Lithium
Li — Element #3
also known as Lithium carbonate, Lithium citrate, Lithium orotate, Lithium chloride
Lithium is an alkali metal present in trace amounts in water supplies and certain foods. At pharmacological doses, lithium carbonate and lithium citrate are well-established mood-stabilizing medications for bipolar disorder. Whether the very low trace amounts found in food and water have biological significance in humans remains uncertain. Some epidemiological studies associate higher tap water lithium levels with lower suicide and homicide rates, but causality has not been established.
- At pharmacological doses (prescription only), lithium is a first-line mood stabilizer for bipolar disorder, reducing mania and depression relapse
- At pharmacological doses, lithium inhibits glycogen synthase kinase-3β (GSK-3β) and inositol monophosphatase, which may account for its neuroprotective effects
- Ecological studies associate higher drinking water lithium levels with reduced rates of suicide, dementia, and violent crime — mechanistic basis is unclear
- Low-dose lithium (orotate) is marketed for mood support, but clinical evidence is insufficient to recommend it as a supplement
Active in Li⁺ ion.
No established dietary UL or RDA; pharmacological lithium has a narrow therapeutic window (0.6–1.2 mEq/L serum)
Pharmacological lithium requires regular blood monitoring; toxicity causes tremor, confusion, ataxia, kidney damage, and can be fatal
Lithium orotate supplements are not FDA-regulated for the same indications as prescription lithium and their safety at sustained doses is not established
Sodium depletion (from low-sodium diets, diuretics, vomiting) increases lithium reabsorption and risk of toxicity in patients on prescription lithium
NSAIDs and ACE inhibitors raise lithium blood levels in patients on prescription lithium — important drug interaction
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