For decades, lithium was the 'go-to' treatment for bipolar disorder. In fact, to this day, it still clinically outperforms widely prescribed billion-dollar pharmaceuticals like quetiapine, valproate and olanzapine when it comes to preventing self-harm and suicide in bipolar patients.1
Many physicians, including Dr Jeffrey Dach, medical director of TrueMedMD Clinic in Davie, Florida, and a patients' rights advocate, are proponents of lithium, and fierce when it comes to denouncing the use of psychiatric pharmaceuticals to treat bipolar disorder and other mood problems when a much more effective, safer and cheaper treatment is available.
"Most of these medications are ineffective, useless and produce horrific adverse side-effects," says Dach. "While current-day antipsychotic drugs such as Haldol, Prolixin, Risperdal, Seroquel, Zyprexa, etc. may serve as chemical lobotomy or chemical straightjackets for the criminally insane, they are inappropriate for children and other victims of the medical system who make the mistake of expecting help with mood or emotional problems."
Public bipolar online forums contain hundreds of glowing personal testimonials for lithium treatment. In addition to its mental-health benefits, clinical studies have shown that lithium provides marked and fast-acting reduction of pain in fibromyalgia sufferers,2 is highly effective as an intervention for traumatic brain injury,3 counteracts neurodegenerative conditions like stroke,4 and may slow and even possibly prevent Alzheimer's disease.5
Lithium has also proved amazingly effective for eliminating cluster headaches.6 Ward Dean, MD, author of The Unique Safe Mineral with Multiple Uses, claims that lithium has also been successfully used to alleviate migraine, improve low white blood cell counts, and mitigate juvenile convulsive disease, alcoholism and liver disorders.
Despite all this, mention lithium and lithium therapy to the average person on the street and you invariably get a negative—even fearful—response.
"Every time I mentioned the word 'lithium' to anyone at the office, they would make an unpleasant face, wrinkle up their nose and start heading for the exit," says Dach. "Why? Because most people associate lithium only with mental illness and prescription lithium carbonate, which is routinely used for bipolar disorder. And that is the great mistake."
Different forms of lithium
A soft silver-white metal belonging to the alkali metal group, lithium easily combines with other molecular carriers to form compound lithium salts, such as lithium carbonate, lithium orotate (lithium bound with oratic acid, a compound made in the human body by a mitochondrial enzyme), lithium aspartate and lithium nitride.
A naturally occurring element, lithium is found in the earth, in seawater, and in trace amounts in most plants and animals. Its effectiveness for treating mood disorders was discovered in 1948 by Dr John Cade, an Australian psychiatrist. Indeed, he found the calming effects of lithium to be so profound in bipolar patients that, at one point, he postulated that the mental disorder might actually be caused by lithium deficiency.
Cade focused his studies on the use of lithium carbonate, and it was many years before a standardized protocol was developed that included regular blood tests to monitor ongoing lithium levels in the bloodstream. During that experimental time, the prolonged use of lithium carbonate at high doses for bipolar disorder sometimes resulted in toxicity, kidney failure and death. As a result, the compound was considered suspect in many quarters and was even illegal in the US prior to 1970. It also didn't help that, as an inexpensive, naturally occurring chemical, it could not be patented by pharmaceutical companies and exploited for commercial purposes.
Yet its effectiveness for what used to be known as 'manic depression' could not be denied. Eventually, with proper monitoring and blood tests, lithium carbonate became the gold-standard treatment for bipolar disorder. To this day, most clinical studies involving lithium—and there have been hundreds—have centered on the use of lithium carbonate. Even though lithium is lithium no matter what kind of molecule it's bound to for biological delivery, very few laboratories investigated the effectiveness of its other forms—that is, until the mid-20th century, when the German alternative practitioner Dr Hans Nieper decided to do so.
"Nieper pioneered the use of lithium in the acetate and orotate form," says Dr Jonathan Wright, medical director of the Tahoma Medical Clinic in Seattle, Washington. "Turns out those forms allowed the penetration of lithium into the cells, so one could have at least partial intracellular lithium. In comparison, lithium carbonate remains almost completely extracellular—the carbonate compound doesn't help anything to get through the cell walls, and it's less well absorbed by the body."
Lithium orotate is also more slowly excreted from the body than the carbonate form, "which makes it potentially good and bad," says London holistic healthcare consultant and therapeutic nutritionist Peter Smith. "It's good in that if you have something that's slowly excreted, you get a nice even dose throughout the day. It lingers in the system for a longer period of time. Potentially, though, if you take an overdose, it's harder to get rid of it."
The keyword is 'overdose.' Fortunately, because it's more easily absorbed by the body and lasts longer, patients don't need to take as much lithium orotate as carbonate to get the same results. This means the chances of toxic overload are considerably reduced.
In psychiatric medicine, the standard recommended dose of lithium carbonate for bipolar disorder is 900-1,200 mg/day. But according to Smith, with the compound lithium carbonate, only 18.8 percent is actually lithium: the rest is carbonate. So the standard dose of actual lithium ranges between 170 mg and 225 mg per day—a dosage considered safe and acceptable industry-wide for the long-term treatment of bipolar disorder.
In contrast, Smith prescribes just 30 mg/day of lithium orotate for maintaining general brain health, and up to 120 to 240 mg/day for managing bipolar disorder. Because lithium orotate contains approximately 3.83 percent lithium—more than twice that of lithium carbonate—and the rest is orotate, these dosages translate to around 1.15 mg of elemental lithium for general purposes, and approximately 4.60 to 20 mg/day of elemental lithium for managing bipolar conditions (compared with the above-mentioned 170-225 mg with lithium carbonate). Such low doses mean that the chances of adverse effects are seriously curtailed, yet they are still effective.
Overcoming fearful perceptions
Smith first stumbled upon lithium orotate when looking to treat his own bipolar disorder. For years, he'd heard stories about people prescribed long-term, high-dose lithium carbonate who'd then experienced toxicity problems. Despite his education and profession, he believed that lithium—no matter what form it came in—was a toxic element to be avoided at all costs.
But then he started reading the clinical studies. "The first thing I discovered is that lithium is highly helpful for people suffering from PTSD [post-traumatic stress disorder]," he says. "Many antidepressant drugs actually increase suicidality. But lithium is one of the very few substances known to reduce suicidality, which, as you know, is very high in soldiers and people suffering with PTSD."
The next thing he discovered was that lithium is a highly effective substance for speeding up recovery from stroke and other brain injuries. "It assists in growing new gray matter," he says. "It's anti-inflammatory. It promotes growth of new synapses, increases brain volume, improves metabolism and delivers DHA [docosahexaenoic acid, an omega-3 fatty acid and a primary structural component of the human brain] to the frontal lobe. And I thought, 'Surely this is something we want more of?'"
He also read the work of Hans Nieper. Somewhat reassured that he could take lithium in its orotate form in low doses, Smith began self-treating, and felt an immediate difference and improvement in his sleep cycles.
Gradually he increased the dose until he was taking 170 mg/day. Over the last five years, he has completely managed his bipolar condition with lithium orotate at much lower doses compared with the considerably higher doses of the more widely prescribed lithium carbonate.
He also found that lithium toxicity symptoms, such as tremor, can be completely eliminated by increasing the amount of essential fatty acids in the diet, a solution also cited by Wright.
"I prescribe a couple of tablespoons of either flaxseed oil or preferably fish oil [which is better for the brain]," says Wright, "and, don't you know, patients pull out of lithium carbonate toxicity within three to four weeks with absolutely no change in the lithium dose."
Now completely convinced that lithium orotate is safe, Smith recommends its use to many of his patients.
"Even so, to this day, I have people who are just dead set against taking lithium even in microdoses because they think of it the way we think about lead and mercury—that it's entirely toxic, has no nutritional benefit and that we don't want it in the diet at all. And yet lithium is incredibly healthy for the brain in the right dosage and has been defined by the World Health Organization [WHO] as an essential nutrient. It's one of the most powerful remedies out there."
In fact, it's even been shown to be effective in the tiny amounts present in public water supplies. A 1990 study of 27 counties in Texas showed that counties with trace amounts of naturally occurring lithium in their water had a "statistically significant" reduction in suicide rates, homicides, rape and other violent crimes compared with those with little or no lithium in their water.7
In Japan, a similar study found that lithium levels were "significantly and negatively associated" with suicide in people with mood disorders,8 findings that were also replicated in Austria.9
"In Japan, they've discovered [that] the more lithium in the water, the longer people lived," says Wright. "The less lithium in the water, the shorter their life span." So lithium may have longevity benefits as well. That stands to reason when you consider that lithium promotes the production of new brain cells and better mitochondria—the power-packs in every cell that convert oxygen and nutrients into adenosine triphosphate (ATP), the body's 'energy currency'—both recipes for longer life.
Florida's Jeffrey Dach points out that one of the reasons lithium works so well for bipolar disorder is that it stimulates those cells responsible for a healthy brain (see box, page 58). "One of the surprising findings in bipolar disorder recently made visible by new MRI brain imaging techniques is the loss of hippocampus neurons and loss of brain volume," he says. "This is also replicated in a mouse model of bipolar disorder, in which GSK-3B [an enzyme promoting neurodegeneration] is upregulated in genetically altered mice. These mice exhibit manic behavior and loss of brain volume, but it's reversed by lithium treatment."
The finding of neuronal loss in people suffering from bipolar and other mood disorders has triggered a whole new "neurotrophic theory of depression," says Dach, and because of its protective capabilities, Dach, Smith and Wright all prescribe lithium orotate in low doses for overall brain health.
"If there's type 2 diabetes and/or alcoholism that runs in the family, I recommend that people start taking low-dose lithium orotate [between 5-20 mg/day] around age 20," says Wright. "If not, then I'd say most us should start taking it around midlife—age 40 or so."
Speaking of alcohol, lithium orotate has been clinically proven to work in the treatment of alcoholism. In an early lithium study in 1986, of the 36 patients who had been hospitalized for an alcohol-related disease at least once in their life, 10 managed to stay away from alcohol for three to 10 years, 13 patients maintained their abstinence for up to three years, while the remainder relapsed after 6 to 12 months.10
Dr Wright has personal experience of successfully treating people suffering from alcohol addiction with lithium (see box page 59), a clinical experience supported by a study carried out by the Denver Veterans Administration Medical Center in Colorado, in which a small group of recently detoxified veterans were given either low-dose lithium carbonate or a placebo. After a year of follow-up, relapse was significantly reduced among those given lithium.11
Wright adds: "And when clinicians talked to the families of the different veterans in the lithium group and asked them what difference did you see in your husband or your dad's behavior during treatment, the answers were the same as the answers I get from family members of alcoholics I treat with lithium orotate: less domestic violence, less anger, less drinking, less depression."
How lithium protects the brain
Lithium's extraordinary effects on the brain mostly have to do with the fact that it slows the death of certain cells while promoting the rebooting of others. Lithium increases levels of the brain protein Bcl-2, which has been shown to suppress apoptosis (natural cell death) of neurons (nerve cells) in the brains of both rats and humans. Lithium also increases the rate of regeneration of axons—the long thin fibers that extend from neurons and conduct electrical impulses (cellular information) throughout the central nervous system—while inhibiting glycogen synthase kinase 3-beta (GSK-3B), an enzyme associated with a greater risk of bipolar disorder and the neurodegeneration found in Alzheimer's disease.1
Clinical studies show that not only does long-term use of lithium slow the progression of cognitive dysfunction in people suffering from mild cognitive impairment (MCI), but it also contributes to the synthesis of brain-derived neurotrophic factor (BDNF), a factor for nerve cell growth.2
"BDNF is a protein the brain makes," says Smith. "Some people call it Miracle-Gro for the brain. Basically, it simulates the growth of dendrites, which are the projections at the end of the nerves. Brain volume [gray matter, comprising neurons and their communicating branches] increases primarily because lithium boosts the BDNF levels that stimulate the growth of synapses."
Lithium treatment for alcoholism
Many practitioners like Jonathan Wright have witnessed the power of this trace mineral to treat not only so-called mental illness, but also violent tendencies, alcoholism—and even personal relationships.
Tracy, a young woman of 21, once consulted Wright to ask if she could get a prescription for low-dose lithium (5-20 mg/day). Wright had seen her as a teenager and treated her parents, both alcoholics, with low-dose lithium with good success.
"During the consultation, she thanked Wright. "My dad's not getting mad and beating up my mother anymore. He still gets mad, but not near as mad as he did before. No more rages. And my mother, she's a lot less depressed. And neither one is drinking as much anymore."
When asked why she felt it necessary to take the mineral herself, Tracy replied, "I've seen what it does for my parents. Don't I have the same genetics?"
Ten months later when Tracy returned for a check-up, she appeared to be a different person—she was dressed differently and showed a marked improvement in mood. "I wanted you to know what lithium did for me," she said. "I got a boyfriend!"
Tracy considered this remarkable because she hadn't had a boyfriend since high school, and every relationship since then had lasted only a couple of months. "Now I've had a boyfriend for the last six months, and I'm getting invited to more parties, and people want to know what I'm doing. It just really helped!"
• Dr Jeffrey Dach:
• Dr Jonathan Wright:
• Peter Smith, nutritional therapist, Hale Clinic, London:
TO PURCHASE LITHIUM
• In the US: over the counter in most drugstores and online
• In the UK: legal to purchase, but not carried in most pharmacies, though it can be purchased online