Autistic teenage vegetarian daughter refusing prescription meds.

[taratill]

Posting on AIBU for traffic.

Does anyone have any experience of this and how to work around it?

DD is 16 (so she has to consent to treatment), she is autistic and has very fixed views.

She takes vegetarianism to the extreme generally and this has been an increasing issue over the years with her refusing cross contamination and not wanting to be near where meat is prepared or sweet wrappers even because of gelatine.

She's normally fit and healthy but the last few months she hasn't felt well and has been experiencing headaches and dizziness and palpatations so she's just had bloods done and it turns out, perhaps unsurprisingly that she's anaemic and has low B12 and vit D. The doctor has phoned and has left the prescription at the surgery pharmacy wanting bloods redone in 3 months.

I've called her and she has said she will not take the prescription if it is not specifically vegetarian, the doctor does know she is vegetarian and autistic but I'm not sure if the meds prescribed will be!

She is an intelligent child but her views on this are horrible. She would rather be ill than break her own rules around products being vegetarian.

I just don't know how to sensibly approach this. I guess if the prescription isn't suitable i can make an appointment for her to explain to dr why she is refusing treatment.

Does the Mumsnet hive mind have any other ideas/ experience? She's at 80% attendance at college due to frequently feeling too washed out to attend and she is county level sport and this is impacted her in that too.

There is just no reasoning with her so it's exhausting.

YEs or specifically ask the GP to prescribe the right thing. Have you checked - they may already be veggie....

Good luck op. Wanted to say that I am vegan and it’s very common to be low on iron, b12 and vitamin d.

As other posters have said there are vegan (PETA approved) versions of all of these. Once your daughter’s levels are out of the dangerous range she should feel much, much better.

But she will most likely continue to need to take supplements. I use nutritional yeast in most meals, take D and gentle iron daily, and take ferrous sulphate when I’m on my period.

Have a look at the Better You vitamin spray range, they are vegetarian, they also have a vegan maintenance spray and have higher IU vitamin D versions so less sprays to get prescription dose if she was went to take the large 20000IU tablets initially to get her levels up.

I never try to sneak non vegetarian food, that would be really unfair as you say.

A few things jumped out to me in your posts. None of this is an attack (I can fully see why you might feel frustrated with the situation) it's just as the previous poster said, the issue you're facing will be easier to address if you can empathise and understand her beliefs around animals and she feels you're on her side with dietary planning.

You said "unsurprisingly she has deficiencies". This suggests you think deficiency is inevitable on a veg diet, which it's not. There are a few key nutrients you need to think about a bit more, but with proper meal planning and supplementation a vegan diet has been proven to be safe at all stages of life including pregnancy and infancy.

You also called her eating disordered but then went on to list completely normal things that millions of vegetarians and vegans around the world avoid (and in some countries the majority of the population has done for centuries, I.e it's totally normal there and not disordered) Which again suggests you either dont understand the 'why' behind her beliefs or you take a negative view of them.

Also, the Italy thing - i would never eat something in Italy unless I asked the chef if it contains animals. I've even asked of it's vegetarian before and they said "yes, it only has a bit of chicken". In Italian and French cooking a lot of vegetable dishes actually use bone or even chunks of meat to flavour the sauce. So it's not extreme of her to check (unless she then doesnt trust what the chef says).

@Sixpence39

Also, the Italy thing - i would never eat something in Italy unless I asked the chef if it contains animals. I've even asked of it's vegetarian before and they said "yes, it only has a bit of chicken". In Italian and French cooking a lot of vegetable dishes actually use bone or even chunks of meat to flavour the sauce. So it's not extreme of her to check (unless she then doesnt trust what the chef says).

this is the point she doesn't trust what anyone tells her. So the chef could confim no parmesan for example or no other meat and she wouldn't eat it because it isn't marked vegetarian on the label/ menu.

Same for the GP saying something is suitable for vegetarians. that's not enough.

When I said 'unsurprisingly she has deficiencies' this is because she doesn't eat a varied vegetarian diet and also not surprising given how ill she feels.

Agree I found Italy difficult when avoiding meat. I stuck to pizza in the end.

I wouldnt have thought OP is putting out every single factor in her daughters eating, she is short handedly explaining some of the issues leading to the fact that her daughters eating habits are causing issues. She knows her daughter better than you do

OP - you may have found a solution, but in case not, have you looked at bariatric supplements, they are extremely high doses due to the lack of being able to absorb very much. Im on very high doses of iron, calcium and B12 and an extremely high dose multi vitamin. I have to take gentle iron due to my stomach and the stuff Ive got is vegetarian.

so in this example she wouldnt touch pizza because:

1. It would cross contaminate with meat unless there is a seperate pizza oven.
2. It is not marked vegetarian on the menu / even if the chef confirmed it is vegetarian/ no parmesan.

Yes my mum is like this. She’d bring food from home to eat in cafes. It was difficult.

Medicines (real ones, not food supplements) are never labelled as vegetarian, even if they are. But they all do (must) list all their ingredients in the leaflet.

Gelatine is an obvious non-vegetarian ingredient but that isn’t found in tablets, just capsules. Some tablets contain lactose, but you said your DD is OK with dairy, so that might be OK. Some colourants and other excipients may also be of animal origin.

It should be perfectly possible for the GP to work collaboratively with the pharmacy (and perhaps your DD too) to identify suitable brands from their leaflets. If the pharmacy is being rubbish, you may be able to find another one that will take an interest in your daughter’s wellbeing.

I mean I don't know how to explain how extreme this is:

She won't go in a room where someone has been eating sweets with gelatin.

She won't open our front door with a key because the rest of the family are not vegetarian and will have touched the key.

She won't eat food prepared by anyone other than me unless it is marked vegetarian on the product label or on a menu.

She literally would starve herself than eat under other circumstances.

Her vegetarian diet is extremely limited / fussy which is why she is lacking in vitamins and feeling ill. She refused supplements.

She is now refusing prescription medicine even though dr / pharmacist has said vegetarian because it isn't labeled.

But yeh according to some of you this is a me problem !

yes i think it was an animal derived colouring which was the issue. Thanks.

I think most of us were able to read between the lines and realise how ill she is making herself and its not an 'anti vegetarian' stance that you have!! Dont worry

thank you x

I used Spatone iron water supplement for getting my ferritin levels up from 17 to 70 in about 3 months. But it was quite expensive as I used 2 sachets a day. At around £10 a box, it might not be the most cost effective way to boost iron levels.

But it's literally just water so obviously suitable for vegans.

I think this is definitely autistic eating disorder territory. I wonder if Beat can help?

In the short term, would you be able to source an iron infusion? I’ve had one in the past and a quick Google says they are vegetarian.

I’d suggest the SEN boards, NT parenting advice doesn’t translate across terribly well as you know. It sounds incredibly difficult, sending lots of love.

This.

I've been vegan almost 25 years and never had a deficiency. I appreciate that someone with ASD may have a more restricted diet however.

I was a vegetarian for 23 years and I don't eat pork. Most drugs are suitable for Kosha and Hindu but not chemotherapy. Mine was made from rodents.
Needs must.

Being underweight isn't the only thing that indicates an eating disorder. You can have an eating disorder and be a normal weight. You can have an eating disorder and be overweight too. Eating disorders aren't just about eating less or getting thinner.

My niece has an NHS-diagnosed eating disorder (ARFID). She's a healthy weight, around a size 10, but like your daughter has various vitamin/mineral deficiencies due to the restricted range of things she will eat. She's currently being treated.

perhaps unsurprisingly she's anaemic and has low B12 and vit D

A vegetarian diet is not an automatic ticket to these. A poor vegetarian diet might be. She needs to take some supplements (prescribed, or over the counter) to get herself back up on a level, and look at including some different foods and a multivitamin / mineral in her diet from now on. If she's keen on doing vegetarianism by the book, then this should be ok for her.

This sounds more down the road of OCD - like you mentioned it’s difficult if she doesn’t see any issues and she’s 16

I think she probably has OCD as well as an eating disorder. There's a lot of overlap.

Hi, thanks, just looked at this and it is vegetarian.

Her ferritin is currently 7.

Thanks I haven't come across Beat before, I'll take a look at it.

I've been reluctant to call it an eating disorder because she is in the normal weight range.