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Forum Name: Psychiatric Topics

Question: Minimizing effect of swallowing sea/salt water on Li levels


 inquisitive123 - Mon Sep 07, 2009 11:31 am

Hi,

I am just wondering how my Lithium levels will be affected now that I have started to go swimming in the ocean. Invariably, swimming in the ocean leads to swallowing salt water, and I know that ingesting higher levels of salts can cause lithium levels to fall. My lithium levels are currently in the safe therapeutic range, but I do not want them to fall too low. Is there any way I can continue to go swimming in the ocean and also make sure that my lithium levels stay in the therapeutic range? I ask this question because there is a lot of talk out there about what will happen to you if you lose a lot of water due to exercise, fever, vomitting, etc--you risk lithium toxicity. However, there is very little information out there about what will happen if suddenly your sodium levels start to go up. I really enjoy swimming in the ocean and I want to be safe and make sure that my health comes first.

Thanks,

Inquisitive123
 Faye Lang, RN, MSW - Wed Jul 21, 2010 12:51 pm

Hello, inquisitive123,

I apologize that this response is so late. I hope this information can still be useful to you, and to others who may read your post.

You are well informed about lithium and clearly understand the need to maintain therapeutic levels. The guideline is to avoid "excessive amounts" of salt while using lithium, and swimming in the ocean wouldn't be likely to fall into the category of excessive. You'd have to swallow a fairly large amount of ocean water to have it significantly effect your lithium level. However, advise your doctor of your swimming, in the event he would choose to increase the frequency of monitoring your lithium level, as a safeguard. While avoiding excessive salt is recommended, it's just as important to maintain a "normal" level of salt intake, since lithium inhibits reabsorption of sodium in the renal tubules (kidney function), and inadequate levels of sodium can also be harmful.

Good luck to you!

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