How Lithium Treatment Aggravated My Diabetes Insipidus

Ever wake up in the morning, and you're so thirsty that it seems like life or death to get a drink? Usually this can happen if you sleep with your mouth open, have cold air blowing on you while you sleep, or especially when a sore throat or cold is present.

June 16, 2007 - I woke up with that feeling. I assumed I was about to come down with a cold or sinus infection, and thought nothing more of it. But, as the days went on, I got more parched, more thirsty, and more desperate for relief. With that came peeing three, four, a dozen more times than I used to.

I was taking Lithium for my manic-causing Bipolar Disorder. A couple years prior I had a taste of Lithium Toxicity and discontinued treatment. I thought Lithium Toxicity was the biggest concern since I had been back on Lithium for almost a year and my Psychiatrist ordered a round of normal blood work. Even when everything is shiny and perfect, Lithium serum levels still have to be checked every couple months. I had expressed my symptoms, but my doctor and I both attributed it to my medication regimen- normal side effects.

Blood work complete, my doctor called me on Independence Day asking if I had been having muscle cramps. No I hadn't, which I think he was surprised to hear. He informed me my potassium levels were low- so low that the option of going to the emergency room and getting a banana-bag of electrolytes was a serious option. The lab I get my blood work done had called him just to pass on this test result. I chose to get a prescription for potassium pills, and found out the next day that some other tests came back abnormally.

Another month went by, and my symptoms only intensified. I was drinking two to three gallons of fluid a day, and couldn't sleep more than two hours at a time because I was constantly waking up to pee. I saw my doctor in August, and that was when Diabetes Insipidus became the accused culprit. With the questionable diagnosis came an even scarier subject - I would have to stop Lithium treatment. I was referred to an Endocrinologist who wanted to test what kind of DI I had. A mix-up in blood work prevented her from giving a formal diagnosis on our next appointment, and she was very sure it was the Lithium causing it.

So in early September, I stopped Lithium treatment- again. It was frightening the first few days off Lithium because my Endocrinologist warned me that the Diabetes Insipidus could have progressed enough that it would continue even after stopping the drug. But thankfully, the symptoms disappeared and I went back to living a normal life. Drinking three-four gallons of fluid a day, peeing 20+ times a day, and not sleeping through the night became a thing of the past.

I've been doing my own research about Bipolar Disorder and everything that it consumes for years. Up until I was diagnosed, I had never heard of Diabetes Insipidus. Pharmacology, psychiatric, psychological and Bipolar books had never touched on DI. I finally found a book last month that covered the risk of DI with Lithium treatment. I suppose it falls under the "crazy rare side effects" category, but I strongly feel there needs to be more awareness of it in doctors and patients who flirt with Lithium treatment.