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doxielover10 posted:
Hi,

I am a rapid cycling bipolar I, extremely bad bipolar in all regards. I tried every drug on the market and I was still not stable. I have a Psychiatrist who is renowned, as well as an expert cognitive therapist.

After taking every drug on the market, I had two choices, ECT or Lithium. I was scared to death of both of them, however, I chose Lithium. I went EVERY
3 weeks for blood draws on Creatinin levels. It was always OK, 1.0 - 1.1.

One day I was at the hairdressers and since I've been with him and all the rest for 18 years they know me well. I left and he called my husband and told him something was wrong with me. He closed the salon, so everyone could look for me. I WAS DRIVING A CAR !!! I do not remember anything.

I arrived DOA in complete renal failure, creatinin level 9.0. Two weeks before my level was 1.0, to this day, no one has any idea what happened ?
I only have 30% kidney function and I keep getting sick.

Any advise on helping myself do more to get my life back ? After being housebound for a year, it's time.

Thanks,
Allison
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john-skpt responded:
I can't begin to address the many factors in bipolar disorder, but it is well-established that lithium and other metal salts (like iodine) are eventually nephrotoxic. It's just the way things are and it often comes down to a benefit/risk judgment on the part of ALL of your doctors, together, not separately.

You probably should have been referred to a nephrologist, if you haven't yet, at least for a baseline assessment.

Some cases of acute renal failure, as apparently your was, can be partly reversed; generally chronic renal failure occurring over decades due to organic disease, cannot.

With an eGFR of roughly 30, it won't get back to 60 or higher, and the goal now becomes slowing the rate of decline. This may demand withdrawal or at least dosage adjustment of the lithium, and dietary management. But this has to be determined by qualified pros, not amateurs like us. Talk to all of your docs about it and get a consensus opinion.


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