Lithium Orotate and Vitamin B12: Benefits for Mood and Cognitive Support

Key takeaways:
~For some people, supplementing with low-dose lithium orotate helps with anxiety, depression, and anger issues.
~For others, lithium orotate supplements seem to have little or no noticeable effect on mood.
~Research shows that small amounts of lithium (natural mineral) influence mood, aggression, neuroinflammation, and more.
~Vitamin B12 comes into play here as well, and lithium orotate along with B12 may help with mood and cognition.

In this article, we will explore the potential lithium orotate benefits, backed by research studies, and discuss its impact on mood, anxiety, and cognition.

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What is low-dose lithium orotate?

Lithium is a naturally occurring mineral found in foods at concentrations dependent upon the mineral content of the soil. It is also an essential element that people need – in small amounts. High amounts of lithium are toxic.[ref]

We get roughly 3 -4 mg of lithium per day naturally in our food and water, although this varies depending on where you live and where your food was grown.

Lithium orotate is a type of natural mineral supplement, and it comes in doses ranging from 5 to 10 mg of elemental lithium. (Just to be clear — I’m not talking about the high dose prescription lithium carbonate that is used for bipolar disorder. Lithium orotate is a different formulation and a whole lot lower dose.)

Naturally occurring levels of lithium impact depression and aggression:

Lithium is found in drinking water in varying amounts, depending on the naturally occurring lithium levels in the soil.

Researchers have looked at areas that have higher levels of lithium in the water and compared them to areas with low lithium levels.

Several studies show that areas with higher lithium levels in their drinking water have lower levels of depression and decreased aggression.

• A meta-analysis of studies on lithium in water showed that suicide rates were >50% lower in areas with higher lithium in the drinking water.[ref]
• Another study found that homicide rates were lower in areas with higher levels of lithium in the water supply.[ref]

In addition to epidemiological studies showing that lithium in drinking water reduces suicide rates, research on prescription lithium chloride also indicates that it reduces suicide attempts, independent of its effect on mood in bipolar disorder.[ref][ref]

The science behind lithium orotate’s benefits:

Studies show that low amounts of lithium, such as what is found in lithium orotate supplements, can help with mood, neuroinflammation, circadian rhythm, ADHD, and more.

Let’s dive into the research on lithium for mood, explore the cellular changes, and understand the mechanisms of action in the brain.

Lithium is thought to act in multiple ways to affect mood:

1. alters GSK3B  expression, impacting circadian rhythm
2. reduces neuroinflammation
3. increases BDNF
4. interacts with vitamin B12 and folate

1.) Lithium orotate: Impact on circadian rhythm and sleep

One way that lithium interacts with mood is by inhibiting GSK3B (glycogen synthase kinase 3beta). GSK3B acts on many different pathways in the body, including circadian rhythm and neuronal plasticity.[ref]

Dysregulation of GSK3B is linked to bipolar disorder, depression, and Alzheimer’s disease.[ref]

Lithium competes with magnesium in binding with GSK3B and inhibiting GSK3B. Through its impact on GSK3B, researchers think lithium can modulate the activity of many different pathways including circadian rhythm. Additionally, lithium may take the place of magnesium in other proteins that need magnesium.[ref]

GSK3B interacts with circadian rhythm and sleep issues, which can be at the heart of depression and mood disorders. Thus, lithium may impact mood and sleep by modifying GSK3B.

Additionally, lithium has been shown in animal and cell studies to upregulate PER2, a core clock gene.[ref]

2.) Lithium reduces neuroinflammation:

Several studies have found that lithium reduces arachidonic acid production in the brain. Arachidonic acid is an inflammatory lipid. Some researchers theorize that this reduction in neuroinflammation is one of the ways prescription-strength lithium chloride works for people with bipolar disorder.[ref][ref]

The reduction in arachidonic acid isn’t an immediate change, though. Animal studies using higher lithium levels, similar to levels found in prescription lithium, show that lipid levels in the brain change within a month. Specifically, choline and phosphatidylcholine levels increased while sphingomyelin levels decreased.[ref]

Phosphatidylcholine and choline are well-studied for brain benefits and are frequently used as supplements to improve cognitive performance.

Related article: Types of Supplemental Choline

3.) Lithium impacts BDNF

Brain-Derived Neurotrophic Factor (BDNF) is important in mood, memory, and learning. It helps the brain to form new connections.

In people with bipolar disorder, BDNF levels are often reduced. Lithium has been shown in multiple studies to increase BDNF levels.[ref]

4.) The connection between lithium orotate, mood, and B vitamins

Clinicians for more than a decade have recognized that lithium orotate and vitamin B12 act synergistically.

For example, Amy Yasko, PhD, states that “Lithium not only plays a role in mood, glutamate control and limiting aggression but also has been shown to be involved in B12 transport.”[ref] In addition to Dr. Yasko’s clinical work associating B12 and lithium, several studies are showing this as well.[ref]

Research studies on lithium and B vitamins:

• People who take prescription levels of lithium long-term for bipolar disorder tend to have lower serum levels of B12 (thus possibly more B12 in cells) than people using other medications.[ref]
• A study that analyzed lithium in hair samples in various locations and populations “suggests a role of lithium in the transport and distribution of vitamin B12.”[ref]
• A recent study (Feb. 2020) finds that for animal models of bipolar disorder, lithium works better in conjunction with folate (vitamin B9).[ref]

Why is vitamin B12 important to your mood?

Vitamin B12 and folate (B9) are required to produce tetrahydrobiopterin (BH4), which is involved in the production of the neurotransmitters serotonin, melatonin, dopamine, norepinephrine, and epinephrine.[ref]

A deficiency of vitamin B12 has been shown to cause symptoms that “may include agitation, irritability, negativism, confusion, disorientation, amnesia, impaired concentration and attention, and insomnia..” Additionally vitamin B12 deficiency increases the relative risk of depression, bipolar disorder, panic disorder, psychosis, phobias, and dementia.[ref]

Lithium orotate supplements and doses:

Low-dose lithium orotate supplements are available in many health and supplement stores. They are also readily available online. Supplemental doses of lithium range from 5 mg to 20mg of elemental lithium.

Safety studies specific to lithium orotate:

While lithium has been used for more than a century for bipolar disorder, there are possible side effects with the high dose prescription levels of lithium.

But what about low-dose lithium orotate?

A 2021 animal study investigated the safety of using lithium orotate. The results showed no genotoxic effects, meaning that it wouldn’t damage DNA. There were no adverse side effects or organ damage in the animal trial. The highest dose tested in animals was 400 mg/kg/day with no observable adverse effects.[ref]

How long does lithium orotate take to work?

Anecdotally, a 5 or 10mg lithium orotate supplement helps some people feel less irritable, angry, or anxious. It may take a week to notice the effect on mood. However, not everyone notices a difference in mood.

It is likely that genetics, diet, stress level, and daily exposure to lithium through drinking water/foods all come together to determine whether supplemental lithium affects an individual’s mood. The genetics part is explained in more detail below.

In addition to improving anxiety and irritability symptoms, there may be other benefits to low-dose lithium, such as Alzheimer’s prevention.

What is ‘microdosing’ lithium?

Several recent peer-reviewed studies reference microdosing of lithium for Alzheimer’s disease prevention or treatment. Essentially, the term microdosing just means a low dose compared to prescription lithium.

For example, clinical trials using a 300 mcg dose of lithium refer to it as microdosing. However, trials using up to 5 mg of elemental lithium also refer to it as microdosing.[ref][ref][ref]

I am bringing up microdosing because the right dose of lithium for Alzheimer’s prevention may be different than for someone who is using lithium orotate for mood regulation.

ADHD and lithium orotate:
Some clinicians recommend low-dose lithium orotate for ADHD.[ref] In adults with ADHD, a study using high-dose lithium found that it was as effective as methylphenidate in reducing irritability, aggressive outbursts, and more.[ref] In animals, lithium increases working memory.[ref]

Related article: ADHD Genes

Lifehacks:

Safety and Side Effects:

Prescription levels of lithium do come with long-term side effects, including higher risks of hypothyroidism and kidney problems.

• A meta-study on side effects from prescription dosages of lithium carbonate used for mood disorders showed that lithium increased the risk for hypothyroidism and weight gain. It also showed an increased risk of renal failure, with the overall risk being 0.5%.[ref]

Lithium orotate has one case study of one patient with an adverse reaction:

• A case study of an 18-year-old who took 18 tablets at once containing 120mg of lithium orotate. This dose would be the equivalent of 90mg of elemental lithium (along with a lot of excipients and capsule coatings). After a trip to the emergency department with nausea, she was discharged within a few hours to a psychiatric hospital.[ref]

Lithium Supplement Details:

Lithium orotate is available in health food stores and online in 5 mg – 20mg doses. Everyone is unique in whether lithium will affect mood and a which dosage is going to be most effective. You may want to start with the lowest available dosage (usually 5mg) and go from there.

Caution: Talk with your doctor if you have any questions on whether a supplement is right for you, especially if you are on prescription medications.

Natural Sources of Lithium:

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