The chances are good that you are exposed to some lithium almost every day of your life. That’s because this natural element is plentiful in nature. It is found in rocks and soil all over the earth. That means it ends up in our food and water supply. Trace amounts can be found in tomatoes, cucumbers, eggs, milk and mushrooms, to name just a few common food sources. Because levels of lithium in water are highly variable, researchers have been studying long-term exposure to this element and its impact on the brain. Is it possible that relatively small amounts of lithium could help prevent dementia?
Could Lithium Be Helpful Against Dementia?
We have been writing our syndicated newspaper column since 1978. King Features distributes it to scores of newspapers around the country. One reason that we have appreciated this opportunity is the feedback we get from readers. This website also allows people to ask questions and/or share stories in the comment section below each post. Visitors also send us email at this address: questions@peoplespharmacy.com.
Sometimes we don’t know the answers—or even if there are answers. But we often find that a search of the medical literature offers fascinating insights.
We recently received just such a question about lithium and dementia. It was short and sweet:
Q. What’s your assessment of the value of lithium to prevent dementia?
A. There have long been hints that lithium might be valuable to reduce the risk for dementia (Progress in Neuro-Psychopharmacology & Biological Psychiatry, Aug. 30, 2006). However, most research has focused on anti-amyloid drugs such as aducanumab (Aduhelm) or lecanemab (Leqembi). A systematic review turned up a number of animal studies but only a few clinical trials of lithium for preventing dementia (Ageing Research Reviews, March 2024).
Doses studied vary widely. When lithium is prescribed for bipolar disorder, doses range from 600 to 1,800 mg daily. Adverse effects may include diarrhea, muscle weakness, drowsiness, changes in thyroid function and kidney damage.
Much lower doses (10 to 20 mg of lithium orotate or citrate) have been used experimentally against depression and dementia. The risks may be reduced at such doses. Much more research is needed on this possible treatment.
Another Reader has a more detailed question about lithium:
“My late mother suffered from dementia for ten years. I helped care for her, and it was utter hell as it progressed. My sister is about to turn 70, and of course, she’s concerned about dementia.
“I have bipolar disorder, so I’ve been taking lithium to treat it for over 35 years now. A few years ago, I began seeing research on using lithium against dementia. The results from various researchers are impressive, including double-blind trials.
“I have learned that a micro-dose of lithium is all that is required, and not the usual dose necessary to treat bipolar disorder. On average, researchers found that 1.5 mg daily drastically reduced the formation of amyloid-B and plaques in the brain.
“What saddens me most is that I might have helped my mom avoid dementia entirely from my own bottle of lithium! But I didn’t stumble on the research until after she passed away in 2020.
“Now I figure that just one of my lithium tablets (300 mg) would supply my sister with nearly a year’s supply. I am tempted to order a micro scale, some gelatin capsules, and compound my own for her. She’s on a limited budget, and her doctor is not supportive at all. Although I’ve encouraged her to get a new doctor, that doesn’t seem likely.
Lithium in Water?
“Is there a form of lithium water she could drink? I’ve heard that others use it. I doubt there would be any need for blood work at such a low dose, but I would insist she get tested anyway, just to be safe.
“My apologies for sounding like Dr. Frankenstein, but I’m totally serious. I don’t want to wait several more years, then discover she’s got dementia like my mom if I could have prevented it!”
Our Answer:
We don’t know how to help your sister find a sympathetic physician. However, we agree with you that there are a number of intriguing studies hinting that low-dose lithium might be protective.
Research on Low-Dose Lithium vs. Dementia:
In one study from England, scientists found that people exposed to lithium were about 40 percent less likely to be diagnosed with dementia (PLOS Medicine, March 17, 2022). These populations were similar in other respects.
The authors conclude:
“We observed an association between lithium use and a decreased risk of developing dementia. This lends further support to the idea that lithium may be a disease-modifying treatment for dementia and that this is a promising treatment to take forwards to larger randomised controlled trials (RCTs) for this indication.”
An analysis of three trials found that all supported the results of lithium for dementia prevention (International Journal of Environmental Research and Public Health, July 22, 2021). Tissue culture studies hint at a possible mechanism (Scientific Reports, Dec. 4, 2019).
Basic research indicates that lithium chloride can reduce beta-amyloid toxicity in the brain (Journal of Alzheimer’s Disease, 2019). In addition, it helps prevent the buildup of tau found in tangles in the brain.
Microdoses of Lithium?
Could microdoses of lithium delay the development of Alzheimer’s disease? A study from Canada suggests that may indeed be the case (Journal of Alzheimer’s Disease, Jan. 21, 2020). Before we share the additional research on lithium and the brain, please stay with us while we present a brief historical perspective on lithium in water.
Research on Lithium in Water:
People who drink water with higher levels of lithium may be less likely to develop dementia. That’s the conclusion of a large epidemiological study from Denmark (JAMA Psychiatry, online, Aug. 23, 2017). Investigators compared 73,731 patients with dementia to 733,653 people without dementia. The subjects ranged in age from 75 to 85 years of age.
Measuring Lithium in Water:
The researchers measured lithium in drinking water from 151 communities around the Denmark and mapped where patients and controls had lived from 1986 to through 2013. Those exposed to naturally higher levels of lithium in their drinking water were less likely to have a diagnosis of dementia.
Prior research has linked lithium treatment to better learning and memory in laboratory animals. In addition, people with bipolar disorder undergoing long-term lithium treatment appear to have a reduced risk for dementia. This study seems to confirm these previous observations.
Lithium vs. Alzheimer’s Disease:
There are currently no effective treatments against Alzheimer’s disease. But researchers at McGill University in Canada have published an intriguing rodent study that goes beyond lithium in water (Journal of Alzheimer’s Disease, Jan. 21, 2020).
Previous research by this team led them to believe that a special very low dose lithium preparation (NP03) could interrupt “…early amyloid pathology stages in the Alzheimer’s-like transgenic rat” (Translational Psychiatry, Aug. 1, 2017). They concluded that:
“These findings thus suggest that NP03 reverses key AD [Alzheimer’s disease] pathologies in an in vivo AD model, and that it may have therapeutic value in the early stages of the disease.”
The Canadian research involved administering microdoses to lithium to rats bred to develop an Alzheimer’s-like brain disorder. This time, though, the brain pathology was more advanced.
This would be roughly equivalent to when amyloid plaque would be present in the brain and cognitive decline would begin to be detected. In the rodent study, the pathology was diminished and cognition improved.
Lithium vs. Bipolar Disorder, Depression and ADHD:
Over the last several years, evidence has been accumulating that low levels of lithium may be beneficial against a wide range of mental problems. If you would like to learn more about this history of lithium for what used to be called manic depression (now bipolar disorder), here is a link.
Did you know that Mineral Wells, Texas was renowned for its lithium-rich water? People found the water helpful for a variety of mental disorders. The original 7 Up soda had lithium in it. Learn all about this history of lithium here:
Rediscovering Lithium for Mood Disorders
Lithium is a mainstay for treating bipolar disorder. Side effects are scary, but could low-dose supplements be safer and more effective for mood disorders?
You will also find out about low-dose lithium in water as a potential preventive against suicide. There is also interest in low doses of this element for treating depression and possibly even ADHD. Here is a link to a free podcast about this intriguing application.
Lithium Is Not Benign:
Lithium is also found in medications. One of my early mentors was Dr. Carl Pfeiffer. He was head of the Neuropharmacology Laboratory at the NJ Neuropsychiatric Institute. He did some of the early research on the use of lithium for what was then called manic-depressive disorder.
In the high doses used to treat what is now called bipolar disorder, lithium can cause several side effects. Not only can it disrupt the digestive system (nausea, vomiting and diarrhea), it can cause an unpleasant taste in the mouth.
Weight gain is another potential problem. More worrisome is kidney damage. Kidney function must be monitored regularly! Other adverse reactions include tremor, excessive urination, thirst, fatigue, muscle weakness, drowsiness, thyroid problems and visual changes. Drug interactions are common and problematical. Anyone taking lithium must have regular pharmacy interaction reviews.
While low or microdoses of lithium are unlikely to cause such complications, anyone contemplating such a program must be under medical supervision! Regular kidney function tests are advisable.
If you have taken lithium in low or standard doses, please share your experience in the comment section below. Do you drink lithium water? What’s that like?
