Well, if you ask that most authoritative of resources, Google, it is ‘one of the most widely used and studied medications for treating bipolar disorder’. Indeed, since being approved by the FDA for treatment of manic illness in 1970, lithium been widely used in the treatment of psychiatric disorders.
But at the base of it all, lithium is simply an element, found naturally as a mineral salt.
And just like so many other minerals – sodium, potassium, chloride and calcium to name just a few – it is vital to many of the body’s natural functions.
Lithium is one of the most widely used and studied medications for treating bipolar disorder
Isn’t lithium a medication, not a supplement?
Lithium has traditionally been used as a medication in the treatment of a range of psychiatric disorders. Its most common use is in the treatment of bipolar disorder, but it is also used for major depressive disorder, schizophrenia, and other psychiatric conditions. Recent research shows that it can also improve behavioural and cognitive deficits in neurodegenerative conditions, including stroke, fragile X syndrome, Alzheimer’s disease and Huntington's disease.
But there’s a reason for lithium’s great success across the board in treating psychiatric and neurological disorders.
Lithium confers wide-ranging neuroprotective and growth-stimulating effects within the brain.
And scientists are increasingly suggesting that these effects may be beneficial not only for the mentally ill, but for normal, healthy people as well.
Are the benefits of lithium proven?
A 1994 study examined the results of weekly self-administered mood questionnaires, measuring overall happiness, friendliness and energy, in 24 former drug users over four weeks. The participants were randomly assigned to receive either 400 μg of lithium per day or a placebo. Those that received lithium showed a steady progressive increase in mood scores, while the placebo group actually showed a slight decrease.
This is compelling evidence for lithium’s calming and mood stabilizing effect.
Conversely, low lithium intake has been linked with increased hospital admissions for psychosis, neurosis and personality disorders, and, alarmingly, homicide rates.
It’s hardly surprising that research has been focused on documenting the influence of lithium on brain health, given its history in the treatment of psychiatric disease. However, lithium has also been shown to have wider health impacts:
- It increases bone density.
- It helps entrain us to a longer circadian rhythm.
- It reduces insulin resistance and therefore diabetes risk in rats.
- It improves mitochondrial function, and therefore cellular energy production, in worms.
But it doesn’t end there. In 2011, scientists found that in Japan, municipalities with higher levels of lithium in their drinking water had significantly lower mortality rates than those with lower levels. When the scientists decided to see whether the same effect could be observed in roundworms, sure enough, they found that lithium supplementation was associated with longer lifespan.
Proof of cause and effect remains to be seen, but it certainly appears that lithium increases longevity.
How does lithium work?
Lithium works by influencing the expression, production and action of a wide variety of enzymes, hormones, growth factors, neurotransmitters, receptors and other proteins in the brain and throughout the body. These mechanisms combine and interact to exert neuroprotective and neurotrophic effects.
- Inhibits apoptosis (cell death) by reducing the influx of calcium into neurons and inhibiting the production and activity of enzymes that promote apoptosis.
- Promotes production of neurotrophins, a class of molecules that supports neuron growth, proliferation, survival, differentiation and migration. This includes brain-derived neurotrophic factor (BDNF), which is essential for cognitive development, synaptic plasticity, and neuronal survival.
- Induces production of heat shock protein-70, which promotes normal protein folding and helps degrade abnormally folded proteins.
- Inhibits inositol monophosphatase, which in turn promotes autophagy, a process that eliminates defective proteins and cells and helps eliminate intracellular pathogens.
- Increases N-acetyl aspartate (NAA) production, which is correlated with higher IQ scores and is thought to be an indicator of neuronal health.
- Increases long-term potentiation (LTP) in the hippocampus, which promotes learning and memory.
- Increases serotonin release in the hippocampus, helping stabilise mood.
How much do we need?
Lithium is not yet officially recognised as an essential nutrient. But then, that’s hardly surprising. It can take years before research translates to public recommendations. For example, leading vitamin D researchers believe the RDI should be ten to fifteen times higher than it is, but there’s no sign that recommendations are about to change any time soon. Similarly, we must look to science rather than authorities to determine the appropriate intake of lithium.
A 2002 report recognised lithium as an essential mineral and recommended a daily intake of 1 mg.
How can I achieve adequate intake?
In some countries, including parts of Spain and Japan, fresh water and produce contain comparatively high levels of lithium, and daily consumption is often as high as 1 mg per day even without supplementation. Unfortunately, in many other countries, including USA, the UK and Australia, we’re not so lucky.
Lithium is found in a wide variety of foods, but in many areas poor soil quality and extensive water filtration can mean the actual concentration is negligible.
Back in 1985, the US EPA estimated average daily lithium intake at 650 to 3100 µg. But those days are gone, and now we can’t even be assured of the measly 1 mg provisional recommendation. We have no choice but to turn to supplementation.
Does lithium have any side effects?
As a medication, absolutely. In fact, the list is extensive, including increased thirst and urination, dry mouth, hand tremors, confusion, impaired memory, headaches, muscle weakness, nausea, vomiting, and diarrhoea. Like any other essential nutrient, there is a threshold where lithium becomes potentially toxic. But we’re not talking about using lithium as a medication, where doses typically hover around the 1800-mg mark. We’re talking about using it as a supplement, at a dosage three orders of magnitude lower.
A dosage of 1 mg per day is not only safe and free of side effects – it’s beneficial, and maybe even essential.