Maybe a source for small amounts of lithium?

or don't think of at all. OK, your friend was not technically bi-polar, but from what you write it does sound like she had some of the intial symptoms of depression, which is one side of the bi-polar spectrum. I chalk it up to something I came to realize many years ago, medicine is perhaps more of an art form than science. Not to say that the science is immaterial, but that the application of the science is often more intuitive than rationalists like to admit. Thus the common mistrust of young doctors, and the inherent value of the infamous second opinion.

Best of luck to you and your friend. If her treatment is that simple, she is lucky.

I wouldn't have leaped right to lithium deficiency, though. It sounds a lot like Vitamin D deficiency. Very common, easy to evaluate, very easy to treat. Vitamin D supplements don't have the range of negative side effects that lithium has.

I probably diagnose and treat 4-5 patients a week with Vitamin D deficiency.

A little Vitamin D will pick them right up.

and was put on lithium but he had problems on it and went off. Later it was determined that he didn't have manic depression but was mildly depressive. He managed that depression without drugs but I can't say if he was low in lithium.

Lithium has some neurogenic properties, one of which is with treatment of Bipolar. It appears to be linked to the absorption/use by the brain of certain vitamins including B12. Not enough Lithium is known to cause more emotional behavior (weepiness, etc.) outside of the effects of Bipolar people.

I would still not have picked Lithium as the cause - Vitamin B12 and/or Vitamin D deficiencies would have been better candidates.

The original formulation for 7Up contained Lithium, which is one of the reasons why they think it helped people feel better.

That said, Lithium has a downside as it can affect the Thyroid and Kidneys. I assume your friend's doctor had checked those levels before prescribing even the lowest dose.

One last thing - there are many sources of lithium in food/water. In fact, to get a normal dose of lithium basically means eating a fairly healthy diet - Pulses , Leafy greens, Grains, Cucumbers, Tomatoes, eggs, nuts. Caffeine and alcohol tend to help prevent absorption.
So it comes to a chicken/egg thing - is it the Lithium which is helping or eating a good diet?

The amount of Lithium found in each depends on the soil, but a varied diet should spread that out.

I have slightly lower Thyroid numbers and chased Lithium one slow/boring night as it was mentioned as something to watch. I'm sure there are people who are better qualified about Lithium in general.

L-

The connection is still murky and not well understood

I would have responded with a quote from Buckaroo Banzai, which is shockingly not on You Tube.

Glad your friend is doing better. A PhD in Mathematics is impressive; I had a professor in college who was a doctor in Mathematics. Interesting guy.

I'll share with her as she's finally happy (bad term) that she's not "depressed" as all the anti-depressants either did nothing for her or she was hallucinating on them. She took them to appease the docs but everyone saw she wasn't getting better - again, not that anyone would think she's depressed, she was tired, but given her schedule of working 70 hour weeks and keeping up a marriage (no kids). Still, she felt "off". . .

By the way, she's one of the MANY "good guys" working for a quasi-governmental agency trying to keep the wolves at bay so given the importance of her job, it's great she's got better focus. And yes, she's a DU(er) too!

And thanks to the person that suggested the Vitamin D - she's low in that too and has been taking 5,000 IUs daily. It took her D levels up, but that's all it did.

Happy New Year to all. . .

Was this a naturopath physician? How was this "test" done? I can tell you that when done to measure blood levels, it's done with a blood draw, and very sensitive. And a "low" level on that test will be for someone who is supposed to be on lithium maintenance therapy, not a normal person.

If it's helping her and her blood levels stay within therapeutic levels or less, I can't object to what her doctor is doing. She may have cyclothymia, or Bipolar II (depression with often unrecognized hypomania that can feel like "normal functioning" ). I technically have Bipolar I, but that's because my first true manic episode progressed to manic psychosis before anyone got me help, and I didn't know what was going on when I couldn't sleep at all.

But you need to make sure she's aware of all of the precautions someone on prescription lithium must remember:

1) Lithium is kidney-processed and levels can get too high if a person is dehydrated. Ensure the person takes precautions to avoid dehydration if they get a stomach bug, are in excessive heat, etc.

2) Look at all medication interactions, there are MANY. One in particular is any type of NSAID -- OTC and prescription alike. Tylenol is liver-filtered so it can be taken, but then you have to remember the precautions to protect your liver when taking Tylenol.

3) Lithium is pregnancy Category D. Birth control more effective than than just condoms is highly recommended for any female on it, even at a low dose.

Her blood levels were .3 on a scale of .6 - 1.2. Shocked everyone because, as you say, it's rare. Her diet is fine and healthy.

The doctor is technically a psychiatrist by original training but wanted to get into family medicine so that's where he holds his current license (yes, went through the board and everything twice - just couldn't take psychiatry). And yes, he's monitoring liver, kidney, and thyroid medications 2x a year. How do I know so much? He's also my doc and I accompany my friend to the visits when I can (she has no family and likes to have someone there to make sure she hears things right).

If she does have cyclothymia, she's kept it well hidden for the 50 years I've known her (childhood friend). But like she, she does have Ehlers-Danlos Syndrome which causes all sorts of crazy stuff with body chemistry.

REALLY appreciate your pointing this out. Yes, lithium is a harsh drug and people need to know it's impact.

Thanks you so much.