Lithium levels

So I was recently put on 450mg 4 times daily. I just had my first blood test since the doctor told me to.

I wanted to know how often I'll be needing blood tests while on that amount of lithium. Also I was wondering if they will call me with the results or just tell the doctor. They're in the same building.

They'll probably determine how often you are tested based on where your levels are at the prior test. With doses like that I'd guess you'll be on the high side but it's all very individual so if you really metabolize it fast then you could be mid-range or low.

You should always request a level be done if you have any symptoms of toxicity that can't be explained otherwise (or that can be but seem to go on too long or that concern you--trust me because I didn't and I was going in and out of toxicity for 6 months before we caught it and I was very sick that whole 6 months). Things to watch for are increase nausea/vomiting, unsteady gait, balance problems, slurred speech, trouble talking (I had trouble finding words every time I was toxic), increased thirst, headaches, diarrhea. I also had hallucinations once when my levels were really high and fortunately my pdoc realized that it was most likely from the lithium and sent me to the medical ER instead of psych.

The lab will release the levels to your dr. Different drs do things differently; some call with results regardless of whether they are normal and some will only call if they are abnormal. You can always call and ask for the results and I'd recommend this. If you keep track of your levels with each blood test then you'll be able to say "I'm feeling this and my last level was this, could we do a level to be sure?" and sound like you know what you are asking for.

Levels can vary; we just were talking about this. I was on a low dose, just 650 mg/day of lithium for years after my 2nd toxicity. My levels were usually .4-.6. I didn't get tested with the 3rd toxicity but I'm sure they were quite high based on how scary sick I got. Just a couple months before my levels had been .8 which we didn't worry about since I wasn't having symptoms and it was completely within the range of normal. But obviously things were creeping up and we should have done labs again sooner than planned. (I think I was due for them and waiting to get to the hospital at the 12 hour mark when the toxicity happened).

It does get easier as you get used to it and hopefully you'll never deal with a toxicity.

When I was taking that dose of Lithium, my levels stayed at around 1.1 and I was tested about every 3 months in the beginning, less often after six months or so.

Thanks for the answers. I just read that people needed blood tests like every 2 weeks. It's worrying me because I'm terrified of needles. I barely made it through my first test.

When you first start Lithium and anytime you change your dose, you should have your levels tested frequently; every week or every other week. But after being on a stable dose for awhile, every 3 months is "normal."

My level usually ranges 1.0-1.1 and I take 1125 mg extend release per day.
I have had toxic levels before. Some of the symptoms I had were hand tremors, diarrhea, losing balance, and being thirsty. You can get toxic levels if you are dehydrated or sick, so you have to keep your fluids up.

If you are on Lithium long-term, you should also have your kidneys and thyroid tested a couple times a year. Lithium can affect both. I lost thyroid function and have to take thyroid medication now.

Your pdoc might have already told you this, but don't take Advil/NSAIDs while you are on lithium. It can make your levels shoot up and that would mean more testing for you.