Lithium Orotate for Mood Stabilization and Neuroprotection

Lithium has recently made resurgence in popularity within the natural health community, with claims to help with Alzheimer’s, mood stabilization, alcoholism,¹ neuro-regeneration and other conditions. This is not the same “lithium” as conventionally used since the early days of psych meds for the treatment of bipolar – that is lithium carbonate. The lithium in question is lithium orotate. Lithium carbonate is dosed between 900 – 1800 mg daily, and is available by prescription only. Lithium orotate is a nutritional supplement and comes in 5mg tablets, usually dosed no more than 20mg daily.

Lithium Orotate

Lithium orotate is used with much success in bipolar cases – anecdotally. The proposed mechanism of action for its mood stabilization and neurogenenerative effects are due to the inhibition of glycogen synthase kinase-3B (GSK-3B).² Lithium also upregulates insulin-like growth factor-1 (IGF-1), and brain-derived neurotrophic factor (BDNF) which stimulate stem cells to generate new hippocampal neurons into adulthood.²

Common Mood Stabilization Dosing

A common dosing schedule for mood stabilization is 5mg daily for five days, followed by an increase of 5mg for another 7 days, until mood stabilizes. 20mg is generally considered the maximum limit to dosing. Unlike lithium carbonate, lithium orotate typically does not require routine kidney function testing, or blood monitoring – the amount of elemental lithium, which is introduced into the body, is extremely low, and side effects are generally not seen. However, because lithium orotate can be purchased directly by the patient, toxicity symptoms should be known in the event that a patient takes too much.^3,4

Known Side Effects Include

The most commonly known side effects of taking lithium are: headache, lethargy and fatigue, drowsiness, hand tremors, muscle weakness, nausea/vomiting, and diarrhea. Signs of moderate lithium toxicity (serum levels of 2.0-2.5 mmol/L) can be: confusion, dysarthria, nystagmus, ataxia, muscle twitches, and ECG changes (flat or inverted T waves). In severe cases consciousness changes, including seizures that can be seen, as well as kidney failure and coma/death. Lithium is also known to affect thyroid function, though there are no studies corroborating this with lithium orotate vs lithium carbonate. Lithium also competes with magnesium.

Sources:

1. Sartori HE. Lithium orotate in the treatment of alcoholism and related conditions. Alcohol. 1986;3(2):97-100.
2. Tam ZY, Gruber J, Ng LF, Halliwell B, Gunawan R. Effects of lithium on age-related decline in mitochondrial turnover and function in Caenorhabditis elegans. J Gerontol A Biol Sci Med Sci. 2014;69(7):810-20.
3. Balon R. Possible dangers of a “nutritional supplement” lithium orotate. Ann Clin Psychiatry. 2013;25(1):71.
4. Pauzé DK, Brooks DE. Lithium toxicity from an Internet dietary supplement. J Med Toxicol. 2007;3(2):61-2.

Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine amongst the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend campout where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.