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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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@pb50
Will they release any outcome data before the end of the trial which I think is in 2029 is a key question?
Also, will they capture any markers that relate to AD, such as tau 217/181, amyloid PET scans , cognitive testing,
I think that using LP’s/CSF testing will discourage participation and enrollment.
I agree - i just translate a CSF result in my mind to an updated 42-40 ratio since the only time anyone will access csf in me is if it is coming out of my nostrils or I am on the Pathologist’s table 🙂 So for that reason i would not enroll.
I wonder about pet scans too.
But I welcome their results!!!!
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1 Reaction@pb50
720 mg/day lithium orotate salt will provide ~27.8 mg lithium /day
While people are usually self administering 5-10 mg lithium /day (130-265 mg lithium orotate) .
In a physician supervised trial, this dosage still seems to be in the safe and low dose Tier.
Hoping for some early positive biomarker results that motivate more trials with combinations - targeting multiple pathways.
Thanks’
Most people I am aware of who are self- administering Lithium Oritate (LiO) are staying within accepted nutritional levels of 5-20mg LiO. The principal investigator in an upcoming human trial sponsored by John Hopkins - the one I reference in the preceding post - will use orotate as the carrier salt but the LiO dosage is multiples of that used in the Harvard mouse study - even after translating to human equivalent dosage. My assumption is that as a psychiatrist he is likely accustomed to large doses of Lithium - albeit Lithium Carbonate - associated with His bipolar patients.
But I don't care. I welcome his study because at whatever dose, the salient question is ‘was Amyloid plaque swept out overnight to CSF’ and can I see effects of that in the 42/40 ratio?
We still await the trial announcement of the Human trial that will be sponsored by Mass General and Brigham's Women’s Hospitals. The principal investigator will I believe be the one who led the Harvard Mouse trial reported in Nature last fall. We expect the launch announcement any time.
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3 Reactions@pb50
"Most people I am aware of who are self-administering Lithium Orotate (LiO) are staying within accepted nutritional levels of 5-20mg LiO"
I think you mean 5-20mg Lithium from Lithium Orotate.
Most labels will either report Lithium amount (from any salt):
Check label for Swanson, Lithium Orotate
Or rarely brands will report both Lithium amount and Lithium Salt amount amount:
Check label for Horbäach Lithium Orotate
130 mg Lithium Orotate (LiO) has ~5 mg Lithium (I feel this is what most people are taking)
265 mg Lithium Orotate (LiO) has ~ 10 mg Lithium.
Note - More technically, the conversion does slightly vary based on whether LiO is monohydrate or anhydrous form, but that is not significant.
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1 ReactionHi, folks. For those taking daily LO doses from 5 mg to 15 mg, have you noticed any changes? If so, what were they? How soon did you notice them? For those dosing more than 5 mg, is it recommended to split the dose and ingest it twice a day?
Thanks for sharing.
/LarryG
@larryg333
Understandably I don't give advice even for a nutritional supplement that is readily available 🙂
I will say that I find no evidence that there is reason to split the dose. Some people report sleep disturbance so I take mine in the morning. The two areas that it may create issues are kidney - you can google kidney issues on Lithium and learn - my doc does a quarterly eFGR anyway, so if there are issues it would be detected. The other area known to have issues is Thyroid and again, I have TSH levels drawn as part of my routine physical.
Everyone I communicate with here has informed their doctors and welcomed their feedback. It will undoubtedly contain "we should wait for human trials". The great news is that human trials are coming soon out of Mass General and Brigham's. There is also one out of John Hopkins that is Clinicaltrials.gov but it is using doses more like bipolar - and the principal investigator is a psychiatrist - so . But in both cases it will be a long time before results are available..
Some primary docs and Neuros are more open to the exploration, but agree it is likely harmless at the doses we are taking. A routine dose for bipolar is around 1000mg - as opposed to 10 or 20 in this case.
You can private message me with other questions.
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2 ReactionsHere is a new link to a discussion with. Guest physician from Cleveland Clinic on the two approved treatments..
https://www.medpagetoday.com/beyond-diagnosis/alzheimers-disease/121095
Big takeaway from the above for many here: You cannot be on an anticoagulant.
Oftentimes at this stage, seniors are prescribed them for
blood clots, anti-stroke therapy, heart attack, pulmonary embolism, and Afib.
Thanks for the post, PB.
@larryg333 thanks. I know both of the approved drugs have some risk of brain bleeds, particularly if the patient has an instance of the APOE4 gene. So it makes sense they would not want to increase that risk with an anticoagulant.
Thanks for that intel