Course Description:

$199
Whenever the word “lithium” is mentioned in medical or psychiatric circles, it tends to inspire more questions than answers.  Is it safe?  Is it toxic?  Is it a medicine?  Is it a nutrient?  Do we need it?  Can it hurt or heal the human body?

As with so many other vitamins and minerals produced by the earth, lithium possess an association with human biology characterized by duality.  At certain concentrations, it is toxic to us; at others, it is a miracle medicine celebrated since the early 20th century for its ability to stabilize mood and used as a first-line treatment for bipolar disorder.  And yet this is not the end of lithium’s story, for a growing body of research literature and empirical clinical evidence suggests that this humble mineral may in fact be one of the most promising treatments available for a range of psychiatric disorders, neurologic diseases, and physiologic maladies.  More, this body of literature underscores an increasingly robust rationale for the existence of a lithium deficiency state in susceptible individuals.  The closer we look at lithium, the more essential it reveals itself to be for human health.

This four-module course, designed for healthcare practitioners, will take registrants on a fascinating journey from the dawn of the known universe to the present day in search of the truths and therapeutic potentials of lithium.  A review of lithium’s natural history will be followed by the presentation of powerful research evidence supporting a lithium deficiency hypothesis and revealing powerful associations between lithium, psychiatric illness, and suicide.  The biologic pathways through which lithium confers its documented neuroprotective, antioxidant, and anti-inflammatory effects will be elucidated, and linked mechanistically to clinical presentations for which lithium is now being utilized in functional medicine practices.  The delineation of specific dose ranges according to physical response will be discussed in detail, refining actionable parameters for “pharmacologic” vs. “maintenance” vs. “micro-dose” and “nutritional” lithium.  Lithium orotate and carbonate will be discussed in regard to their differential pharmacodynamic effects and clinical applications, as will recommendations and best practices for the quantification of lithium status through lab testing.  Finally, rationale for the existence of a de facto lithium deficiency that in some individuals may be exacerbated by genetic or epigenetic factors will be objectively presented.

Upon completion, registrants will be able to safely incorporate low-dose nutritional lithium into functional medicine protocols for a variety of psychiatric and neurologic ailments.

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Modules:

1. Mineral: From the Big Bang to Modern Medicine

Module 1 will explore the history and orthomolecular identity of lithium, one of nature’s – and modern medicine’s – most misunderstood elements.  From its inception at the dawn of the universe to its use as a folk remedy to its inclusion in the 2018 WHO list of Essential Medicines, lithium’s chemical composition, geologic distribution, and tumultuous journey to the frontiers of modern functional medicine will be examined.  Shifting attitudes borne by the medical establishment about lithium will be clarified through a look at early 21st-century psychiatric applications for high-dose lithium, and recent studies documenting powerful correlations between groundwater lithium concentrations and rates of mental illness and suicide will be reviewed.  This evidence will be tied conceptually and causally to a fascinating hypothesis of lithium deficiency.  Just how essential is lithium?  Are there some individuals who have an intrinsic need for higher lithium intake?   How might lithium deficiency be phenomenologically and etiologically tied to disease pathogenesis, and influence pathologic susceptibility?  Answers to these questions will objectively examined through the lens of orthomolecular theory, and supported by epidemiologic data, case studies, and meta-analyses.  Finally, the differential pharmacodynamics and clinical applications of lithium carbonate, lithium orotate, and lithium chloride will be appraised.

2. Medicine: Lithium for Bipolar and Beyond

The association between lithium and bipolar disorder is one of vast significance.  Having been utilized as such for decades, lithium remains to this day a first-line treatment for the reduction of manic frequency and severity.  Thanks to this long history of use, the medical and scientific communities have amassed a large body of clinical data derived from bipolar patient populations, and it is from this data that we have learned about lithium’s potentials beyond bipolar disorder.

Module 2 will begin with a review lithium’s history of use as a pharmacologic agent for the treatment of bipolar illness, and the mechanisms underlying lithium’s mood-stabilizing effects.  The review will segue into an examination of the stunning associations that have been revealed through retrospective analyses of bipolar subject groups; specifically, those linking lithium and Alzheimer’s disease, and lithium and suicide.  Additional evidence supporting an inverse correlation between lithium and suicidality will be objectively reviewed, providing an empirical foundation for a biologic model of suicide risk wherein suicidal behaviors are understood to arise from a dynamic continuum of biochemical susceptibilities.  This biologic model will be elucidated in detail, with a focus on the neurologic and cognitive sequelae of essential lipid deficiencies and systemic inflammation.  The mechanisms through which lithium addresses these etiologic progressions will be examined, underscoring an orthomolecular rationale for lithium’s inclusion in integrative protocols for suicide prevention.

3. Medicine: Low-Dose Nutritional Lithium for Neurodegenerative Illness

Retrospective evidence demonstrating significantly reduced rates of neurodegenerative illness amongst bipolar disorder patients treated with lithium has shed a bright light on an otherwise dark horizon.  Amidst a frenzied and as-yet unsuccessful race to procure a pharmaceutical ‘fix’, lithium stands apart, and is arguably the most promising treatment available in all of modern medicine for the neurologic decline associated with Alzheimer’s disease, Parkinson’s disease, and other forms of dementia.

Module 3 will begin with an objective assessment of the established Alzheimer’s therapeutic model, and treatment options available to today’s patients which, despite significant advances in our understanding as to the genetic and cellular bases of Alzheimer’s disease, have changed little over the last several decades.  Next, the implications of studies revealing a lengthy prodromal period in Alzheimer’s pathogenesis will be discussed, and will underscore an empirically substantiated rationale for shifting the therapeutic paradigm away from reaction and towards prevention.  Lithium’s viability as a component of integrative Alzheimer’s prevention strategies will be established with an in-depth examination of biologic mechanisms through which it exerts its documented neuroprotective effects and combats tau and amyloid aggregations.  Finally, lithium’s potentials as an orthomolecular treatment will be expanded with a look at Parkinson’s, ALS, and cancer and the etiologic pathways common to these diseases upon which lithium is shown to exert pharmacodynamic effects.

4. Miracle: Expanding the Scope of Lithium's Potential in Integrative Practice

Module 4 will examine lithium’s utility and clinical potential as a treatment for Chronic Traumatic Encephalopathy (CTE) and Traumatic Brain Injury (TBI), and for psychiatric disorders characterized by emotional dysregulation, disinhibition, and impulsivity.

First, the enormous therapeutic implications of lithium’s ability to disrupt cellular processes leading to tau and amyloid deposition will be examined as they relate to CTE and TBI, devastating neurologic ailments associated with emotional disinhibition, impulsivity, violence, and suicide.  Experimental studies documenting lithium’s ability to suppress TBI-induced neuroinflammation and beta-amyloid accumulation, inhibit GSK-3, attenuate disruption of the blood-brain barrier, and enhance dopaminergic neurotransmission will be presented, providing a mechanistic rationale for the inclusion of lithium in functional medicine protocols for TBI and CTE.  Next, the clinical utility of low-dose lithium as a treatment for Conduct Disorder, Oppositional Defiant Disorder, Disruptive Mood Dysregulation Disorder, and ADHD will be explored, and substantiated through a review of relevant clinical literature.  Finally, lithium’s effects on neurotrophic factor synthesis and the modulation of neurotransmission pathways will be discussed as they relate to the pathogenesis of substance abuse disorders, highlighting yet another practical and significant application for lithium in integrative functional medicine practice.

Learning Objectives:

Upon completion of this course, registrants will be able to:

  • Substantiate the clinical utility of low-dose nutritional lithium as part of an integrative approach to support patients with psychiatric and/or neurologic illness
  • Safely and effectively incorporate evidence-based lithium augmentation strategies into therapeutic protocols
  • Provide an empirically supported rationale for the lithium deficiency hypothesis, and identify intrinsic and environmental factors that might precipitate a higher maintenance lithium requirement
  • Elucidate the differences between lithium carbonate, orotate, and chloride as they relate to pharmacodynamics and therapeutic applications
  • Describe the quantitative and functional differences between pharmacologic and nutritional doses of lithium
  • Elucidate the biologic mechanisms through which lithium exerts neuroprotective, antioxidant, anti-inflammatory effects and inhibits processes leading to amyloid and tau deposition
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