Posted by Sunnely on July 13, 2000, at 19:38:46
In reply to Lithium testing…, posted by Janice on July 12, 2000, at 23:34:38
Doubt drinking more water would lead to significant drop in lithium level.
No, in fact drinking excessive caffeine beverages would bring the lithium level down. On the other hand, if you been stable with lithium level and at the same time a coffee drinker, stopping the use of coffee could lead to an increase in lithium level.
Unless you are experiencing clinical signs or symptoms of lithium toxicity, my hunch is that your manic symptoms have been under good control and your doctor wants to see if you'll do OK with a lower but still therapeutic liithium level. The caveat here is, dropping it too low may cause a manic relapse. Lithium level of 1.08 is still within the therapeutic range (0.8 to 1.2, some consider 0.6 lower number as still OK if you have been clinically stable). This level range is not applicable to the elderly.
Lithium levels can be checked at a minimum of every six months if:
1) you have been regularly taking your lithium for quite sometime now and the levels have been steady at the therapeutic range;
2) your lithium dose have remained the same;
3) no change in formulation of lithium;
4) you have not changed your salt or coffee intake habits;
5) you are not experiencing a flu, fever, vomiting, dehydration;
6) no new medication(s) that could interact with lithium has been added such as: a) NSAIDs (Motrin, Advil, Orudis, etc.); b) blood pressure meds (ACE Inhibitors such as Vasotec, Zestril; Calcium channel blockers such as Cardizem, Calan; diuretics such as Dyazide, Lasix); c) Metamucil which can decrease lithium level;
7) you are not experiencing urinary infection or other kidney disorder;
8) you have not been involved in excessive exercise;
9) you have not gone to sauna or steam baths;
10) you have not lost water (sweating) due to hot weather.
Any of the above factors can affect the lithium level (down or up) and may cause serious problem such as manic relapse (too low level) or toxicity (too high level).
If your psychiatrist notices that your lithium levels have been steadily going up, this may indicate your kidneys may be getting affected by lithium. He may want to closely monitor your lithium levels and also do more tests referable to kidney functions.
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> •if I drink more water, will this bring the numbers down?
>
> •if the answer is yes, would that mean if I drank caffeine, would that bring the numbers up?
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> •Why do I have to be tested every month? It just seems so random. Why not go in every 4 days for 3 weeks?
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> Thanks, Janice
>
> I always have so many questions, and they always seem to come to me when I leave his office.
poster:Sunnely
thread:40272
URL: http://www.dr-bob.org/babble/20000708/msgs/40359.html