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Blood Test Results (Lithium)


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I've been on lithium since early/mid-August.  

Got bloodwork done Thursday.  I didn't realize that a)the bloodwork needed to be fasting as they were doing glucose too and b)that lithium levels should be taken approx. 12 hours after dose.

When I started the lithium, I discussed with the pharmacist when to take it and settled on the morning.

I had the bloodwork taken approx. 22 hours post dose (because I did realize that it needed to be fasting and that I couldn't do the test in the afternoon).  

My results were, I believe, 0.2.  (I can look up the results online).  This is low - but is it reasonable given how long it had been since my last dose?  I don't feel stable.

I also show reduced kidney function, but not renal disease.  I doubt that's all the lithium, but what do I know.  

And I am definitely hypothyroid.  I just wish someone would give me meds for it already.  Still waiting on the endo's report that is taking FOREVER.  It's been almost THREE MONTHS now.  

Edited by jarn
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I'm honestly not sure how to interpret the results given the timing of the test. The therapeutic range, I believe, is something like 0.7-1.2 or something close to that. Mine was at 0.8 when last tested. But that was after 12 hours roughly. Someone else might be able to give you an answer, but my gut instinct is that you might just need to redo the test.

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I think, forgive me dances, that the lowest therapeutic level is .5. .2 is way low, but yes, given the timing of the dosage, that could be way off. I'm sorry, just curious, why do you take it in the morning? I take mine at night, it doesn't make me sleepy, but I do think it somewhat relaxes me. 

Yes, I'd take the test over again, bearing in mind the 12 hour time frame. 

Sorry to hear about the thyroid level, I hope you can get that sorted soon.

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I don't take it in the morning anymore, I just did it that way to space my meds out throughout the day.  Sigh.

I was worried that the kidney stuff is because I can be a heavy drinker, but my liver values are fine.  Phew!  I didn't think I drank THAT much but you never know.

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12 and 22 hours are very different. Maybe shoot your pdoc an email and ask him/her what to do?

As for the therapeutic dose, I think - could be totally off base here - that it depends on what your pdoc is prescribing it as. As in, if it's supposed to boost other drugs, the dosage can be lower than if it's your primary mood stabilizer. Don't know what that means about levels, though.

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Just sharing what I've been advised about when it comes to doing your lithium levels.

The night before, you take your regular dose of lithium.
You go for the blood test in the morning.
You don't take your morning dose until after the blood test.

I hope this tidbit helps.

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Just sharing what I've been advised about when it comes to doing your lithium levels.

The night before, you take your regular dose of lithium.
You go for the blood test in the morning.
You don't take your morning dose until after the blood test.

I hope this tidbit helps.

^^This is what I had to do also.  Except I was told taking the lithium needed to be close to 12 hours as possible, before the blood work.  So I took it at night depending on the time of the blood work in the morning, but made sure it was close to 12 hours apart.

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Even if your kidneys were super-duper kidneys and able to eliminate lithium very efficiently, you'd still be ~50% serum level at 22-hours (half life is 18-36 hours). If we do some back of a napkin math, that'd put your levels ~0.4 (it's really a curve in reality, but let's avoid the complicated math).

I'm not a doctor, nor do I play one on TV, but I'd suggest getting a proper 12-hour test to see what's going on.

Also, you're not splitting your dose? Being 22-hours between doses suggests you're not. Ask your doctor about splitting your dose -- cuts down on side effects a little and tends to "smooth out" your serum levels. Unless you're taking ER, which is intended to do this as-is.

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