Nutritional Lithium and Mental Health

Recent reports have emphasized the possible advantages of lithium in treating cognitive disorders, and I would like to discuss it.

When I started my Integrative Psychiatry Fellowship last summer, I began to learn about nutritional lithium. Dr. Greenblatt, who directs the program, is a huge proponent of this mineral for mental health. I’m here to share some insights to help you understand the difference between clinical lithium and nutritional lithium, as well as the potential benefits of low-dose lithium. Then, you can make an informed choice with your provider about whether to try it or not.

Nutritional lithium is different from lithium used to treat bipolar disorder. Lithium carbonate has been used to treat bipolar disorder since the 1970s and is one of the gold standard treatments for mania and for maintenance therapy for bipolar. The dose of lithium for bipolar disorder is typically 600 to 1800mg. This dose range can lead to serious side effects, including kidney problems, thyroid problems, and even toxicity at higher levels, so people have to be regularly monitored for these side effects. Nutritional lithium is lithium orotate and is typically dosed from 1mg to 10mg and has few if any side effects.

There are a few summary articles about low-dose lithium, and I wanted to review one here.

Dr. Greenblatt wrote the following article in the Psychiatric Times in 2024:

Low-Dose Lithium: A New Frontier in Mental Health Treatment

This article discusses how low-dose lithium doesn’t have the same side effects as higher-dose lithium and in which conditions low-dose lithium may be helpful:

Cognitive Decline: Low-dose lithium may have neuro-protective effects, potentially helping to prevent dementia and cognitive decline.

Suicide Prevention: There is a correlation between higher lithium levels in a community's water supply and lower suicide rates.

Treatment-Resistant Depression: Low-dose lithium can be used as an augmentation strategy for people with depression who have not responded to other treatments. It may also help with irritability and anger associated with addiction recovery.

More recently, lithium has been in the news because there was an article by Aron et al. in Nature that showed benefits of nutritional lithium for Alzheimer’s disease:

Lithium deficiency and the onset of Alzheimer's disease

The article theorized that we need lithium in our brains to help with aging and that a disruption in its balance may be an early event in the development of Alzheimer's disease.

Some of what was studied:

They looked at brains and blood concentrations of various minerals in people with and without cognitive impairment and found that lithium was lower in people with cognitive impairment versus people without. The part of the brain that was affected was the prefrontal cortex, which is the area of the brain that executive function (complex reasoning and judgement) comes from and which Alzheimer’s disease affects the most.

Then, the researchers depleted lithium from the diet of mice that were modified to get Alzheimer’s disease as well as aging normal mice. This resulted in the brains of the mice with Alzheimer’s disease having more amyloid-β plaques and tau tangles (markers of Alzheimer’s in the brain). Both sets of mice had more brain inflammation and lithium depletion also affected their performance on cognitive tests. They also gave normal aging mice low-dose lithium orotate and found that it helped the mice with age-related inflammation in various parts of their brains.

The authors propose that lithium replacement therapy with a salt that can evade amyloid plaques, such as lithium orotate, could be a potential approach for the prevention and treatment of AD.

The Greenblatt article and the Nature study suggest that low-dose lithium might have some positive effects on the brain. More research is needed to fully understand the benefits, but it seems like low doses don’t have many side effects. So, it might be worth considering as a supplement.