While most people think of lithium as a medication for severe mental health problems, research since the 1970s has strongly suggested that low levels of lithium also function as a nutrient. The World Health Organization considers lithium a nutritionally essential trace element, alongside zinc, iodine, and others. The human body contains around 7 MG of lithium, and on average in the US, individuals consume between 0.65-3.1 MG of elemental lithium per day in the form of nuts, legumes, cereal grains, vegetables, eggs, milk and tap water. By contrast, in psychiatry, large doses of lithium (900-1500 MG QDAY) are used to stop mood cycling in Bipolar Disorder but with these high doses can be several side effects: tremor, cognitive impairment, diarrhea, and nausea along with the necessity of regular blood work to monitor the kidneys, thyroid and lithium level. However, lithium in smaller doses (less than 300 MG QDAY) is almost like a different medicine that has no side effects, no blood work requirement and a surprising benefit in terms of depression, impulse control, and lowering the risk of Alzheimer’s Disease (AD). In this next article, I will discuss these other uses of lithium that may not even require a doctor’s prescription.
Lithium is one of the few medicines in psychiatry that is a natural cell salt. All the research in treating Bipolar Disorder occurred in the form of lithium carbonate but there are two other versions: lithium citrate (available in liquid) and lithium orotate that tend to be equal in effect to lithium carbonate. When dissolved in the blood, the lithium floats separately. The toxic level of lithium is only a little higher than the therapeutic level when treating Manic Depression (Bipolar I Disorder) especially when treating acute mania. Thus, extra care is necessary when using lithium in these situations and frequent monitoring of the lithium level is necessary when the dose is relatively high.
When lithium is used for depression, the dose can be much smaller (150-300 MG) either by itself or as an add on to another medication. Lithium increases BDNF which is the growth hormone in the brain mentioned in a previous article that is associated with an antidepressant effect and also prevents cell death. Careful, frequent monitoring is not as important and with very low doses, no monitoring at all is necessary. When one is on 150 MG QDAY, usually the lithium level comes back “undetectable.”
In recent decades, there has been replicated research throughout the world demonstrating that where there is more lithium in the drinking water, there is significantly less Alzheimer’s Disease compared to an area that has less lithium in the water. For example, a 2018 study compared different counties in Texas over seven years and showed in the counties with higher trace lithium in the public water supply a significant slowing/preventing AD, obesity, and type 2 diabetes. There was a study in Great Britain that showed just taking low dose lithium every day improved cognitive abilities of elderly people with Mild Cognitive Impairment (MCI) after one year; fewer MCI patients converted to AD when on lithium. Although more studies are required to further demonstrate the therapeutic effect of low dose lithium for AD prevention and alleviation, supplementing tap water with low levels of lithium has already been considered to improve mental health across communities.
Areas of the world with high amounts of lithium in the drinking water were found to be around 0.3 MG QDAY. Lithium orotate is available in smaller doses: 5 MG, 10 MG, 20 MG, and 120 MG. If a person were to take one 5 MG tablet a week that would average to 0.7 MG per day and would lower the risk of AD. Lithium orotate is an over-the-counter supplement that can be obtained online and in some health food stores. The research on the use of lithium orotate for mood issues is not as robust but some of my colleagues report that the 120 MG pill a day is high enough to help depression in some people, sometimes within two weeks or sometimes more gradually over a year or two.
There are other benefits to low dose lithium beyond preventing AD. If you get a stroke or other brain injury, 50% more of your brain survives if on lithium; lithium makes grey matter (the thinking matter) of the brain grow slowly over time and it is reportedly the only substance that makes the thinking part of the brain expand. Lithium specifically reduces impulsivity and acting on suicidal thoughts even if the lithium doesn’t help the person’s depression. Lithium seems to help with herpes and with seborrheic keratitis but it does increase psoriasis and acne. Lithium reduces the incidence of some neurological disorders and cancers such as prostate cancer. There was even a study where lithium increased and normalized the length of telomeres which delays aging. One third of people with Bipolar Disorder (manic depression) get AD but if they are on lithium, only one in twenty get AD. Lithium has no sexual dysfunction at least in low doses.
Who should not take lithium even in small doses? Anyone with heart, kidney, or liver disease or has had a recent surgery. Women should not take when pregnant or lactating. Lithium should not be used by individuals with sodium depletion or those taking diuretics or ACE inhibitors. Lithium should be not be mixed with NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen, aspirin, Celebrex, or naproxen.
With the projected increase in the aging population over the next 20 years, Alzheimer’s Disease will have a growing impact with annual costs already exceeding $100 billion in the U.S. Thus, the need for innovative treatments to prevent, delay onset, or alleviate symptoms of AD are at the forefront of public health concerns. In a previous article on healthy brain aging, I discussed several preventative strategies for AD including an anti-inflammatory diet, moderate physical activity, mental exercise, and stress reduction. I would now also include adding a microdose of lithium, such as 5 MG of lithium orotate per day, especially for anyone with early signs of mild cognitive impairment.