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Q: Is There a System for
Lithium Monitoring?
Dear Doctor Phelps,
Maintaining balanced levels of Lithium seems to be an important issue in the
the avoidance of side effects. Though no substitute for lab testing and
monitoring by a competent Psychiatrist, it would perhaps be useful if someone
made a Lithium monitoring Gizmo, a bit like the diabetic folks have for checking
their blood glucose levels. Are you aware of such a device?
Thank
you.
Hello Simon –
Fingerstick lithium level systems do exist. One was FDA approved several years
ago, but I’ve not seen much evidence of it being distributed, or marketed. It
costs $400. The target users are doctors’ offices, not individuals. I just
looked to see if the company is online, and surprisingly found very little. The
patent holder is Akers, the device is called InstaRead Lithium, and the company
marketing it is ReliaLab, Inc., of Basking Ridge, New Jersey. (Why are they not
on the internet?)
As you point out, there is no
substitute for laboratory testing. When I get a lithium level, I also have the
opportunity to check a routine test of kidney function, creatinine, which I
track over time (because after years of lithium use, particularly at high serum
levels, there is a tendency for kidney function to decrease, and this routine
test can see that coming).
Likewise, checking thyroid
function is also important when people are taking lithium. Not every time, but
often, I will check a thyroid status when checking lithium. since neither
creatinine nor thyroid status can be tested using a finger stick method, I’ve
not been strongly inclined to use this in-office lithium testing system.
Finally, lithium levels should
generally be stable enough, and far enough away from any problem levels, that
routine monitoring and home is not necessary. That’s quite different from
measuring glucose for people with diabetes, where big fluctuations can occur
spontaneously and need quick management.
So overall, I’m not too
enthused about the finger stick method, as you can gather. But this tool has
only recently arrived. I will keep an open mind to see how it might be useful.
Dr. Phelps
Published June, 2009
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