ABOUT 'BEAT YOUR A-FIB'...


"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su Cavanaugh Heart Center, Phoenix, AZ

"Your book [Beat Your A-Fib] is the quintessential most important guide not only for the individual experiencing atrial fibrillation and his family, but also for primary physicians, and cardiologists."

Jane-Alexandra Krehbiel, nurse, blogger and author "Rational Preparedness: A Primer to Preparedness"



ABOUT A-FIB.COM...


"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

Dr. Jeremy Ruskin of Mass. General Hospital and Harvard Medical School

"I love your [A-fib.com] website, Patti and Steve! An excellent resource for anybody seeking credible science on atrial fibrillation plus compelling real-life stories from others living with A-Fib. Congratulations…"

Carolyn Thomas, blogger and heart attack survivor; MyHeartSisters.org

"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

Terry Traver, former A-Fib patient

"If you want to do some research on AF go to A-Fib.com by Steve Ryan, this site was a big help to me, and helped me be free of AF."

Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013


Drug Therapies

Don’t Take Any Medication Without Asking These 10 Questions

Before taking any prescription drug to treat your Atrial Fibrillation, you should educate yourself about the drug. We’ve prepared the top 10 questions you should ask your doctor. As a service to our readers, we offer the questions as a free PDF worksheet you can Download. It has convenient spaces to write down your doctor’s replies for later review.

Print as many as you need and take a copy to every doctor appointment (you never know when you’ll need one). Download our worksheet (and don’t forget to save to your hard drive).

Before Starting a Prescription Drug, Ask These Questions

Use our worksheet as a guide as you ask these questions of your doctor or healthcare professional, and note their responses:

Download our Free Worksheet

1. Why am I being prescribed this medication?
2. What are the side effects of this drug?
3. Are there any precautions or special dietary instructions I should follow?
4. Can it interfere with my other medications?
5. What should I do if I forget a dose?
6. How long before I know if this drug is working?
7. How will I be monitored on this drug? How often?
8. What happens if this drug doesn’t work?
9. What if my A-Fib symptoms become worse?
10. If I don’t respond to medications, will you consider non-pharmaceutical treatments (such as a Pulmonary Vein Isolation procedure)?

Keep your medical records in a binder or folder. at A-Fib.com

Keep your medical records in a binder or folder.

Your A-Fib Binder or Folder

When completed, file the worksheet in your A-Fib binder or file folder to use for future reference and follow-up.

Your A-Fib binder is where you should file and organize all your A-Fib-related treatment information: printouts of information from the internet and your local public library or medical center library, notes from phone calls with doctors’ offices, and answers to “interview” questions during doctor consultations.

Research Any Prescription Drug 

To determine if the prescription is the right one for you, do your research. An excellent prescription database is the U.S. National Library of Medicine Drug Information Portal. (For an example, see the page on Warfarin [Coumadin].)

Also see the free worksheet: Keep an Inventory List of Your Medications


Worksheet from Chapter 6 of Beat Your A-Fib: The Essential Guide to Finding Your Cure, by Steve S. Ryan, PhD

Editorial: Leaving the Patient in A-Fib—No! No! No!

Recently I corresponded with a fellow who just found out he was in “silent” Atrial Fibrillation with no symptoms.

I commend his family doctor for discovering he was in A-Fib during a routine physical. Otherwise, he might easily have had an A-Fib stroke. (Of those with untreated A-Fib, 35% will suffer a stroke.) We don’t know how long he might have been in A-Fib before being diagnosed.

I wish I could commend his cardiologist too, but I can’t. His cardiologist just put him on the rate control drug, diltiazem, and left him in A-Fib.

That is so wrong for so many reasons!

Rate control drugs aren’t really a “treatment” for A-Fib. They slow the rate of the ventricles, but they leave you in A-Fib.

Rate Control Drugs Don’t Really “Treat” A-Fib

Rate control drugs aren’t really a “treatment” for A-Fib. Though they slow the rate of the ventricles, they leave you in A-Fib. They may alleviate some A-Fib symptoms, but do not address the primary risks of stroke and death associated with A-Fib.

Effects of Leaving Someone in A-Fib

A-Fib is a progressive disease.

Leaving a patient in A-Fib can have long-term damaging effects with disastrous consequences. Atrial Fibrillation can:

• Enlarge and weaken your heart often leading to other heart problems and heart failure.

• Remodel your heart, producing more and more fibrous tissue which is irreversible.

• Stretch and dilate your left atrium to the point where its function is compromised.

• Lead to progressively longer and more frequent A-Fib episodes and within a year can progress to chronic (continuous) A-Fib.

• Increase your risk of dementia and decrease your mental abilities because 15%-30% of your blood isn’t being pumped properly to your brain and other organs.

I’m So Angry at Doctors Who Just Leave Patients in A-Fib!

I can’t tell you how angry I am at cardiologists who want to leave people in A-Fib.

Even if a patient has no apparent symptoms, just putting them on rate control meds and leaving them in A-Fib can have disastrous consequences (and verges on malpractice).Don't Settle for a lifetime on medication April 2016 600 x 935 pix at 300 res

What Patients Need to Know

The goal of today’s A-Fib treatment guidelines is to get A-Fib patients back into normal sinus rhythm (NSR).

Treatment options includes antiarrhythmic drugs, chemical and electrocardioversion, catheter ablation and mini-maze surgery.

Unless too feeble, there’s no good reason to just leave someone in A-Fib.1

Don’t let your doctor leave you in A-Fib. Educate yourself. Learn your treatment options. And always aim for a Cure!

References    (↵ returns to text)
  1. A cardiologist may cite the 2002 AFFIRM study to justify keeping patients on rate control drugs (and anticoagulants), while leaving them in A-Fib. But this study has been contradicted by numerous other studies sinse 2002.

New FAQ: Risks of Xarelto and 3 Alternatives to Anticoagulants

We’ve posted a new FAQ and answer about the risks of anticoagulants and three alternatives to taking them.

“I have A-Fib, and my heart doctor wants me to take Xarelto 15 mg. I am concerned about the side effects which can involve death. What else can I do?”

You are right to be concerned about the side effects of Xarelto, one of the new Novel Oral Anticoagulants (NOACs). Uncontrolled bleeding is the primary risk (patients have bled to death in the ER.)

Be advised: No anticoagulant will absolutely guarantee you will never have a stroke.

All anticoagulants are inherently dangerous. You bruise easily, cuts take a long time to stop bleeding, you can’t participate in any contact sports; there is an increased risk of developing a hemorrhagic stroke and gastrointestinal bleeding. (Most EPs are well aware of the risks of life-long anticoagulation.)

Anticoagulants cause or increase bleeding. That’s how they work. To decrease your risk of blood clots and stroke, they hinder the clotting ability of your blood. But, they also increase your risk of bleeding. But in spite of the possible negative effects of anticoagulants, if you have A-Fib and a real risk of stroke, anticoagulants do work.

What Else Can You Do? Remove the Reason for an Anticoagulant—Three Options

The best way to deal with the increased risk of stroke and side effects of anticoagulants is to no longer need them. Here are three options…<…continue… to read my full answer…>

Patients’ Best Advice #7: Persevere—More Than One Treatment May be Needed

THE TOP 10 LIST #7

Persevere-Try More Than One Treatment if Necessary

A-FIB PATIENTS’ BEST ADVICE

From Beat Your A-Fib: The Essential Guide to Finding Your Cure, Chapter 12: Your Journey to a Cure. These patients needed more than one type of treatment to become free from the burden of Atrial Fibrillation:

Joan S.

Joan Schneider, Ann Arbor, MI, USA, tells about starting with drug therapy:

“The Pill-in-the-Pocket (PIP) [drug therapy] served me well prior to my [catheter ablation] procedure.” (pp. 119-124)

Jay Teresi, Atlanta, GA, describes his second ablation after being A-Fib free for three-years:

Jay T.

Jay T.

“[My EP] explained that my first procedure was a success. However, during the healing process a tiny spot did not scar and this allowed the A-Fib to trip again. He ablated that portion and touched up all the other areas. I have now been free of A-Fib for over four years (as of September, 2011).” (pp. 98-100)

Harry Emmett Finch, Malibu, CA. With 40-years of A-Fib, Emmett’s treatment evolved beyond drug therapy to his PV catheter ablation, then AV Node ablation with Pacemaker and, most recently, installation of the Watchman device:

Emmett F.

Emmett F.

“There is more help available today than when I first developed my A-Fib [in 1972], and I’m sure more treatment options (like the Watchman device) will be available in the future.” (pp 181-189)

A-Fib is Not a One-size-fits-all Disease

Your Atrial Fibrillation is unique to you. Along with various treatments, you may need to address concurrent medical conditions (i.e, hypertension, diabetes, obesity, sleep apnea). Likewise, you may need to make lifestyle changes (e.g., diet, exercise, caffeine, alcohol, smoking).

In addition, your heart is a resilient muscle that tends to heal itself, so you may need repeated procedures.

Try More Than One Treatment if Necessary.

Learn more at: Treatments for A-Fib


‘The Top 10 List of A-Fib Patients’ Best Advice’ is a a consensus of valuable advice from fellow patients who are now free from the burden of Atrial Fibrillation. From Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD (beatyoura-fib.com)

Next, look for #8 on the
Top 10 List of A-Fib Patients’ Best Advice
Please, share the advice ♥ 

FAQs A-Fib Drug Therapy: Safety of Multaq [dronedarone] vs amiodarone

 FAQs A-Fib Drug Therapy: Safety dronedarone vs amiodarone

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

Safety of dronedarone

25. “Is the antiarrhythmic drug Multaq [dronedarone] safer than taking amiodarone? How does it compare to other antiarrhythmic drugs?”

Multaq is probably safer than amiodarone, but it isn’t just “amiodarone-lite.”

Higher Death Rates with Dronedarone

Some studies indicate Multaq by Sanofi-Aventis (generic name: dronedarone) has its own set of problems.

In a study of dronedarone in high-risk patients with permanent A-Fib (PALLAS-3,236 patients), patients taking dronedarone were dying at more than twice the rate of those on a placebo. The ratio of stroke and hospitalization for heart failure was also more than twice as high.

The EMA recommends dronedarone not be used in patients still in A-Fib.

Dronedarone Shouldn’t Be Used in Patients in A-Fib

The European Medicines Agency (EMA) has recommended that the antiarrhythmic drug dronedarone not be used in patients still in A-Fib, that it should be discontinued if A-Fib reoccurs, that it shouldn’t be used in patients who have previous liver or lung injury following treatment with amiodarone, and that patients using it should have their liver and lung functions regularly monitored.

Who Should be Taking Dronedarone (If Anyone)?

The Committee for Medicinal Products for Human Use (CHMP) of the EMA said that dronedarone may be a useful option in patients who are in sinus rhythm after a successful cardioversion. But even in this case, dronedarone should only be prescribed after alternate treatment options have been considered.

…Dronedarone should only be prescribed after alternate treatment options have been considered.

About dronedarone, noted A-Fib blogger, Dr. John Mandrola wrote, “I’m surprised that the drug has persisted. I don’t know any of my colleagues who would start a patient out on Multaq [dronedarone]. It just doesn’t work.”

Editor’s Comments
According to these studies and news reports, no one with any type of A-Fib should be taking dronedarone (Multaq).
This is a major change in treatment options for patients with A-Fib.
Dronedarone may be associated with increased strokes, hospitalizations, heart failure, liver damage, lung damage and death. And it may not be very effective anyway.
No antiarrhythmic drug is 100% safe and effective for all A-Fib patients. But until we get more favorable research on dronedarone, all patients with A-Fib should consider not taking it and try alternative options.

References:

Connolly SJ. Dronedarone in High-Risk Permanent Atrial Fibrillation. PALLAS Clinical trial (Permanent Atrial Fibrillation Outcome Study Using Dronedarone on Top of Standard Therapy). New England Journal of Medicine, 2011; 365: 2268-76. http://www.nejm.org/doi/full/10.1056/NEJMoa1109867 DOI: 10.1056/NEJMoa1109867

O’Riordan, Michael. “EMA recommends restricting use of dronedarone” HeartWire, Sept. 22, 2011. http://www.medscape.com/viewarticle/750196

Burton, Thomas M., FDA Reviews Heart-Rhythm Drug. The Wall Street Journal, September 22, 2011. http://www.wsj.com/articles/SB10001424053111904563904576585091471862916

The European Medicines Agency (EMA): a decentralised agency of the European Union (EU) is responsible for the scientific evaluation, supervision and safety monitoring of medicines developed by pharmaceutical companies for use in the EU. http://www.ema.europa.eu/ema/; See: Multaq/dronedarone

Last updated: Wednesday, May 25, 2016 Return to FAQ Drug Therapies

A-Fib Drug Therapies: Joann’s Success with Multaq

Recently I got good news from Joann Sickinger. She wrote me about controlling her A-Fib with drug therapy. She has been almost A-Fib free for 2 years and has not experienced any side effects.

She has been taking Multaq (dronedarone) 400 mg twice a day, along with metoprolol 12 1/2 mg once a day and Xarelto 15 mg once a day.

Joann says “I am not sure how long this will last and will opt for ablation if I start having attacks again.”

Thanks, Joann for sharing. I’m glad you are aware that drugs often stop working over time and that you are prepared to have a catheter ablation if that happens. (With a successful ablation, you may be able to stop all medications.) We wish you continued good heart health!

What's working for you? Share your tips at A-Fib.com

Email us what’s working for you.

Joann invites your email about Multaq. You can reach her at: joannbday(at)aol.com

Do you have a drug therapy story to share?

Are drugs working for you? Are your A-Fib symptoms under control? Or, have A-Fib drugs been ineffective or with side effects? Email us and share your experiences with our A-Fib.com readers.

FAQs A-Fib Drug Therapy: Anticoagulant Side Effects and Alternatives to Xarelto (NOACs)

 FAQs A-Fib Drug Therapy: Alternatives to Xarelto

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

24. “I have A-Fib, and my heart doctor wants me to take Xarelto 15 mg. I am concerned about the side effects which can involve death. What else can I do?”

You are right to be concerned about the side effects of Xarelto, one of the new Novel Oral Anticoagulants (NOACs).

All anticoagulants are inherently dangerous. You bruise easily, cuts take a long time to stop bleeding, you can’t participate in any contact sports; there is an increased risk of developing a hemorrhagic stroke and gastrointestinal bleeding. (Most EPs are well aware of the risks of life-long anticoagulation.)

Primary risk: Uncontrolled bleeding is the primary risk (patients have bled to death in the ER.) Anticoagulants cause or increase bleeding. That’s how they work. To decrease your risk of blood clots and stroke, they hinder the clotting ability of your blood. But, they also increase your risk of bleeding.

Normally, clotting is a good thing like when you have a scrape or cut.

Other risks: Do the NOACs have the same long-term problems as warfarin (Coumadin), i.e., microbleeds in the brain, hemorrhagic stroke, early dementia, etc.?

We don’t know yet. The NOACs haven’t been around long enough to determine their side effects. But intuitively one would expect so. (The recent spate of ads from lawyers seeking clients who have been harmed by NOACs would seem to lead to this conclusion.)

Anticoagulants Protect You and Give Peace of Mind

But in spite of the possible negative effects of anticoagulants, if you have A-Fib and a real risk of stroke, anticoagulants do work. You’re no longer 4–5 times more likely to have an A-Fib (ischemic) stroke. Taking an anticoagulant to prevent an A-Fib stroke also may give you peace of mind.

What Else Can You Do? Remove the Reason for an Anticoagulant—Three Options

Be advised: No anticoagulant will absolutely guarantee you will never have a stroke.

Be advised that no anticoagulant or blood thinner will absolutely guarantee you will never have a stroke. Even warfarin [Coumadin] only reduces the risk of stroke by 55% to 65% in A-Fib patients. See Risks of Life-Long Anticoagulation.

The best way to deal with the increased risk of stroke and side effects of anticoagulants is to no longer need them. Here are three options:

#1 Alternative: Get rid of your A-Fib.

As EP and prolific blogger Dr. John Mandrola wrote: “…if there is no A-Fib, there is no benefit from anticoagulation.”

Action: Request a catheter ablation procedure. Today, you can have an ablation immediately (called ‘first-line therapy’). You don’t have to waste a year on failed drug therapies. See Catheter Ablation Reduces Stroke Risk Even for Higher Risk Patients

#2 Alternative: Close off your Left Atrial Appendage (LAA).

The Left Atrial Appendage is where 90%-95% of A-Fib clots originate.

Action: Request a Watchman device. The Watchman device is inserted to close off your LAA and keep clots from entering your blood stream. See Watchman Better Than Lifetime on Warfarin

#3 Alternative: Consider non-prescription blood thinners

Ask your doctor about your CHA2DS2-VASc score (a stroke risk assessor). If your score is a 1 or 2 (out of 10), ask if you could take a non-prescription approach to a blood thinner.

Perhaps you can benefit from an increase in natural blood thinners such as turmeric, ginger and vitamin E or, especially, the supplement Nattokinase. See FAQ: “Are natural blood thinners as good as prescription blood thinners?” 

Bottom Line

Whether or not to take anticoagulants (and which one) is one of the most difficult decisions you and your doctor must make. Talk to your doctor about alternatives to anticoagulants: 

Taking an anticoagulant isn’t like taking a daily vitamin. Only take one if you are at a real risk of stroke.

• Catheter ablation
• LAA closure (Watchman device)
• Non-prescription blood thinners

If you decide to stay on a NOAC, ask your doctor about taking Eliquis instead of Xarelto. Eliquis tested better than the other NOACs and is considered safer. See Warfarin vs. Pradaxa and the Other New Anticoagulants and the FAQ: Is Eliquis Safer.

Thanks to Jim Lewis for this question.

Remember:
You must be your own best patient advocate.
Don’t settle for a lifetime on anticoagulants or blood thinners.

Don't Settle for a lifetime on medication 10-2015 400 x 500 pix at 300 res

Last updated: Thursday, May 19, 2016 Return to FAQ Drug Therapies

Are Anticoagulants and blood thinners the same thing? How do they thin the blood?

We’ve posted a new FAQ and answer under Drug Therapies and Medicines in our section:

Are Anticoagulants and blood thinners the same thing? How do they thin the blood?

Blood clots are usually good, such as when you get a scrape or cut.

Since A-Fib increases your risk of clots and stroke, blood thinners are prescribed to prevent or break up blood clots in your heart and blood vessels and thereby reduce your chance of an A-Fib-related stroke.

Although referred to as “blood thinners”, they don’t actually affect the “thickness” of your blood.

Anticoagulant Warfarin chemical diagram

Anticoagulant Warfarin

There are two main types: anticoagulants and antiplatelet agents.  They work differently to accomplish the same end effect.

Anticoagulants work chemically to lengthen the time it takes to form a blood clot.

Common anticoagulants include warfarin (Coumadin), Heparin and the NOACs such as apixaban (Eliquis).

Antiplatelet Aspirin

Antiplatelets prevent blood cells (platelets) from clumping together to form a clot.

Common antiplatelet medications include aspirin, ticlopidine (Ticlid) and clopidogrel (Plavix) .

Final answer: Yes, an anticoagulant is a blood thinner, but not all blood thinners are anticoagulants.

Note: To read about ‘clot buster’ drugs or treatments that could save you from a debilitating stroke, see my article: Your Nearest ‘Certified Stroke Center’ Could Save Your Life.

Patients’ Best Advice #4: Don’t Just Manage Your A-Fib with Meds. Seek your Cure.

Top 10 List #4 Meds don't cure A-Fib 600 x 530 pix at 300 res

THE TOP 10 LIST #4

Drugs have a role, but other treatment options target a cure.

A-FIB PATIENTS’ BEST ADVICE

From Beat Your A-Fib: The Essential Guide to Finding Your Cure, Chapter 12: Your Journey to a Cure. Advice from patients now free from the burden of Atrial Fibrillation:

Dan Doane at A-Fib.com

Dan Doane

Daniel Doane, Sonora, California, USA, shares his mistake:

“Don’t think that the medication is a long term solution. Don’t put up with nasty side effects. That was the mistake I made. I thought I could tough out the medication as long as I stayed out of A-Fib.” (pp. 152-162)

Terry DeWitt, Massachusetts, USA, advises act sooner than later:

Terry Dewitt at A-Fib.com

Terry D.

“I knew I could continue on medication for several years, but I was concerned about the remodeling of my heart. …I would need an ablation…and sooner seemed better when my heart was still strong.”  (pp. 138-143)

Max Jussila, Shanghai, China, says meds are for the short term:

“Do not listen to your doctors if they suggests medication as a long-term solution!
Max Jussila, A-Fib Support Volunteer at A-Fib.com

Max J.

The doctors who see medication as a solution commit serious negligence and are ignorant of the terrible nature and consequences of Atrial Fibrillation.” (pp. 92-97)

Don’t Just Manage Your A-Fib with Meds. Seek your Cure.

According to Drs. Savelieva and Camm:

“The plethora of antiarrhythmic drugs currently available for the treatment of A-Fib is a reflection that none is wholly satisfactory, each having limited efficacy combined with poor safety and tolerability.”

In general, don’t expect miracles from current medications. Antiarrhythmic drugs are only effective for about 40% of patients; many can’t tolerate the bad side effects. When they do work, the drugs become less effective or stop working over time. To date, the magic pill that will cure your A-Fib probably doesn’t exist.

Drugs don’t cure A-Fib but merely keep it at bay.

Learn more at: Drug Therapies.


‘The Top 10 List of A-Fib Patients’ Best Advice’ is a a consensus of valuable advice from fellow patients who are now free from the burden of Atrial Fibrillation. From Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD (beatyoura-fib.com)

Next, look for #5 on the
Top 10 List of A-Fib Patients’ Best Advice
Please, share the advice ♥ 

New A-Fib Patient Story: Pill-In-The-Pocket Works, Until It Doesn’t

Lise Soares Personal experience story on A-Fib.com

Lise Soares

Our newest patient A-Fib story is told by a retired nurse from Arizona. (Coincidently, her husband had A-Fib, too.) Both are now A-Fib free. Her story begins in an all too familiar way.

I Woke at 2 AM with an Urgent Need to Urinate

My first episode started in September 2006 when I woke up at 2 AM with an urgent need to urinate. My heart was beating so hard that I thought it would come out of my chest. My pulse was irregular, I had chest pain and was dizzy. I was anxious and scared. At the emergency room, just before I was scheduled for a cardioversion, to my great relief, I went back into sinus rhythm.

I was discharged with a ‘pill-in-a-pocket’, Flecainide 100 mg, if I got another episode. I thought I would be free from other episodes. But 10 months later I woke up at 1 AM again with an urgent need to urinate. My heart was beating out of my chest and my pulse was over 130 per minute.

But this time I took Flecainide 100 mg and was back in sinus rhythm at 2:15 AM with a pulse of 68.

My cardiologist instructed me to eat salty foods such as chips and nuts while in A-Fib 

Why Did I Urinate 10-15 During an A-Fib Episode?

As my A-Fib became more frequent, I wanted to know why I urinated so many times (10-15) during an A-Fib episode. Apparently, when in A-Fib, the “atrial natriuretic peptide hormone” in the atria kicks in and acts as a diuretic to lower the blood pressure and regulate the calcium and salt in the body.

My cardiologist instructed me to eat salty foods such as chips and nuts while in A-Fib and drink plenty of water so as not to get dehydrated. I was also told that my A-Fib episodes were vagal… .

To read more of Lise’ A-Fib story and how she beat her A-Fib for more than three years, go to: Retired Nurse: Over 3 Years A-Fib Free (Husband Had A-Fib, Too).

Retired Nurse: Over 3 Years A-Fib Free (Husband Had A-Fib, Too)

Lise Soares Personal experience story

Lise Soares

A-Fib Patient Story #82

Retired Nurse: Over 3 Years A-Fib Free (Husband Had A-Fib, Too) By Lise Soares, November 2015

By Lise Soares, October 2015

My name is Lise Soares, and I live in Arizona with my husband, Robert. We have been happily married for 46 years and we both have had A-Fib. [We hope Robert will also write about his A-Fib experiences.] I write this in the hope that it will help others make proper decisions about their A-Fib.

Healthy Lifestyle But A-Fib Runs in My Family

I am a senior citizen who lives in a healthy manner. Along with my husband, I take care of myself, eat well and exercise regularly. I also try to keep stress out of my life as much as possible.

I would like to mention that A-Fib runs in my family. I have a nephew in Canada who had his first ablation at 18 by a pioneer in the field. It took two more ablations for him to be A-Fib free. Now in his 40’s, he feels he is cured. I have a brother and a sister who also have A-Fib.

September 2006: First A-Fib Attack

My first episode started in September 2006 when I woke up at 2 AM with an urgent need to urinate. My heart was beating so hard that I thought it would come out of my chest. My pulse was irregular, I had chest pain and was dizzy. I was anxious and scared.

Reluctantly, I woke my husband and told him I needed to go to the emergency room. Upon our arrival, the medical staff told me I was in atrial fibrillation and would monitor me until I got out of it. In the morning, the emergency room cardiologist decided that he would do a cardioversion to put me back in sinus rhythm. It was scheduled for 1 PM. At 12:50 PM, to my great relief, I went back into sinus rhythm.

I was discharged from the hospital with a pill-in-a-pocket, Flecainide 100 mg, if I got another episode.

Pill-In-The-Pocket Works, Until It Doesn’t

I thought I would be free from other episodes. But 10 months later I woke up at 1 AM again with an urgent need to urinate. My heart was beating out of my chest and my pulse was over 130 per minute. But this time at 1:47 AM I took Flecainide 100 mg and was back in sinus rhythm at 2:15 AM with a pulse of 68.

Keeping a Log or Diary Important

I kept a log of all my episodes of A-Fib and of my symptoms as I wanted to see how often they were happening and their severity. (In the early years, I got only 2 or 3 episodes.)

A-Fib begets A-Fib, and this pattern was happening to me.

I read on the A-Fib website that A-Fib begets A-Fib, and this pattern was happening to me. Keeping careful notes was important to me as a long-retired nurse. Accurate record keeping often helps doctors make a diagnosis.

In August 2009 (while my husband was in the hospital for a successful ablation by Dr. Andrea Natale), I had an episode that night in my hotel room and, later on that week, another one.

There are many patients who write about keeping an A-Fib Diary about their episodes, triggers, etc. Just enter the word “diary” in the ‘Search’ box in the upper right of this page.

Stops Flecainide, Deals with Excessive Urination

In August of 2010, my internist suggested I see another cardiologist who worked closely with Dr. Natale. My new cardiologist stopped my Flecainide because it made me sick during my A-Fib episodes. He prescribed another antiarrhythmic drug, Multaq, 400 mg/day.

My cardiologist instructed me to eat salty foods such as chips and nuts while in A-Fib and drink plenty of water so as not to get dehydrated.

I also wanted to know why I urinated so many times (10-15) during an A-Fib episode. Apparently, when in A-Fib, the “atrial natriuretic peptide hormone” in the atria kicks in and acts as a diuretic to lower the blood pressure and regulate the calcium and salt in the body.

My cardiologist instructed me to eat salty foods such as chips and nuts while in A-Fib and drink plenty of water so as not to get dehydrated. I was also told that my A-Fib episodes were vagal, from the vagus nerve.

A-Fib Progresses and Becomes More Frequent

From October 2010 to February 2012, I suffered 11 episodes of A-Fib with my symptoms getting more severe every time.

On January 7, 2012, during an A-Fib episode, I borrowed my husband’s Holter monitor to record my episode. My cardiologist made me erase it because it was not “my” monitor. I protested and told him it should be recorded.

Finally, he did give me a monitor to wear 24 hours a day for 30 days. As luck would have it, during that period I did not have any episodes.

(Dr. Natale could not believe that my cardiologist had done this. I subsequently got a new cardiologist, Dr. Timothy Marshall, and he is wonderful.)

Back in the Emergency Room

My episode in February 2012 landed me in the hospital. I woke up at 1:00 AM with an urgent need to urinate, palpitations, irregular pulse, dizziness, chest pain and I felt like I was going to pass out.

I went to the emergency room and was unable to convert back on my own, so I was given Cardizem IV, Lovonox and Magnesium 1000 mg to bring me back into sinus rhythm. While giving me these drugs, the “crash cart” was kept outside the room.

May 2012: Ablation Procedure with Dr. Andrea Natale

After that episode, my cardiologist advised me to have an ablation with Dr. Andrea Natale. I had already made an appointment in March 2012 for a consultation. Dr. Natale said I would be a good candidate for an ablation. I was put on Coumadin two months before my May 2012 ablation procedure and stopped taking it 5 months after my ablation. I now take Aspirin 81 mg daily.

On May 18, 2012, Dr. Natale successfully ablated my pulmonary veins. He did not need to do the left atrial appendage.

Participant in Clinical Trial for Contact Force Sensing Catheter

I was also taking part in a random experiment with a Contact Force sensing catheter. This probe helps the electrophysiologist determine the amount of pressure applied on the heart muscle as he uses the radio-frequency heat catheter.

It wasn’t until a year later, that I found out the Contact Force sensing catheter was used on me.

To read more about the Contact Force Sensing Catheter, see my AF Symposium report: The New Era of Catheter Ablation Technology: Force Sensing Catheters.

Three Years After the Successful Ablation

I have been episode-free for over 3 years–knock on wood. I hope I am cured but I do not dare say as I do not want to tempt fate.

I had GERD at the time Dr. Natale performed the ablation. After the ablation, GERD caused chest pain. When I was discharged from the hospital and came home, I started making my own yogurt and, after eating it for two weeks, I felt much better. It is also excellent for the gut.

The only symptom that keeps persisting is waking up once or twice at night with an urge to urinate. I suspect that the “Atrial Natriuretic Peptic Hormone” or “Atrial Natriuretic Hormone” (ANH for short) is still active in the muscle of my heart, since an ablation does not remove the hormone. I discussed this with my urologist recently, and she said it is quite possible because my urine output is quite large for nighttime (I had measured my urine output for a period of time).

If you have A-Fib, do something about it. Do not wait until it takes control of your life. It will not go away!

My Parting Thoughts

A-Fib.com was a great source of information, and my husband and I are grateful to Dr. Ryan for keeping it up-do-date.  We thank him also for being available when we needed him.

If you have A-Fib, do something about it. Do not wait until it takes control of your life. It will not go away!

If you have questions, please contact Steve Ryan, and he will get in touch with me.

Lise Soares
Arizona, USA

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If you find any errors on this page, email us. Y Last updated: Saturday, July 23, 2016

Drug Watch: FDA Approves Reversal Agent Praxbind® for the Anticoagulant Pradaxa

The FDA granted “accelerated approval” to Praxbind®, a reversal agent (antidote) to Pradaxa®. Praxbind is given intravenously to patients who have uncontrolled bleeding or require emergency surgery.

The accelerated approval program is designed to provide patients with earlier access to new drugs.

Pradaxa (dabigatran), a novel oral anticoagulant (NOAC), reduces the risk of clots and stroke in patients with Atrial Fibrillation. The new NOACs are alternatives to warfarin (Coumadin).

Patients on Pradaxa Were Bleeding to Death in the ER

Patients on Pradaxa have been bleeding to death in the ER while doctors were powerless to stop their bleeding and could only watch them die. See Stop Prescribing or Taking Pradaxa.

Praxbind - antidote to Pradaxa

Praxbind®, reversal agent for Pradaxa®

In clinical trials, 5gs of Praxbind (idarucizumab) reversed the anticoagulant effect of Pradaxa within minutes (which is significantly faster than the current antidotes for warfarin). In one ongoing trial, the anticoagulant effect of Pradaxa was fully reversed in 89% of patients within four hours. This effect lasted at least 24 hours.

Praxbind works by binding to Pradaxa to neutralize its effect (measured as unbound Pradaxa plasma concentration). The most common side effects of Praxbind were headache, low potassium, confusion, constipation, fever and pneumonia.

Boehringer Ingelheim (a privately-held German company), which manufactures both Pradaxa and Praxbind, will be required to submit additional clinical information after approval to confirm the clinical benefit of Praxbind.

After Praxbind, Get Back on Anticoagulants ASAP!

Boehringer Ingelheim recommends that patients resume their anticoagulant therapy as soon as medically appropriate. In the clinical trials of Praxbind, five patients suffered strokes after reversal. They were not receiving anticoagulant therapy at the time of their stroke.

Other NOACs Will Soon Have a Reversal Agent

Pradaxa was the first NOAC to win FDA approval, but now there are three other new anti–blood clotting drugs available to doctors and patients.

Despite its newly approved reversal agent, Pradaxa’s advantage over the other NOACs will probably be short lived.

• Xarelto® (rivaroxaban) by Bayer Pharma/Janssen Pharmaceuticals
• Eliquis® (apixaban) by Pfizer/Bristol-Meyers Squibb (tested the best with the best safety record)
• Lixiana®/Savaysa® (edoxaban) by Daiichi-Sankyo (newest NOAC to be approved by the FDA)

The other NOACs will soon have a reversal agent, Andexanet Alfa, which has done well in clinical trials and is also on fast track FDA approval. It’s being developed by Portola Pharmaceuticals.

Despite its newly approved reversal agent, Pradaxa’s advantage over the other NOACs will probably be short lived.

References for this article

New FAQs About Hormone Replacement Therapy and A-Fib

Drug Therapies for Atrial Fibrillation, A-Fib, AfibThanks to Mary LaPorte for this question: “Do you have information about Hormone Replacement Therapy (HRT) and if it might help or hinder my atrial fibrillation?”

One would expect that, if properly administered, HRT would have good effects like decreasing menopause symptoms, improving bone density, improving cardiovascular health, etc. HRT might reduce the risk of A-Fib by improving a woman’s overall health.

But research on this topic isn’t all that clear. I found two contradictory studies…Read the rest of Steve’s answer here.

NOTE: I am way out of my comfort zone discussing womens’ health and HRT and would welcome comments from anyone with insights about this topic. Email me.

Resveratrol Reduces A-Fib Episodes in Animal Studies

Resveratrol is a natural and safe compound found in certain plants, has antioxidant properties and is known to improve cardiovascular health. It is found in red wine, red grape skins and seeds, peanuts and other foods.

Photo by Stoonn

Photo by Stoonn

A new medicine based on resveratrol, a ‘resveratrol derivative compound 1’ (C1), was effective in reducing the duration of A-Fib episodes in animal studies.

Dr. Peter Light of the University of Alberto, Edmonton, Canada published this study in the British Journal of Pharmacology. (This resveratrol research was funded by the Canadian Institute of Health Research and TEC Edmonton, with additional support from the Center for Drug Research and Development.)

How Does Resveratrol Work?

‘Resveratrol derivative C1’ seems to work by targeting multiple pathways involved in A-Fib, not just one or two as is the case with many current A-Fib drugs. These pathways include several ion channels as well as “pathways that cause adverse restructuring of the atria that may lead to A-Fib.”

Dr. Light thinks that the first in-human trials of ‘resveratrol C1’ may start in two-to-five years.

It’s highly unlikely that the ‘resveratrol derivative C1’ will be significantly better than natural resveratrol.

What This Means to A-Fib Patients

What’s important in this animal study is that a type of resveratrol reduced the duration of A-Fib episodes.

The beneficial effects of Resveratrol on cardiovascular health is well-documented. But, its usefulness for A-Fib patients requires more research. It’s possible Resveratrol could work as a ‘pill-in-the-pocket’ to reduce the duration or stop A-Fib episodes without the need for antiarrhythmic drugs.

Sources of Resveratrol

You don’t have to wait for Dr. Light’s trials to benefit from Resveratrol. (It’s highly unlikely that the ‘resveratrol derivative C1’ will be significantly better than natural resveratrol.) Resveratrol occurs naturally in red wine, red grape skins and seeds, grape juice, peanuts, mulberries, and some Chinese herbs. Resveratrol supplements are also available.

Caution: Resveratrol supplements could interact with medicines like blood thinners, blood pressure drugs, NSAID painkillers, and supplements like St. John’s wort, garlic, and ginkgo.

Talk with your doctor or healthcare provider before adding Resveratrol supplements to your diet.

To learn more about Resveratrol as a supplement, go the Memorial Sloan Kettering Cancer Center/Integrative Medicine database, About Herbs, Botanicals & Other Products, Resveratrol.

NOTE: In the US, substances found in nature like resveratrol cannot usually be patented by pharmaceutical companies and thus be under the control of the FDA. (This isn’t the case in other countries where natural substances are often regulated like drugs and consequently are often difficult to obtain.)

However, pharmaceutical companies can sometimes get around this restriction by making a change in the structure of a natural substance. Now it can be patented because it is no longer ‘natural’. Then it’s up to pharmaceutical reps to convince doctors to prescribe the patented version rather than the natural (and cheaper) substance.

References for this article

Case Studies: Testosterone Cures A-Fib in Aging Men

Much media attention has been paid to the importance of testosterone in men and how testosterone levels tend to decrease with aging. But few studies have looked at how low testosterone affects A-Fib and A-Fib stroke risk.

Testosterone-ball-and-stick-model

Testosterone-ball-and-stick-model

Low Testosterone Can Cause or Trigger Stroke

Low Testosterone can be responsible for or trigger acute ischemic stroke, stroke severity, and related death in men, according to Dr. George Eby of the George Eby Research Institute. Low testosterone is also associated with coronary disease, myocardial infarction (heart attack) in men, and with all-cause mortality in men.

Case Studies: Testosterone Cures A-Fib in Aging Men

In an article in the journal, Cardiology, Dr. Eby described cases where Testosterone Therapy (TT) made aging men A-Fib free.

Case #1:  A 59-year-old man with a low Testosterone level of 361 ng/dl had daily A-Fib episodes for the last year. Other than PACs, he had no other heart problems.
Within 45 days of daily Testosterone Therapy (TT), his serum Testosterone rose to 1,489 ng/dl, and he had no instances of A-Fib and very few PACs. (After the second week of TT, his INR increased from 2.5 to 5.4 which required his Warfarin dosage to be lowered.)
 Case #2: A 59-year-old man had strongly symptomatic nocturnal paroxysmal A-Fib and depression. His serum Testosterone was only 150 mg/dl which is much lower than normal. Previously he had had congestive heart failure and persistent A-Fib which had been treated with ablation and cardioversion.
 He received both DHEA (25 mg/day) and natural testosterone (50 mg/day) as a gel applied to his shoulders. After Testosterone Therapy, his depression and ectopics ended with only two observed instances of A-Fib after two weeks.

Dr. Eby’s Conclusions

• “Testosterone Therapy (TT) is necessary, safe, and superior to antiarrhythmic drugs, and may prevent A-Fib and stroke in aging men.” According to Dr. Eby, “TT is a necessary, superior and safe natural rhythm treatment for A-Fib.” “TT may play an important role in treating A-Fib and preventing stroke in aging men.”

• “Testosterone is low in men with Lone A-Fib.” Testosterone has been shown to be low in men with lone A-Fib compared to non-A-Fib controls.

• “Beta-blockers lower testosterone [levels] in men.” Dr Eby also pointed out that beta-blockers lower testosterone in men.

• “Low Testosterone is a risk factor for stroke and death in men.” Testosterone is an independent risk factor for acute ischemic stroke, stroke severity, and related death in men. Low Testosterone is also associated with coronary disease and with myocardial infarction (heart attack) in men, and with all-cause mortality in men.

What This Means to Male A-Fib Patients

These may be the first reported cases of Testosterone Therapy for A-Fib and to prevent stroke in men. Obviously more research then a few case studies needs to be done on this subject.

If you are an aging man with A-Fib, you should have your Testosterone level checked. And for those with low Testosterone, raising your level, besides making you feel better and more youthful, may also prevent A-Fib and stroke.

References for this article

New FAQ About Testing of NOACs and Natural Blood Thinners

Complementary & Natural Therapies

Complementary & Natural Therapies

I’ve posted a new FAQ in the Complementary & Natural Therapies section:

“Have there been any tests comparing natural blood thinners to the new anticoagulants (NOACs) in terms of efficacy and speed of onset?”

Comparison testing is unlikely. It’s highly unlikely that pharmaceutical companies and the FDA will one day pay for unbiased tests comparing their products to natural blood thinners. They have everything to lose and nothing to gain. Clinical trials are expensive, so it’s unlikely any others (i.e., the nutritional supplements industry) will have a financial incentive to pursue it either.

FAQs A-Fib Drug Therapy: Hormone Replacement Therapy and A-Fib

 FAQs A-Fib Drug Therapy: HRT

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

22. Do you have information about Hormone Replacement Therapy (HRT) and if it might help or hinder my atrial fibrillation?”

Intuitively one would expect that, if properly administered, HRT would have good effects like decreasing menopause symptoms, improving bone density, improving cardiovascular health, etc. HRT might reduce the risk of A-Fib by improving a woman’s overall health. But research on this topic isn’t all that clear. I found two contradictory studies.

Danish Study 2012: I found one Danish observational research study that HRT was associated with a decreased risk on new-onset A-Fib in women who had had a heart attack. They looked at 32,925 women and followed them for a year after discharge from the hospital after a heart attack. New onset A-Fib was diagnosed in 1,381 women (4.2%). But A-Fib rates decreased significantly if the women were on HRT (37.4 incidence rate vs. 53.7 for no HRT use).

Womens Health Initiative Study: Another observational study found a “modest” link of HRT to Atrial Fibrillation. These results were somewhat unusual in that women [with a hysterectomy] taking estrogen alone had a higher rate of A-Fib. But women with an intact uterus taking estrogen plus medroxyprogesterone didn’t have a significantly higher rate of A-Fib.

The lead author, Dr. Marco V. Perez, described how anecdotally women say that at certain times-during a period, pregnancy, or menopause-their arrhythmias can flare up. Hormones may play a role in A-Fib in women. Dr. Perez said he would now add A-Fib to the list of risks associated with taking HRT.

Takeaway: These two studies obviously contradict each other. But the results in the Dr. Perez WHI research were so “modest” and even contradictory that, when making decisions about HRT, we should probably favor the Danish study. However, much more research needs to be done in this area. If properly administered HRT improves your overall health, that might decrease your risk of developing A-Fib.

(I am way out of my comfort zone discussing womens’ health and HRT and would welcome comments from women or from anyone with insights about this topic.)

References for this article

Last updated: Monday, September 28, 2015

Return to FAQ Drug Therapies

Steve’s Inbox: International Mail & A-Fib Awareness Month

Many people email me for advice and support. This past week was quite the international experience for me. In addition to emails from the US, I also received emails from Syria, South Africa and Ecuador! Let me share a few with you.

The A-Fib Patient in a War Zone: Someone in a war-torn country was trying to find medical help for his A-Fib. A doctor started him on a heavy dose of amiodarone for his A-Fib. I told him about the toxic effects of amiodarone, but recognized that he was lucky to find any kind of medical help in a war zone. I couldn’t find any EPs still practicing in his country, but did find two centers in an adjacent country not at war. But I don’t know if he will be able to travel there. Please think positive thoughts/pray for him.

Airport Rendezvous: A traveler described a chance meeting in an airport with a well-known EP. This was more like a ‘sign’ than a chance occurrence. This wonderful EP answered her A-Fib questions and referred her to another EP near her for an ablation. She wrote that talking with the ‘airport’ EP helped her make the big decision to have a catheter ablation. (She had been looking at another surgery treatment option which I suggested might be overkill for her.)

Our A-Fib Support Volunteers were so supportive and helpful that she decided to become a volunteer, too.

A-Fib Support Volunteers in Action: Another woman described an all too common frustration with her primary care doctors and cardiologists who didn’t take her A-Fib symptoms seriously. They wouldn’t even refer her for a cardioversion. She was helped a lot by getting in touch with five of our great A-Fib Support Volunteers who had widely different experiences. They were so supportive and helpful that she decided to become an A-Fib Support Volunteer herself.

Amiodarone Advice: Another patient wrote that his cardiologist put him on a heavy dose of amiodarone when he first started having A-Fib episodes. I recommended the patient get a second opinion, that amiodarone is a very toxic med usually only prescribed as a last resort or for short periods of time like during the blanking period after a catheter ablation.

Negative Feedback: I warned someone about an EP whom I had heard negative things about. I referred the patient to a ‘master’ EP in his area for his ablation. I also told him to give his long-suffering wife a hug from all of us. All too often spouses of A-Fib patients put up with a lot and often feel alone and overwhelmed. I told them about the wonderful story “The Spouse’s Perspective: A Young Wife and Mother Copes with Husband’s A-Fib” in our book “Beat Your A-Fib: The Essential Guide to Finding Your Cure.”Top 10 Questions Families Ask About A-Fib - 150 pix at 96 res

September is A-Fib Awareness Month: As you see, there are many, many A-Fib patients out there seeking help and answers for their particular situation. A-Fib is not a one-size-all kind of disease. But A-Fib can be Cured! You don’t have to live a life on meds! Won’t you pass on our message to others with A-Fib and their families and friends? Send them a link to our special FREE report: The Top 10 Questions Families Ask About Atrial Fibrillation.

—Your A-Fib friend, Steve

FAQs Natural Therapies: NOACs vs. Natural Blood Thinners Tests?

Complementary & Natural Therapies

Complementary & Natural Therapies

 FAQs Natural Therapies: NOACs vs Natural Blood Thinners?

10. “Have there been any tests comparing natural blood thinners to the new anticoagulants (NOACs) in terms of efficacy and speed of onset?”

Comparison testing is unlikely. It’s highly improbable that pharmaceutical companies and the FDA will one day pay for unbiased tests comparing their products to natural blood thinners. They have everything to lose and nothing to gain. Clinical trials are expensive, so it’s unlikely any others (i.e., the nutritional supplements industry) will have a financial incentive to pursue it either.

Last updated: Sunday, October 25, 2015 

Return to FAQ Natural Therapies

Arterial Calcification From Warfarin: Vitamin K May Reverse it

The blood thinner, warfarin (Coumadin) is a “vitamin K-antagonist” which works by blocking vitamin K thereby affecting several steps in the anticoagulation pathway and decreasing clotting proteins in the blood.

Graphic: Warfarin and vitamin KBut vitamin K is essential for heart and bone health. Without enough K-2, osteocalcin, a protein that binds calcium to bone, doesn’t function. “When calcium doesn’t stay in bones, it can end up clogging your arteries, causing a heart attack or stroke.” Vitamin K functions to keep calcium out of soft tissues.

In one study, people with the lowest blood levels of vitamin K-2 had a 57% greater risk of dying from heart disease than those with the highest levels. They were also at increased risk for osteoporosis and bone fractures.

Why I Warn Against Taking Warfarin

In a study of 451 women using mammograms to measure arterial calcification, after just one month of warfarin use, arterial calcification increased by 50% compared to untreated women. After five years, arterial calcification increased almost 3-fold.

To avoid arterial calcification, if you are on warfarin (Coumadin), talk to your doctor about switching to Eliquis (apixaban) which tested the best of the NOACs and has the best safety test results. (See my article, Warfarin and the New Anticoagulants.)

Research: Vitamin K Reverses Arterial Calcification from Warfarin

If you have been on warfarin for a while, you will be interested in the evidence that high doses of vitamin K may reverse arterial calcification.

An analysis of kidney failure patients on dialysis found over 50% had vascular calcification (one devastating side effect). A clinical study tested supplementation with vitamin K2 (MK-7) over a six-week period. In the group given 360 mcg of MK-7, the favorable response rate was a remarkable 93%. (When supplementation ceased, these high-risk patients were once again vulnerable to vascular calcification.)

There are three forms of vitamin K: vitamin K1, vitamin K2(MK-4) and vitamin K2(MK-7).

An animal study involved groups of rats who were all initially fed a six-week diet of warfarin to induce calcium buildup in the blood vessels. This was followed by some groups receiving high-dose vitamin K1 or K2 (MK-4).

In six weeks, not only was there no further arterial calcium accumulation, there was a 37% reduction of previously accumulated arterial calcification. After 12 weeks, there was a 53% reduction. The high-dose vitamin K1 and K2 groups also showed a reversal in carotid artery stiffness.

Warfarin - Coumadin tablets various dosages

Warfarin (brand name Coumadin) various dosages

If on Warfarin, You’re Deficient in Vitamin K

According to the U.S. Department of Agriculture (USDA), the recommended range of normal vitamin K intake ranges between 60-80 micrograms for women and 80-120 micrograms for men. (The typical recommended supplement dosage is 90 mcg females, 120 mcg males.)

Nearly everyone is deficient in vitamin K. While most of us may get just enough vitamin K from our diet to maintain adequate blood clotting, most of us should increase our intake of vitamin K through foods like leafy greens, or take vitamin K supplements.

You must always take your vitamin K supplement with fat since vitamin K is fat-soluble and won’t be absorbed without it. Dr. J. Mercola

But if you’re on warfarin, you are NOT getting enough vitamin K to protect you from arterial calcification and a variety of other heart health problems. And certainly not enough to reverse the effects of warfarin on soft tissue calcification.

Counteract Arterial Calcification: What Dosage of Vitamin K?

So the question arises, is there anything we can do to reverse arterial calcification? What amount of vitamin K should you be getting? Sadly, we don’t have enough human research as to the correct dosage, but we do have some indications.

Referring back to the study above with rats, the human equivalent of the vitamin K dose given to the rats is in the range of 52,000 mcg (52mg) to 97,000 MCG) (97mg) per day. Also, in Japan, a 45,000 mcg (45mg) daily dose of the MK-4 form of vitamin K2 is approved as a drug to treat osteoporosis. Admittedly, these are high doses compared to the dietary industry standards. 

Consider a high quality MK-7 form of vitamin K2. And as they are inexpensive, include vitamin K1 and MK-4 to help inhibit and possibly reverse vascular calcification.

Although the exact dosage of vitamin K is yet to be determined, one of the world’s top vitamin K researchers, Dr. Cees Vermeer recommends between 45 mcg and 185 mcg daily for adults. (LifeExtension magazine recommends 200 mcg.)

Consider a high quality MK-7 form of vitamin K2. And since vitamin K1 and MK-4 are inexpensive, it makes sense to include them to inhibit and possibly reverse as much arterial calcification as possible. One product to look at is Life Extension Super K with Advanced K2 Complex Softgels, 90-Count available from Amazon.com

Balancing Vitamin K and Warfarin for Proper INR Ratio

People taking warfarin are often told to lower their intake of vitamin K foods like leafy greens, liver, etc., because they interfere with the anti-blood clotting effect of warfarin. Not true.

Prolific A-Fib blogger Dr John Mandrola (Dr. John M.), posted about misinformation surrounding warfarin patients and vitamin K. He wrote:

“I am so utterly tired of correcting this mistake….Patients on warfarin can indeed eat green vegetables; they should just eat them consistently. I have vegetarians who do beautifully on warfarin. The problem comes when people vary the weekly dose of vegetables.

So, if you and your doctor decide that you should take warfarin, take more vitamin K, not less! You can take vitamin K. The key is to be consistent on a daily schedule. If consumption of vitamin K does affect your INR, your doctor can always adjust the warfarin dosage.

Your Bottom Line Goal

If you continue to take warfarin, your goal is to maintain the highest healthy levels of vitamin K to counteract the effects of warfarin on your arterial and bone health.

If you change from warfarin to a NOAC, your goal is to restore your arterial and bone health from the effects of warfarin by maintaining the highest healthy levels of vitamin K.

References for this article

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