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.

no it's a food colouring in the brand.

I just don't think our GP / Pharmacist were desperately helpful.

I ended up googling. The drug itself is generally suitable for vegetarians but the brand they prescribed is not.

I use the b12 and vitamin d sprays, very easily taken and tolerated. The situation may be difficult but you need to respect her views re gelatine.

Ferrous numerate, bit D and bit B12 are vegetarian.

OP I am veggie but not as strict as your daughter.

is she restricting her diet in other ways? Did the GP ask wider questions and put her diet and health into context? Because it’s not uncommon that autism and eating disorders go hand in hand, and it’s also a known thing for restrictive diets to become anorexia in adolescents.

I think the GP might need to widen out the issues your daughter is dealing with - she needs help to pull the different issues apart

Op - I am someone who naturally has very rigid thinking. (Probably undiagnosed ND.)

One thing that I have realised is that when I am tired or ill it is much harder for me to think about my rules and whether they are sensible or whether I should break them. (“Yes I always go for a walk at lunchtime and it does make me feel more awake but there is currently gale force winds and horrendous rain so maybe I should delay. But I always go. Oh - I’ll just put my hood up.”)

She sounds physically very ill right now so is not going to be able to make those types of decision. Don’t think about the future and the fact that what she is doing is long term very problematic - just do what you practically can to get her feeling a bit better.

Get her to drink orange juice with iron pills. It helps absorption. Also, she may need laxatives and iron can bung you up

Former prescriptions clerk here, people used to request vegan medication often. It’s a ball ache and the doctors practice and pharmacy won’t love you for it but I’ve never known a medication not to have a vegan form or suitable alternative. You need to let them know you require this, the doctor isn’t going to be trying to source this for you they don’t have time. The pharmacy team will be able to but tell them asap so they don’t have to do it twice.

Until she is 18 you are responsible for her medical decisions. Of course it is better that she makes those decisions herself but if she is risking her long term health then this needs to be addressed.

My autistic teen has a very limited diet, she has to supplement folic acid and vitamin d.

We found out she was having vit d issues as her joints were hurting, prescription strength to get it resolved and then OTC stuff to maintain. Then she passed out one day, she was folic acid deficient , another prescription strength course but now a regular OTC multi vitamin is proving to maintain things (blood tests have confirmed).

There are so many good multi vitamins available, once you have got passed this blip hopefully a daily dose of a quality multi vitamin will help long term. DD will have to take them for life unless she suddenly starts eating fruit and vegetables (they make her retch so unlikely!)

Better You B12 spray states it's vegetarian, as does the Better You D spray. Both on Amazon.

Yes I agree. My DD also won't eat bits with gelatine in. But there's good advice on here and options for her for versions without gelatine and hopefully through taking vits regularly she can keep on top of this.
Good luck! X

I really wouldn't bother consulting a dietician, ime they know less than the patient. However a pharmacist will get able to tell you which supplements are vegetarian/ vegan. Some surgeries have a pharmacist as a member of the team but any dispensing pharmacist will be able to tell you and find suitable supplements. You might have to stand your ground to be heard, though.

The pharmacy said it was the doctor who had to write the correct script.

They can only prescribe the prescribed medication and can't change it for a vegan alternative.

Doctor was useless, said he didn't know.

I had to google and try and find it when i was with him.

Even then the 'vegan friendly' medication had a dye which is not vegan.

thank you, I think this is good advice.

That's not quite right 16 year olds are deemed medically competent.

https://www.nhs.uk/tests-and-treatments/consent-to-treatment/children/

This is the one I use hux d3. 20000 iu Vegetarian.

And my dd used sunvit 400iu

Vegan option on Amazon vit d3 too

You can get a liquid vit d supplement on prescription - my son is taking it. You can mix with a drink or just take in a medicine syringe like calpol. He’s on a very high dose for a couple of months. If you can get some things in liquid form and only have tablets when there’s no alternative that might be a little easier. My son is autistic and struggles with tablets. He is totally fine with needles though and positively loves a vaccination.

the liquid vit D we have is THORENS and only contains colecalciferol (vit d) and olive oil

OPs daughter is 16, she will need to give consent for treatment/referrals etc

No doctor is going to do something/give something/treat something/refer for something without her consent.

And its pointless anyway, what sort of therapy or intervention/education session could take place with either her not turning up or she turns up and just sits there saying 'no thank you I dont want this service'.

Our dds sound very similar! Mie is 14 and asd adhd had iron of 4 in october. Luckily mine isnt veggie but is the asd picky eater. Iron came up to over 20 by xmas.
Annoyingly mine was ok if picky but the weighing for adhd meds and shes restricting (not due to meds as not on them).
We even have the same re needles injections and giving the blood for the blood test she had to be held down.

Out of interest is yours sound sensitive or get hallucinations/daydreams??

Imo we shouldbe blood testing for at least iron for ND kids as so many are anaemoc

You can get high dose b12 1000 and 5000 mg

Does she eat okay generally? Is she restricting food in other ways?

This is how my DDs eating disorder started….

EDs and autism are very closely linked.

I appreciate you've moved on from the original request, but when you manage to get her iron stabilised, you could try Feroglobin liquid - 14mg per 10ml spoonful (plus other vits & minerals). I think it tastes delicious, and it says Vegetarian Society approved' on the carton. Or if you need to get something in her if your recently found solution doesn't work.

There will be a pharmacy team within the surgery not the pharmacy where you are collecting the medication. Their job is to process prescriptions and deal with queries. They will be able to find this out and liaise with the GP on your behalf. I would advise you to make an electronic request via patient access or the link on their website. These go directly onto the patient record and cannot be ignored as there is a paper trail. Although it feels better to speak to someone on the phone it’s much easier for them to kick the can down the road and continue to evade the query. I hope you can get this resolved 🙏

You might have to let her suffer until she’s prepared to change her tune. She sounds an absolute pain.

that is really helpful thank you. I'll put in the request tomorrow.