.8-1.2 range. Should it be my objective to be in the INR 2.0 – 3.0 moderate intensity therapeutic range that one would be maintaining if following vitamin K antagonist therapy practices? Can one get there by means other than use of anticoagulated drugs? If so, using alternative methods, what protocol would be follow?
I have a CHADS2 risk criteria score of 0. The just completed routine follow-up with my cardiologist where we reviewed results of a recent echocardiogram showed a healthy heart in all respects, including normal ventricular size and function. Wall thicknesses were all within normal ranges, and ejection fraction close to 60%. No remodeling was evident. As their training is allopathic medicine, both my Primary Care doctor and Cardiologist would prefer that I be on vitamin K antagonist therapy, but they do appease and work with me as I pursue alternative approaches to treatment. I fully understand choices and consequences which lie before me.
Though in prior posts on this board I have provided information about my A-Fib history, I am again including some of that here to make it easier for the reader to understand my background.
Am 68 years of age, vegetarian for 37 years, vegan for many, but currently consume salmon, tuna, eggs and raw cheese. Seldom eat processed foods and intake is mostly organically grown. Exercise daily and am a non-smoker. During summers of 2009 and 2010, I began noticing how easily I tired but passed it off to thinking it was a result of increased heat and humidity which we experience in Central Florida. In January of 2011, while undergoing an annual physical with primary care doctor, the ECG identified an irregular heartbeat. Though much of it was silent, in retrospect, there were many signs which went overlooked at the time, as not knowing what atrial fibrillation even was, they went unaddressed. Both my Cardiologist and EP confirmed I was already in permanent A-fib. Underwent routine tests such as nuclear medicine stress, echocardiogram, etc., which identified healthy heart with no identifiable heart disease or structural abnormalities. Arteries were clear but I was faced with heart electrical issues. I have worn the Holter monitor twice over the past 18 months, with findings each time reaffirming permanent A-fib with heart rate at times in the 120 to 130 BPM range.
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Over the next couple months I completed a series of tests with the Primary Care Doctor, a Complementary/Alternative Medicine MD and Natural Practitioner (herbalist). I have over the past 18 months addressed mineral electrolytes, adrenal and thyroid issues, as well as chelation therapy, and am a much improved individual today compared to the person which I was 18 months ago. Seldom feel my heart, and when I do it is usually upon awakening during the night, and is a minimal quiver.
Current supplements consist of:
General:
• Vitamin B-12 (DaVinci 2000 mcg; 1 1000 mcg tablet mid morning)
• Folic Acid (Doctor’s Best 400 mcg; 1 cap mid morning)
• Vitamin B-6 (Solgar 100 mg cap with lunch) *B12, Folic Acid and B-6 to be replaced with Homocysteine Supreme next month.
• Vitamin D-3 (Ortho Molecular 5000 IU; 1 cap with dinner)
• Vitamin K-2 MK-7 (NOW 100 mcg; 1 cap with dinner)
• Water/MSM (1 16-ounce glass with breakfast)
• Kelp Cap (NOW 325 mcg; 1 cap with breakfast)
A-FIB:
• Nattokinase (Doctor’s Best 8,000 FU; 2000 FU morning on empty stomach, 2000 FU mid afternoon on empty stomach, 4000 FU before bed on empty stomach)
• Magnesium (Doctor’ Best 900 mg High Absorption 100 % Chelated; 300 mg with breakfast, 300 mg with lunch, 300 mg with dinner)
• Potassium Gluconate (NOW 2,160 mg; 540 with breakfast, 540 with lunch, 540 with dinner and 540 spread through the day in drinking water)
• Taurine (NOW 3000 mg; 1000 mg with breakfast, 1000 mg with lunch, and 1000 mg with dinner)
• D-Ribose (Healthy Origins 7 g; 1 heaping tsp mixed with water and MSM drink noted above)
• Fish Oil (Rx Omega-3 Factors 800 mg EPA, 400 mg DHA, 1,260 mg Omega-3 fatty acids; 1 cap with breakfast and 1 cap with dinner)
• Selenium (Source Naturals 200 mcg plus 30 IU Vitamin E, 2 mg Vitamin B2, and 150 mg broccoli seed extract; 1 cap with lunch)
• L-Carnitine (NOW 500 mg from L-Carnitine Tartrate; 1 cap with lunch)
• CoQ10 (Healthy Origins 200 mg; 1 cap with breakfast)
• Cayenne (Mountain Rose Herbs 600 mg; 200 mg with breakfast and 300 mg with dinner)
• Turmeric (Mountain Rose Herbs 300 mg with lunch)
• Raw garlic cloves, blueberries, and other blood-thinning foods are consumed daily with meals
• In addition, Super Foods such as chlorella, spirulina, etc. are added into fruit and green smoothies consumed daily.
The combining of foods and supplements gets me to approximately 1,700 mgs of magnesium daily, and I have yet to reach a level of intolerance. The April 2012, EXA result for magnesium was 34.4 within reference range of 34.0 – 42.0, so I am still working to reach the higher end of the range. The combining of foods and supplements gets me to approximately 6,000 mg of potassium daily. The April 2012, EXA result was 108.5 within reference range of 80.0 – 240.0, so I am still extending myself here as well. Potassium to sodium was 21.2 within reference range of 19.4 – 38.9. I try to keep sodium between 500 and 1000 mg daily, and am still trying to get myself averaging the 4/1 ratio.
The May 2, 2012, blood results showed fibrinogen at 252, platelet count of 162, and ECG at 87 BPM. June 20, 2012, ECG at 92 BPM. I take my pulse several times daily and it never exceeds the mid to high 80s.
Now, if you are not dozing and have hung in there with my dribble, I am back to where I began. As I am not on anticoagulation therapy, should my objective be to get within the 2.0 – 3.0 INR range that one would be maintaining if they were following moderate intensity antagonist therapy? Is that even possible? As anticoagulation drugs do not really thin blood, but rather delay the clotting process, is there an alternative avenue to drugs which would get me into the 2.0 - 3.0 range required to delay the clotting process? If so, can someone provide thoughts which would help me navigate to that end? Thanks.