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Lithium orotate upper limit?


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#1 bgwithadd

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Posted 14 December 2008 - 09:20 AM


I've decided to try lithium orotate. My shrink tried several drugs for suspected bipolar disorder with bad results, but I'm amazed to see my mood finally feels RIGHT. I feel just...normal. Well, in combination with adderall and st john's wort I feel normal, anyway. Without it my mind is still all over the place and completely negative and lacking in willpower to do the sinplest things but now the negativity and irritibility and depression are just about gone completely, and without ramping me up into a manic state of artificial high mood that's very unpleasant as happens when I get desperate and drop a zoloft, which will immediately send me to the moon.

I've been taking two 120mg tablets once a day. How high up can I go before I have to worry about toxicity? I was planning to double my dose if it seemed safe.

#2 rwac

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Posted 14 December 2008 - 11:13 AM

I've decided to try lithium orotate. My shrink tried several drugs for suspected bipolar disorder with bad results, but I'm amazed to see my mood finally feels RIGHT. I feel just...normal. Well, in combination with adderall and st john's wort I feel normal, anyway. Without it my mind is still all over the place and completely negative and lacking in willpower to do the sinplest things but now the negativity and irritibility and depression are just about gone completely, and without ramping me up into a manic state of artificial high mood that's very unpleasant as happens when I get desperate and drop a zoloft, which will immediately send me to the moon.

I've been taking two 120mg tablets once a day. How high up can I go before I have to worry about toxicity? I was planning to double my dose if it seemed safe.


I believe you're taking 10 mg of elemental lithium right now.
The labeling on lithium supplements tends to be misleading.

I believe there are people on this board who take 20mg/day
I think it should be ok, but someone with more experience (I only take 5mg/day) should probably confirm that.

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#3 Mixter

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Posted 14 December 2008 - 03:15 PM

I believe you're taking 10 mg of elemental lithium right now.


Hmm, just a quick note: metal orotates are much better absorbed than
elemental lithium taken alone (I know, thats the purpose of it :|?). The higher
bioavailability might increase the toxicity, e.g. 20mg elemental via orotate
could be as toxic as 50mg elemental taken alone. Or not. If it helps you cope
with diagnosed bipolar, just ask a doc how high you can go with a long-term dosage...

#4 NDM

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Posted 14 December 2008 - 03:23 PM

Have you started to get pimples or cysts from lithium?
Although I was tempted to get some lithium because it is one of the very few drugs that actually increases grey matter
in the prefrontal cortex, I gave up the idea because of the widespread rumor that it leads to massive acne.

#5 bgwithadd

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Posted 14 December 2008 - 06:27 PM

Well, I have only tried it a few days and no acne yet, but side effects vary person to person. Unlike most people I get very few bad effects from adderall for example, so you could just give it a try.

Lithium carbonate is about twice the elemental lithium per gram, it seems after further googling. So, it's like I'm taking half the lithium carbonate dose. So if I take 4 then that would be like taking 240 of lithium carbonate, which is a pretty low dose. Also, I read about a lithium orotate overdose of 18 pills that only had minor effects. I don't plan to go into any really high dose but if I experience nausea or tremors then I will back the dose down.

Impressively, it seems that it actually helps generate new brain cells and acts as a neuroprotectant. Only drawback so far is that taking it on an empty stomach makes me feel I've been stabbed in the gut. Unfortunately, many pills do this to me.

#6 pycnogenol

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Posted 14 December 2008 - 11:52 PM

I don't take it currently but am considering doing so in the very near term.

Life Enhancement has an article on it:

http://www.life-enha...ate.asp?id=1675

#7 VampIyer

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Posted 16 December 2008 - 04:39 AM

I briefly experimented with large doses of prescription (psychiatrist) Lithium Carbonate. Therapeutic doses range from 600-1200mg daily. I was using it to potentiate the effects of another med.

It REALLY slowed my already slow thyroid, and the effect was obvious. I also notice that I've developed some small, freckle-like spots on my upper cheek area. It looks like an allergic reaction of some sort, but I didn't suspect the lithium until now. I've discontinued use.

I doubt the thyroid effects would be an issue at these nootropic dosages.

#8 yoyo

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Posted 16 December 2008 - 03:28 PM

I believe Li Carbonate is 19% elemental or so. I looked for a while and could not find anything on bioavilibility other than a few pharmacist texts which claimed near 100%.

I take 480mg Li orotate a day, which based on the above is about the same as 120 of the prescription stuff. I wanted a margin of error to be sure i was getting enough for the neutrophic effect on the PFC.

#9 pycnogenol

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Posted 16 December 2008 - 05:07 PM

Check out this website all about Lithium Orotate:

http://mysite.verizo...tate/index.html


Hope this site helps, bgwithadd.

#10 FunkOdyssey

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Posted 16 December 2008 - 05:10 PM

Lithium carbonate is about twice the elemental lithium per gram, it seems after further googling. So, it's like I'm taking half the lithium carbonate dose. So if I take 4 then that would be like taking 240 of lithium carbonate, which is a pretty low dose. Also, I read about a lithium orotate overdose of 18 pills that only had minor effects. I don't plan to go into any really high dose but if I experience nausea or tremors then I will back the dose down.


Here is the study you mention:

J Med Toxicol. 2007 Jun;3(2):61-2.
Lithium toxicity from an Internet dietary supplement.
Pauzé DK, Brooks DE.

Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. pauzedk@upmc.edu

INTRODUCTION: The widespread availability of medications and herbal products on the Internet has increased the potential for poisonings. We are reporting a case of mild, acute lithium toxicity occurring after the intentional misuse of a lithium-containing "dietary supplement" (Find Serenity Now) obtained over the Internet. CASE REPORT: An 18-year-old woman presented to our emergency department (ED) after ingesting 18 tablets of Find Serenity Now; each tablet contained, according to the listing, 120 mg of lithium orotate [3.83 mg of elemental lithium per 100 mg of (organic) lithium orotate compared to 18.8 mg of elemental lithium per 100 mg of (inorganic) lithium carbonate]. The patient complained of nausea and reported one episode of emesis. Her examination revealed normal vital signs. The only finding was a mild tremor without rigidity. Almost 90 minutes after the ingestion, her serum lithium level was 0.31 mEq/L, a urine drug screen was negative, and an electrocardiogram (ECG) showed a normal sinus rhythm. The patient received intravenous fluids and an anti-emetic; one hour later, her repeat serum lithium level was 0.40 mEq/L. After 3 hours of observation, nausea and tremor were resolved, and she was subsequently transferred to a psychiatric hospital for further care. Prior human and animal data have shown similar pharmacokinetics and shared clinical effects of these lithium salts. DISCUSSION: Over-the-Internet dietary supplements may contain ingredients capable of causing toxicity in overdose. Chronic lithium toxicity from ingestion of this product is also of theoretical concern.

PMID: 18072162


Note their concern about chronic lithium toxicity -- lithium has a half-life of approximately 20 hours. You won't reach steady concentrations of lithium until you've taken a given dose for five to seven days. If the data suggesting typical dietary intake of lithium to be 1mg daily is correct, 5mg already represents a high level of supplementation, and the 20mg you're taking can only be described as pharmacological self-medication with lithium. And if you are thinking 20mg of elemental lithium is not that much compared to typical lithium carbonate therapy, consider that there may be differences in bioavailability and elimination that make lithium orotate more potent (the word toxic could be substituted depending on your perspective):

An animal study by Smith and Schou suggests that the kidneys clear lithium orotate significantly less effectively than lithium carbonate, and that this accounts for the higher serum levels of lithum when lithium orotate is taken compared to the equivalent amount of lithium carbonate. They conclude: "The higher lithium concentrations could be accounted for by the lower kidney function. It seems inadvisable to use lithium orotate for the treatment of patients."[3] Proponents of lithium orotate therapy argue that this study was flawed because equal amounts of each compound of lithium was employed, whereas the point of using lithium orotate is to consume less elemental lithium than with lithium carbonate therapy.[4]

The study which concluded that lithium orotate was inadvisable for treatment of patients was done as a direct follow-up study to one performed by Kling, Manowitz and Pollack in 1978. Their study suggested that lithium orotate could be used in lower amounts than the amounts required when using lithium carbonate, while achieving therapeutic results.[5] However, an earlier study did not find a difference in the uptake, distribution and elimination of the orotate salt, as compared to carbonate or chloride salts of lithium.[6]

Self-treatment of a psychiatric disorder with these supplements is potentially dangerous, since lithium is toxic in high doses.[7] The active principle in these salts is the lithium ion Li+, which interacts with the normal function of sodium ions to produce numerous changes in the neurotransmitter activity of the brain. Therapeutically useful amounts of lithium are only slightly lower than toxic amounts when lithium carbonate or lithium citrate are used, so the blood levels of lithium must be carefully monitored during treatment.

3 ^ Smith DF, Schou M. Kidney function and lithium concentrations of rats given an injection of lithium orotate or lithium carbonate. J Pharm Pharmacol. 1979 Mar;31(3):161-3. Retrieved 18 April 2007
4 ^ Lithium Orotate - Herbal Miracle or Internet Snake Oil?. Retrieved February 22, 2008.
5 ^ Kling MA, Manowitz P, Pollack IW. Rat brain and serum lithium concentrations after acute injections of lithium carbonate and orotate. J Pharm Pharmacol. 1978 Jun;30(6):368-70.
6 ^ Smith, DF (April 1976). "Lithium orotate, carbonate and chloride: pharmacokinetics, polyuria in rats". Br J Pharmacol. 56 (4): 399–402. PMID 1260219, http://www.pubmedcen...ubmedid=1260219.
7 ^ Pauzé DK, Brooks DE (June 2007). "Lithium toxicity from an Internet dietary supplement". J Med Toxicol 3 (2): 61–2. PMID 18072162, http://jmt.pennpress...302_061_062.pdf.


At a dose of 150mg lithium orotate daily, less than a third of your dose, 20% of the patients in this study developed side effects including muscle weakness, loss of appetite and apathy. Side effects resolved with less frequent dosing.

Alcohol. 1986 Mar-Apr;3(2):97-100.
Lithium orotate in the treatment of alcoholism and related conditions.
Sartori HE.

The subjects were 42 alcoholic patients (33 males and 9 females) who were treated with lithium orotate during an alcohol rehabilitation program in a private clinical setting for at least six months. They derive from a total number of 105 patients who received this treatment initially, while the remainder discontinued the treatment within six months. The data were collected from a private practice record and the follow-up varied between six months and 10 years. The 42 patients studied displayed a multitude of complaints in addition to chronic alcoholism. These included liver dysfunction, seizure disorders, headaches, hyperthyroidism, affective disorders. Meniere's syndrome, liver and lung cancers. Thirty-six of the 42 patients studied had been hospitalized at least once for the management of their alcoholism. Lithium orotate was given, 150 mg daily, with a diet low in simple carbohydrates and containing moderate amounts of protein and fat. In addition, calcium orotate (for hepatic involvement), magnesium orotate, bromelaine, and essential phospholipids (for cardiac problems), and supportive measures were instituted, if required. Lithium orotate proved useful as the main pharmacologic agent for the treatment of alcoholism. Ten of the patients had no relapse for over three and up to 10 years, 13 patients remained without relapse for 1 to 3 years, and the remaining 12 had relapses between 6 to 12 months. Lithium orotate therapy was safe and the adverse side effects noted were minor, i.e., eight patients developed muscle weakness, loss of appetite or mild apathy. For these patients, the symptoms subsided when the daily dose was given 4 to 5 times weekly.


Edited by FunkOdyssey, 16 December 2008 - 05:21 PM.

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#11 bgwithadd

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Posted 17 December 2008 - 02:41 AM

That's a good point about the halflife, but at the same time there's a big difference between side effects and toxicity. I mostly want to make sure I'm not going to have to worry about kidney or liver failure, but even in the overdose case the effects she experienced were not major by any means. Virtually everyone suffers side effects with lithium in the doses used to control bipolar disorder, which is usually 100-200mg a day of elemental lithium and if anything the studies seem to suggest that lithium is lithium regardless of the type. Also, that 'effective dose' is not necesarily the dose at which it does anything. Pulling someone out of severe mania takes a much more severe action than what I am looking for.

In fact from the results I'm experiencing I'd say it's having a BIG effect even at 10mg of elemental lithium a day. I feel like my mood is enhanced but also...different, not really like taking typical antidepressants where I feel 'up' but not necessarily happy. Not sure that I have pinned it down exactly, but I simply feel like my brain is functioning a lot more smoothly and I take more pleasure from my daily activities and worry less. I can really believe it's increasing my brain's capacity. My blood pressure is down to 104/67, too, even when on my usual amphetamine and nicotine patch dose. Usually, it's in good shape when I wake up but borderline bad when I have all my drugs.

You are probably right that it's in the realm of 'self medication' to take much higher than the suggested dose, but I am largely comfortable with that so long as I am pretty sure I'm not in the realm of the wildly dangerous. That's basically the only way I've been able to get any real relief from my 'issues' so far. So far, this one seems almost like a miracle cure to me, even better than saint john's wort or omega 3s. I'm going to watch closely for side effects and lower my dose if anything crops up, though. I'll report back if I have any issues.

#12 FunkOdyssey

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Posted 17 December 2008 - 05:30 AM

I've taken 120mg lithium orotate (5mg elemental lithium) for a period of time and didn't notice anything dramatic. I had a zombie'ish quality to my mental state but I was also taking deprenyl which can cause the same, so I'm not sure which was responsible.
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#13 rwac

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Posted 17 December 2008 - 06:02 AM

I've taken 120mg lithium orotate (5mg elemental lithium) for a period of time and didn't notice anything dramatic. I had a zombie'ish quality to my mental state but I was also taking deprenyl which can cause the same, so I'm not sure which was responsible.


No, It's probably the lithium.
I feel I have reduced dopamine levels when I'm taking lithium.
I supplement DLPA to fix that.

#14 yoyo

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Posted 17 December 2008 - 07:16 PM

The minimum therapeutic dosage for antidepressant augmentation (which is insufficient for anti-manic effects) is 300-600mg of carbonate per day. A few case reports of some recovering alcoholics who also had other problems who were feeling out of sorts does not convince me that they were experiencing toxicity, especially in the absence of blood test. the woman in the other story had a serum level only a third of that targeted by psychiatry for benefit. 4 pills a day would not result in half her serum levels. If she hadn't taken any on previous days, it would indicate she got higher than usual levels if absorbtion was the same, or expected if orotate absorbs somewhat better than inorganic. Some other studies have shown more equivalent absorbtion.

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#15 bgwithadd

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Posted 23 December 2008 - 06:00 AM

Well, my blood levels should have normalized by now and I still feel great with no side effects experienced.

I think it's interesting/bizarre that doctors can be so alarmist towards supplements. The more I think of it, the more silly all the bad reactions I see are. It's pretty easy to calculate the blood levels of a drug if you know its half life, and while that does vary person to person it's generally not by much. A quick calculation shows my stable blood level should be about .15, one tenth the range that you even start to worry let alone the serious danger zone. With lithium you'll also be vomiting and/or palsied long before you get to the point of liver or kidney failure, as well. It turns out that omega 3s can help prevent this damage, as well. It's also the blood levels which lead to the bad side effects, not the amount that's in the actual cells, so if lithium orotate does enter the cells more effectively that doesn't make it more dangerous (and the research seems to suggest lithium is just lithium anyway).

By contrast, if you take even a relatively small amount of potassium above what's recommended you can have a heart attack, but I don't see any doctors bashing on potassium supplementation and calling it quack medicine. Thousands of people die from aspirin and tylenol use per year, too, but you seldom hear any move to take it off the market.

I guess you never know with anything without long term study, but I feel pretty confident now and I just thought I'd report back by lack of side effects to date - and if anything they should lessen with time, anyhow. Overall, though, I have to say the medical profession is batting zero when it comes to me personally. I have had to make every single diagnosis myself for anything more complicated than a sore throat to get any relief, and I've had better results from 'quack medicine' than I have from anything they've prescribed, and I had to practically beg on my hands and knees to get the few meds that actually do help.




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