Sunday, February 7, 2010

Kidney Problems and the Effects of Antidepressants

For the past two years my mother has been having kidney problems. Her kidneys have been functioning only at 25%. The only real advice her doctors (primary care and nephrologist) have given her is to reduce her sodium intake. She understands the need to do whatever it takes to get her kidneys functioning properly so she has done a very good job at reducing her sodium intake.

What I found odd was that neither of her doctors recommended that she drink more water – you know that pure fluid that our kidneys require to flush out all those pesky toxins we ingest every single day? No, her doctor told her that drinking more water would not necessarily help get her creatinine to an ideal level.

For years we have been telling my mom that she needs to drink more water. We visibly see her dry mouth – which, she claims is a result of her medications. "All the MORE reason to drink more water," we tell her. It was very frustrating to know that her doctor, in whom she has placed much trust, would give her this kind of information. Although she has tried to drink more water since we have explained that it is indeed important to kidney function – regardless of what her doctor says – I felt like that was a huge step back in our quest to help her see where she could do something so simple to improve her health.

My mother is a very stubborn lady...I’ve been telling her for years that she needs to take supplements because we just don’t get the proper nutrition from the food we eat. Due to the over-processing of food as well as all the pesticides used on our “fresh” produce our food is just not very nutritious. She disagreed with me again, of course. She believes that she eats just fine, thank you very much. She’s set in her ways, what can I say?

She’s been seeing her nephrologist every six months at which time she goes over my mother’s blood test results with her and tells her at what percentage her kidneys are functioning. I decided that I should go with her to her last appointment to hear the latest verdict. It turned out that her kidney function had dropped, yet again. I sat there listening to the doctor asking questions…and checking my mom’s legs. I watched as the nephrologist took a phone call on her cell phone during my mom’s paid visit. I also saw her check the phone a second time at which point I was prepared to say something to her had she taken the call. She then asked my mom again, the same question…and checked my mom’s legs for swelling…again. Had she forgotten she’d already done it? She then said that there was a note from my mom’s regular doctor that stated that her liver enzymes were high now so she wanted my mom to have another blood test and go back to see her in two months. Two months? Hmmm, I guess she wasn’t that worried.

That was about the gist of the appointment. Had it not been for the liver count, my mom would have made an appointment for 6 months out and that would have been that. Additionally (more of an aside), her blood pressure was up. The doctor recommended that my mother have her blood pressure checked over the next couple of weeks and if it showed her blood pressure to be high, she would recommend a medication to lower it. Of course, another medication; I’m sure that would solve everything.

Meanwhile I apparently forgot that I was actually able to speak. The only useful thing that came out of my mouth was “Can I have a copy of the blood test results?” which she “allowed” me to have. I got the copy and we left.

A couple of days later I started thinking, “What the heck was wrong with me? Why didn’t I say something about the phone call…or ask what her real purpose was? Was she just monitoring my mom’s creatinine levels until her kidney function got so low that she had to go on dialysis?” She had absolutely no useful information to help my mom get better. This is when I decided that I needed to take matters into my own hands. I took a copy of the blood test results to my chiropractor who had been treating my mom. I also wanted to try and figure out what was causing the kidney problems in the first place.

After looking at the blood test results, it became clear that the problem is the medication she has been on for over a decade. It is no secret that, for the most part, allopathic doctors only look at whether or not levels are within the accepted range. They clearly do not look at what the implications of other issues might be; it doesn’t really matter if they’re on the cusp. They also typically only look at each issue separately and not how they may contribute to the main problem or be part of the same problem.

For example, the results of her test showed that while her blood sugar was within the normal range, it was at the very low end. It was in fact, the lowest reading within the normal range. Also, the same was true for her sodium levels. Another issue that we noticed on her blood test results was a pretty major vitamin D deficiency. On top of everything, my mother was vitamin D deficient. Hello! Vitamin D is essential for life; it’s like a cure all! Well it turned out that the doctor wasn’t completely out to lunch, she did call my mother the next day regarding the deficiency – she had apparently not noticed it (and in her defense, it wasn’t easily seen) and prescribed a very high dose of vitamin D. So far I think that prescription might not kill her (I’m hoping it will actually do her good)…but the jury is still out. I’ll post more on that in another blog.

The bottom line is that the doctor is clearly addressing a symptom and not looking at the overall picture. The body is complex; common sense should tell us that issues can’t be understood by looking at just one deficiency or elevated enzyme. For example, kidney disease goes hand-in-hand with diabetes (HIGH blood sugar); however, in my mom’s case, her blood sugar is LOW. This tells me that the kidney failure is a result of something else – something probably unnatural, i.e her medication. Because of this realization I decided to research the medications she was on – Zyprexa and Effexor.

What I found out was that, first of all, caution should be taken when prescribing these medications to individuals with kidney issues. Both medications seem to exacerbate kidney problems. In the case of effexor, individuals with kidney problems should take no more than the minimum dose available. Apparently my mother has been taking the second to the lowest dose twice a day. Clearly the doctor dropped the ball on this one. In the case of zyprexa, a potentially fatal symptom complex referred to as Neuroleptic Malignant Syndrome (NMS) can be linked to the use of zyprexa. Two of the symptoms of this syndrome are low blood sugar and renal failure. I’m not saying this is what my mom has. In fact I’m hoping this is not it. What I am trying to point out is that these are the types of effects with which zyprexa and effexor are associated.

Additionally, low sodium can be linked to depression. It has been said that sodium (in the form of natural sea salt – particularly Himalayan or Celtic) is a natural antidepressant. Also, vitamin D is a natural mood enhancer. I am fairly certain that the low sodium result began when the doctors recommended sodium reduction for the kidney problems; however, it would be interesting to see what her vitamin D levels have been over the years.

Ultimately what I believe happened is that the depression medication caused the kidney problems. The only real nutritional recommendation, which was to reduce sodium intake, made by the doctor most likely affected my mom’s mental health further. The vitamin D deficiency also affected my mother’s mood and mental well-being in a major way. I believe that by avoiding these medications from now on, and by flushing out the residual chemicals and toxins from her kidneys she will begin to see an improvement in kidney function. Once this happens she will not have to be so careful in terms of sodium intake, in fact it should help the underlying problem – the reason she was on those medications to begin with. I am also hoping that with information and persuasion she will begin using more natural products (such as the Celtic or Himalayan sea salt). Additionally, knowing that she is lacking vitamin D I am hoping that she takes steps to increase her vitamin D production via natural sunlight (preferred) and also vitamin D supplements in the form of cholecalciferol.

Incidentally, a couple of other side effects of the drugs are hypertension and liver problems (remember I said the doctor wanted to monitor her blood pressure because it seemed high and that her regular doctor noted elevated liver enzymes?). By the way, I get all my information on side effects straight from the horses mouth - the drug companies themselves.

In my next blog I will discuss, in more detail, what I found in terms of side effects and interactions of zyprexa and effexor.
For now, I think this will give you an idea of why I decided to do this blog and also some of the effects of anti-depressant/anti-anxiety medications.

Until then, have a great week!

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