Uncontrolled Graves’ disease as a driver of amplified warfarin sensitivity

Uncontrolled hyperthyroidism can significantly increase warfarin sensitivity, leading to unpredictable and potentially dangerous INR elevations even on low doses.Improvement in thyroid function decreases warfarin sensitivity, often necessitating careful dose adjustment and frequent INR measurement to maintain therapeutic anticoagulation and prevent thrombotic and bleeding complications.Effective management of anti-coagulation in patients with thyroid dysfunction and mechanical heart valves requires multidisciplinary collaboration and patient adherence to optimise outcomes.