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New intel re Lithium Orotate
I have discussed previously that I have mild cognitive dysfunction and after two rounds of neuropsych testing over two years and Lab & imaging testing confirming my clinical profile, I am taking Lithium Orotate as a nutritional supplement. But I consume professional intel on studies religiously. Like this one.
https://www.psychiatrictimes.com/view/lecanemab-or-lithium-compare-benefits-risks-and-dose
The key question that stood out to me which the physician author (Dr Phelps) asks in his review of studies is below. I highly emcourage reading this. You have to follow some links and jump back and forth a bit but make the effort. For those of you fond of calculating elemental lithium there is a section on calculating equivalent dosing to the mice study.
“Brain lithium prevents amyloid plaque formation and phosphorylation of tau proteins. In the process of AD dementia, lithium is sequestered in plaques, creating a positive feedback loop: more plaque, less lithium, leading to more plaque, and so on. Giving lithium orotate to young adult mice almost completely prevented plaque formation and tau phosphorylation. Starting lithium orotate after plaques and phosphorylated tau have already formed almost completely reversed the expected cognitive impairment. Lithium carbonate is far less effective. If all this were true in humans, lithium orotate would be an obvious treatment both to prevent AD dementia and to treat it once detected.
Of course, skeptics’ first response has been “these are mouse data.” Aron et al point out that lithium levels in human and mouse brains are comparable, supporting the relevance of mouse models for studying the biological effects of lithium. Skeptics, including a prominent neurologist following a national presentation on AD treatment, have said that we should wait for a randomized trial of lithium orotate in humans (personal communication, August 2025). But the recent lithium carbonate randomized trial took 8 years to mount and complete. What shall we suggest to patients and families for the next 8 years?
A healthy lifestyle—including a Mediterranean-like diet, regular physical activity, and avoidance of smoking, excessive alcohol, social isolation, sleep disorders, and hearing loss—is an important means of preserving cognitive function in people at risk of developing dementia.
The subsequent article will compare lecanemab and lithium’s benefits, risks, and costs. With ApoE genotyping and the new pTau/amyloid blood test, patients and families need help now deciding between treatment alternatives.”
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In reading through these threads I haven't seen anything about potential kidney damage. Has anyone read studies regarding lithium orotate dosages and potential kidney damage?
I was told it can induce a diabetes like condition and that symptoms to be on lookout for are frequent thirst and frequent urination. My primary doc already routinely includes an eGFR kidney function test in my semi annual labs. So we can monitor that. I was also told to watch for metallic taste in mouth.
Remember the dosage for Bipolar disease is high, so if risk was common we would be aware. The recommendation for nutritional dosage is like 1/1000 of that prescribed for Bipolar Patients.
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1 ReactionA subscription to a group which evaluates supplements is valuable. There are several. One is Consumer Pharmacy
I have learned that your question was answered in the study described below. But yes the 42-40 ratio does change to reflect a decay -clearing of the amyloid from brain to spinal canal, showing up in CSF. That said, i have a big question about a specific
Reference in study design description that I will try to get answered this week.
The research described in the comment refers to a long-term randomized clinical trial conducted by Orestes V. Forlenzaand colleagues at the University of São Paulo, Brazil. Specifically, the findings regarding the 30% increase in CSF Aβ42 levels after 36 months were published in the following article:
Forlenza, O. V., Radanovic, M., Talib, L. L., & Gattaz, W. F. (2019). "Clinical and biological effects of long-term lithium treatment in older adults with amnestic mild cognitive impairment: randomised clinical trial." The British Journal of Psychiatry, 215(5), 668–674
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, 2.
Key Details of the Research:
Study Design: A single-center, randomized, double-blind, placebo-controlled trial involving 61 older adults with amnestic mild cognitive impairment (aMCI) 1.
Treatment: Participants received low-dose lithium carbonate aimed at subtherapeutic serum concentrations (0.25–0.5 mEq/L) for up to 4 years 1, 2.
Biomarker Results: While the placebo group showed stable or declining levels of CSF Aβ1-42, the lithium-treated group experienced a significant increase in these concentrations at the 36-month mark 1, 2.
Interpretation: This increase is interpreted as a sign of enhanced amyloid clearance from the brain parenchyma into the cerebrospinal fluid, potentially reflecting a disease-modifying effect that prevents the further accumulation of toxic amyloid plaques in the brain 1, 2.
This study is part of the broader "Lithium-MCI" trial series, which also includes earlier reports on the reduction of phosphorylated tau (P-tau) after 12 months of treatment 3 and a recent 13-year follow-up demonstrating sustained cognitive benefits in the lithium-treated cohort 2.
I was taking it for cognition and the urine poured out of me. I had to stop.
Yes. We chatted here about that. And we are very happy you connected the dots and stopped it. I believe you said you were taking 5mg and that is a typical nutritional dose in its supplement context. So you are sensitive to it.