Can warfarin cause low hemoglobin?

Ah, warfarin – the drug of choice for blood thinning. It has been around since 1948, which means that a lot of people have taken it, with varying degrees of success. Some would say that its efficacy is somewhat debatable, but one thing we know for sure- it can cause low hemoglobin levels in patients.

Low hemoglobin (or anemia) means lower oxygen transport capacity in your bloodstream. This condition can be caused by multiple factors such as chronic diseases or iron deficiency however, warfarin’s role must be taken into consideration especially amongst those who take it to manage cardiovascular disease or deep vein thrombosis.

So what does this all mean? Let’s dive deeper into the topic and find out!

What is Warfarin?

Warfarin is an anticoagulant medication widely used to treat and prevent blood clotting disorders like DVT and PE. It acts by reducing vitamin K availability within our body impairing the production of clotting agents by liver cells.

Fun fact: Warfarin originated from a derivative found in moldy hay fed to cattle which had bleeding disorders. Novel right?

Some commonly known brands are Coumadine (USA), Marevan (Australia & New Zealand), and Waran (Germany). Important note: Not suitable if you’re looking for flavors like mango or grapefruit.

Mechanism behind Low Hemoglobin Production

But how does using warfarin lead to low hemoglobin levels? The mechanism behind this phenomenon lies through inhibition of protein synthesis via Vitamin K-dependent steps; including those involved in haemostasis cascade along with other crucial roles towards red blood cell formation [Vitamin K being essential cofactor here]. Therefore use over prolonged periods may hamper erythropoietic process resulting in decreased RBCs count .

Interestingly enough, some studies suggest that those with low hemoglobin levels tend to absorb the drug more efficiently hence, lower doses are recommended for such patients. It’s practically a Goldilocks situation – not too high, not too low.

Signs and Symptoms

How would someone know they have anemia? Great question. Here are some of the signs and symptoms that could indicate red flagging concerns related to low hemoglobin concentration:

• Fatigue
• Shortness of breath
• Pale skin
• Rapid heart rate
• Dizziness or lightheadedness

If you experience any of these symptoms while on warfarin medication or in general, consult your healthcare specialist at the earliest as they can lead to emergency situations like myocardial infarction.

Risk Factors

There might be chances where an individual is at a higher risk of having low hemoglobin levels due to certain factors outside taking Warfarin! Below mentioned are few:

Nutritional deficiencies

Iron-deficiency anaemia is one such example, pertaining lack sufficient iron intake through diet. Vegetarians may face greater difficulties meeting their requirements since meat sources rank in highest place for heme type dietary iron absorption which isn’t easily sourced from plant-level foods thus increasing risk.

Chronic diseases

Those who suffer from chronic blood disorders like sickle cell disease (common among African-Americans) may potentially have compounded effects leading towards reduced RBC counts along with other contributing mechanisms/medical conditions making them prone to increased risks overall​. So it is imperative this cohort keeps regular checkups so appropriate action will follow if there appears any likelihood towards development ^[[Matthew Heeney et al 2017]]^.

Pregnancy

Being pregnant puts additional demands on your body facilitating accommodation for two beings’ nutrition supply demand therefore adequate amounts required throughout pregnancy decreases oxidative stress improves pre/postnatal outcomes determined by ATP production efficiency resulting directly impacts haemoglobin count furthermore pregnancies carrying multiple fetuses display higher chances towards anemia.

So, it’s essential not to assume that only warfarin causes low hemoglobin levels.

Diagnosis and Treatment

A simple blood test could indicate if your haemoglobin level has decreased below normal parameters. Physicians suggest iron supplements along with dietary changes for those who develop anemia in lieu of treatment against the background of vitamin K antagonist therapy like warfarin as a preventive measure; dosage adjustments are made accordingly ^[[Rey JA et al. 2008]]^.

Takeaway

Although Warfarin is widely used anticoagulant medication managing thrombotic disease but at times dose adjustments required cautiously while taking account chronic health status including underlying factors during pregnancy due higher nutritional demand absorption complexities which can lead development/lower RBC count resulting in subsequent anemia symptoms anyone take note to beware cautious!

Sources:
– Rey JA1, Caro-Vega L, Núñez ERD, Garrote VJ (2008) – The pathogenesis of early central nervous system hemorrhage in very-low-birth-weight infants: a reconsideration.
– Matthew Heeney et al. (2017) — Sickle Hemoglobin Polymerization: It Takes Two To Tango
– P WHROOMAN ET AL., Recent Developments In Antithrombotic Therapy | Circulationn Research vol37pp165–172 1975