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Twice since I've been on Lithium (1 year), I ended up making emergency doctors appointments because I had flu-like symptoms (headache, nausea, weakness, feeling a bit off) and worried about chronic toxicity and frankly got quite panicked. Twice the values were within range and it turned out I just had a bit of a mild flu. Both doctors I ended up seeing seemed supportive of me showing up in emergency care because of harmless symptoms and encouraged me to do so or just call in to get an extra bloodtest. It just feels hypochondriac to call a doctor and basically say "I've had a bit of a headache and feel a bit nauseous, could you check my kidneys are not shutting down?".

Have you learned to recognize when a few days of headaches (or other diffuse toxicity symptoms) are just what they are or do you get extra tests?

 

 

 

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I crossed in to toxic territory. Intense, horrible headache, myclonic-style twitching, vomiting even water (which compounded the issues). I actually couldn't even get myself to the ER the first day; didn't know whether I had a really nasty flu or not. The second day my wife took me in to the ER and I had a 30-second long myoclonic whilst the nurse was trying to take my blood pressure.

At that point I was at the top end of therapeutic (coming back down) and still twitching and shaking.....so my point being is you'll likely get some notice before you get to to true toxic levels. Now that this has happened, I could probably easily identify the start of toxicity -- but I wouldn't have known for sure without seeking medical care the first time.

Lithium gets a bit of a bad rap. It's not 100% safe by any means, but most of the bad stuff doesn't sneak up on you without warning -- once you're stable on a dose, you're more likely to see slowly appearing, chronic issues like kidney damage than the acute fast-approaching issues like toxicity. And the chronic issues only affect a relatively small percentage of patients, too.

In my case, not having had my usual (large) dose of caffeine may have contributed (rebound effect) to the initial symptoms and then for some reason I took ibuprofen for the headache, which is not so smart. No decent doctor will deny you a simple blood test to make sure everything is okay and you shouldn't feel awkward about asking :) Being aware and informed is your best defence and 'nobody will care as much as you do'.

Good luck.

 

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Thanks. I think I'm being a bit paranoid about the vague list of chronic toxicity symptoms, and getting really scared never helps for vague symptoms. I'll just call in for bloodtests if I feel very off again and wait till I get used to the whole Lithium thing. It's a brilliant medication, but a bit scary. :)

 

 

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Thanks. I think I'm being a bit paranoid about the vague list of chronic toxicity symptoms, and getting really scared never helps for vague symptoms. I'll just call in for bloodtests if I feel very off again and wait till I get used to the whole Lithium thing. It's a brilliant medication, but a bit scary. :)

 

 

I agree that lithium is brilliant. Cheap, effective, unpatented -- it's the last point that makes it unattractive to a very large industry :)

The only silent worry with lithium is chronic toxicity (rather than acute). Kidneys often don't complain when they're first getting sick. But that's easy to watch for with a kidney function test every six months, so remind your Dr you need them -- nobody cares as much as you do, after all. :)

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