Medication fears

[doodah]

Hello - I'm wondering if anyone else has a fear of taking tablets and, if so, have you managed to overcome it?

I have had anxiety/agoraphobia for years but managed to get myself into a position where I could cope okay. At the end of last year I was overmedicated with levothyroxine which caused my nerves to go haywire again, also constant upset stomach. This led me to being over cautious about what I was eating and I lost a lot of weight. Cutting a long story short, about 2 months ago my blood tests showed that I am low in Vitamin D (17) and I was given a high dose of Vitamin D3. Although I was nervous of taking pills, I took the first one but about 3 hours later felt really nauseous. The nausea carried on for a week so I stopped taking the Vitamin D, saw the Dr who said she thought it could be acid reflux. Given pills for this which help a little but am still nauseous. I realise I need to start taking the Vitamin D again because I'm feeling so low physically and mentally, but am getting worked up about possible side effects. I had a phone appointment to arrange to see someone at the mental health services who said they could help me but that there was a 56 day waiting list!

Can anyone offer any advice on overcoming this fear of taking medication as I don't want to have to wait another 2 months.

Thanks.

[MyNameIsTerry]

I think a lot of us have had this, I know I have. Mine came from a big adrenaline rush I had when exercising as I had added new stimulating supplements to my current mix and they wre far too strong for me at that level as they were for advanced only. That made me fear not only exercise but supplements, meds, etc. I even stopped taking my asthma inhalers out fo fear and was taught a lesson by way of a minor asthma attack hence starting them again. I stopped taking any supplements and even paracetamol. I never really had the same issues with antidepressants though, I guesss the first time I was desperate for the help and the second time I knew they would cause bad side effects so just accepted I had to pass through that stage.

What I did with supplements is attempt it as you would in ERP, by starting with a lower fear and working up to it. So, I picked the one supplement that was never going to cause me any issues - vitamin C. It made me anxious for the first so many times I took as I knew it would but after repeating it enough times, I got past this. Then I started paracetamol as it's something I had always taken many times in the past. The same kind of worries came again but not as pronounced.

From here I started looking at more supplements that I was unfamiliar with with the intention of working up to ones that had a stimulating affect. Because of my panic experience I had built some beliefs around feeling stimulated as being a bad thing, even if it was a healthy stimulation i.e. like your vitamin D is to restore your levels and make you feel better.

Is there anyway you could see yourself approaching it like this? Or maybe even if it is a tablet, approaching it by cutting it into tiny pieces and working up? Your GP wants to restore your levels but they have to be prepared to get you onto it somehow and it's not satisfactory for them to just say take it when they know you have a fear of it.

[doodah]

Thank you ever so much for your reply Terry. It makes perfect sense. If I put my "logical" head on the vitamin D capsule I took originally was 20,000 units (I think that's equivalent to 500 mcg – I was supposed to take 1 tablet twice a week), but the capsules I have now are 800 units to be taken daily which is equivalent to 20 mcg so that's quite a big drop in dosage isn't it.

I think I will try to get my head around when to take it to fit in with the Levothyroxine and Lansoprazole (for acid reflux) and whether I take it with food or not! I’ve avoided looking at the leaflet for fear of seeing the list of side effects! Being very underweight from my experience last year from thyroid medication, I have gradually been introducing more foods, but am now on pretty basic food again due to the acid reflux – grr.

I can feel myself getting hett up just thinking about it but I will do my best to lower my anxiety and start adding the Vitamin D tablet – phew!

Wendy :)

[MyNameIsTerry]

Hi Wendy,

Yes, I've seen a clinic online explaining why they do that and it's about getting levels up quite sharply initially and then letting a maintenance dose keep you topped up or moving towards the final goal more slowly in a more sustainable way that needs less immediate monitoring. Something like that anyway.

Oh, I know. I've been the same with supplements and I'm still working on it. I started taking a 5000IU vitamin D tablet about 4 nights ago. I research the things to try and get them here but then it can be a while before I work them into the routine. I still feel that same internal tug over starting something new but I have far more control in dismissing it thesedays. The battle is still if I notice physical changes, even if they are good ones.

It's part of the whole control & uncertainty issue. At my worst I tried to control everything around me to reduce any further anxiety and this would include basic daily chores likes washing, brushing teeth, shaving, etc. It was a very bad period. So, those same issues are still underlying in my subconscious and the only way past them is to face them through graded exposures so that they don't bother me anymore. It will take time until I can be care free about taking things but with each step forward you will always create a new association that is good and help to mothball the old associations.

This is tricky because with this being a medical need, you could do with a GP agreeing to it, but is it possible to try to work in a routine gradually? So, could you take a smaller dose for a few days, then increase and keep going until you hit the full 800IU per day? Like how people try to taper off meds or even taper on if they have a fear of medication? I'm thinking thhat this way your fear won't be quite as strong as you will know that any effects you feel will be based on reduced doses.

[pulisa]

Wendy, do you have these same fears regarding the lansoprazole?

[doodah]

Thanks again for your help Terry - why on earth didn't I think of asking for a much, much lower dose?! I've phoned my doctors surgery to make an appointment with my doctor - the earliest is next Wednesday (a phone appointment) but it's better than waiting 2 months to see the mental health team. You really are a star!!

---------- Post added at 20:08 ---------- Previous post was at 20:05 ----------

Hello pulisa - I started the Lansoprazole about 3 weeks ago and I was really, really anxious before taking them. I felt so ill with this acid reflux that I went to my daughter's house to take the tablet - "just in case"! Thankfully I didn't drop down dead but each morning when I take it I double check that I'm taking it between 30 mins and an hour after my thyroxine tablet, and half an hour before food! I'm really hoping that the acid reflux was just a coincidence and wasn't caused by the big dose of Vitamin D!

[MyNameIsTerry]

Thanks Wendy, I really appreciate that, just glad if I can help.

Your GP will be interested in getting your sorted as quick as he/she can hence they will dish out what is needed to resolve the problem but they probably don't realise things like this. Maybe they will be able to lower it, if the med comes in lower doses and they are happy to monitor a slower increase, but if not maybe they can just advise on how much IU you need per day and you can get their with supplements? These vitamin D, iron supplements, etc are just medically licenced versions because they will be stronger but supplements of these things are very cheap and easily accessible which may give you some control over doing it slightly slower - as long as your GP is happy with it.

Something I would say is, if you feel anxious or panic the first few times, try to persevere with it. I've done this whether there were stimulating effects or not and you get beyond it the more you do it.

[pulisa]

If you are taking the PPIs on a long-term basis then it's certainly important to try to boost your depleted Vitamin D levels, Wendy. Do you need to stay on the PPIs beyond the usual length of the course?

[doodah]

I was just given the prescription, pulisa _ I asked if there were likely to be side effects and the Dr just said that all tablets have side effects. Have been taking them for three weeks now and the Dr has put them on a repeat prescription because she said they can take up to 6 weeks to work?! Having thought about yours and Terry's posts I think I need to write a list of questions to ask my Dr for the phone apt next week. They are very understaffed at the moment and I have never seen the same Dr more than once. The Dr who prescribed the PPIs was originally looking at the wrong patient's records on her PC screen and I had to tell her twice that it wasn't me! There's never been any mention of them monitoring me so I will definitely check that out. Not good when you have health anxiety.

[pulisa]

Was the doctor certain you had acid reflux or was it just a question of seeing whether the lansoprazole helped your symptoms?

[doodah]

She just said she thought it was acid reflux.

[pulisa]

Well your GP knows best and I hope the lansoprazole is helping with the nausea? If it makes no difference I'd query the repeat prescription.

[doodah]

Thanks pulisa. So far it helps in the morning but the nausea returns towards evening. I will definitely check with the Dr when I speak with her next week.

[ray.olsen]

Hello doodah

Based on your story I can tell that you've been traumatized by the over-medication experienced you've had before. But there are still many possible reason why when you took the vitamin D pill it had that effect on you. It is possible that your body is recalling to that trauma so when you took the vitamin D pill you had that kind of reaction. It is also possible that you got overdosed since you mention that what was given to you was a very high dosage and what happened to you were the side effects. Or your doctor is right and it could have been acid reflux.

Therapy in my opinion is the best way to face and eliminate our fears, you mentioned that you had agoraphobia then go back to your clinician and tell him about your new worries. You can also ask your doctor if there's any procedure where you can take the medications and you can reduce its side-effects.

[doodah]

Thanks for your reply Ray :)

Just a quick update - I had a telephone appointment with one of my doctors when I asked her if I could have a lower dose of vitamin D to slowly get my mind used to taking them. She was very "off" with me and said that there weren't any lower doses (which I know isn't true). I asked about the results of a previous bone density scan that I'd had done about 3 weeks previously, and she said "it shows you have thin bones" - said I'd have to take a different Vitamin D with calcium added and Alendronic Acid once a week. I asked if I should carry on taking the acid reflux tablets as I was still having the symptoms and she just said she'd write me a repeat prescription. Her attitude was awful and if anything my anxiety was even worse after this consultation. I found out that the new vitamin D and calcium tablets are chewable ones which will be difficult for me as my lack of teeth makes it impossible to chew! And the thought of taking Alendronic Acid puts the fear of God into me.

Soooo I decided I've had enough and contacted another surgery to change my doctor. I have an initial appointment tomorrow afternoon so am hoping and praying they will be a little more sympathetic and explain to me what's going on with me. I'm actually wondering whether I have low stomach acid as I'm hypothyroid and sometimes pass undigested food?!?! Aaargh.

I know I must be a doctor's worst nightmare but fingers crossed!