Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Janice on July 12, 2000, at 23:34:38
Hello,
I'm on 900 mg of lithium, and had my blood tested recently at 1.08. My psychiatrist says he likes it at about .8, but I do so well on lithium that this is fine and we will just continue to monitor my blood every month or so. So my questions are:
•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?
•Why do I have to be tested every month? It just seems so random. Why not go in every 4 days for 3 weeks?
Thanks, Janice
I always have so many questions, and they always seem to come to me when I leave his office.
Posted by Jennifer on July 13, 2000, at 1:50:36
In reply to Lithium testing…, posted by Janice on July 12, 2000, at 23:34:38
Janice,
Hi! Yes, if you increase your water intake, it will "lower your number". I don't get much of a diuretic (water loss) effect from caffeine, but if you do, it will increase the number. Lithium is throughout your entire body, which is hugely water. Changes in your normal fluid intake will change your results, as will things like increased salt intake that make you retain fluid. Just think of it diluting itself in the water. If you are new to Lithium, it's great that your doctor is testing your level. No real need to do it more often. Many times when people are right at the "top edge" of levels, they get tremors. If you find this happening to you, let your MD know. Otherwise, he just wants to see how it's building up and hanging around in your system, so there is no need to test every 4 days. If your levels remain stable for several months, he will hopefully back off the the labs and trust your instict as to how you feel. I could tell right where my level was, but it takes time. Hope this helps a bit. I'll watch for others replies to your question. Jennifer> Hello,
>
> I'm on 900 mg of lithium, and had my blood tested recently at 1.08. My psychiatrist says he likes it at about .8, but I do so well on lithium that this is fine and we will just continue to monitor my blood every month or so. So my questions are:
>
> •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?
>
> •Why do I have to be tested every month? It just seems so random. Why not go in every 4 days for 3 weeks?
>
> Thanks, Janice
>
> I always have so many questions, and they always seem to come to me when I leave his office.
Posted by Janice on July 13, 2000, at 18:14:37
In reply to Re: Lithium testing…, posted by Jennifer on July 13, 2000, at 1:50:36
thanks Jennifer,
you answered that so clearly. My levels must have been at 1.5 for about 2 months when I was inbetween pdocs recently. i felt fine physically during this time, no tremors, no diarrehea (excuse spelling). So is it the more water someone has in their body, the more lithium it takes to treat them?
Janice
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.
================
>
> •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?
>
> •Why do I have to be tested every month? It just seems so random. Why not go in every 4 days for 3 weeks?
>
> Thanks, Janice
>
> I always have so many questions, and they always seem to come to me when I leave his office.
Posted by Janice on July 13, 2000, at 21:38:33
In reply to Re: Lithium testing… » Janice, posted by Sunnely on July 13, 2000, at 19:38:46
thank you so much Sunnely. I am going to print that out. I appreciate both yours and Jennifer's efforts very much. thanks, Janice
Posted by Jennifer on July 14, 2000, at 0:08:27
In reply to Re: Lithium testing…, posted by Janice on July 13, 2000, at 18:14:37
Sunnely had great info! The last question you had regarding the more water someone has, the more it takes to treat them is not really the deal. People have approx the same percent of water makeup dependent on diet, exercise, weight etc. Your weight is taken into acct when initiating therapy. Changes in your body water % do change the lithium levels, so you have to watch if you decide to change something you do. Even mild dehydration from hiking at a high altitude one day could temporarily increase your level...but you'll get use to knowing where you are. Nobody can maintain the exact same water level everyday...all we can do is dose you by your average. Glad to see all your questions were answered. Jen
> thanks Jennifer,
>
> you answered that so clearly. My levels must have been at 1.5 for about 2 months when I was inbetween pdocs recently. i felt fine physically during this time, no tremors, no diarrehea (excuse spelling). So is it the more water someone has in their body, the more lithium it takes to treat them?
>
> Janice
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.