Is Lithium Orotate the Secret to a Happier Mood?

If your only knowledge of lithium is the aptly titled Nirvana song, congrats, you’ve got great taste in music. But Kurt Cobain isn’t the only one linking being “so happy” with the element: Doctors have been using a type of lithium to treat bipolar disorder for over half a century (1, 2). More recently, a different kind of lithium—lithium orotate—has gained attention for its potential to boost mood in people without the psychiatric disorder. 

Psychiatrist Gauri Khurana, M.D., M.P.H. noticed increased interest in lithium after medicine 3.0 doctor Peter Attia, M.D., mentioned he was using two types of lithium for mood stabilization on The Drive podcast in 2020. In the episode, he mentions that he didn’t tell anyone he was taking lithium, but his wife picked up on behavioral changes. She noticed that after starting lithium, he’d been “less of an asshole.” 

And mood may not be the only thing lithium orotate helps with: It may also have neuroprotective effects. “I think people are experimenting with lithium orotate because it was mentioned on various popular podcasts that it’s a potent nootropic and can help with brain function and resiliency,” says psychiatrist Gauri Khurana, M.D., M.P.H.

What Is Lithium? 

Also known as elemental lithium, lithium is a metal found in the earth’s crust. Your body also contains trace amounts, as does drinking water, certain spices, and several foods including potatoes, tomatoes, fish, and nutmeg (3).

One form of lithium, called lithium carbonate, is the type that’s FDA-approved for treating bipolar disorder. It contains high doses of elemental lithium, which may explain why it has such a calming effect on mood. 
Lithium orotate (made of low-dose elemental lithium and the molecule orotic acid) is an over-the-counter supplement that may also positively influence mood and cognitive health (4).

About the Experts 

Amy Reichelt, Ph.D, is a neuroscientist, neuropharmacologist, and the chief innovation officer at PurMinds Neuropharma.

Gauri Khurana, M.D., M.P.H., a psychiatrist and a clinical instructor, Yale University School of Medicine, Department of Psychiatry.

Potential Lithium Orotate Benefits

While there are limited studies on lithium orotate benefits specifically, researchers have identified a few promising connections between low-dose lithium and mental well-being.

May improve mood

More clinical trials are needed, but one 2018 epidemiological paper suggests that in populations where elemental lithium is higher in drinking water, rates of violence and suicide are lower (3). 

For example, one of the studies included in the above research looked at lithium levels in drinking water in 27 Texas counties from 1978-1987. The most notable finding? The counties with the highest lithium levels had nearly 40 percent fewer suicides than the counties with the lowest levels (5). 

Another study included in the research found lower rates of suicide in areas of Japan where lithium was present in the drinking water. The authors of that study speculated that lithium may enhance the growth of neurons (6). Neuron production may play a vital role in combating depression and other mental disorders, according to research in Nature (7). 

These studies don’t prove lithium is responsible for these drops; they just show a link. However, they suggest that low doses of lithium might positively impact mood (8).

Going back to Attia: In the episode, he shared that at one point, he took as much as 600 mg of elemental lithium daily. As of 2020, he said he was taking about 10-20 mg of elemental lithium daily. He notes this is about the same amount found in the drinking water of regions where suicide rates are lower. 

Still, some experts remain skeptical about lithium’s effects on mood and mental health. “At best it’s just a placebo, at worst it could be genuinely harmful,” says neuroscientist Amy Reichelt, Ph.D., pointing to the potential for toxicity at high doses (9).  

Note: Early symptoms of lithium toxicity include nausea, abdominal pain, muscle twitching, slurred speech, and more (9). 

Attia significantly cut back on lithium because the higher dose made him nauseous as he traveled across time zones. He found out that on these travel days, he was taking as much as 900 mg of elemental lithium in a 24-hour period by accident. That’s a near-toxic amount for some, and the dose that many bipolar patients are prescribed, he added.  

May slow cognitive decline

The connection between low-dose lithium therapy and delaying cognitive decline hasn’t been proven, but research hints it might help. 

Two 2014 studies demonstrated an association between both low and standard doses of lithium and reduced cognitive decline in those with Alzheimer’s disease (AD) and other dementias (10, 11). Another 2022 study suggests lithium may slow the risk of AD and dementia (12). But most people in the study had bipolar disorder, which may increase the risk of certain neurodegenerative diseases (13). So it’s unclear if lithium could help people with these conditions (14). 

May help reduce ‘inflammaging’

As you age, you naturally develop low-grade chronic inflammation, or “inflammaging.” Over time, this can lead to chronic conditions such as cardiovascular disease, type 2 diabetes, osteoporosis, and dementia (15).

According to a 2014 review in the journal ACS Chemical Neuroscience, lithium may help fight inflammation in your body by lowering the production of pro-inflammatory cytokines, or proteins that help regulate the immune system (16). 

The research is limited on whether low-dose lithium orotate supplementation would be powerful enough to help completely offset inflammaging (17). But you might consider it as 

part of your multi-faceted quest to fend off age-related inflammation: A recent review in the journal Current Neuropharmacology suggests that low-dose lithium therapy may also reduce oxidative stress, which stokes the fire of inflammation (17). 

The only caveat? Many studies included in this review used rats as subjects. Clinical trials are needed to confirm whether humans can reap similar benefits.

May help those with bipolar disorder

The form of lithium traditionally prescribed for bipolar is lithium carbonate (18). A 2021 review in the journal Brain and Behavior suggests lithium orotate may be able to treat the disorder with fewer side effects since it crosses the blood-brain barrier and enters cells more easily than lithium carbonate. But, the authors caution more research is needed (19).

What Is a Safe Dose?

If you’re confused about how much lithium orotate is safe to take, you’re not alone. 

“With lithium orotate, no one really understands the dosing because it has not been studied [in humans],” Khurana says. Most studies on lithium orotate have been conducted on rats or in Petri dishes (20, 21). 

In addition, supplements aren’t regulated by the FDA so there isn’t a standard dose. That said, practitioners often prescribe 120 (mg) of lithium orotate, which translates to about 5 mg of elemental lithium (22). 

The authors of a study in the Journal of the American College of Nutrition hypothesize that the average person likely only needs 1 mg of lithium daily to enhance mood and cognition (23). That’s because the body already has trace amounts of elemental lithium (24). Plus, a liter of tap water in some parts of the world, may contain as much as 5.2 mg (3). If you’re drinking the recommended daily amount of water (3.7 liters for men, 2.7 liters for women), plus enjoying any of the foods listed above, you’re already getting plenty of elemental lithium (25). 

Just like any supplement, too much doesn’t translate to better results. According to the National Kidney Foundation, too much elemental lithium can cause acute or chronic kidney disease and kidney cysts (26). And one older study suggests that excessive lithium intake can also cause hypothyroidism as it inhibits the release of thyroid hormone (27).  

Lithium orotate contains much less elemental lithium than its carbonate counterpart, so you’re less likely to hit toxic levels with the former.  Still, “I’d recommend keeping your doctor informed and using a journal to track what you’ve noticed since starting the medicine,” Khurana says.

How to choose a lithium supplement

If you are considering giving lithium orotate a try, check with your doctor first. If they don’t recommend a brand, the general rule of thumb is to look for products with verified third-party testing.

“Make sure that the bottle is approved by the USP,” Khurana says. That’s United States Pharmacopeia. “It’s a scientific, nonprofit organization that sets federally recognized public standards of quality for medicines, dietary supplements, and foods,” she adds. 

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