A number of people have written about their experiences with lithium orotate as an alternative to pharmaceutical lithium (lithium carbonate or lithium citrate). I wanted to know more about it, so I reviewed the research. The bottom line is that we know very little about lithium orotate – the data is scant and old and tells us very little about the safety or effectiveness of lithium orotate as a substitute for lithium carbonate, the standard formulation.
Lithium orotate is an over-the-counter (OTC) product that, when taken, releases the lithium ion into the blood stream and brain. This is exactly the same result as when someone takes lithium that has been prescribed by a physician. And this is what reduces symptoms of bipolar disorder, so the positive effect of lithium orotate is exactly the same as prescription lithium.
The touted advantage to the orotate formulation is that it is more “bioavailable,” meaning that it creates higher blood and brain levels from smaller doses than regular lithium. In theory, this could reduce side effects of lithium by requiring lower doses to get the same effect. However there have been no human studies that have shown that it is more bioavailable or that it causes fewer side effects.
Only three studies look at any part of the bioavailability concept scientifically – they were all done in the 1970’s and they were all done on rats:
One human study was done in 1986 but this looked at the treatment of alcoholism. No human studies have looked at whether or not lithium orotate is effective in treating bipolar disorder. A recent article (Pauze et. al. 2007) described lithium toxicity due to an intentional overdose of lithium orotate.
My assessment is that lithium orotate probably works for bipolar disorder – it releases lithium into the brain and body and we know that the lithium ion is effective in treating bipolar disorder for many people. The problems are that I have no research to support that conclusion and what little research I do have about this compound is conflicting and done only on rats.
There is a suggestion that lithium orotate could be successfully used at lower doses than regular lithium, but there are also very serious concerns about kidney function and high blood levels of lithium using this product. Just like regular lithium, there is little difference between a therapeutic blood level and a toxic blood level of the lithium ion, and the toxic level can cause grave illness and even death. We have no well designed studies in humans looking at any of these questions.
Warning: I would strongly recommend against self treating with lithium orotate. Like all conditions, we sometimes use things that we don’t have a lot of evidence for in extreme situations, and I imagine there could be rare circumstances in which, together with a prescriber, someone might use this product instead of lithium carbonate, but people who were to choose this approach would still need to be followed for blood levels and any evidence of lithium toxicity.
Keep in mind as well that lithium orotate is marketed as a supplement, not a drug, so it is not regulated by the FDA – as a result, it is hard to know which products are even reputable or provide what they say they do. If you are interested in lithium orotate, talk about it with your prescriber and consider it carefully – remembering that, in fact, it is actually a psychoactive medication and it needs to be managed carefully.
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
Pauze DK, Brooks DE (June 2007) “Lithium toxicity from an Internet dietary supplement.” J. Med Toxicol 3 (2): 61-2
Sartori HE. “Lithium orotate in the treatment of alcoholism and related conditions.” 1986 Mar-Apr; 3 (2): 97-100
Smith DF, Schou M. “Kidney function and lithium concentrations for rats given an injection of lithium orotate or lithium carbonate.” J Pharm Pharmacol. 1979 Mar; 31 (3): 161-3
Smith DF (April 1976) “Lithium orotate, carbonate and chloride; pharmacokinetics, polyuria in rats.” Br J Pharmacol. 56 (4): 399-402
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Thanks Dr Fink. It is very frustrating trying to obtain reliable information about lithium orotate, but there is huge public interest in it. I get many requests from people who want advice on using lithium orotate. The lack of data and FDA approval is concerning and I hope authorities such as yourself can get enough attention for some further research to be done - it would be very helpful to know if this is a supplement with genuine benfefits or not.
My daughter is on lithium carbonate, and feels that it causes her to have insomnia. She has not been able to get off the lithium. Is there a substitute that she can use the will not cause insomnia?
granted this is anecdotal but sometimes since no one outside of big pharma cares to put money into research I choose good repeated anecdotes for my care all the time..
a good friend of mine got toxic on lithium carbonate. He could have died of kidney disease. His kidneys recovered to some degree. he now takes lithium orotate and gets blood draws and there has been no continued kidney damage as there would have been with the carbonate…
he has been stable on orotate for over 5 years.
I also know many others who have found low doses to be very effective. I hang out in alternative mental health care circles and so hear hundreds of anecdotal stories.
no one gets toxic…ever. blood tests show it’s much safer than carbonate…a drug that has killed three people I know personally.
orotate is over the counter because it’s never killed anyone…believe me if there was any toxic reaction the FDA would have it off the market way faster than any pharmaceutical that kills since big pharma makes sure to milk the heck out of any drug that’s killing people before it finally gets taken off market…
vioxx ring a bell?
or zyprexa and lithium that currently routinely kill but are still on the market…
no supplement ever gets that chance adding to my confidence that it is very safe.
Anita
I would strongly recommend that your daughter review all the options with her prescriber. Something like Lithium orotate may or may not make a difference in a side effect like insomnia - but even if she were to consider such a switch she should do it in conjunction with her doctor.
There have been reported cases of toxicity on lithium orotate, so it still needs to be monitored carefully.
I have been taking between 2 and 3.5 tables (10 to 17.5mg approx) of Lithium Orotate a day since mid June 2008 - a total of just over 400 tables (purchased from iHerb - California). I started taking the tablets during a hypomanic episode and felt the difference after 4 tablets. I have not had any Cyclothymia symptoms since (bliss) and I also have not had any side effects. I have been diagnosed by a psychiatrist so I do have Cyclothymia although I do not have a deep depressive cycle. It does work. I am also having regular blood tests (6 monthly) as recommended by my doctor.
Dr I am with you 100% anyone taking Lithium Orotate should wait until more studies are done on its safety and those who are on it should have regular blood test
Dr,
One dose of lithium orotate taken yesterday has put me into lithium toxicity.. unfortunately, for me, I bought into the hype
Hello, I want to start by saying that I am mostly anti-psychiatry. Most of their drugs are very addictive and I know this for a fact. Most of them will tell you to only take their drugs not because of your health but because of what goes into their pockets. (Notice how quick they are to start you on the medications)! Years ago the tobacco company denied that tobacco was a dangerous and addictive drug. Why? It’s very simple, it’s all about the money. And their drugs kill millions every year, including children!!! Yes, Lithium Orotate has not had much scientific study, but a lot of those standard medications are no good either. The grass is not exactly greener on the other side. Your best bet is to do your research on your own and talk to a REAL doctor about your issues. Google Citizens Commission on Human Rights “CCHR”. Be your own advocate. I have abnormal mood swings (during the month), PMDD, Anxiety and not to mention winter depression.If I go to one of them, I could easily be put on four medications. Well, Personally I would rather take a street drug like heroin that makes me feel good rather than me take their drugs and them profit off of me! I could die either way can I?
If taking lithium orotate - how do you test for toxicity levels? Do you just get a regular lithium level test like with lithium carbonate???
Hi Heather -
Yes - the test is the same - looking for the concentration of lithium in the blood. I would strongly encourage anyone taking Lithium Orotate to work with a doctor and the doctor can order the tests and keep track of the level with you.
Melatonin is ok to use with lithium……It will fix your daughters problem with insomnia….check with doctor for dosages …as it is a vitamin supplement …it is best to have a doctors advice before ….thanks
I recently had a kidney removed (cancer and only
12% use. I am also bipolar and use lithium
1200mg per day. Would I be better off changing
my lithium to something else. Depakote alarms me
cause the weight gain seems to be a big issue.
What can you recommend.
Harry
While I can’t comment on the safety of adding self-prescribed lithium ions to your body, there is a substantial amount of literature showing that the orotate ion is quite safe.
A short article which discusses magnesium orotate and the orotate ion and it’s safety and side effects in reported literature can be seen at:
http://www.aor.ca/assets/Research/pdf/Advances_10_May_2006_The_New_New_Magnesium.pdf
Lithium Orotate has made such a difference in my life. I take 120 mg a day to start, then when I feel better I cut down to 1/2 tablet. It really helps my depression and PMS symptoms. I take it periodically, when stress is bad I take it for a while, then I was off it all summer, now I am back on. I have had no side effects whatsoever. What prescription drug leaves you feeling better with no side effects? I never found one. I am just grateful to have something that makes me feel better. Depression is horrible. My depression is more situational (job, money problems), so it is probably not as bad as some, but it really takes a toll on me.
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