Lithium levels question

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Know this is probably going to be a no, but does anyone know what makes lithium level fluctuate by about 0.1 on steady dose? have to do a meds change & hoping can put lithium up instead of another med. it’s a low level 0.53, but get dangerous physical side effects around 0.8 so its a risk. Also my bipolar has very strong reaction to changes in meds especially lithium , so if put it up, don’t tolerate it, I’ll relapse badly & I don’t want that. Just wondered if anyone knew what changes blood levels cos mine aren’t that stable vary by 0.1 on the same dose so trying to work out how much room I have to increase it. Any advice or info very welcome. Don’t trust my psychiatrist at all

I wish I could help, I used to be on Li. Replying in the hope that it will bump your post up.

Thank you TitusMoan it’s appreciated. Maybe it’s a question I need to ask a pharmacist, I don’t know.

Do you often need to take NSAIDs like ibuprofen? Apparently they can cause increases in blood lithium levels by 40-50% (from what I've seen online). But yes I think going into a pharmacy and asking would be helpful. Xxx

Also apparently the amount of salt in your diet. I expect there's lots of factors, but a pharmacist might help you work out what's most relevant to you/your lifestyle and what to focus on

Thanks moondip, I don’t take ibuprofen I knew it affects it but didn’t know it was that much - must be why they say don’t take it then!!

I will talk to a pharmacist I suppose maybe it’s not as likely to it being completely constant

Hydration is the big one and any variance in the time of the bloods.
When I was in the hospital it had to be 12h exactly but the GP surgery accepts 10-14h and I know my bloods around the 13h mark where low than my bloods at the 12h mark - the clinic was running nearly an hour behind so even though the appointment was booked at 12h

My target level was 0.9 and I felt awful after taking it on days I hadn't drunk enough and felt better if I drank 1-1.5 pts of water over the night.

Thanks Superscientist, I have my bloods pretty much at 12h, always have. Don’t know if a variation of 0.1 is normal? Do yours vary that much? Hydration as you say maybe. I can’t tolerate a blood level of 0.9 anymore, wish I could because this decision would be simple.

I'm not on it any more, I came off it nearly a year ago to try to conceive.
My levels varied between 0.75 and 0.9.
I was on it for 18 months and for the first year when it dropped to 0.75 my depression return, I was on 800mg and I kept pushing for 850 or 900mg so that even if my levels dropped a little I would still have the benefit but they were hesitant to increase it further. I was on 1000mg briefly in hospital but that sent me up to 1.2 and developed a tremor.
Once my mood was stable even when the lithium dropped a bit I felt able to look into coming off it to conceive. So far it's been ok. I am on quetiapine as well, I've been on this since 2012 for bipolar and it was only when I developed treatment resistant depression after having my daughter that I need lithium as well.

Thanks Superscientist, that’s really helpful to know how much your values changed by. What brand of lithium did you take, if you remember? Didn’t know you could increase it by so little.

Sorry I don't and it's no longer on my repeats so I can't check that. Priadel would be my best guess
I can't remember what dose I was on at the time but at one point when I was titrating up I had to snap the 100mg tablets in half when on leave. I think that's the smallest tablet they make but the ones I had had a break line to split into 2. It was when they were targeting 1.0 as my dose so were doing small increments to try to avoid me reaching a toxic level....then I heat wave happened and it shot up to 1.2 so they had to reduce it and went back to targeting 0.9. my mood had improved to the point I could get out of bed and engage with the staff so they didn't need as heavy handed approach

Thank you so much I’ll find out if I can get a lower dose tablet as I was thinking I’d have to increase it by 200mg which is a big jump when worried about side effects. Thank you so much, will phone the pharmacy tomorrow & ask, I just assumed I couldn’t put it up by less than 200mg. Thank you