Evidence Based
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Lithium Deficiency Symptoms + Ways to Fix

Written by Mathew Eng, PharmD | Reviewed by Ana Aleksic, MSc (Pharmacy) | Last updated:
Jonathan Ritter
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology) | Written by Mathew Eng, PharmD | Reviewed by Ana Aleksic, MSc (Pharmacy) | Last updated:

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Lithium Deficiency

We humans have adapted to getting trace amounts of lithium from food and water, and it seems that getting a bit more might make people more friendly and peaceful. Too little lithium may increase criminal behavior, raise the risk of mental illness, and shorten your lifespan. In this post, we’ll show you how (and why!) to spot and prevent lithium deficiency.

Could You Be Deficient in Lithium?

When we think about all the important vitamins and nutrients the body needs, we rarely think of lithium.

And it’s hard to blame people for overlooking lithium – it’s usually associated with drugs for bipolar disorder and their scary side effects.

But lithium wears many hats. The shocking truth is that it has a number of benefits unrelated to its use as a high-dose pharmaceutical. Your body requires lithium in trace amounts.

The amount you carry in your body is also known as endogenous lithium, which you get from water and food. And this tiny amount of lithium – tiny when compared to its prescription dosage, at least – has intriguing biological effects [1, 2].

People are surprised when they find out they need some lithium. Each person needs a miniscule amount, about 1 mg per day. Compare that with prescription lithium, which is usually given at 600-1200 mg/day of lithium carbonate (about 108-216 mg of elemental lithium) [1].

Lithium is an essential mineral that the body needs in very small amounts.

Why Are Some People Deficient?

Even though we need only tiny amounts of lithium each day, more people are deficient than was previously thought [1].

Where you live can have a huge impact on your chance of deficiency, since lithium concentrations in soil and water can vary wildly depending on location [3, 4].

Areas with little to no lithium may be causing a population-wide lithium deficiency, leading to negative effects on cognition and behavior [3, 4, 2, 5, 6].

The Curious History of Lithium

Let’s take a step back and first talk about what lithium is. The story about lithium is anything but ordinary.

Lithium is a chemical element naturally found in minerals, rocks, and bodies of water. It is one of the three elements created in the Big Bang. We humans have adapted to getting some lithium from water and food. We weren’t really aware of this until recently, though [7].

“Crazy Waters”

Many mineral springs contain lithium. Some of them, such as Mineral Wells in Texas, have long-held reputations as “crazy waters.” Texas was well known for its mineral water resorts back in the 19th century. Thousands of “crazy” people and those with various chronic health problems used to gush to these springs to get the healing benefits of lithium [8].

Medical Discoveries

The potential health benefits of lithium were first discovered in 1847. Back then, a London-based physician named Alfred Baring Garrod started using lithium to treat gout – including “brain gout.” By the 1930s, lithium became a widely-available drug [8].

Around that time, French physician Dr. Reyss-Brion remembers that a preparation called “Dr. Gustin’s Lithium” was popular in the south of France. “It’s quite simply for that reason that you don’t have a lot of manic-depressives in Marseilles,” he said [8].

It wasn’t until the 1940s that doctors started using lithium for mania. At the time, lobotomies and electroshocks were pretty much the only other available therapies. This makes lithium the first psychiatric drug [8].

Lithium predates modern antidepressants by some 40 years. Some even argue that it unfairly fell out of favor precisely because newer, more expensive drugs (like Depakote – Valproic Acid) were being marketed by companies [9, 8].

Even to this day, lithium perseveres. It continues to be the preferred treatment for bipolar disorder. Some doctors consider lithium the single most effective treatment in psychiatry [8].

Lithium was first used in medicine over 100 years ago. It’s the first psychiatric drug, and it is still considered one of the most effective treatments for bipolar disorder.

Where We Stand Today

Today, lithium salts are available as prescription medication and supplements. Many people get confused by these: is it the same if you take prescription lithium and supplements? And why is one form available only by prescription and the other is sold as a supplement?

In fact, these forms are different for two main reasons: first, prescription forms use high doses, whereas supplements are taken at much lower doses; secondly, the prescription version mostly contains lithium carbonate, while supplements usually have lithium orotate [10, 11].

Lithium aspartate and liquid formulations of lithium carbonate are used both as prescription medication and supplement, depending on the dosage [10].

All supplemental forms of lithium – as all supplements in general – are not approved by the FDA to treat any medical disorder, disease, or condition [10].

We’ll go into more detail on supplemental forms of lithium in the “supplements” section. You can also check out our lithium orotate article for a full breakdown of this supplement.

Supplemental forms of lithium, like lithium orotate, are widely available and used in much lower doses than the prescription forms.

Causes of Lithium Deficiency

1) Low Lithium in Food and Water

Most people get almost all of their lithium from the food and water they consume [1].

The problem is that lithium levels in groundwater and soil can vary greatly [1].

Just in the U.S., lithium concentrations in groundwater range from almost zero to well over 170 micrograms/L [12, 13].

It can even come down to your specific city – neighboring cities or counties can have much different lithium levels in their water sources. For example, water supplies in Los Angeles County average around 0.5 micrograms/L of lithium while drinking water in nearby Orange County contains as much as 10 micrograms/L [12, 13, 4].

Generally speaking, dryer regions in the U.S. tend to have higher levels of lithium compared to more humid areas. This might explain the “crazy water” in Texas, which is famous for its high lithium content [14].

Likewise, fruits and vegetables grown in lithium-poor soil will also have lower levels [1].

The average person in the U.S. gets somewhere between 0.6 to 3.1 mg of lithium each day. The recommended dietary allowance of lithium is 1 mg daily [1].

If you live in a lithium-poor area, there is a real chance you may not be getting enough lithium.

In that case, you might also want to look into how your water is being purified. Some forms of purified water, like distilled water, will not provide any lithium [15].

On the other hand, filtered water typically does contain lithium. This is because carbon filters, which most commercially available water filters use, are not great at removing trace metals [16].

You may not be getting enough lithium from your drinking water if you live in a lithium-poor area.

2) Medications

Certain drugs can cause lithium levels to drop, usually by increasing the amount of lithium that leaves the body through urine [17].

The bulk of research comes from people taking prescription lithium, and their doses need to be increased in combination with these medications. But even if you’re not on prescription lithium, these drugs will likely increase your daily lithium needs [17].

Drugs that significantly reduce lithium in the blood include [17]:

There are reports of other drugs lowering lithium levels, including [18]:

  • Acetazolamide (for altitude sickness)
  • Cisplatin (chemotherapy)
  • Sodium bicarbonate (baking soda)
  • Verapamil (for heart disease)

3) Dialysis

Dialysis is a medical procedure that filters the blood, removing excess water and toxins. It’s usually performed in patients with impaired kidney function, such as in chronic kidney disease [19].

The procedure also removes lithium. In fact, lithium overdoses are sometimes treated with dialysis [20].

In turn, patients on dialysis may have increased lithium requirements [21].

Symptoms & Health Effects of Lithium Deficiency

1) May Increase the Risk of Mental Illness

Prescription lithium is used to treat several psychiatric conditions, including bipolar disorder, depression, and schizophrenia [22, 23, 24].

But the benefits of trace amounts of lithium are something else. In tiny amounts, lithium supports balanced mental health. Lithium is normally found in drinking water worldwide. Simply put, humans are used to getting lithium from water [25].

As a result, lithium deficiency may increase the risk of mental illness.

Another study of over 3k students in Japan discovered that low lithium levels in tap water correspond to worse symptoms of depression [26].

Ironically, lithium concentrations in drinking water do not appear to alter rates of bipolar disorder, despite being the main condition that lithium is used for [27].

Why do lithium levels affect mental health?

The psychiatric benefits of endogenous lithium are not totally understood. Some researchers think that lithium may protect against neurotoxicity caused by lead exposure [25].

A lithium deficiency may lead to worse symptoms of depression.

2) May Worsen Cognition

A massive study performed in Denmark compared drinking water samples from over 800k people. They found that people drinking water with lower levels of lithium had higher rates of dementia [6].

Low lithium levels in drinking water also increase the risk of death in Alzheimers patients, according to a study looking at water samples from 234 counties in Texas [5].

3) May Increase Suicide Risk

Lithium stands out from other psychiatric drugs because of its ability to reduce suicidal behavior. Prescription lithium does this much better than most antidepressant and antipsychotic medications [28, 29].

According to some estimates, prescription lithium reduces the risk of attempted and completed suicides by 80% [30].

You might get similar effects with tiny amounts of lithium. Research suggests that even the trace amounts of lithium found in groundwater lower suicide rates [3].

One study compared over 3.1k water samples to suicide rates in 226 counties in Texas. They found that lower lithium levels in public drinking water are strongly linked to higher suicide rates [3].

A different study looking at water samples from 40 cities in Japan discovered the same link: lithium deficiency was connected with increased suicide rates. However, this association was only seen in women (men were unaffected) [4].

In contrast, a Lithuanian study found that lithium deficiency is linked to higher suicide rates in men, but not in women [31].

Lithium deficiency has been linked to suicide in other countries, including Italy and Greece [32, 33].

Lower levels of lithium in public water supplies are linked to higher suicide rates.

4) May Reduce Lifespan

Could a lithium deficiency shorten your life?

It may sound far-fetched, but scientists uncovered a serious link between lithium and lifespan.

According to one study, lower levels of lithium in tap water are linked to higher rates of death by any cause (not just suicide). This is based on data collected from 234 Texas counties and over 6.1k water samples [34].

What could possibly explain the results? According to several studies, lithium’s increases the length of telomeres–small proteins that cap your DNA-protecting chromosomes. The longer telomeres are, the more leeway your cells have to divide. The length of telomeres is something like the sand in the top part of your lifespan hourglass–the more you have, the better [35, 36, 37, 38].

Bottom line? People with a lithium deficiency may use up their telomeres faster, potentially resulting in a shorter lifespan [35, 36].

5) May Reduce Cellular Regeneration

Adding to the effect above, deficiency in lithium may negatively impact cell development and growth. This is because lithium stimulates and regenerates several types of stem cells [39].

Stem cells act as foundational units in the body. They’re full of potential and can transform into more specialized cells depending on what the body needs [40].

Studies show that lithium stimulates multiple types of stem cells, including ones found in the brain, blood, and bones [39, 41].

Lithium also increases the production of growth factors in the brain, like BDNF and NGF. In fact, people who take prescription lithium drugs often have increased brain cell density and gray matter [41, 42].

People with lithium deficiencies may have a reduced ability to generate stem cells, which could slow down cellular growth and repair [39, 1].

A lithium deficiency may reduce the number of stem cells and growth factors in the body, leading to slower cell growth and repair.

6) May Increase Criminal Behavior & Aggression

Here’s the most intriguing part: it’s not just about longevity, mental illness, and suicide rates. Lithium seems to make people more mellow and easygoing. Lithium deficiency, on the other hand, has been linked to aggression and violence [2, 43].

Research looking at crime revealed some unexpected results.

One study analyzed data collected from 27 counties in Texas during a 9 year period. They found that areas with little to no lithium in the drinking water have higher rates of homicide, rape, and theft [13].

A study performed in Greece found similar results. Areas with low lithium levels in the drinking water have higher rates of homicide, rape, and drug abuse [44].

Why does this happen?

The connection between low lithium and criminal behavior is not totally understood, but lithium’s ability to improve impulse control likely plays a major role [2].

Areas with little to no lithium in the drinking water have higher rates of crime.

Ways to Increase Lithium

Why You Should Consider It

Could it be that communities of more peaceful, less aggressive, less impulsive, and happier people simply had more lithium in their water? Could the rise in firearm violence, suicides, and homicides be – at least in part – due to declining lithium levels [2, 43]?

We still don’t have answers to these questions, but it’s possible that we are getting less lithium than before. It could also be that we are getting a different kind of lithium…

As companies are mining out more lithium to make batteries in large basins of water – such as in Bolivia – the amount of lithium that naturally passes into water and soil is rapidly changing [45].

We know that lithium mining is bad for the soil because of the chemicals used to extract it from these basins. Plus, lithium is made into batteries with other toxic metals, such as lead, cobalt, and nickel [45].

The end equation is still uncertain – if we are putting more or less lithium into the environment – but we do know that getting anything from batteries is worse than getting it from natural, clean water.

Study after study has shown that getting a bit more lithium naturally is beneficial. Here’s how to do it…

1) Food and Water Sources

Most people get all of their lithium from food and water. The average person in the U.S. gets roughly 0.6 to 3.1 mg of lithium each day. The recommended dietary allowance (RDA) is 1 mg/day, though it’s possible that a bit more is optimal [1].

Water

Drinking water can be a great source of lithium, but that heavily depends on where you live. In the United States, lithium levels in drinking water can range from close to zero to over 170 micrograms/L [12, 13].

Some other parts of the world have exceptionally high amounts of lithium in the water. For example, one study found that certain areas of Argentina have over 1000 mcg/L of lithium. If you were to live there, just one liter of water would give you 1mg of lithium, the RDA [46].

How much lithium is in the water where you live?

The United States Geological Survey (USGS) publishes information on trace elements in water samples taken from across the country [14].

Just be aware that lithium levels can vary greatly, even between nearby water sources. This means water lithium levels from a neighboring city may not reflect your own [14].

If you do live in a lithium-poor area, you may want to consider eating more lithium-rich foods or taking lithium supplements.

Plus, water in Texas, especially from mineral springs, seems to be exceptionally high in lithium. Dr. Lynch, the man who bought the “crazy water” mineral springs in Texas back in the 19th century attributed improvements in his health to lithium. Allegedly, these springs also contain other beneficial minerals, such as calcium, magnesium, and sulfate [8].

Spring water spas in Texas are not as popular as they used to be, but they might be worth checking out.

The lithium content in water can vary greatly depending on where you live. If you live in a lithium-poor area, you may want to consider eating more lithium-rich foods or taking lithium supplements.

Food

Many different foods can provide a good amount of lithium.

Some examples of lithium-rich foods include [47]:

  • Nuts (8.8 micrograms/g)
  • Cereals (4.4 micrograms/g)
  • Fish (3.1 micrograms/g)
  • Vegetables (2.3 micrograms/g)
  • Dairy products (0.5 micrograms/g)

This means that a cup of cereal will give you 0.4 mg of lithium, while half a cup of nuts or 200g of fish will have about 0.6 mg of lithium [48].

Certain types of tea may also be a good source of lithium.

A quarter liter of black tea provides about 0.58-1.35 micrograms/g of lithium, while the same volume of red tea contains 0.72-1.70 micrograms/g [47].

2) Supplements

If you’re not getting enough lithium through your diet, supplements may be a good option.

There are several supplements that contain low doses of lithium. One of the more popular ones is lithium orotate. Lithium aspartate and lithium citrate supplements are also available.

Lithium orotate contains about 4 mg of actual or elemental lithium per 100 mg dose. This is in contrast to lithium carbonate, which contains about 19 mg of lithium per 100 mg [49].

Have in mind the following dosage differences:

  • Lithium carbonate is typically prescribed at doses of 600-1800 mg/day. This would give you about 114-340 mg of elemental lithium.
  • Lithium orotate usually contains about 5 mg of elemental lithium per dose.

This difference in dosage means that lithium supplements are highly unlikely to cause the toxicities associated with prescription lithium.

There are case reports of people “self-medicating” with lithium orotate at doses of up to 240 mg/day, but even that amount provides only 10 mg of elemental lithium [50].

Are there advantages to using lithium orotate?

A couple of old studies claim that lithium orotate may be better at penetrating the blood-brain barrier, allowing it to reach higher levels in the brain [51, 52].

However, other studies have refuted these results. In addition, research on lithium orotate in the past couple of decades has stalled due to safety concerns. Even less research has been done on the other available lithium supplements [53, 54].

If you would like to learn more lithium supplements, including safety and benefits, check out our article here.

Supplements like lithium orotate are safe at low doses and are a good way to get the health benefits of lithium.

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Want Better Ways to Improve Your Mood?

If you’re interested in natural and more targeted ways of improving your mood, we at SelfHacked recommend checking out this mood DNA wellness report. It gives genetic-based diet, lifestyle and supplement tips that can help improve your mood. The recommendations are personalized based on your genes.

SelfDecode is a sister company of SelfHacked. This post also contains sponsored links, which means that we may receive a small percentage of profit from your purchase, while the price remains the same to you. The proceeds from your purchase of this product are reinvested into our research and development, in order to serve you better. Thanks for your support.

Takeaway

Lithium is a highly overlooked element. It has many benefits in trace amounts.

We all require miniscule amounts of lithium for good health. Getting a tiny bit more lithium may make people sharper, less impulsive, and more peaceful. Low doses also likely improve overall mental health, and they might even prolong your lifespan.

Many people probably aren’t getting enough lithium in their diet. Avoid lithium deficiency by eating lithium-rich foods like nuts, cereal grains, and vegetables. Supplements such as lithium orotate may also be a good option.

About the Author

Mathew Eng

Mathew Eng

PharmD
Mathew received his PharmD from the University of Hawaii and an undergraduate degree in Biology from the University of Washington.
Mathew is a licensed pharmacist with clinical experience in oncology, infectious disease, and diabetes management. He has a passion for personalized patient care and believes that education is essential to living a healthy life. His goal is to motivate individuals to find ways to manage their chronic conditions.

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