Tegretol may cause low folic acid and vitamin D

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Permalink Reply by Richard A. "Red" Lawhern on May 24, 2011 at 7:36pm

Another factor to be aware of, Jamie, is that Tegretol should not be taken with grapefruit juice.  The components of grapefruit juice can reduce blood levels of Tegretol -- something ELSE that the docs may neglect to mention. 

Anyone who is on this medication should be checked every 90 to 180 days with a liver panel (blood work), to assess liver function and bone marrow activity.  In relatively rare cases, patients who take high doses of Tegretol may experience toxic suppression of bone marrow, or related complications in the renal system.

Regards and best,

  Red Lawhern, Ph.D.

  Master Information Miner

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Permalink Reply by Karri Garza on May 26, 2011 at 11:45am

I had ultra low levels of vitamin D but I was warned not to go out into the sun.  My doctor wrote me script for a fast absorbing vitamin D but not all pharmacies carry it.  I take

CHOLECALCIFEROL 50000 UNIT CAP not not

VITAMIN D (ERGOCALCIFEROL) 50000 UNIT CAP. 

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Permalink Reply by jamie leigh on May 26, 2011 at 1:20pm

Have you noticed a difference in how you feel Karri?

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Permalink Reply by Karri Garza on May 26, 2011 at 1:26pm

It took about a 6 months but my bones hurt less and I have a tad more energy.  I don't get sick as often and I have started running b/c my muscles aren't sore.  It wouldn't hurt to get tested.  I take 1 tablet every week and they are about $1 a pill so its worth the money.  Have you gained weight or suffer from depression?  Both of those are symptoms of low vitamin D levels.  I blamed my inability to lose weight on my hypothyroidism but every since my vitamin D levels has tested as normal I lost weight.  25 pounds since Christmas.  I do diet and exercise which I did before.  HTHs.

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Permalink Reply by Elaine Kobelka on May 27, 2011 at 4:00am

I am very sorry you found this out the hard way.  Between your Doctor and Pharmacist you SHOULD have been told about the Folic / D / Grapefruit Juice.  AND you should be expecting blood panels every three months or so to monitor your liver enzymes.  Don't ask me to explain it all - I just know the liver processes Tegretol and its a pretty harsh drug.   Dr. Red is certainly correct in this.  I was fortunate that my "team" had this covered right from the start.

Elaine

 

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Permalink Reply by jamie leigh on May 27, 2011 at 6:12am

How low was your vitamin D Elaine? I'm taking 5,000 units daily. I have been suffering from depression. No real weight gain, but I have extra fat on my stomach that I never had before. I'm glad you're feeling better! My muscles and joints hurt too and I haven't been able to exercise like I used to.

Elaine Iles said:

I am very sorry you found this out the hard way.  Between your Doctor and Pharmacist you SHOULD have been told about the Folic / D / Grapefruit Juice.  AND you should be expecting blood panels every three months or so to monitor your liver enzymes.  Don't ask me to explain it all - I just know the liver processes Tegretol and its a pretty harsh drug.   Dr. Red is certainly correct in this.  I was fortunate that my "team" had this covered right from the start.

Elaine

 

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Permalink Reply by Richard A. "Red" Lawhern on May 27, 2011 at 8:45am

One cautionary note, if I may (and this is in no way a slam on you, Elaine):  I realize that the term "Dr. Red" may be playfully intended and that's fine.  But anyone who reads my postings should be aware that my doctorate is in engineering systems.  I spent most of my professional career as an information miner, open source intelligence analyst, and acquisition manager/systems engineer.  I research the medical literature and write websites on behalf of pain patients and I try to provide emotional and informational support wherever I can.   But I'm not a medical doctor and I'm careful to suggest that any information I find for people should be checked out with a licensed practitioner. If this seems a little finicky on my part, I beg your pardon.  But I must operate under the same dictum that medical doctors do, even though I'm not among their number:  First do no Harm.  I can make mistakes and have been known to.

 

That being said, I'd also caution Jamie:  5,000 units of Vitamin D daily is rather a high dose. Here is a link to an  NIH article on the subject:  http://ods.od.nih.gov/factsheets/vitamind/  It's long but highly authorative.

Go in Peace and Power,

 Red

 

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Permalink Reply by Elaine Kobelka on May 31, 2011 at 3:15am

We've never looked at my D levels so they must be ok.  I take a multi everyday and I choose one with the highest D available.  Like you, I have been very tired and depressed just like the winter blues so mines might be on the low side though the doctor doesn't seem to be worried enough to mention it.

jamie leigh said:

How low was your vitamin D Elaine? I'm taking 5,000 units daily. I have been suffering from depression. No real weight gain, but I have extra fat on my stomach that I never had before. I'm glad you're feeling better! My muscles and joints hurt too and I haven't been able to exercise like I used to.

Elaine Iles said:

I am very sorry you found this out the hard way.  Between your Doctor and Pharmacist you SHOULD have been told about the Folic / D / Grapefruit Juice.  AND you should be expecting blood panels every three months or so to monitor your liver enzymes.  Don't ask me to explain it all - I just know the liver processes Tegretol and its a pretty harsh drug.   Dr. Red is certainly correct in this.  I was fortunate that my "team" had this covered right from the start.

Elaine

 

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Permalink Reply by Elaine Kobelka on May 31, 2011 at 3:17am

Red, this certainly is NOT finicky to make this distinction and I am glad you did.  I had understood or assumed that you were a medical practioner. Thanks Elaine

Richard A. "Red" Lawhern said:

One cautionary note, if I may (and this is in no way a slam on you, Elaine):  I realize that the term "Dr. Red" may be playfully intended and that's fine.  But anyone who reads my postings should be aware that my doctorate is in engineering systems.  I spent most of my professional career as an information miner, open source intelligence analyst, and acquisition manager/systems engineer.  I research the medical literature and write websites on behalf of pain patients and I try to provide emotional and informational support wherever I can.   But I'm not a medical doctor and I'm careful to suggest that any information I find for people should be checked out with a licensed practitioner. If this seems a little finicky on my part, I beg your pardon.  But I must operate under the same dictum that medical doctors do, even though I'm not among their number:  First do no Harm.  I can make mistakes and have been known to.

 

That being said, I'd also caution Jamie:  5,000 units of Vitamin D daily is rather a high dose. Here is a link to an  NIH article on the subject:  http://ods.od.nih.gov/factsheets/vitamind/  It's long but highly authorative.

Go in Peace and Power,

 Red

 

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Permalink Reply by Karri Garza on May 31, 2011 at 8:09am

My dosage was set by a doctor but different vitamin D products are absorbed by the bodily differently.  Tegertol also interacts with my thyroid medication as well.  Mine is a capsule.  The one that my doctor didn't want me taking is like a gel cap.  HTHs.

 

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Permalink Reply by jamie leigh on May 31, 2011 at 8:37am

I'm taking a little round gel cap...uh oh.

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Permalink Reply by EmmyJ on May 31, 2011 at 4:50pm

Slightly off topic but still Tegretol related. When I was taking Tegretol I carefully followed the instructions about no grapefruit and to be careful in the sun as your skin could be more sensitive to the sun and burn more easily.

When I was in Tenerife back in February I got some sunburn on my arms followed within days by the return of my shooting pains which had been well under control for around six weeks. It may well have been a coincidence but I will personally be careful in the future in case there was any correlation between the two events.

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