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Low-Dose Lithium: A multifaceted tool in integrative psychiatry*

by Kelly Heim, Ph.D.

Since its discovery as a food ingredient and medicinal agent, lithium has intrigued scientists with its profound effects on the human mind. In 1949, its capacity to influence mood was first reported, and in 1970, lithium carbonate became available as a pharmaceutical agent in the U.S. Lithium has since been widely recognized as a powerful substance with potential dose-dependent effects on thoughts, feelings, cognition and behavior.*

The prominence of lithium in allopathic psychopharmacology has overshadowed its fundamental identity as a trace mineral occurring naturally in the diet. In contrast to the high dose (typically 180-360 mg) employed in allopathic psychopharmacology, dietary intake of natural lithium ranges from 0.1 to 10 mg, with vegetables, grains and tap water providing up to 90% of the total amount.1 Even in these modest concentrations, observational and interventional studies have positively associated dietary lithium with mental, emotional and behavioral health. Based on this research, a provisional daily requirement of 1,000 mcg has been suggested.1*

Effects on mood and behavior
Studies assessing municipal water supplies and institutional statistics have positively correlated lithium in drinking water with mental health.2 In areas of the U.S. with little or no lithium in the drinking water, crime rates tend to be higher, even when data are corrected for population density.3 Randomized, double-blind, placebo-controlled trials have indicated positive emotional and behavioral changes with short courses of low-dose supplementation. In one study of 24 participants with histories of aggression, impulsivity and social transgressions, a 4-week course of 400 mcg of lithium daily provided measurable support for indices of happiness, friendliness, energy levels and other mood-related parameters.4*

Effects on cognition and memory
Studies evaluating memory and markers of neuronal health in aging humans have documented efficacy of doses ranging from 150-600 mcg over durations of 6-12 months. Systematic examinations of mental state before and after supplementation reveal significant support for functional and biochemical measurements of neurocognitive health.5 In a double-blind trial that randomized 45 aging participants to receive lithium or placebo, support for neuronal health biomarkers, memory and attention task performance was statistically significant at 12 months.6 Maintenance of serum levels of brain-derived neurotrophic factor (BDNF), a powerful endogenous neuroprotectant, is a potential mechanism of action.7,8*

Bioavailability and dosage
Lithium is highly bioavailable when bound to an organic acid such as orotate or citrate. While support for mood and emotional wellness may become apparent within 1-4 weeks, neuroprotective benefits may require longer durations of daily use.1,6 For the foregoing applications, 500 mcg is within the clinically validated nutritional dose range, with strong evidence of efficacy and tolerability. As part of the PureSYNAPSE™ product line and collaboration with Dr. James Greenblatt, Lithium liquid (micro-dose) delivers 500 mcg of bioavailable lithium, as lithium citrate, with versatile utility as a trace mineral for emotional wellness and neurocognitive support.*

References

1) Schrauzer GN. Lithium: occurrence, dietary intakes, nutritional essentiality. J Am Coll Nutr (2002) 21(1):14-21.
2) Dawson EB. The relationship of tap water and physiological levels of lithium to mental hospital admission and homicide in Texas, in Schrauzer & Klippel, Eds. Lithium in Biology and Medicine. Cambridge, VCH, 1991:169-188.
3) Schrauzer GN, Shrestha KP. Lithium in drinking water and the incidences of crimes, suicides, and arrests related to drug addictions. Biol Trace Elem Res (1990) 25(2):105-113.
4) Schrauzer GN, de Vroey E. Effects of nutritional lithium supplementation on mood: A placebo-controlled study with former drug users. Biol Trace Elem Res (1994) 40(1):89-101.
5) Nunes MA, Viel TA, Buck HS. Microdose lithium treatment stabilized cognitive impairment in patients with Alzheimer’s disease. Curr Alzheimer Res (2013) 10(1):104-107.
6) Forlenza OV, Diniz BS, Radanovic M, et al. Disease-modifying properties of long-term lithium treatment for amnestic mild cognitive impairment: randomised controlled trial. Br J Psychiatry (2011) 198(5):351-356.
7) G, Saur R, Laske C, et al. Influence of lithium treatment on GDNF serum and CSF concentrations in patients with early Alzheimer’s disease. Curr Alzheimer Res (2011) 8(8):853-859.
8) Leyhe T, Eschweiler GW, Stransky E, et al. Increase of BDNF serum concentration in lithium treated patients with early Alzheimer’s disease. J Alzheimers Dis (2009) 16(3):649-656.


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