lithium and kidney function

I am alarmed.

I will say I am aware of the possibility of thyroid issues connected to taking lithium; but, I had never heard of a decline in renal function.

As a result of blood work (which I have done regularly and I encourage you all to do the same), I am being sent to my family doctor for testing and more lab work pertaining to my thyroid.

However, it is the deteriorating kidney function whis is most alarming. It isn't at a low level but over the course of my blood work, it is trending a steady decline. Thus, I am off to see a nephrologist (kidney specialist) to see just how bad the situation is.

Ultimately I suppose this means discussing a different treatment for my bipolar with my psychiatrist.

Has anyone heard of this?

Well I had Lithium toxicity once and it shut down my kidneys and ended up in the ICU and on dialysis (I'm in my early 20's) for a week among other problems, I fully recovered though. My doctor kept increasing my dose and didn't know what the hell she was doing, I weighed 110 and am 5ft 3'' and she had me on 1800mg which is the max dose

thanks for sharing. I've never heard of this.

If you haven't already. I suggest you cross post in the BP forum, I remember quite a few first and second hand tales of renal failure.

On the other hand, you can also use the search function to find lithium related threads...

That way you'd also be able to get more insight on what to expect and so forth.


Ps. Your dr should've have warned you, its common knowledge due to the fact that lithium doesn't metabolize in the same manner, and that's actually the reason behind all the blood work. Thyroid is secondary.


It's a metal on the periodic table after all, no matter how carefully you science it into an ingestable "salt".

My husband went into kidney failure on from lithium toxicity. He was put on dialysis and in the ICU for a week. It was a very close call. They took him off of lithium and we will NEVER put him on it again.

Hi justafriend306,

Can I ask what, specifically, tests you had and your results? Like maybe a BUN and creatinine, any others? And was your blood pressure normal?

bluemonday

My mother is literally in the hospital with this exact issue as we speak. Has been since Sunday evening. I've been checking in daily an she's been on dialysis a couple of times already but they say she'll be out in a few days. One nurse also said there could be permanent cognitive effects.... When the paramedics came for her she had barely been able to move for several days (she had been complaining of stomach problems, and I thought she was just sick and maybe having a brief depressive episode) and was barely able to speak coherently; an ER doctor later told me she was mildly disoriented, not sure what month or day it was. I knew from previously trying to help her get to the bathroom that she could barely walk or move without holding onto things (again, a condition she had had for about a week, but was attributed to a stomach flu).

OP: Some other symptoms of lithium toxicity can include cognitive disorganization, extreme lethargy and weakness, and gastrointestinal symptoms (nausea, diarrhea etc). Lithium can fail to be metabolized and build up in the kidneys, so it has to be removed and can cause all kinds of shutdown in the meantime.

Definitely look into new medication.

I wish I knew specifically. I went for my standard blood tests a week ago. I was sent for additional blood tests regarding my thyroid today and I'm to pick up a requisition for tests (I assume kidneys) tomorrow.

justafriend306, I'm hoping the very best for you.

The reason I asked is because I've been following my BUN and creatinine tests for several years.

With BUN and creatinine the higher they go the worse it is. A creatinine above 1.2 and BUN over 26 or 27 are out of normal range. Of course, maybe you had different testing done.

At one point my BUN was a 70-something and creatinine was 2.3 (both significantly abnormal) and I asked my GP if I should see a nephrologist and he said that a nephrologist wouldn't do anything about it at those levels anyway. But due to high levels spread out over over 12-15 various blood draws, I do have a diagnosis of stage 2 kidney disease.

One thing everyone should know...if you ever have to have dye injected for an MRI or CAT scan, they should draw at least a creatinine, if not a BUN too, right before the procedure and wait for the results to make sure your kidneys can handle the dye. If it's high, they shouldn't do the scan.

Feel free to call your doc's office and ask a nurse (or the doc if you can):
> what tests were done
> what your results were
> normal values for that test

If it were me, I'd ask a follow-up question about why I need to see a nephrologist.

Sorry this response is so long, but I'm a strong believer in patient knowledge, whether it's why they're taking a drug or what tests they're having and why. Think of it this way...if you were going to pay for a new transmission, wouldn't you want to know why?

I worked in a hospital lab for over 12 years, so I understand the significance of lab tests, and have had a number of MRIs and CAT scans if you're wondering where I get my info. Also, if I'm going to give out info in a forum, I research it before I write it. I so hope that your issue is a false alarm.

in your corner, bluemonday



Sometimes you're the windshield, sometimes you're the bug. -Mary Chapin Carpenter

I don't want to hijack this thread, but I have a question.

Does anyone know anything about permanent cognitive issues from lithium toxicity? I had a half day at work and I went and visited my mom. She's still having trouble moving, walking, and definitely speaking. Her memory is poor and her thoughts seem disorganized based on hearing her talk. She said something about the speech problems being permanent...can that happen? Or is it too soon to tell?

No worries ScientiaOmnisEst, your input/questions are pertinent.

I picked up the latest requisition for blood tests; they seem rather extensive (including the creatine, etc). I also have to provide a 24 hour urine sample. On the 24th I have an ultrasound scheduled and on the 29th (oh yeah, my 50th birthday) I have the examination by the phrenologist. Doesn't sound like things are too worrying if the visit to the kidney specialist is that far away.

I realize this may be too much information; but, if it spurs even one person who could be sick to get their blood tests done then this thread won't be useless.

Another personal post:

I got a call from my mom today and we had the first coherent conversation in weeks. Apparently, her psychiatrist did up her dose from about 100mg to around 400mg not long before the symtoms set in: kidney failure, cognitive issues, and, according to her, a micro-stroke. The doctors are going to move her to a rehab facility to help her get back to normal physically, so she'll be there for a few days. We were saying it might actually be kindn of a good thing that I got fired yesterday, since now I have time to manage this stuff as need be.

My mom has no memory of anything that happened when she was in the hospital, including of my visiting her on Veteran's Day. I'll be bringing her a change of clothes and some other items today, but it's great to hear her actually able to converse normally. Still though - all that from lithium??

If she had a minor stroke in addition to the lithium issues, the speech difficulties could have been related to that. The other issue is that dialysis pulls all meds off the system very abruptly. In my husband's case, it threw him into pretty immediate severe psychosis that lasted almost a week. To this day, he has no rational memory of what happened. He vividly remembers his delusions and hallucinations though. He did recover fully with no permanent kidney damage, but it was a completely traumatic event for all of us. No more lithium for our household!

Thankyou everyone for sharing your stories. It has meant a great deal, even those not so rosey have been helpful.

Allegedly, the lithium might have caused the stroke (it was so tiny though, the doctors almost missed it). She's made a full physical recovery though, and plans on firing her psych as soon as she gets out of PT. I mean, 4x the dose?! Really? In addition, my mom mentioned to me that a drug she takes for her heart also contains small amounts of lithium, meaning she was getting even more - then throw in weight loss and recent illness...

Today we actually conversed like normal people: she talks just like before anything happened, which is fantastic.

My daughter takes this stuff called lithium orotate that she get online at Walmart or amazon.

Well another update...

This waiting game until I see the kidney specialist is agonizing. I am worrying and stressing over the fact I could be potentially dangerously sick is really taking it's toll. I have been thinking catastrophically and even my CBT tools have been of absolutely no help.

I have been experiencing horrid symptoms. They could be the flu. They could be psychological. But they could be symptoms of lithium toxicity too.

My Anxiety was so bad yesterday that I even packed a bag to go to the hospital.

But I called my family doctor first. He was unavailable but his partner was of help. The office was on the receiving list of my blood tests. He didn't say there was no problem. But he did say there was nothing that couldn't wait until the appointment with the specialist. Not entirely something that put me at ease but it was at least enough for me to unpack the bag.

Well, finally an update.

My kidney tests show that function is acceptable. However, concern has moved on to my thyroid and parathyroid glands. I've had more blood tests, an ultrasound on my throat, and am waiting for an appointment for a ct scan on my neck. Hmmmm. Not sure what to think about all this.

I don't meet with my Psychiatrist until the New Year. It is pretty obvious to me that he will change my medications. Of course, my catastrophic thinking has me worried it might mean hospital time (I always think the worst and my CBT in this case isn't doing a damn thing to calm me down).

More to follow.

i am a 70 yr. old woman who had been only on 450mg. lithium for about 30 years...always had blood work done regularly in spite of low dosage and this is merely giving you a heads up on lithium: probably in my late 30's or early 40's i had thyroid issues and have been on synthroid ever since and then i had my parathyroids removed because lithium induced extra calcium; have been on calcium ever since their removal, and finally about 2 yrs. ago i had creatine (kidney issues from long-term use of lithium) and i got off it completely and kidney functions return to normal..i am merely suggesting being your own advocate and learning as much as you can because not all psych dr. are aware of the side effects of long-term lithium use...all the blood work was for lithium levels and none of the many psychiatrists over the yrs. mentioned kidney function issues or checked the creatine when i was having blood work.

Lithium messed up my kidney function in less then 7 years. My doctor was really surprised because he said it usually takes 20 years of being on it to mess up your kidneys. I was really worried about getting off lithium but, it was one of the best things I ever did.

It is just never ending.... while doing an ultrasound on my neck looking for parathyroid issues, they found a goiter (enlarged thyroid). Yet another issue possibly related to the lithium. As for the parathyroid, the ultrasound inturn resulted in my being sent for a CT scan of my throat to determine if I need surgery to remove one or more of the glands.

As for the lithium. My psychiatrist has started to wean me off of it. I'm at about 2/3rds of what I was once taking. I admit it hasn't been the most pleasant of experiences. I have been given additional seroquel as a prn.

I took high-dose lithium for years, then had to stop after it had damaged my kidneys. My kidney function has recovered and I am resuming lithium. I just had my blood drawn this morning. Lithium is the truth. Lithium is delicious.

UPDATE: After 13 weeks of tests and scans there seems to be no answers. The good news however is:

1) the goiter is small and benign
2) the parathyroids are normal (no surgery)
3) the kidneys check out as okay

There are still a few questions though like what IS causing the symptoms (high calcium ets)

Nice justafriend306