LITHIUM - DIETARY
Vitamins & Supplements Updated July 26, 2016
Lithium is a highly reactive, light metal naturally found in very low levels throughout the body. It is available as a dietary supplement and is commonly found in drinking water and in many foods, including grains, vegetables, mustard, kelp, pistachios, dairy, fish, and meat. At daily doses between 0.3 to 5 milligrams, it could theoretically protect the brain, but the evidence is limited. Although high doses can cause serious side effects, daily doses below 5 milligrams are relatively low risk.
EVIDENCE
No clinical research has investigated dietary or supplemental lithium in patients without dementia. Our search identified:
• 1 small randomized clinical trial in patients with Alzheimer's disease
• 1 preclinical study using a microdose of lithium in rodents; numerous preclinical studies using far higher doses
POTENTIAL BENEFIT
While preclinical trials of lithium show promise for preventing dementia, we do not yet know whether those benefits will extend to humans, especially at low doses [1][2]. Lithium may increase the activity of stem cells and ramp up the transport of vitamin B12 and folate into cells, which could, in turn, protect the brain. Lithium may increase the number of mitochondria [3], (i.e., the powerhouse of cells) and increase autophagy, a process by which cells remove waste including the misfolded proteins associated with cognitive decline [3][4]. Lithium might also protect against Alzheimer's and related dementias by reducing the tau tangles common in Alzheimer’s and some other forms of dementia [5][6].
FOR DEMENTIA PATIENTS
Lithium can potentially benefit dementia and Alzheimer's patients, but the evidence is limited. In a preclinical Alzheimer's study, long-term microdoses of lithium carbonate were reported to protect against memory deficits and beta-amyloid plaque accumulation [7]. In a 15-month double-blind clinical trial in Brazil, a small microdose of lithium (0.3 milligrams) was reported to have slowed cognitive decline for Alzheimer's patients [8]. But this was a pilot trial, and it is unclear whether this benefit improved patients' lives.
SAFETY
Lithium derived from food, water, and dietary supplements below 5 mg/day is typically considered safe, although the safety of supplements has generally not been tested in clinical research. Higher doses have serious health risks [9][10]. Side effects include damage to the thyroid and parathyroid glands, weight gain, kidney damage, and possible risks to unborn children. Toxicity to the brain, while rare, is possible. Although lower doses typically cause fewer problems, safe dosage varies by individual. Older adults typically require lower doses and women may be more sensitive to the side effects [10][11]. Lithium toxicity is a particularly high risk for people with renal (kidney) or cardiovascular disease, dehydration, and sodium depletion as well as those who take diuretics or haloperidol. Many common drugs, including antidepressants, anti-inflammatory drugs, and caffeine, can interact with lithium and alter the levels deemed safe [10][12][13].
NOTE: This is not a comprehensive safety evaluation or complete list of potentially harmful drug interactions. It is important to discuss safety issues with your physician before taking any new supplement or medication.
HOW TO USE
Lithium is commonly found in drinking water and various foods, with dietary intake estimated at 0.6 to 3.1 milligrams per day in the United States in 1985 [14]. Lithium supplements are sold as pills, liquid capsules, solutions, and syrups of lithium orotate or lithium aspartate. Prescribed medications, in contrast, typically use lithium carbonate or lithium citrate. Lithium orotate supplements are typically sold in doses of 5 to 10 milligrams and are often touted as being safer, more natural, or more effective at reaching the brain than other lithium salts like lithium carbonate. However, our review of the research found no credible evidence to support these claims [15][16].
LEARN MORE
A report of pharmaceutical lithium is also available on Cognitive Vitality.
Lithium safety precautions and drug interactions from Drugs.com
REFERENCES
Gamez, J., et al., Lithium for treatment of amyotrophic lateral sclerosis: much ado about nothing. Neurologia, 2013.
Group, U.K.-L.S., et al., Lithium in patients with amyotrophic lateral sclerosis (LiCALS): a phase 3 multicentre, randomised, double-blind, placebo-controlled trial. Lancet Neurol, 2013. 12(4): p. 339-45.
Fornai, F., et al., Autophagy and amyotrophic lateral sclerosis: The multiple roles of lithium. Autophagy, 2008. 4(4): p. 527-30.
Sarkar, S. and D.C. Rubinsztein, Inositol and IP3 levels regulate autophagy: biology and therapeutic speculations. Autophagy, 2006. 2(2): p. 132-4.
Noble, W., et al., Inhibition of glycogen synthase kinase-3 by lithium correlates with reduced tauopathy and degeneration in vivo. Proc Natl Acad Sci U S A, 2005. 102(19): p. 6990-5.
Engel, T., et al., Lithium, a potential protective drug in Alzheimer's disease. Neurodegener Dis, 2008. 5(3-4): p. 247-9.
Nunes, M.A., et al., Chronic Microdose Lithium Treatment Prevented Memory Loss and Neurohistopathological Changes in a Transgenic Mouse Model of Alzheimer's Disease. PLoS One, 2015. 10(11): p. e0142267.
Nunes, M.A., T.A. Viel, and H.S. Buck, Microdose lithium treatment stabilized cognitive impairment in patients with Alzheimer's disease. Curr Alzheimer Res, 2013. 10(1): p. 104-7.
Balon, R., Possible dangers of a "nutritional supplement" lithium orotate. Ann Clin Psychiatry, 2013. 25(1): p. 71.
Grandjean, E.M. and J.M. Aubry, Lithium: updated human knowledge using an evidence-based approach: part III: clinical safety. CNS Drugs, 2009. 23(5): p. 397-418.
Rej, S., et al., Lithium dosing and serum concentrations across the age spectrum: from early adulthood to the tenth decade of life. Drugs Aging, 2014. 31(12): p. 911-6.
D'Souza, R., et al., Use of lithium in the treatment of bipolar disorder in late-life. Curr Psychiatry Rep, 2011. 13(6): p. 488-92.
McKnight, R.F., et al., Lithium toxicity profile: a systematic review and meta-analysis. Lancet, 2012. 379(9817): p. 721-8.
Schrauzer, G.N., Lithium: occurrence, dietary intakes, nutritional essentiality. J Am Coll Nutr, 2002. 21(1): p. 14-21.
Smith, D.F. and M. Schou, Kidney function and lithium concentrations of rats given an injection of lithium orotate or lithium carbonate. J Pharm Pharmacol, 1979. 31(3): p. 161-3.
Smith, D.F., Lithium orotate, carbonate and chloride: pharmacokinetics, polyuria in rats. Br J Pharmacol, 1976. 56(4): p. 399-402.
Cognitive Vitality, an ADDF Program Alzheimer's Drug Discovery Foundation
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