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Medical Questions and Answers
about Lithium Orotate
by Dr. Ward Dean

Please note: Dr. Dean is not a creator of or a contributor to this website.

The information below is from:


Dear Dr. Dean:

Assessment Criteria for Lithium Orotate

Dear Dr. Dean: If one doesn't need to have blood tests to measure therapeutic range using lithium orotate in lieu of lithium citrate, by what clinical standards is successful dosing measured? DL

Dear DL, The reason blood tests are performed with prescription forms of lithium is more to prevent toxicity than to judge therapeutic effect. Just because lithium levels are in the "therapeutic range" doesn't mean they are effective. Successful dosing with lithium orotate is measured by clinical effects on the patient, rather than by blood levels. Because of its high bioavailability, lithium orotate dosages are usually about 1/20 of the dosage of prescription lithium. Ward Dean, M.D.

Bi-Polar Disorder, and Questions about Lithium Orotate Side Effects

Hi Dr. Dean, I have read your article and Q and A re lithium orotate at VRP.com and I have a few more questions. Does lithium orotate cause sleepiness or weight gain (or does it hinder weight loss)? I take 4 200 mg SAMe & 3 100 mg 5HTP per day to alleviate depression (as well as natural progesterone, B-12 and lots of other vitamins). (I had been on Effexor, Zoloft and Welbutrin - but I got off them to eliminate the side effects.) The natural antidepressants have enabled me to get off the prescription ones - I feel that they work for me - I'm not perfect - I still get down and I still get angrier than I should at times. My bi-polar sister recently died and I have always felt that I have some tendencies toward that condition. From reading your answers I thought it might be a good thing for me to try Lithium orotate. I would like your opinion about that and answers to my questions re sleepiness and weight gain. Thanks a lot. B.C.

Dear Ms. Cunningham, Lithium Orotate will not cause weight gain, nor will it cause sedation or sleepiness. It will not adversely interact with any of the other supplements you are taking (or medications that you have taken in the past). Good luck, Ward Dean, M.D.

Bipolar Disorder and Depakote

Dear Dr. Dean, I was being treated for depression and bipolar mood disorder with 2000mg/day of Depakote, and 5mg /day of Zyprexe. I discontinued this course of treatment after six months because I felt like a zombie and was not any better. In fact, I felt much worse. Are there any natural products or supplements I could take to improve my condition, and that I should avoid? ( I am a 47 year old male with no prior diagnosis of depression and no other medical conditions) Thank you for your help. Sincerely, GT

Dear GT, I'm amazed at how the neurologists love Depakote. My first choice for bipolar disorder is Lithium Orotate. Please read our article on Lithium Orotate on VRP's website. It is amazing (and inexpensive) stuff. Lithium Orotate is about 20 times more bioavailable than the prescription forms of lithium. It does not require blood tests to establish a "therapeutic" level, as the prescription forms do, nor is it toxic to the kidneys as the prescription forms are. Other substances to try include high-dose Ethyl EPA (6-9 grams daily), and the combination of Syncholamine and Positrol. Syncholamine should be used during the day in the "down" phase, and Positrol should be used at night during the "up" phase. The prescription Neurontin (GabaPentin) may also help at night during the "up" phase. Hope these suggestions help. Ward Dean, M.D

Blood Tests for Lithium

Dr. Ward Dean, Re: Lithium Orotate I have started my BiPolar Son on the lithium orotate to address his mania. This has been added to his current regime of vitamins/minerals and amino acids, as prescribed by Dr. Billie Sahley of the Pain & Stress Center. His psychiatrist, Dr. John Alston of Evergreen, CO was quite interested in this safer form of lithium. It is wonderful not to have to be concerned about its toxicity. However, Dr. Alston also uses the blood test results to determine whether a patient is at a "therapeutic level." The blood level test serves as a tool for him to determine appropriate dosage levels. Even though blood tests are not required for testing toxicity, can they be used to determine whether a patient has a therapeutic amount of the lithium in their system? Would it be the same blood test? Would the results be interpreted the same way? I appreciate your reply and will share the information with Dr. Alston. Thanks --

Dear Mrs. Dalton, Prescription lithium is poorly absorbed by the cells, where it needs to be to do its job. Because it is so poorly absorbed, blood levels need to be fairly high to "drive it into the cells." Unfortunately, these "therapeutic" blood levels are dangerously close to the toxic level. That's why patients on prescription lithium need to be carefully monitored. The level needs to be high enough to push the lithium into the cells, but not too high to pickle the kidneys. However, with lithium orotate, it is not necessary to reach "therapeutic" blood levels, because it seems to go right into the cells where it belongs, and where it can do its intended job. I think a more effective way to determine whether lithium orotate is working, and whether an adequate dose has been prescribed, is to monitor the patient. Usually, asking them how they feel is enough. The effects are evident to the patient, as well as to the people around him. I think doing a blood test when taking lithium orotate is a waste of blood. Ward Dean, M.D.

Lithium Orotate and Bipolar Disorder

Dear Dr. Dean, I have a friend who has been diagnosed as bi-polar and treated accordingly with various anti-depressants, anti-psychotic meds, etc. The side effects of these meds have been most unpleasant for her! She has ordered the lithium orotate from VRP; took the info to her psychiatrist to request his review and to request that he work with her to transition from her meds to the lithium orotate. His response, "Don't waste my time talking about nutrition!" Thus, our question to you is, how would you recommend she best transition from the meds to the lithium orotate? Her meds are taken as follows: Risperdal - 4 mg taken at bedtime Amandatine - 100 mg. taken at bedtime (this med is taken exclusively to control the Parkinson's type symptoms she experiences as a side effect from taking the Risperdal. Sincerely, J. Halbert

Dear Ms. Halbert, First, I would have your friend consult a different psychiatrist. Lithium Orotate could probably be taken along with the Risperdal, as Lithium Orotate is extremely safe, with no known adverse side effects or drug interactions. Risperdal, on the other hand, is a powerful anti-psychotic medication with a significant side effect profile. I suggest that your friend work with a more open-minded and sympathetic psychiatrist who can monitor her response to Lithium Orotate and try to reduce/discontinue Risperdal. Ward Dean, M.D.

Lithium Orotate and Manic Depression

I have been using the product Lithium Orotate for approximately one year to control Manic-Depression. I started with two capsules daily and currently I am using six capsules daily (2 per meal). I have my blood level monitored by my Doctor. With two capsules daily my blood level result was 0.25. My level has never changed and it still shows 0.25 while I have used six capsules daily during the past four months. Is this normal? Also is there an amount that could be toxic that I should be aware of? Are there side effects associated with this Lithium? Could I be doing myself harm unknowingly by taking too much? I am not experiencing any apparent side effects. I feel good and I believe I am doing well - no complaints from family, friends or co-workers. I am grateful for this product since I discontinued Depakote and the prescribed Lithium almost destroyed me years ago. I am also grateful for the VRP newsletter and your answers to these questions.

Please re-read the article on lithium orotate. Lithium's clinical effects depend upon its intracellular concentration. Unfortunately, prescription forms of lithium (i.e., lithium citrate and lithium carbonate) are poorly transmitted across the cell membrane. Thus, in order to drive the lithium into the cell, blood levels must be quite high. The blood levels required to obtain this effect ("therapeutic blood levels") are very close to toxic levels. That is why prescription lithium has such a narrow "therapeutic window." Lithium orotate, on the other hand, is very efficiently transported across cellular membranes. Consequently, lithium orotate can be therapeutically effective, without significantly effecting lithium blood levels. Your physician is looking for your lithium levels to climb into the "therapeutic range"--which is neither required nor desirable when lithium orotate is used. Since, as you say, you are feeling well and are not experiencing any side effects, I would stay on your current dosage. You might want to show my article on lithium orotate to your physician.

Lithium Orotate vs Prescription Lithium

Hi, Dr. Dean, I would like to replace my patient's 600 mg of prescription lithium with lithium orotate. What is the equivalent dosage for 600 mg? Thank you Eugene Vasin, MD

Dear Dr. Vasin, Lithium orotate is 20 times more bio-available than lithium carbonate or lithium citrate. If this were the case in everyone, then 30 mg of lithium orotate (about six capsules) would be the equivalent of of 600 mg of prescription lithium. However, your patient may not need that much. I've seen patients respond to amazingly low doses. Nevertheless, I would start the patient on three capsules daily, and adjust the dose upwards (if necessary) based on his clinical response. I know of one patient who was taking 14 capsules daily without any signs of toxicity. His physician was fruitlessly trying to get his lithium into a "therapeutic range." Of course, this is not necessary with lithium orotate. Let me know your experiences. Ward

Loose Stools from Lithium Orotate

Dear Dr. Dean. I have recently been taking the Lithium Orotate twice a day - 120 mg = 4.8 mg elemental - for chelation of any accumulated metals. I noticed after a few days that I was having loose stools, so I quit taking the lithium for a couple of days. This cleared up the problem until I started taking the lithium again. Is this one of the side effects of taking the litihium? I have not seen any mention of this in any literature I have read. RM

Dear Mr. M, Thanks for the report. I have not previously heard of this being a side effect of lithium orotate, although it has been occasionally reported with prescription forms of lithium. I'd suggest reducing the dosage to below what appears to be "bowel tolerance" for you. Thanks again for letting me know of your experience. Ward Dean, M.D.

NSAIDs and Lithium Orotate

Dear Doctor, I take Lithium Orotate for a recurrent depressive illness and I should like to know if there is any danger to take it together with Naproxen Natrium which -like other Non-Steroida Anti-Inflammatory Drugs (NSAIDs)- risks raising the level of Lithium in the blood. Thank you in advance and best regards. CD

Dear CD, With the superior bioavailability of Lithium Orotate over the prescription forms of lithium, there is no concern for lithium toxicity. Since doses of Lithium Orotate that are clinically effective are about 1/20th of the required prescription dose. Consequently, it is not necessary to monitor blood levels. The dangerous part of taking Lithium Orotate with NSAIDs is not the lithium. I would be more concerned with the NSAIDs themselves. Ward Dean, M.D.

SSRIs, Bi-Polar Disorder, and Lithium Orotate

Dear Dr. Dean: I have been taking Zoloft for about 3 years. During that time I have also tried Paxil, Wellbutrin and a few others. My Dr. is now suggesting I take Prozac. I am fearful that taking anti-depressants is going to dumb me down. My Dr. has also suggested I am bi-polar. I am moody and always have been, but my father was an alcoholic and my mother was busy working and in denial. I'm not going for the sympathetic violin music, I just don't know if I can trust my Dr. as I feel she is very liberal in dispensing anti-depressants. Today, I have weaned myself off Zoloft and must decide whether to take Prozac or Wellbutrin. Or can I truly get off all medications and take 5HTP and or St. Johns Wort? I take DHEA every day and ginkgo and a few other odds and bits of vitamins. I also take 3 mg. of Ativan every night, and I have for 6 years. Any suggestions? I cannot take L-carnitine or phenylalanine as they do make me feel nuts and quite bitchy. Thank you for you time. SH

Dear SH, You might be able to reduce your dependence on Wellbutrin by taking 5-HTP. However, if phenylalanine does not agree with you, St. Johns Wort may not be appropriate for you. One of the mechanisms of St. Johns Wort is to act as a monoamine oxidase B inhibitor. This would tend to increase the stimulatory catecholamines--as phenylalanine does. On the other hand, I'd suggest trying Lithium Orotate. Lithium Orotate has antidepressant properties, and tends to level out those who are bipolar. Also, Lithium Orotate is not only more effective but is also much safer and does not require the periodic blood tests and physician monitoring of prescription forms of lithium. I would not be concerned about Prozac and the other SSRI's causing you to be "dumbed down"--they can be helpful in many people when appropriately used. Ward Dean, M.D.