Autistic teenage vegetarian daughter refusing prescription meds.

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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.

Would your DD take spirulina powder or tablets? It contains high amounts of iron and can be almost as effective as iron tablets in treating anaemia.

https://www.darwin-nutrition.fr/en/tips/spirulina-iron/

Iron infusions are about £80 and vegetarian. Instant fix.

Where? When I've looked they are £500++++

My dd has anorexia and ARFID. Not diagnosed as she refused (was too anxious, possible undiagnosed ND) to deal with CAMHS and got herself signed off as soon as she reached 16. So I can well understand why you won’t go down that route.

You've had some brilliant advice about supplements from people, who really know their stuff. Once your dd’s levels are back to normal levels, I would think a decent multivitamin would be a good idea. I take Metagenetics, which is also a really decent brand and are labelled vegetarian. They sell on Amazon and do tablets for women and tablets for pregnancy. I think the main difference is the pregnancy have higher iron content and of course, folic acid. I have been giving these to my dd for a long time now.

if you have the funds to contact a dietician, I would go with someone specialised in eating disorders / disordered eating. This is a link to recommended dietitians. The list was collated by Jenny Langley, who has been working in ED for 20 plus years and co-wrote parental / carer workshops and books for loved ones with eating disorders. https://newmaudsleycarers-kent.co.uk/expert-eating-disorder-dietitians/ They should be well versed in dealing with parents and carers as it’s very common for people, who are ND not to be able to see there is an issue. As a result, their loved ones need to step in nudge them forward.

This brings me back to Jenny Langley, who has written a brilliant 5 part workshop for parents and carers on how to engage ED sufferers. She also does regular monthly carer groups. The workshops are run by various people at the Charlie Waller trust. https://charliewaller.org/mental-health-training-support/parents-and-carers/eating-disorder-workshops. I’ve attended two (the same thing), one run by Jenny and another by Catherine O’Dea Hughes. Both were excellent. These are currently funded by the charity and they ask for donations if you possibly can.

Jenny also runs a series of running individual workshops and recently wrote and delivered one on OCD. Jenny’s email address is on the new Maudsley website if you want to attend any workshops or the monthly carer’s meeting.

As for the OCD, someone from one of the workshops mentioned she did an excellent workshop with a company called OCD excellence.

As for our dd, we have been using and ED coach with dd for well over a year now. She isn’t local and was a recommendation on the long standing eating disorders thread. Dd has engaged minimally with her and I’m doing most of the work, acting both as her mum and performing a therapeutic role to guide dd to recovery. The coach worked for over 20 years as a mental health nurse in ED and therefore works with all elements of mental health, including OCD. She charges about the same amount as a dietician per hour. If you want her details, please let me know.

@Mummyoflittledragon that’s amazing info to share: thank you. I have 3 ASD DCs with ARFID / Autistic eating challenges and had been unable to find anyone to help us either with NHS or private (NHS dietician was supportive but didn’t know enough about ARFID and ASD to really help). Thank you.

Floradix Liquid Iron and Feroglobin Liquid explicitly labeled as suitable for vegetarians

Haven’t read all comments but what about the B12 injection, the GP should be able to arrange this.

have you looked at the Beat charity
it is an Eating Disorder charity

If you post what she has been prescribed ie the strength maybe someone can suggest an alternative for you. It’s very common for veggies to be deficient in these so she will not be the only veggie with this problem
my sister gets iron and vit b12 injections

I’m vegetarian. When I was anaemic, I got my medication OTC as it was cheaper than a prescription (obvs not the case for a child who doesn’t pay for prescriptions), and the pharmacist was happy to help. There is info about dietary suitability on the Patient Information Leaflet, and I’m sure there are pharmaceutical reference books/websites with this stuff. It wasn’t difficult - most “powdery” tablets are mineral based. They become non- veggie when things like gelatin or shellac coatings get involved.

i have bought veggie supplements OTC from Holland & Barrett too in the past.

Re strength: if she needs say 1000mg a day, but you can only get veggie supplements in lower strength, then surely she could take more lower strength tablets? It’s about the amount of Iron not the concentration.

Also, Floradix make a range of veggie iron supplements.

If she has a genuine phobia of putting something in her veins I really wouldn’t speak to her about how similar blood tests are to that. My best guess based on everything that you have written is that she will then refuse blood tests which will make it almost impossible to get her well.

I think that your own instincts here are spot on, and that the answer is to find vegan tablets which supplement the things which she needs, and support her with checking ingredients.

I do agree that longer term she needs some ocd/eating disorder support, but I would wait until her levels are normal before you even begin the conversation.

My DS sounds very similar to your DD (and me).

Go with the lower strength, easily tolerated iron for now. There will be an improvement. There was a study a decade or so ago that found lower strength iron 3 times a week was more effective at raising iron levels than high strength every day.

I can't even tolerate the low strength stuff, after a few days it nakes me permanently nauseous and sleepy, much worse than the symptoms of anaemia. I had some iron infusions are brilliant, it is a shame DD won't have them.

My son is vegetarian and was found to have low iron. He was prescribed a supplement designed for vegetarians by the GP - I am sure this is possible for the other vits too. I would contact them.

Your daughter, it seems to me and I am not a Dr, that your DD is using 'vegetarian' to hide an eating disorder.

I once watched a programme about a treatment centre for girls with eating disorders, one of their rules is that whilst in the treatment centre no one is vegetarian.

I'm sorry I cannot be more helpful OP.

She has been taking Floridex supplements.

When I looked at the dose, she would need to take 21 tablets a day to make the prescription dose up!

She was already on the low dose supplements and still has dangerously low iron levels so unfortunately that is not an option.

I am not a doctor either but that treatment seems inhumane.

Forcing a vegetarian to eat meat is not an option that i find palatable.

She's been vegetarian for 7 years now. I respect her views on that. It is the disordered thinking around it that needs solving, not force feeding her meat.

Can you even imagine the psychological problems that would cause?!

That's a good point about putting her off even having the blood tests. Thanks.

that's no where near strong enough, she was already using those supplements and still has dangerously low levels.

Thanks so much for this. Can you please send me the details by PM.

JFC can people no longer even fart without asking ChatGPT for help????

Just to say again, that the Spatone iron water really did help me as it was well tolerated and easily absorbed, so it was a good way of getting iron without awful side effects 😀 I'd get advice on how many sachets are safe but I remember using two a day and feeling OK. There sachets might need to get advice about but if her levels are very low, it's probably not going to harm.💖

This sounds so different for you OP, and her. It’s obviously it’s not her diet that is the problem, it’s her disordered eating. I have no useful insights tbh but she needs to be very very aware that if she continues and ends up collapsing and in hospital they may well deem her unable to make that choice due to her issues.
tbh I’d be inclined to speak to another doctor.

I’ve just had another thought - when I had iron deficiency many years ago, I tried Ferro-Grad C tablets which are vegetarian/vegan and are slow release. I took one each night and didn’t get any of the horrible side effects I usually had from other iron tablets. The red dye is artificial. I’ve attached the leaflet which gives the ingredients in case it is any help. https://www.drugs.com/uk/pdf/leaflet/1081341.pdf

I don't think it's particularly strange for a vegetarian to want vegetarian medication, I think that's quite reasonable and you sound quite negative about it! I'm a vegetarian, I would ask for vegetarian medication.

Surely your role is to support her in gaining appropriate treatment around her beliefs? Rather than expect her to go against what she believes in?