Lithium level weight-dependent?

[dancesintherain]

I tried to find this by google and failed.  Sorry.

is your lithium level going to change, even if you’re taking the same dose, if your weight changes?

for example (just using round numbers), if I weight 100 pounds and take 600mg, will my level be the same as if I was weighing 150 pounds and taking 600 mg?  If not, how does it change?

[notloki]

Weight/size generally has little effect on dosing for adults. It is more about 1) Your liver 2) genetics that controls processes in the liver 3) Kidney function. In the PI you almost never see a mention dosing vs weight for adults. For kids, yes.

[dancesintherain]

Thanks a bunch.  I went toxic (had to be hospitalized and neurologically compromised) at 900mg and I’m terrified of taking that amount again.  My pdoc keeps mentioning raising my lithium from the 750 I take because my level is low (0.5).  I keep refusing.

I was trying to think of things that could have caused me to go toxic at a dose only a tiny bit higher and all I could think of was that I was much thinner.  So much for that explanation.

[looking for answers]

my weights been stable i was on as high as 1350 a day. My level only once on that dose crossed into therapeutic range at .61. mostly fluctuated around in the .4-.5 range .We then dropped it to 900. have been on that for a while. My blood draws have been twice since then, 0.55, 058. SO basically my lithium levels are now consistently higher on 450mg less. Make sense of that. Lithium levels are fickle from what ive been able to read. but im sure others know more. and liek @notlokisaid, liver, hydration, genetics, random thigns that no one understands can affect your levels, so can thing like stress, time of year, 

[dancesintherain]

yeah, that's about as logical as mine, if not worse.  I just wish my pdoc would stop pushing a higher dose.  I'm terrified that it will happen again.  She should feel lucky that I'm willing to keep trying lithium after how poorly it went (which was not her fault--I was already toxic when I got to her, I think). 

[looking for answers]

1 hour ago, dancesintherain said:

yeah, that's about as logical as mine, if not worse.  I just wish my pdoc would stop pushing a higher dose.  I'm terrified that it will happen again.  She should feel lucky that I'm willing to keep trying lithium after how poorly it went (which was not her fault--I was already toxic when I got to her, I think). 

what does she say when you resist

[dancesintherain]

she listens and accepts it.

she just seems unwilling/unable to remember that we've had the conversation and then raises it at the next appointment.

Edited December 12, 2018 by dancesintherain

[looking for answers]

4 hours ago, dancesintherain said:

she listens and accepts it.

she just seems unwilling/unable to remember that we've had the conversation and then raises it at the next appointment.

my doc often forgets things too, its frustrating, but he spends a while with me. only once have i been rushed out. Hes always behind on appointments, like 30-2hours behind. but thts because he talks and listens to u. I spend 30 -40 min on average in there with, so ill take the forgetfulness at times, and the huge waiting room times for a chance to be heard, and collaborated with..............hopefully your doc is similar

curiosity, what are your levels? when you went toxic how did it happen? did u take like ibprofen or something to boost the level? what was your level at 600? vs 900 how long on 900 till u went toxic

[dancesintherain]

i'm currently a 0.55.  No clue on how the toxicity happened (nothing i wasn't supposed to do) which is why I was wondering if weight was a factor.  My former therapist believes it was a case of chronic toxicity leading to acute toxicity because I had GI symptoms for a while (months) and then neuro symptoms for another few months.  I have no memory of the entire month of October 2017.  I reportedly couldn't form sentences (in addition to the aphasia), take care of myself, or walk carefully.  I was hospitalized October 31st, 2017.  I don't know what the level was when I got to 900...only that when I was in the hospital being fed bananas and gatorade and such things it took me probably 3-4 days to come to and learn where I was. 

[looking for answers]

8 minutes ago, dancesintherain said:

i'm currently a 0.55.  No clue on how the toxicity happened (nothing i wasn't supposed to do) which is why I was wondering if weight was a factor.  My former therapist believes it was a case of chronic toxicity leading to acute toxicity because I had GI symptoms for a while (months) and then neuro symptoms for another few months.  I have no memory of the entire month of October 2017.  I reportedly couldn't form sentences (in addition to the aphasia), take care of myself, or walk carefully.  I was hospitalized October 31st, 2017.  I don't know what the level was when I got to 900...only that when I was in the hospital being fed bananas and gatorade and such things it took me probably 3-4 days to come to and learn where I was. 

I completely understand the concern! Good luck I wish I could be of more help! I hope your doc listens!

[dancesintherain]

she's definitely great overall--much like you've described.  it's just this one thing that gets under my skin because then i feel like i'm being resistant, when in reality i'm terrified it would happen again.