Posted by Squiggles on August 14, 2002, at 14:23:16
In reply to Re: Symptoms, posted by katekite on August 14, 2002, at 13:35:28
Hi Kate,
Well, if you are not a doctor you could have fooled me. :-)
> Hi Squiggles,
>
> This is long so is separated into part I and II.
>
> Part I, increased urination.
>
> You are right: if you have had a recent urinalysis that showed no protein or glucose and showed your urine was normally concentrated you most likely do not have either kidney problems or diabetes of any sort.**** I think my dr. was looking for that, so it can be excluded;
>
> However, you still pee too much.**** I believe my dr. said i just drank too much water;
>
> This can be caused by problems at the level of the kidney, whole body metabolic problems, or a hormonal problem.**** Once change i have noticed is the terrible thirst at night -
i now must have at least a glass of water at night by my bedside;
I think this is recent (2 yrs); it could be related
to Rivotril withdrawal which really screwed my thermometer;
>
> The workup of your excessive urine would be a urinalysis, and a blood chemistry panel. The important values on the urinalysis are protein (not normally present but present in the dreaded nephropathy, and sometimes in infections), glucose (present in bad diabetes mellitus) and how concentrated it is (if well concentrated all forms of diabetes insipidus are unlikely). The important values on the blood chemistry are glucose (which would be elevated in diabetes mellitus), electrolytes like calcium and sodium (which would be off in a metabolic problem) and creatinine (increased value means poor kidney function.)**** I recently had an electrolyte test and it was normal;
i don't know what my dr. saw but it could proteinurea; in the
past 2 years i pee more frequently and with greater force -
that seems coincidental with menopause too.
>
> If a blood chemistry panel and urinalysis are normal then you are looking at one of two things: either a hormonal problem or a side effect of lithium (or that you were just drinking too much).***** Of course lithium always makes you pee a lot; but recently it has
been noticeably more;
>
> Most hormonal disorders (Cushing's, probably hyperthyroid though I hadn't heard of that before, DI, DM) can cause increased urination.**** No way I am hyperthyroid with a 12.96 TSH i think; and my
dr. knows i am hypothyroidic - i have edema and since
my Synthroid was reduced from 0.155 to 0.112 it is very
hard to lose weight, and recently my neck seems to be
getting wider;
>
> Lithium can cause increased urination by itself as a weird known side effect. In order to show it was the lithium causing the extra urination you would reduce it and see if the urine volume went down: I don't know how long it takes to get out of your system or even if that's a wise thing to just do on your own. I remember you tried reducing lithium in the past to see if the neuropathy was due to it: do you recall if you peed less?
>
**** I don't recall, but I can test again - not for too long, because
the Synthroid picks up and I get terribly speedy - not surprising;
do you think a couple of days of skipping every other day for 4 days or
so would be indicative - if the urine output went down?
> So -- in summary for the increased urination -- a regular doctor could rule out many problems by doing a urinalysis and a blood chemistry panel. If they do not find the cause you should be referred to an endocrinologist. If you can, try to discover if it is the lithium or not. Do not ignore this problem as it could be an indication of something serious, though I hope it is nothing.
>
> Part II. Bubbles, TSH, candida.
>
> You mentioned your urine has bubbles in it. If it is foamy that can be an indication that there is protein in the urine, which should not be there. Bubbles occur too in some urinary tract infections but you would probably have other symptoms of a urinary tract infection like urgency or burning.**** I told my dr. about the bubbles - there is also a
seemingly glycerine look to the urine unlike before;
He said don't worry about the bubbles (and it is not foam - just
occasionally bubbles - again since menopause but maybe
that is coincidence);
>
> I saw a note somewhere on the net from someone taking lithium and tegretol who was asking about bubbles in urine, so maybe it is a drug side effect. If the bubbles are new and haven't been there the whole time you've been taking lithium I would ask a doctor.**** Yes as i said i did.
A urinalysis would be able to show if there was protein or a urinary infection.**** It is possible that it is an infection and that the
therefore did not consider it worthy pursuing.
>
> Your TSH went up over the last year. Which means, I think (but do not know for sure) that your thyroid gland is becoming less sensitive or less active, that your thyroid problem worsened.***** That is what my dr. said and we tried 0.125 Syntrhoid
instead of 0.112 and i had a heart block feeling; he told
me not to go on - since my Synthroid crisis i suppose
i became very sensitive to thyroxine. BTW I called
just now the nurse, and asked for my results, so i hope
to see if the TSH is getting even lower.
>
> Not getting a call about results does not mean anything. Always call. I have had several personal experiences where no one called even though my results were abnormal.**** Ugh -we get call for my summer vacation shots,
or my cosmetic order but not for that - Not Good.
>
> I read a little thing on the web about research showing benzodiazepines (they were talking only about valium though) interact with the proteins that carry thyroid hormone around in the blood. To me this says that restarting klonopin could possibly affect your thyroid level and you might need to tweak your thyroid dose.It might affect the amount of free thyroid hormone. Sometimes it is not enough to test TSH: the actual T3 and T4 levels might be useful to test as well. How you feel is of course a good indication of your thyroid level as well and you are probably pretty good at knowing if it is too high.
**** I am convinced that my thyroid was affected when
i reinstated the Rivotril, but i have no proof -
i just felt slower, slept more, and got more edema,
esp. ankles and face;>
> Not everyone can stay on lithium very long term. It sounds like it has worked for you and of course it is not great to change what has worked. On the other hand it may continue to make your thyroid problem worse and can have other long term effects so it might be good to have a back up drug in mind.***** Yes, that is why I asked my dr. to lower the Lithium now that
he has lowered the Synthroid, and perhaps i don't need 900mg of it,
as in Europe they use less and it works. But he said
that my lithium levels have always been low i.e. 0.8 - 1.2;>
> I don't know much of anything about systemic candidiasis. I have had the more common oral candidiasis infection recently with having high cortisol (I have reduced immune function) and took the drug Nystatin, which cleared it up in a few days. With oral candidiasis, when you wipe off the white part there should be a red raw area underneath.***** Yes that is what is like for me and I think it
has become "systemic" but i don't think my dr.
saw it really - i showed it thinking something was
wrong with my tongue, but he said there was nothing
wrong with my tongue; sigh.
***** I would guess if it isn't raw at all underneath it is not candidiasis.
>
> My feeling is you should ask to be referred to an endocrinologist and go to them and tell them you are urinating too much and just let them work it up. The regular blood chemistry and urinalysis will probably be normal if you are not feeling on death's door. You seem worried about your health so I wouldn't just ignore the increased urination.
>
> Hope this has been helpful. Please do not consider anything I say as substitute for asking a doctor. Even though I sound knowledgeable sometimes I might be just plain wrong.***** You have been very helpful, and you are extremely
knowledgeable. I have gone to other drs. during
emergencies and i have always felt very guilty. I
really like my dr. - i am just very paranoid because
of some misadventures in medicine.********** Hey, i just got the nurse's call:
She said the reason the dr. did not call is because
there was nothing wrong; OK the TSH bounced back
to 6.8 - where's my Lamborghini?Well, i hope this has been as much fun for you
as it has for me; i thank you for all the tips.Squiggles
poster:Squiggles
thread:116094
URL: http://www.dr-bob.org/babble/20020814/msgs/116423.html