This is part one of Dr. Greenblatt's Nutritional Lithium series. Part two can be found here.
As far as cosmologists can tell, there were only three elements present when the universe was first formed some 13.8 billion years ago: hydrogen, helium, and lithium.
As one of the three original elements, lithium is found throughout our atmosphere. The sun, stars, and meteorites burn brightly with the gleam of this highly reactive element. On earth, lithium remains a major mineral component of granite rock, and also lingers in significant amounts in sea water, mineral springs, and soils.
Lithium has also found its way into our cell phones, electric cars, and holiday fireworks. Every organ and tissue in the human body contains the mineral lithium, with particular importance in health, specifically brain health.
Integrative Psychiatry as an Approach to Promoting Brain Health
As a practitioner of integrative psychiatry, I treat individuals with a complex array of emotional, behavioral, and physical symptoms. One of the core concepts of Integrative Psychiatry is the concept of increasing the body’s nutrient reserves to promote long-term health. Lithium is one of the essential nutrients required to achieve optimal health.
History of Lithium use for Improving Mood
Soft drink entrepreneur Charles Leiper Grigg understood there was something special about lithium. In 1929, he unveiled a drink called Bib-Label Lithiated Lemon-Lime Soda with the slogan: “It takes the ouch out of the grouch.” Hailed for improving mood and curing hangovers, this product was eventually rechristened 7-Up. The “7” supposedly represents the rounded-up atomic weight of the element lithium (6.9), and the “Up” suggests its power to lift spirits. Lithium remained an ingredient of 7-Up until 1950.
Centuries before the advent of this celebrated soft drink, lithium was associated with calming moods. Soranus, a physician from ancient Ephesus, observed the benefits of alkaline springs for soothing the wild spirits of some of his patients. Lithium, it turned out, was abundant in these springs.
Efficacy of Low-dose Lithium as an Alternative to Pharmaceutical Dosing
I consider nutritional lithium the most effective nutritional supplement I have used for neurological and psychiatric disorders in 30 years of practice. My respect and enthusiasm for lithium treatment may seem surprising considering some of the drug’s diverse applications throughout history, its association with severe mental health disorders, and its reputation for side effects. At pharmaceutical doses, lithium is an effective treatment for bipolar disorder, recurrent depression, and suicidal tendencies (Lewitzka et al., 2015). But today many psychiatrists, including myself, hesitate to prescribe lithium because of potential side effects at high doses. Their concerns are not unwarranted. Lithium prescribed at pharmaceutical doses can have disabling, irreversible side effects including kidney and thyroid disease.
I consider nutritional lithium the most effective nutritional supplement I have used for neurological and psychiatric disorders in 30 years of practice.
It was not a huge leap for me in 1990 to start exploring the lowest dose of lithium possible that would alleviate my patients’ symptoms. Rather than basing my judgment on a number from a lab test, I listened to patients’ descriptions of their symptoms. I began to see that patients on lower doses of pharmaceutical lithium or nutritional lithium orotate still experienced significant clinical benefits.
I have found that side effects are non-existent when lithium is used as a nutritional supplement. Nutritional lithium is a safe integrative strategy for the treatment of psychiatric and neurological disorders. In fact, it has the potential to dramatically change your clinical practice. Instead of pulling out my prescription pad, in most cases I now recommend that patients take lithium as a nutritional supplement. Not only does low-dose lithium not have any side effects, there are tremendous benefits related to many aspects of mood, behavior, and emotional health.
The Potential of Nutritional Lithium
Even though lithium is among one of the oldest medications in psychiatry, large scale scientific studies of low-dose lithium are limited. Why? Because there is no profit in researching nutritional supplements. Pharmaceutical companies do not eagerly sponsor studies of inexpensive generic drugs. A prescription for lithium costs pennies, and of course, pharmaceutical companies reap no benefit from a nutritional supplement purchased at a health food store.
More recently however, small observational and interventional studies have positively associated modest concentrations of lithium with mental, emotional, and behavioral benefits. Small randomized, double-blind, placebo-controlled trials have indicated positive emotional and behavioral changes with short-term low dose supplementation with lithium. In one study, 24 participants with histories of aggression and impulsivity took a four-week course of 400 mcg of lithium daily. At the end of the month, their scores on measures of happiness, friendliness, energy, and mood had improved (Schrauzer & deVroey, 1990). In another study, participants receiving low-dose lithium for 12 months experienced statistically significant increases in both memory and attention (Leyhe et al., 2009).
Lithium in Drinking Water
Studies of lithium in the water supply provide enlightening evidence of the benefits of low-dose lithium. Low lithium content in the water supply is correlated with higher rates of mental and emotional disorders. In 1970, one research study analyzed levels of organically derived lithium in the water of 27 Texas counties and compared them to the incidence of admissions and readmissions for psychoses, neuroses, and personality disorders at local and state psychiatric hospitals (Schrauzer & Shrestha, 1990). The authors noted a clear trend: the higher the lithium content in the water supply, the lower the rate of psychiatric illness in that county. This association remained significant even after possible confounding variables were accounted for.
Nutritional lithium is a safe integrative strategy for the treatment of psychiatric and neurological disorders. In fact, it has the potential to dramatically change your clinical practice.
Uncertain whether these striking findings were unique to the geographical region, researchers sought to replicate the study in other areas. Lithium water studies have been conducted in Austria, England, Greece, and Japan (Giotakos et al., 2013; Kabacs et al., 2011; Kapusta et al., 2011; Ohgami et al., 2009). Data collection from all of these studies has confirmed a strong inverse correlation between aggressive crime and suicide, and supplemental levels of lithium in the water supply.
The potential of far-reaching use of low-dose lithium remains an exciting possibility. In 2014, Anna Fels MD proposes in her New York Times editorial:
“What if micro-dose lithium were again part of our standard nutritional fare? What if it were added back to soft drinks or popular vitamin brands or even put in the water supply? The research to date strongly suggests that suicide levels could be reduced, and even perhaps other violent acts. And maybe the dementia rate would decline. We don’t know because the research hasn’t been done.” (Fels, 2014)
From Plain Element to Promising Life-changer – Lithium as Cinderella
The story of lithium is a true Cinderella story. Lithium is a common and simple element, found in the rocks we walk on. Its benefits have not been heralded, as the fanfare associated with lucrative pharmaceuticals eclipses its simplicity. When newer treatments appear on the market, lithium is treated like somebody’s stepchild, often ignored and forgotten.
But also like Cinderella, lithium shows great promise. It has only to be recognized. Its ordinary nature is deceptive because it holds the power to transform lives.
Adapted from Nutritional Lithium: The Cinderella Story written by James Greenblatt, MD and Kayla Grossman, RN (CreateSpace, 2016, https://www.createspace.com/5433178).
About the Authors
James M. Greenblatt, MD, is chief medical officer and vice president of medical services at Walden Behavioral Care. Dr. Greenblatt is board-certified in child and adult psychiatry. Dr. Greenblatt is a clinical faculty member in the psychiatry department at Tufts Medical School as well as the Geisel School of Medicine at Dartmouth College in New Hampshire. Dr. Greenblatt is the author of six books including those on depression, eating disorders and ADHD. He can be reached at: (781) 647-2901. For more information on Dr. Greenblatt please visit www.jamesgreenblattmd.com.
Kayla Grossman, RN, works as a nurse advocate and freelance writer specializing in integrative health research and practice. She supports several large organizations in the field by contributing to their ongoing educational initiatives and clinical programming.
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 Fels, A. (2014). Should we all take a bit of lithium?. The New York Times. p. 6.
 Giotakos, O., Nisianakis, P., Tsouvelas, G., & Giakalou, V.V. (2013). Lithium in the public water supply and suicide mortality in Greece. Biological Trace Elements Research, 156(1-3), 376-9.
 Kabacs, N., Memon, A., Obinwa, T., Stochl, J., & Perez, J. (2011). Lithium in drinking water and suicide rates across the East of England. British Journal of Psychiatry, 198(5), 406-7.
 Kapusta, N.D., Mossaheb, N., Etzersdorfer, E., et al. (2011). Lithium in drinking water and suicide mortality. British Journal of Psychiatry, 198(5), 346-50.
 Lewitzka, U., Severus, E., Bauer, R., Ritter, P., Müller-Oerlinghausen, B., & Bauer, M. (2015). The suicide prevention effect of lithium: more than 20 years of evidence-a narrative review. International Journal Of Bipolar Disorders, 3(1), 32.
 Leyhe, T., Eshweiler, G.W., Stansky, E. et al. (2009). Increase of BDNF serum concentration in lithium-treated patients with early Alzheimer’s disease. Journal of Alzheimer’s Disease, 16, 649-656.
 Ohgami, H., Tetao, T., Shiotsuki, I., et al. (2009). Lithium levels in drinking water and risk of suicide. British Journal of Psychiatry, 194(5), 464-5.
 Schrauzer, G. N., & de Vroey, E. (1994). Effects of nutritional lithium supplementation on mood. A placebo-controlled study with former drug users. Biological Trace Element Research, 40(1), 89-101.
 Schrauzer, G.N. & Shrestha, K.P. (1990). Lithium in drinking water and the incidences of crimes, suicides, and arrests related to drug addictions. Biological Trace Elements Research, 25(2), 105-13.
 Zarse, K., Terao, T., Tian, J. et al. (2011). Low-dose lithium uptake promotes longevity in humans and metazoans. European Journal of Nutrition, 50(5), 387-389.