Lithium Supplementation

There have been discussions in the forum about Lithium which does seem to have some merit as part of the WNT pathway.

I have just got some test results in.

Earlier this year I started on 1mg Lithium and after a month or so the steady state serum rate was below 50 microMole/Litre. That, however, was below the lower limit of the blood test I was using. Ideally I think it needs to be somewhere around 25-50 mcmol/L. There is not a lot of research on this, but there is some.

I increased it to 5mg and have just got a result of 100 mcmol/L. I will, therefore, be reducing to probably an average of 2.5mg a day.

Obviously not everyone will be affected exactly the same way by Lithium supplementation, but I have not seen any reports as to what dosage results in what serum concentration so thought it would be helpful to post this.

There is more research on the serum levels required for mental health effects

The minimum there is 600 mcmol/L and to get better effects 1,200mcmol/L. However, I would think that at a higher concentration it would be excreted faster as well.

This paper looks at nephrotoxicity

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456600/

The serum levels there are generallly 600 mcmol/L or higher.

Obviously a question that is important to me is whether there is any sign of nephrotoxicity from lithium. Sadly the only way I can check this is by using the quite variable creatinine figure and I had to move labs between the comparable figures. However, the creatinine figure just before I increased dosage from 1mg to 5mg was 73 mcmol/L and 5 weeks later (the last I have for the year) was 75mcmol/L. From that I cannot say reliably that there was no effect, but I can say there is no substantial effect. I still intend dropping back the dosage, but it is useful to know for me that it does not seem to be doing any harm. That may not apply, of course, for anyone else.

Edit 15/1/23 - I have now redone my Lithium dosage and am taking 5mg 3 times a week. This should average 2 1/7.

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I had rash and drowsiness when taking 5mg/weekly, I wonder to know what are your side effects when your lithium serum is 50 mcmol/L and 100 mcmol/L respectively.

When I started taking lithium at 1mg I had a bit of a buzz. However, I cannot isolate out any other aspects of changes that are caused in isolation by lithium.

My broader objective is improve health, the strategy for that is more gene expression. I think part of that is the inhibition of glycogen synthase kinase 3.

However, beyond the initial buzz I cannot attribute lithium to anything specifically.

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Lithium may affect sodium level and cause hyponatremia in susceptible patients. Important to watch.

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Are you taking lithium for general health, or for depression/mental health?

I am taking Lithium for its general longevity benefits. I think that the mechanism is GSK3 inhibition

I am not aware of any sodium issues below about 0.6mmol/L serum levels. My assumption is to get say 10mcmol/L intracellular concentration I will need slightly higher in serum to enable a diffusion gradients though into the cytosol. I am not aware of any published research that indicates dosage through to serum level through to cellular level and then inhibition level.

This paper used really low levels.

This is one of a number of papers looking at longevity

Lithium has quite a long history of being associated with longevity at low concentrations. What is unclear is the minimum concentration and as I need to aim for some concentration I am aiming for around or under the 50 micromolar level.

That as far as I can tell has no reported negative effects. Whether it is too high or too low to have positive effects is also not that clear, but it seems a reasonable level.

Normal longevity doses are in the 1mg-20mg range. It looks to me now that I should be going for 2.5mg on average daily (elemental lithium in the form of orotate or aspartate).

Possible negatives from Lithium are effects on the kidneys and arguable potentially some hair loss. As I am still gradually regrowing hair even though I am taking lithium I am finding my current serum level of 100 micromolar having a negative effect and I have explained the kidney situation.

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So, have you found any data that supports more than 1 mg a day? That seems like the standard dosage.

There does not appear to be much useful data.

Gradually regrowing hair? Do tell :grin:

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Related Thread: A primer on Lithium, Lithium + Rapamycin & other Lithium salts with potentially more stable and safer pharmacokinetics

And More data on Lithium microdosing:

From: For Researchers | Cognitive Vitality | Alzheimerā€™s Drug Discovery Foundation

Lithium-microdose-Cognitive-Vitality-For-Researchers.pdf (291.8 KB)

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So that says 5mg or less. I do think the optimal range is the 1-5mg range. My own experence is a serum level of 0.1mmol/L for 5mg per day and I think that is really a bit high as a serum level. Hence I am reducing to about 2.5mg per day.

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I have to put on my Psychiatrist hat here and just mention that; 1. These are individuals with serious mental health conditions, and those conditions carry an increased probability of having a metabolic syndrome (increased lipids, obesity, etc.) (even if these individuals are untreated). 2. The ā€œOther antipsychotic drug usersā€ are likely on what we call ā€œtypical or atypical antipsychotics (risperidone, olanzapine, etc.),ā€ which carry a markedly increased likelihood of metabolic syndrome and early death.
Lithium, by itself, for bipolar disorder, does not typically increase the risk of metabolic syndrome. So, in summary, I am saying that showing an increased lifespan in these subjects only on lithium compared to subjects taking typical or atypical antipsychotics cannot necessarily be generalized to adult subjects without one of these psychiatric conditions, if that makes sense.

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I have a question. Why hasnā€™t lithium orotate, which seems a much more benign form of lithium than lithium carbonate, been prescribed more by psychiatrists?

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It is not that the orate is more benign; if you take enough, you can get tremors, thyroid problems, kidney problems, etc., just as severely as with the carbonate form. Lithium daily dosage for bipolar disorder can range from 450 to 900+ mg (much higher than the supplement doses). You are aiming for a small target blood level. Both could be used as medications, but physicians have much more experience using the carbonate form.

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Surely you mean the supplement doses are lower? They are usually 5 to 15 mg of elemental lithium.

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Yes, I meant to say, ā€œmuch higher than the supplement doseā€. Thanks for catching that.

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The longevity doses tend to be orotate or aspartate. I have no good information as to which is best. I have in part been driven by the availability in the dosing quantity that I want. I started at 1mg, found my serum levels were too low to be measured (below 50 micro) moved to 5mg (got about 100 micro) and have just moved to 2 1/7 (5mg three times a week). In a while I will test the serum levels. (probably about a month).

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Sourced from the notes to Paul and Shou Ching Jaminetā€™s book Perfect Health Diet:

Analyzing overall mortality data from 1,206,174 individuals in Oita prefecture of Japan regarding their possible correlation with drinking water Li+ concentrations, we find that tap water Li+ levels in the 18 municipalities within the Oita prefecture are inversely associated with overall mortality rates adjusted for gender and age (Ī² = āˆ’0.661, p = 0.003) (Fig. 1a). We additionally adjusted for suicide rates in this prefecture, since these have been previously shown to be negatively associated with tap water Li+ levels in this particular cohort [8]. After additional adjustment for suicide, overall mortality was still inversely associated with tap water Li+ levels (Ī² = āˆ’0.580, p = 0.037) (data not depicted). This inverse correlation suggests that Li+ exposure may contribute toreduced overall mortality in humans independent of suicide riskā€¦

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