Lithium + Exercise + Weight Gain - Thyroid
July 15, 2022 12:59 AM Subscribe
I was started on Lithium yesterday. I have some questions about weight gain and exercise.
YANMD. I'm a 49 year old male. 127kg. I had thyroid cancer some years ago, and do not have a thyroid. I have a vegan diet, and rarely consume sugary drinks.
(feeling a bit manic right now, so I'll try an keep this under 1238961298631 characters)
I posted this just over a year ago. I'm a devops-type engineer at a tech company. I've been dealing with a lot of stress, and have seen that the swings in my bipolar are increasing in frequency (I have been on lamotrigine for the last several years). In the last 6 months, I started having severe panic attacks at work, especially when working on production systems, for fear that I would break production. It started after I got confused, and made a small mistake that completely broke production. It was very bad for the company. I didn't get fired, or reprimanded, really. It was a mistake, and we learned from it. Yay.
Anyway, panic attacks. Since them, my cycles have increased in both frequency and amplitude. I struggle to hide it at work, but I'm failing. After having to wait 2 months for an appointment, I finally saw a psych doctor 2 days ago. As a result, I'm starting a 4 week mental health leave from work, and am now taking Lithium.
I've heard wonderful things about lithium. Also terrible things. The number one concern for me is weight gain. It's already something I struggle with (I went from 117kg to 127kg in 6 months because of thyroid med issues, and stress). I've found some information that the primary cause of weight gain is due to the impact of lithium on the thyroid. Well, I don't have one! And my levels are now well controlled.
Another site said that increased thirst often leads to people consuming more sugary drinks. I drink 2-4L of water, both still and carbonated, per day. Sometimes I'll have a Coke at work if I'm craving something sweet. And sometimes I'll indulge and put sugar in my coffee (I prefer sucralose, in general).
I'm also getting back into cycling regularly. I'm currently working to increase my distance (10km each week; I'm doing a 60k ride this weekend). But I've read that excess sweating can be very bad. This makes me sad because I love cycling most when it's very hot outside.
Also also, I'm terrified of the cognitive effects. I have a fairly "thinky" job. And stress aside, I love what I do. The last 6 months, my brain already feels like it's slowed to a crawl. I'm also a (not particularly skilled, but really love doing it) musician, and I'm worried my creativity will get snuffed out.
So the questions - what can I expect? I know everyone is different, and I have some snowflake factors about me. Should I keep cycling regularly? Or am I doomed to be a lump? Will I become dull? The thought of reducing the swings sounds amazing, and would generally help me enjoy life more. But is it worth losing these other things?
p.s. I recognize this is a very sensitive subject for people to talk about publicly. Feel free to DM or email me.
Thanks for any feed back.
YANMD. I'm a 49 year old male. 127kg. I had thyroid cancer some years ago, and do not have a thyroid. I have a vegan diet, and rarely consume sugary drinks.
(feeling a bit manic right now, so I'll try an keep this under 1238961298631 characters)
I posted this just over a year ago. I'm a devops-type engineer at a tech company. I've been dealing with a lot of stress, and have seen that the swings in my bipolar are increasing in frequency (I have been on lamotrigine for the last several years). In the last 6 months, I started having severe panic attacks at work, especially when working on production systems, for fear that I would break production. It started after I got confused, and made a small mistake that completely broke production. It was very bad for the company. I didn't get fired, or reprimanded, really. It was a mistake, and we learned from it. Yay.
Anyway, panic attacks. Since them, my cycles have increased in both frequency and amplitude. I struggle to hide it at work, but I'm failing. After having to wait 2 months for an appointment, I finally saw a psych doctor 2 days ago. As a result, I'm starting a 4 week mental health leave from work, and am now taking Lithium.
I've heard wonderful things about lithium. Also terrible things. The number one concern for me is weight gain. It's already something I struggle with (I went from 117kg to 127kg in 6 months because of thyroid med issues, and stress). I've found some information that the primary cause of weight gain is due to the impact of lithium on the thyroid. Well, I don't have one! And my levels are now well controlled.
Another site said that increased thirst often leads to people consuming more sugary drinks. I drink 2-4L of water, both still and carbonated, per day. Sometimes I'll have a Coke at work if I'm craving something sweet. And sometimes I'll indulge and put sugar in my coffee (I prefer sucralose, in general).
I'm also getting back into cycling regularly. I'm currently working to increase my distance (10km each week; I'm doing a 60k ride this weekend). But I've read that excess sweating can be very bad. This makes me sad because I love cycling most when it's very hot outside.
Also also, I'm terrified of the cognitive effects. I have a fairly "thinky" job. And stress aside, I love what I do. The last 6 months, my brain already feels like it's slowed to a crawl. I'm also a (not particularly skilled, but really love doing it) musician, and I'm worried my creativity will get snuffed out.
So the questions - what can I expect? I know everyone is different, and I have some snowflake factors about me. Should I keep cycling regularly? Or am I doomed to be a lump? Will I become dull? The thought of reducing the swings sounds amazing, and would generally help me enjoy life more. But is it worth losing these other things?
p.s. I recognize this is a very sensitive subject for people to talk about publicly. Feel free to DM or email me.
Thanks for any feed back.
Please disregard if this is not helpful but I am taking a medication well known for cognitive effects, topamax, which has the nickname dopamax. I had a definite slowing down for a bit and forgot where some stuff was near my house when I was driving the first couple weeks and whenever I upped my dose but apart from having words on the top of my tongue sometimes the cognitive effect has always dissipated after a couple weeks so don’t panic if you feel weird at first.
posted by catspajammies at 5:43 AM on July 15, 2022
posted by catspajammies at 5:43 AM on July 15, 2022
Best answer: I have a close family member on lithium. From experience with them, weight gain isn't an issue if you're eating healthily and exercising regularly. Lithium can slow the metabolism down a bit and affect the thyroid, but you don't have a thyroid and you're eating healthily and exercising plenty, so you should be all good.
Their cognitive function is the same as ever, if not better because lithium makes them stable. They get hypo-mania less often, which was kinda like their super power as it made everything so easy, but the cost of that few hours was the ensuing and awful mania. They would not trade the stability for the occasional bust of hypo-maina.
The problem with sweating is that you can sweat out too much water which makes your salt levels too high and cause lithium toxicity. The flip side is that drinking too much water can cause you to pee a lot....which makes your salt levels too high. It's a balancing act which can take a little time to get right, but you absolutely can get it right. And the stability that lithium brings means you'll mentally have the time to get it right.
If you can, try to get the enteric-coated tablets to prevent the sickness. Lithium tablets are a big lump of salt, and the cheaper the brand the less palatable it will be. If you get really sick on one brand, try another. A big reason why people aren't medicine compliant on lithium is because of how sick it makes them, but it doesn't have to be that way.
Good luck!
posted by underclocked at 7:27 AM on July 15, 2022 [1 favorite]
Their cognitive function is the same as ever, if not better because lithium makes them stable. They get hypo-mania less often, which was kinda like their super power as it made everything so easy, but the cost of that few hours was the ensuing and awful mania. They would not trade the stability for the occasional bust of hypo-maina.
The problem with sweating is that you can sweat out too much water which makes your salt levels too high and cause lithium toxicity. The flip side is that drinking too much water can cause you to pee a lot....which makes your salt levels too high. It's a balancing act which can take a little time to get right, but you absolutely can get it right. And the stability that lithium brings means you'll mentally have the time to get it right.
If you can, try to get the enteric-coated tablets to prevent the sickness. Lithium tablets are a big lump of salt, and the cheaper the brand the less palatable it will be. If you get really sick on one brand, try another. A big reason why people aren't medicine compliant on lithium is because of how sick it makes them, but it doesn't have to be that way.
Good luck!
posted by underclocked at 7:27 AM on July 15, 2022 [1 favorite]
Best answer: I joined specifically to answer this question! Has your doc mentioned how long you might be on lithium? I was spinning up into hypomania a few years ago (while on 200 mg/day of lamotrigine), caught it within two weeks and went on a baby dose (300 mg, which is supposed to be sub-therapeutic) for about a week. It was supposed to be a short course and I stopped when I started to feel sluggish. Not a direct answer to your question, but even a week on it can make a difference in terms of symptom reduction. Don’t know how many docs would prescribe like that (mine said it was off-label), but it might be worth asking about it to avoid side effects. It was wonderful the first six days and pretty instantly gave me a feeling of quiet that I hadn’t had in weeks.
posted by SaneCatLady at 8:12 AM on July 15, 2022
posted by SaneCatLady at 8:12 AM on July 15, 2022
This thread is closed to new comments.
I hope people with direct experience will chime in, but I just wanted to say that as far as I can tell, you are not doomed.
posted by inexorably_forward at 3:15 AM on July 15, 2022 [2 favorites]