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In psychiatry it has been well-documented that lithium has brain-protecting results when used at highly concentrated therapeutic doses. Pharmaceutical lithium (600-1200mg) has long been considered the gold standard option in the treatment of bipolar disorder and, more recently, has been deemed a candidate therapy for disease modulation in neurodegenerative disorders like Alzheimer’s disease.[1]  Yet as a naturally occurring mineral, lithium is also present in trace amounts in food and water supplies.[2]  Results of a nationwide Danish study published in the Journal of the American Medical Association (JAMA Psychiatry) has sought to decipher whether or not these subtherapeutic, dietary levels of lithium may also positively influence human cognition.[3]

In the study, a team of researchers compared levels of lithium in local drinking water with the incidence of dementia across segments of the population. Data from national registries was collected to identify 73,731 patients aged 50-90 with a diagnosis dementia. Long-term exposure to lithium was estimated using municipal water sampling statistics from the individual’s place of residence. This information was then collated with that from 733,653 age- and sex-matched controls without dementia.

Patients with the highest lithium exposure (>15 ug/L) showed a reduced incidence rate ratio of dementia when compared to those with the lowest level of lithium exposure (2-5 ug/L). This association was not significant for moderate lithium exposure. These results suggest that long-term exposure to higher levels of lithium in drinking water may be associated with a lower incidence of dementia in a nonlinear way.

This study builds on an existing base of research suggesting that subtherapeutic levels of lithium may indeed have neuroprotective effects. A 2-year randomized, placebo-controlled trial published in 2011 found that long-term treatment with daily low-milligram doses of lithium (150mg-600mg) may decrease the rate of developing Alzheimer’s disease among individuals with mild cognitive impairment.[4] Another 15-month randomized placebo-controlled trial suggested that a daily microdose of just 300 mcg of lithium could stabilize cognitive decline in patients with Alzheimer’s disease.[5]

The findings from the latest study provide a much-needed glimmer of hope in the field of dementia research. With an aging population and the incidence of neurodegenerative disorders on the rise, dementia has become a major public health concern. Yet, from the perspective of conventional medicine, almost nothing is known about how to treat or stop it. Even skeptics admit that “…the prospect that a relatively safe, simple, and cheap intervention (ie, optimizing lithium concentrations in the drinking water) could lead to the primary prevention of dementia is a tantalizing prospect.”[6]  Low dose lithium supplements, which are already available to consumers, can also provide the protective dose in a safe, targeted, and cost-effective way.

References

1  Forlenza, O.V., De-Paula, V.J.R, & Diniz, B.S.O. (2014). Neuroprotective effects of lithium: implications for the treatment of Alzheimer’s disease and related neurodegenerative disorders, ACS Chemical Neuroscience, 5(6). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063497/

2  Schrauzer, G.N. (2002). Lithium: occurrence dietary intakes, nutritional essentiality. The Journal of the American College of Nutrition, 21(1). https://www.ncbi.nlm.nih.gov/pubmed/11838882

3  Kessing, L.V., Gerds, T.A., Knudsen, N.N., et al. (2017). Association of lithium in drinking water with the incidence of dementia. Journal of the American Medical Association Psychiatry. http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2649277

4  Forlenza, O.V., Diniz, B.S., Radanovic, M., Santos, F.S., Talib, L.L. & Gattaz, W.F. (2011). Disease-modifying properties of long-term lithium treatment for amnestic mild cognitive impairment: randomized controlled trial. The British Journal of Psychiatry, 198(5). https://www.ncbi.nlm.nih.gov/pubmed/21525519

5  Nunes, M.A., Viel, T.A., & Buck, H.S. (2013). Microdose lithium treatment stabilized cognitive impairment in patients with Alzheimer’s disease. Current Alzheimer’s Research, 10(1). https://www.ncbi.nlm.nih.gov/pubmed/22746245

6  McGrath, J.J. & Berk, M. (2017). Could lithium in drinking water reduce the incidence of dementia? Journal of the American Medical Association Psychiatry. http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2649275