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As the Renaissance physician Paracelsus famously wrote, “All things are poison / and nothing is without poison / the dosage alone makes it so a thing is not a poison.” This is an eloquent encapsulation of a principle that, at a glance, seems obvious. Everyone knows that maintaining a Goldilocks-esque balance in all things is important for health.

We consider the principle of balance, as it applies to nutrients, less frequently . . . but we shouldn’t. The consequences of straying beyond “just right” and into the realm of “too much” or “too little” can be serious. ALL nutrients may be toxic when taken in excess or may lead to deficiency when taken in insufficient amounts.1,2

The mineral lithium is no different. In trace quantities or administered at “nutritional” dose ranges, lithium is a powerful promoter of health, an essential micronutrient with a range of benefits. At large, pharmaceutical doses, however, lithium is less benign; it may have side effects as a medication and can be toxic if dosages exceed prescribed amounts.

Side Effects of Lithium Carbonate

On the pharmaceutical end of the spectrum lies lithium carbonate – long celebrated as a medication for bipolar disorder, schizophrenia, and psychosis, and typically administered at doses between 600 – 2,000mg/day. At this range, lithium is associated with side effects such as kidney damage, blurred vision, muscular weakness, and thyroid issues; lower pharmaceutical doses may cause drowsiness, nausea, and frequent urination.

It is for this reason that patients taking lithium carbonate must be closely monitored, and undergo routine blood testing. For some patients, the side effect profile of lithium carbonate can be severe to the extent that it affects their compliance with treatment.

Side Effects of Lithium Orotate

At the other end of the spectrum is lithium orotate, with a dose ranging up to a maximum of 30mg/day. When administered at this “nutritional” or low dose range, lithium is not only safe and well tolerated, with minimal-to-nonexistent side effects, but also happens to be among the more effective treatments currently available for a wide range of mental health conditions.3

I would go so far as to say that lithium is the backbone of my clinical practice, a natural tool in the modern therapeutic arsenal that can confer tremendous benefits.

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  1. Noël L, Chekri R, Millour S, et al. Li, Cr, Mn, Co, Ni, Cu, Zn, Se and Mo levels in foodstuffs from the Second French TDS. Food Chem. 2012;132(3):1502-1513.
  2. Szklarska D, Rzymski P. Is lithium a micronutrient? From biological activity and epidemiological observation to food fortification. Biol Trace Elem Res. 2019;189(1):18-27.
  3. Murbach TS, Glávits R, Endres JR, et al. A toxicological evaluation of lithium orotate. Regul Toxicol Pharmacol. 2021;124:104973. doi:10.1016/j.yrtph.2021.104973