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My pdoc isn't going to take me off of the lithium. He thinks that I haven't cut myself in two month it is a sign that the lithium is working. He doesn't listen when I say I've pretty much been white knuckling it to every 10 day milestone.

 

His response to my thyroid concern was that I'll just have to raise my synthroid as needed. I don't like that solution at all. I don't feel like the lithium is working and I don't feel like he's listening to me. 

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i agree that talking to your family doctor about the thyroid issue is a good idea.  mine handles my synthroid, while my pdoc handles my psych meds.

 

synthroid and lithium do battle it out sometimes (i had to have my synthroid raised too).  i know you'd prefer to get off the lithium, but can i make a suggestion?  if your thyroid levels are out of whack, you can still feel like utter hell even though your lithium level "looks" fine.  once your thyroid meds are working properly, depression and energy and stuff like that get better (to some degree).  then it might feel like the lithium is doing something worthwhile.  would it be a good compromise to allow the synthroid changes, then wait awhile to see if it helps before quitting the lithium?

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My pdoc keeps my dosage low so he doesn't have to test my levels.

 

Like others have said, I will echo that your pdoc is incompetent.  No matter how much lithium you are on you need the blood tests (at least when I was taking lithium years ago I had to especially get lots of levels done in the beginning when titrating up).  Then the blod work was less frequent, but I still had to get it done.

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Demand a blood test for lithium levels. It's really irresponsible to prescribe lithium without those tests, because a) you can't tell if the dose is actually therapeutic or not and b) you have no idea how much room there is to raise the dose without a blood level.

 

That said, I do not think that mild hypothyroidism is a good reason to stop the lithium, IF the hypothyroidism is controlled with Synthroid or similar. I developed hypothyroidism on lithium, but I stayed on it for about a year because it helped me, and once I was put on Synthroid my thyroid tests came back well within the normal range, with no reason for alarm or concern on that front. It's cheap, it works, and taking one more tiny pill is not a big deal in the grand scheme of things if you're on a therapeutic dose of lithium and feeling better. Maybe your pdoc is right that your reduced self-harm is partially due to the lithium. I would encourage you to stick with it and not worry so much about the hypothyroidism.

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 if you're on a therapeutic dose of lithium and feeling better. Maybe your pdoc is right that your reduced self-harm is partially due to the lithium. I would encourage you to stick with it and not worry so much about the hypothyroidism.

Problem is that I'm not feeling better. I would cut this afternoon if I wasn't four days away from my next target.

Edited by Damik
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You're kind of in a catch-22, Damik. The lithium might not be helping because the dose isn't therapeutic, and you won't know until you get the blood tests done and adjust the dose accordingly. Lithium is a great med for many, many people, and I'd hate for you to discount it because your doctor was too lazy to check your lithium level to ensure accurate dosing.

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450mg is very little; My blood level was .4 or something at that level. 600mg has been therapeutic for me at .5, but technically that is too low. But we were able to decide to stay at .5 because of blood tests. 600mg is not very much, but it worked for me at sub-therapeutic levels, so we left it.

 

I really cannot believe your pdoc, that is malpractice.

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