Can stress affect my PT/INR level when taking warfarin?


Simply put, yes. Science has shown that because of the effect stress can have on your body, warfarin can stay in your system longer than normal, causing a spike in PT/INR levels.1 If you are able to recognize when you are stressed, you can take steps to manage it. Understanding what is causing your stress may help you to find ways to manage it. Consider the external pressures that you may be able to manage, or find ways to build your own emotional resilience, to help you cope during tough situations.


There are different ways to help deal with your stress:

  •    Identify what may trigger your stress to help you predict when you may need more support
  •    Make adjustments to the way you organize your time to help you feel less pressurized
  •    Accept the things you can’t change

It is also helpful to find ways to relax
: read a book, go for a walk, listen to music, or meditate, which has been scientifically proven to reduce the symptoms of stress.2


How meditation can help2



Slow heart rate




Slow rapid breathing




Reduce blood pressure




Improve attention and concentration


Find peace of mind

There are many forms of meditation, but at their core, they are very similar. In all of them there is a deliberate technique designed to promote relaxation. Here are a few different forms of meditation:

  •    Guided meditation: uses a guide, which could be live or via a recording, to listen to directions that aim to
       help focus your mind on the here and now. This is one of the easiest forms of meditation to practice.
  •    Mindfulness-Based Stress Reduction (MBSR): attention is focused on inhalation and exhalation as well
       as on the physical body.
  •    Transcendental Meditation: uses a series of words or phrases to help the practitioner focus during
  •    Yoga: moving through poses, practicing yoga breathing and focusing your thoughts on something specific
       creates a beneficial mind-body connection.

Meditation is something you can do anytime, anywhere—much like measuring your own PT/INR values. If you worry that your PT/INR values are outside of therapeutic range, being able to measure them yourself can put your mind at ease. Together, meditation and self-testing might help reduce the stress in your life.
  1. Hawk, T. L., Havrda, D. E. (2002). Effect of stress on international normalized ratio during warfarin therapy.
    Ann Pharmacother 36, 617-620. 
  2. Hussain, D., Bhushan, B. (2010). Psychology of meditation and health: present status
    and future directions. Int J Psychol Psycholog Ther 10, 439-451.


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