I'm 1.8 and I'm doing ok with platelets at 46 so with all the other improvements I would not worry either.
Of course it does take a while to stop bleeding if I cut myself....but If I don't be stupid and cut myself, voila...no problem ! :)
Now if I can just find where I left that spare liver ...things will really shape up !
Duane
Rubye said
Mar 10, 2015
Well, it's all well over my head. :) Regardless, it's good to know it's not a worry at this point.
Thank you guys!
Tig said
Mar 9, 2015
Malcolm,
Thanks for the explanation! It helps to understand the correlation between the components. I've seen more reference to the PT/PTT than the INR. Separate test. I've witnessed more use of the PT when determining clotting times in patients undergoing anti coagulant therapy with various anti coagulants/blood thinners. It's all interesting, but as you say, quite complicated. I appreciate it...
Tig
mallani said
Mar 9, 2015
Tig,
Whole Blood Viscosity is a very complex subject. That article was mostly referring to antiplatelet/ anticoagulant treatments.
Usually , cirrhotics have a higher WBV until end stage. Blood viscosity is determined by 2 factors- the cellular components and the plasma components. The cellular factors are mostly RBC's- the number, shape and 'stickiness'. Platelets would need to be very low (? <40K) before they factor in. The plasma viscosity is pretty constant even though it contains all the clotting factors.
Personally, I prefer the Prothrombin Time (PT) which measures the clotting time in seconds (Normal range: 11-13.5 seconds). Cheers.
Tig said
Mar 9, 2015
Malcolm,
I had mentioned the platelet scenario after reviewing a paper(s) that mentioned low Platelet counts amount to a lower blood viscosity and can affect INR, but high platelet counts have no effect on the INR. Did I misinterpret that? Thanks for your help.
"Conversely, international normalized ratio is statistically significantly higher in low blood viscosity relative to hyperviscosity"
The INR (International Normalised Ratio) has nothing to do with platelets. It is a more reliable way of measuring the Prothrombin Time (PT). As the liver produces the pro-coagulant blood factors, eg Factor 2 (prothrombin). Factor 5 and fibrinogen, as well as the anticoagulant factors, the INR is used to assess the liver's health. It is used in calculating the MELD score.
The normal range is 0.8- 1.2. Yours is just a bit up, so don't worry about it. Cheers.
Tig said
Mar 9, 2015
Linda,
While not being an expert on this, I think it's a combination of those two factors. A low Platelet count can cause an elevation in your INR. Your cirrhosis is also a contributing factor, but that should show signs of improvement due to your SVR. It will take time but any improvement is a good thing. I think as your platelet count recovers, you will likely see a normalization in your INR. At least that's my non professional opinion! If you're concerned, I would just ask your doctor for clarification on this.
Tig
Rubye said
Mar 9, 2015
My platelets are 86 now. They were 65 for quite awhile with a lower INR. I didn't think it was anything to be concerned about either but for some reason I kept wondering Good to know it's nothing to worry about.
Thanks Tig.
Tig said
Mar 9, 2015
Hi Linda,
What is your platelet level? You may be experiencing a lower than normal platelet count which may be responsible for that elevation. It's not uncommon with liver disease to see an elevated INR.
PS: I don't think 0.1 increase is anything to worry about. Patients on anti coagulants can see a level between 2 and 3.0.
Rubye said
Mar 9, 2015
Does anyone know if a move from 1.11 to 1.22 INR means anything serious? Everything else is perfectly normal and Alk Phos, AST, and ALT are all mid-range normal. But, it's always been below 1.20 previously.
I'm 1.8 and I'm doing ok with platelets at 46 so with all the other improvements I would not worry either.
Of course it does take a while to stop bleeding if I cut myself....but If I don't be stupid and cut myself, voila...no problem ! :)
Now if I can just find where I left that spare liver ...things will really shape up !
Duane
Well, it's all well over my head. :) Regardless, it's good to know it's not a worry at this point.
Thank you guys!
Malcolm,
Thanks for the explanation! It helps to understand the correlation between the components. I've seen more reference to the PT/PTT than the INR. Separate test. I've witnessed more use of the PT when determining clotting times in patients undergoing anti coagulant therapy with various anti coagulants/blood thinners. It's all interesting, but as you say, quite complicated. I appreciate it...
Tig
Tig,
Whole Blood Viscosity is a very complex subject. That article was mostly referring to antiplatelet/ anticoagulant treatments.
Usually , cirrhotics have a higher WBV until end stage. Blood viscosity is determined by 2 factors- the cellular components and the plasma components. The cellular factors are mostly RBC's- the number, shape and 'stickiness'. Platelets would need to be very low (? <40K) before they factor in. The plasma viscosity is pretty constant even though it contains all the clotting factors.
Personally, I prefer the Prothrombin Time (PT) which measures the clotting time in seconds (Normal range: 11-13.5 seconds). Cheers.
Malcolm,
I had mentioned the platelet scenario after reviewing a paper(s) that mentioned low Platelet counts amount to a lower blood viscosity and can affect INR, but high platelet counts have no effect on the INR. Did I misinterpret that? Thanks for your help.
"Conversely, international normalized ratio is statistically significantly higher in low blood viscosity relative to hyperviscosity"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341636/
Tig
Hi Linda,
The INR (International Normalised Ratio) has nothing to do with platelets. It is a more reliable way of measuring the Prothrombin Time (PT). As the liver produces the pro-coagulant blood factors, eg Factor 2 (prothrombin). Factor 5 and fibrinogen, as well as the anticoagulant factors, the INR is used to assess the liver's health. It is used in calculating the MELD score.
The normal range is 0.8- 1.2. Yours is just a bit up, so don't worry about it. Cheers.
Linda,
While not being an expert on this, I think it's a combination of those two factors. A low Platelet count can cause an elevation in your INR. Your cirrhosis is also a contributing factor, but that should show signs of improvement due to your SVR. It will take time but any improvement is a good thing. I think as your platelet count recovers, you will likely see a normalization in your INR. At least that's my non professional opinion! If you're concerned, I would just ask your doctor for clarification on this.
Tig
My platelets are 86 now. They were 65 for quite awhile with a lower INR. I didn't think it was anything to be concerned about either but for some reason I kept wondering Good to know it's nothing to worry about.
Thanks Tig.
Hi Linda,
What is your platelet level? You may be experiencing a lower than normal platelet count which may be responsible for that elevation. It's not uncommon with liver disease to see an elevated INR.
Tig
http://www.nlm.nih.gov/medlineplus/ency/article/003652.htm
PS: I don't think 0.1 increase is anything to worry about. Patients on anti coagulants can see a level between 2 and 3.0.
Does anyone know if a move from 1.11 to 1.22 INR means anything serious? Everything else is perfectly normal and Alk Phos, AST, and ALT are all mid-range normal. But, it's always been below 1.20 previously.