Lithium orotate

About Lithium orotate

Lithium bound to orotic acid, sold over the counter at 1–20 mg of elemental lithium per tablet. Lithium carbonate at hundreds of times this dose is a prescription mood-stabilising medicine with mandatory blood monitoring.

Lithium orotate is the clearest instance in this catalogue of a drug being sold as a nutrient. Lithium has no established essential role in human nutrition, no RDA and no upper limit. What it does have is a narrow therapeutic index as a psychiatric medicine: the gap between an effective blood level and a toxic one is small enough that prescribing requires regular blood tests, and lithium toxicity causes tremor, confusion, kidney injury and can be fatal. The supplement market rests on ecological studies correlating trace lithium in drinking water with lower suicide rates across regions — an association across populations, not a demonstrated effect in individuals — plus one small trial in Alzheimer disease. No safe over-the-counter dose has been established, and the orotate salt was promoted decades ago on animal data suggesting greater tissue delivery, which would make it more rather than less consequential.

Sold as

Tablet, Capsule, Liquid drops, Component of mood-support blends

Also known as

Low-dose lithium, Nutritional lithium, Lithium supplement

Regulation: Sold in the US as a dietary supplement with no pre-market efficacy or safety review, at doses that are not established as safe for unmonitored long-term use. Prescription lithium carries mandatory serum monitoring, kidney and thyroid testing and a boxed warning about toxicity in several jurisdictions. Several countries restrict lithium to prescription status regardless of the salt.

What the research used

The amounts, forms and durations published trials of Lithium orotate actually administered.

When it was taken

Each window says whether a trial compared it against an alternative, or whether it is convention and pharmacology. Most timing advice is the second kind.