Symptoms of high lithium levels

What Causes Lithium Toxicity? Accidental Overdose and its Effects

Written by WebMD Editorial Contributors

What Is Lithium Used For

Lithium is commonly prescribed by psychiatrists to manage recurrent bipolar illness. Lithium was approved in the 1970s by the U.S. Food and Drug Administration (FDA) as a mood stabilizer and a treatment for mania.

Lithium is a powerful medication that has antimanic properties. Though lithium has been approved as a treatment, its effects on the brain aren’t completely understood. Researchers believe lithium makes the brain less responsive to stimulation that causes manic episodes. It’s also thought to reduce the responsiveness to neurotransmitters.

Lithium can become dangerous when it’s taken in excess. When excessive amounts are taken intentionally or accidentally, it can cause acute or acute-on-chronic overdose symptoms.

Side Effects of Lithium

To determine whether you’re experiencing lithium toxicity, you first need to know the common side effects of prescribed lithium. They include:

Headache
Nausea or vomiting
Dizziness or drowsiness
Diarrhea
Changes in appetite
Hand tremors
Dry mouth
Increased thirst
Increased urination
Thinning of hair or hair loss
Acne-like rash‌

Some signs of lithium toxicity are similar to its side effects, but more severe. Symptoms of lithium toxicity include severe nausea and vomiting, severe hand tremors, confusion, and vision changes. If you experience these, you should seek immediate medical attention to check your lithium levels.

Types of Lithium Poisoning

There are three types of lithium toxicity. They range from mild and uncomfortable to severe and dangerous if left untreated. ‌

Acute lithium toxicity. Symptoms commonly include feeling weak, having a worsening tremor, feeling unbalanced or uncoordinated, poor concentration, diarrhea.

Acute-on-chronic lithium toxicity. With this level of poisoning, you could experience gastrointestinal (GI) problems. You may also experience neurological problems. ‌

Chronic lithium toxicity. At this level, you will mostly experience neurological symptoms. Severity will depend on the levels of lithium in your body.‌

Early Signs of Lithium Toxicity

If you have one or more of the following symptoms, you may be experiencing early lithium toxicity:

Loss of appetite, or vomiting

Blurred vision
Excessive thirstiness
Needing to pee frequently
Uncontrollable urination and bowel movements
A lightheaded or drowsy feeling
Confusion and blackouts
Shaking, muscle weakness, twitches, jerks, or spasms affecting your face, tongue, eyes, or neck
Trouble speaking

Lithium toxicity mostly affects your kidneys and central nervous system. In acute lithium toxicity, your GI tract will be affected too. In more severe cases, you may experience neurological or cardiovascular problems. In early lithium toxicity, you may have mild confusion. As the toxicity worsens, you may feel delirious or even have seizures or go into a coma.

In very rare cases, lithium toxicity may cause diabetes insipidus. This condition leads to large amounts of urine in your body, regardless of how much fluid you drink. You’ll also experience a significant amount of thirst.

If you're experiencing any of these symptoms or side effects, you should seek immediate medical attention. Left untreated, lithium toxicity can progress and worsen. Lithium poisoning can be life-threatening and should be monitored and treated promptly.

By noticing the early signs of lithium toxicity, you can get the help you need. Contact your doctor or psychiatrist if you feel like you're experiencing any side effects from your medication. You can also have them check your lithium levels to find out if they're too high.

Treating Lithium Toxicity Early

When caught early, lithium toxicity can be treated by keeping or reducing your lithium levels to the low to medium range. If you notice a lithium-induced tremor, you may be treated with beta-blockers. ‌

Diligent monitoring is the best way to avoid lithium toxicity. You’ll also need to make sure other medications you're on don't affect your lithium excretion. If your body excretes too much lithium, it can also create toxic levels in your body. ‌

Medications that can interfere with this include:

ACE inhibitors (used to treat high blood pressure and heart failure)
Nonsteroidal anti-inflammatory medications (NSAIDs)
COX-2 inhibitors (a type of NSAID)

‌Your doctor should monitor you closely to ensure you're taking the right levels of lithium. It's also important that you tell them about any side effects. Since lithium toxicity can happen through your body's excretion, you might not know initially whether you have high levels in your body.

Levels, Signs and Symptoms, Causes, and Treatment

What is lithium toxicity?

Lithium toxicity is another term for a lithium overdose. It occurs when you take too much lithium, a mood-stabilizing medication used to treat bipolar disorder and major depressive disorder. Lithium helps reduce episodes of mania and lowers the risk of suicide in people with these conditions.

The right dosage of lithium varies from person to person, but most people are prescribed between 900 milligrams (mg) to 1,200 mg per day, in divided doses. Some people take more than 1,200 mg per day, especially during acute episodes. Others may be more sensitive to lower doses.

A safe blood level of lithium is 0.6 and 1.2 milliequivalents per liter (mEq/L). Lithium toxicity can happen when this level reaches 1.5 mEq/L or higher. Severe lithium toxicity happens at a level of 2.0 mEq/L and above, which can be life-threatening in rare cases. Levels of 3.0 mEq/L and higher are considered a medical emergency.

People taking lithium need to carefully monitor how much they take it and when. It’s easy to accidentally overdose on lithium by taking an extra pill, mixing it with other medications, or not drinking enough water. In 2014, for example, there were 6,850 reported cases of lithium toxicity in the United States.

The symptoms of lithium toxicity and their severity depend on how much lithium is in your blood.

Mild to moderate toxicity

Symptoms of mild to moderate lithium toxicity include:

diarrhea
vomiting
stomach pains
fatigue
tremors
uncontrollable movements
muscle weakness
drowsiness
weakness

Severe toxicity

Serum levels of lithium above 2.0 mEq/L can cause severe toxicity and additional symptoms, including:

heightened reflexes
seizures
agitation
slurred speech
kidney failure
rapid heartbeat
hyperthermia
uncontrollable eye movements
low blood pressure
confusion
coma
delirium
death

Side effects in lower doses

Keep in mind that lithium can also cause side effects when taken in lower doses. Tell your doctor if you take lithium and notice any of the following side effects:

frequent urination
thirst
hand tremors
dry mouth
weight gain or loss
gas or indigestion
restlessness
constipation
rash
muscle weakness

These side effects can happen with low doses of lithium and don’t mean you have lithium toxicity. However, they may be a sign that you need to adjust your dosage or need more frequent monitoring.

Lithium toxicity is usually caused by taking more than your prescribed dose of lithium, either at once or slowly over a long period of time.

There are three main types of lithium toxicity, each with different causes:

Acute toxicity. This happens when you take too much lithium at once, either accidentally or on purpose.
Chronic toxicity. This happens when you take a little too much lithium daily over a long period of time. Dehydration, other medications, and other conditions including kidney problems, can affect how your body handles lithium. Over time, these factors can cause lithium to slowly build up in your body.
Acute-on-chronic toxicity. This can happen if you take lithium every day for a long period of time, but then suddenly take an extra pill one day, either accidentally or on purpose.

If you think someone is at immediate risk of self-harm, overdosing, or hurting another person:

Call 911 or your local emergency number.
Stay with the person until help arrives.
Remove any guns, knives, medications, or other things that may cause harm.
Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Sensitivities and interactions with lithium

Some people are more sensitive to lithium and may experience symptoms of lithium toxicity at lower levels than others. This is especially true in people who are older or dehydrated. It’s also more likely in people with cardiovascular and kidney problems.

Certain foods or drinks may also affect lithium concentrations in the body. It’s best to not adjust the following unless monitored by a doctor:

INSERT LONG LIST FORMAT:

Salt intake. Less salt can make your lithium levels rise, while increasing your salt intake can cause it to fall.
Caffeine intake. Caffeine found in coffee, tea, and soft drinks may have an effect on lithium levels. Less caffeine can cause your lithium levels to rise, while more can cause it to lower.
Avoid alcohol. Alcoholic beverages can have a negative effect on many medications.

In addition, taking lithium with other medications can also increase your risk of lithium toxicity. If you take lithium, make sure you talk to your doctor before using:

nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Motrin, Advil) or naproxen (Aleve)
indomethacin
selective cyclooxygenase-2 (COX-2) inhibitors, such as celecoxib (Celebrex)
acetaminophen (Tylenol)
metronidazole
calcium channel blockers such as amlodipine (Norvasc), verapamil (Verelan), and nifedipine (Adalat CC, Procardia XL)

angiotensin-converting enzyme (ACE) inhibitors, such as enalapril (Vasotec) or benazepril (Lotensin)
diuretics

Mild lithium toxicity is often difficult to diagnose because its symptoms are similar to those of many other conditions. Your doctor will likely start by asking you some questions about how much lithium you take, as well as how often you take it.

Be sure to tell your doctor about all of your symptoms, any recent illnesses, and whether you’re taking any other medications, including vitamins, supplements, and even teas.

They may also use one or a combination of the following tests:

an electrocardiogram to test for an abnormal heartbeat
a blood chemistry test to look at your metabolism and electrolyte levels
a blood or urine test to determine your serum lithium levels
a blood test to check your kidney function

If you’re taking lithium and experience any of the symptoms of lithium toxicity, seek immediate treatment or call the Poison Control Center hotline at 1-800-222-1222 for instructions on what to do.

There’s no specific antidote for lithium toxicity.

Mild toxicity

Mild lithium toxicity usually goes away on its own when you stop taking lithium and drink some extra fluids. However, your doctor may still want to keep an eye on you while you recover.

Moderate to severe toxicity

Moderate to severe lithium toxicity usually requires additional treatment, such as:

Stomach pumping. This procedure may be an option if you’ve taken lithium within the last hour.
Whole bowel irrigation. You’ll swallow a solution or be given one through a tube to help flush the extra lithium out of your intestines.
IV fluids. You may need these to restore your electrolyte balance.
Hemodialysis. This procedure uses an artificial kidney, called a hemodialyzer, to remove waste from your blood.
Medication. If you start to have seizures, your doctor might prescribe an anticonvulsant medication.
Vital sign monitoring. Your doctor may choose to keep you under supervision while they monitor your vital signs, including your blood pressure and heart rate, for any unusual signs.

Lithium toxicity can have lasting effects, so it’s important to seek medical attention immediately if you think you may have it. Avoid home remedies, such as activated charcoal, which doesn’t bind to lithium.

When caught early, lithium toxicity is often treatable with extra hydration and reducing your dosage. However, moderate to severe lithium toxicity is a medical emergency and might require additional treatment, such as stomach pumping.

If you take lithium, make sure you know the signs of an overdose and keep the number for poison control (1-800-222-1222) handy in your phone. Contact your doctor if you have any concerns about medication or food interactions that might occur while you take lithium.

Lithium in the blood

Lithium is one of the most well studied and commonly used drugs for the treatment of patients suffering from bipolar disorders.

Synonyms English

Lithium.

Research method

Atomic absorption spectrometry (AAS).

Units

µg/L (micrograms per liter), mmol/L (millimoles per liter).

What biomaterial can be used for research? nine0006

Venous blood.

How to properly prepare for an examination?

Do not eat for 2-3 hours before the examination, you can drink pure non-carbonated water.

Do not smoke 30 minutes before the examination.

Overview of the study

Lithium preparations are among the most well studied and widely used in the treatment of bipolar disorder, a mental illness characterized by alternating periods of depression and mania. These periods can last from several days to several months and even years. The patient's condition ranges from apathy to euphoria. Both adults and children are susceptible to bipolar disorder. nine0003
Lithium is often referred to as a "mood stabilizer" and is commonly prescribed for patients not responding to other drugs. It is a relatively slow-acting drug, sometimes it can take several months before it stabilizes the mental state.

The amount of the drug must be sufficient to create a stable concentration of lithium in the blood, necessary for a therapeutic effect. This dosage for each patient is individual and depends on age, general health and other medications. nine0003
Lithium levels should be checked regularly: if it is too low, treatment will not be effective, and if it is too high, it can lead to poisoning with nausea, vomiting, diarrhoea, confusion and trembling. Very high concentrations of lithium can lead to stupor, heart attacks, and even death.

What is research used for?

To control whether the lithium level is sufficient for treatment.

To determine the necessary concentration of lithium in the blood at the beginning of taking medications. nine0034
To monitor fluctuating lithium levels.

To find out how a patient's medications affect lithium levels.

If lithium toxicity is suspected.

When is the examination scheduled?

At the beginning of treatment with drugs containing lithium, or when they are taken again after a break.

Regularly after reaching a sufficient level of lithium in the blood for treatment - to confirm that the required level is maintained. nine0034
When it is necessary to find out the reason for the failure of lithium therapy (whether the amount of the drug taken is too low, or the fact is that, for example, the patient does not comply with the prescription for taking lithium).

For symptoms suggestive of a toxic effect (drowsiness, weakness, incoordination, slurred speech, nausea, vomiting and diarrhea, clouding of consciousness, trembling).

What do the results mean?

Reference values

Concentration: 0.7 - 84 µg/l.

Therapeutic concentration: 0.6 - 1.2 mmol/l.

If the lithium level is within the normal range, then the drug has a therapeutic effect without a toxic effect.

If the concentration of lithium in the blood is low, then most likely the patient does not receive the right amount of medication, if it is higher and there is a side effect - the dose taken is too high. However, you should not reduce the amount of the drug or stop taking it without consulting a doctor, as this may complicate the disease. Treatment should be prescribed by a doctor: for each person, taking into account individual characteristics, he will select the dose that has the most favorable therapeutic effect. nine0003
What can influence the result?

Theophylline and caffeine lower lithium levels.

Important Notes

Lithium is excreted primarily through the kidneys, so long-term use increases the chance of kidney failure, and kidney dysfunction can cause elevated lithium levels.

Lithium intake may cause hypothyroidism. Therefore, when taking lithium preparations, regular monitoring of thyroid function is necessary. nine0034
Various medications, as well as some dietary supplements, can affect the concentration of lithium in the blood. Medications that increase lithium levels include anti-inflammatory drugs (ibuprofen, naproxen) and diuretics (hydrochlorothiazide and furosemide).

Several drugs contribute to the side effects of lithium, including neuroleptics (clozapine and olanzapine), blood pressure lowering drugs, and anti-seizure drugs (carbamazepines).
nine0033 The loss of salts and water from the body (as in a salt-free diet, increased sweating, or diseases accompanied by nausea and vomiting) contributes to an increase in the level of lithium in the body and the manifestation of its side effects.
Blood for lithium testing is usually taken 12-18 hours after the last dose of a lithium-containing drug.

Also recommended

Serum creatinine

Daily urine creatinine

Thyroid Stimulating Hormone (TSH)

Who orders the examination?

Neurologist, psychiatrist, narcologist.

23 roles of lithium in the human body. Scientific data.

Lithium is an alkali metal found naturally in trace amounts in minerals, water, soil, and fruits, vegetables, and other plants grown in lithium-enriched soils (https://www.ncbi.nlm.nih.gov/pubmed /11601880).
Lithium is essential for the proper functioning of a number of enzymes, hormones, vitamins, growth factors and the immune and nervous systems (https://www.igsli.org/general-information-on-lithium/biochemical-effects-of-lithium.html). nine0139 In addition to lithium's role in treating psychiatric patients, this mineral has many health benefits, and the list continues to grow.

1. Lithium has a neuroprotective effect (protection of brain cells)

Long-term lithium treatment reduces glutamate-induced toxicity mediated by N-methyl-D-aspartate (NMDA) receptors. This effect was at least partially explained by the ability of lithium to suppress calcium influx, which affects the activity of the NMDA receptor. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39)
Thus, lithium has the potential to be beneficial for conditions such as mood disorders, Alzheimer's, diabetes, cancer, and inflammatory and autoimmune diseases (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/# R39).

2. Lithium inhibits apoptosis

Lithium increases levels of heat shock proteins (HSPs), which promote proper 3D folding of proteins, refolding of damaged proteins, and utilization of atypical proteins (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
Among heat shock proteins, HSP70 has a wide range of neuroprotective effects against apoptosis. These effects are caused by GSK-3 inhibition (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39). Lithium is also known to inhibit GSK-3 (https://www.ncbi.nlm.nih.gov/pubmed/8994831).
Long-term lithium treatment has been noted to induce the production of Bcl-2, a protein in the frontal lobe of the brain that protects cells from apoptosis (https://www. ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).

3. Lithium increases levels of neurotrophic factors BDNF, NGF and GDNF

Prolonged exposure of neurons to lithium in culture induces BDNF activity. (reference 2)
BDNF is one of the main neurotrophic agents indispensable for cognitive development, synaptic plasticity and neuronal survival, which also has antidepressant and calming effects. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39)
This probably occurs as a result of GSK-3 inhibition. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39)
Lithium also increases nerve growth factor (NGF) and glial neurotrophic factor (GDNF) levels in the hippocampus, frontal cortex, occipital region, and striatum (https://www.ncbi.nlm.nih.gov/pubmed/12974988). NGF and GDNF help increase neuronal survival and plasticity (the ability to regenerate and form new connections) among dopaminergic, cholinergic, and serotonergic neurons in the central nervous system. nine0003
4. Lithium promotes the regeneration of cerebral and cardiac vessels (VEGF)

Lithium leads to an increase in the production of vascular endothelial growth factor, VEGF, which promotes cell growth and regeneration of blood vessels after a stroke (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
By increasing VEGF levels, lithium may promote faster recovery after a stroke or heart attack (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
The likely mechanism is lithium inhibition of GSK-3 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).

5. Lithium induces autophagy

Autophagy or "cell self-destruction" is when cells break down and recycle cellular components to reuse raw materials (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39). Autophagy is thought to slow down aging, prevent cancer, and is important for neuronal function and survival (http://genesdev. cshlp.org/content/21/22/2861.full, https://www.ncbi.nlm.nih .gov/pmc/articles/PMC2020444/). nine0139 Lithium can induce autophagy by depleting inositol stores independently of mTOR inhibition (which by itself usually induces autophagy) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
Since lithium induces autophagy, the drug may be especially useful for patients with neurodegenerative diseases - Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis and Huntington's disease, since such disorders are characterized in part by the accumulation of misfolded proteins (https://www.ncbi.nlm .nih.gov/pmc/articles/PMC3172812/#R39).

6. Lithium increases neurogenesis and improves cognitive function

Lithium has been found to stimulate progenitor and stem cells in a culture of brain hippocampal neurons (neurons from the memory center). In addition, lithium prevents loss of proliferation caused by glutamate or cortisol (glucocorticoids). Also, long-term lithium treatment promotes the conversion of these precursor cells into neurons (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
In addition, long-term lithium treatment not only improves neurogenesis in the hippocampus (memory center) in healthy mice, but also restores neurogenesis in the brain of an animal model of Down syndrome (https://www.ncbi.nlm.nih.gov/pmc/articles /PMC3172812/#R39).
The drug also enhances neurogenesis (the formation of new neurons) in the subventricular zone, the only area besides the hippocampus (memory center) where such an effect was observed, which caused a persistent increase in gray matter volume in patients (https://www.ncbi.nlm.nih. gov/pmc/articles/PMC3172812/#R39).
Lithium increases N-acetyl aspartate (NAA) levels (http://www.biologicalpsychiatryjournal.com/article/S0006-3223(00)00252-3/abstract), which can be seen as an indicator of creativity and correlates with IQ scores (https http://www.ncbi.nlm.nih. gov/pubmed/21983183). One possible consequence of this may be more efficient communication between the two hemispheres of the brain, resulting in improved brain activity. (https://www.ncbi.nlm.nih.gov/pubmed/21983183)
Long-term lithium treatment increases long-term potentiation (LTP) in hippocampal neurons, which makes nerve cells more efficient and thus aids in learning and memory (http://europepmc.org/abstract/MED/17996377).

7. Lithium can calm and stabilize mood

In animals, lithium staunchly reduces search activity and aggression. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2150568/)
In humans, lithium is also known to have a calming and mood-stabilizing effect, and is also used to treat depression, bipolar disorder, and schizophrenia (https://en.wikipedia.org/wiki/Lithium_(medication).
Lithium carbonate is the standard of care for bipolar affective disorder (BAD), reducing the frequency of manic episodes (https://www.ncbi.nlm. nih.gov/pmc/articles/PMC2560740/pdf/10885180.pdf, https://www. ncbi.nlm.nih.gov/pmc/articles/PMC3181868/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3876031/). nine0139 Lithium has also been shown to be effective in reducing aggressive behavior in people with attention deficit hyperactivity disorder (ADHD) (https://www.ncbi.nlm.nih.gov/pubmed/12154153).
Increased levels of naturally occurring lithium in drinking water may reduce suicide rates (https://en.wikipedia.org/wiki/Lithium_(medication)). This may be partly due to the fact that lithium increases the synthesis and release of serotonin (it also reduces the level of norepinephrine) (https://en.wikipedia.org/wiki/Lithium_(medication)). nine0139 Lithium increases CCK levels in the brain and this is part of the mechanism by which lithium prevents mania in bipolar disorder.

8. Lithium fights depression

Lithium administration is one of the most studied approaches in the treatment of depression refractory to standard therapy (https://www. ncbi.nlm.nih.gov/pubmed/22796912).
Lithium increases postsynaptic sensitivity to serotonin via the 5-HT1A receptor, which partly explains its antidepressant activity. (http://onlinelibrary.wiley.com/doi/10.1002/syn.8
302/abstract?systemMessage=Wiley+Online+Library....)
Lithium also increases BDNF levels, which helps with depression.
Lithium partially alleviates depression in animals by increasing the number of neural stem cells.

9. Lithium has potential use in the treatment of Huntington's disease

Lithium prevents nerve cell death in animal models of Huntington's disease (https://www.ncbi.nlm.nih.gov/pubmed/11591460, https://www.ncbi.nlm.nih.gov/pubmed/14702090).
Lithium reduces excess NMDA receptor function, and thus may potentially counteract the increased NMDA receptor activation that occurs in the brains of patients with Huntington's disease (https://www.ncbi.nlm.nih.gov/pubmed/21492946).
Research into patients with Huntington's disease is ongoing.

10. Lithium reduces insulin resistance

Lithium improves insulin-stimulated glucose transport and glycogen synthesis in insulin-resistant rat muscle rat muscle (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC26339thirty/). These effects depend on p38 MAPK (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633930/).
Lithium reduces insulin release (https://www.ncbi.nlm.nih.gov/pubmed/369819).
The use of lithium significantly increased glucose transport into muscle cells by 2.5 times in response to insulin administration and also increased insulin sensitivity (https://www.ncbi.nlm.nih.gov/pubmed/8013755).

11. Lithium has a positive effect on autoimmune diseases and reduces inflammation

Lithium has shown strong immune system activation effects (https://www.ncbi.nlm.nih.gov/pubmed/15236914/, https://www.ncbi.nlm.nih.gov/pubmed/12208183).
Lithium, by inhibiting GSK-3, has been noted to have a beneficial effect in animal models of autoimmune disease. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532311/)
Lithium inhibits the activity of Th2 cells and interferon-gamma (but not Th27 cells). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532311/)
Lithium has anti-inflammatory effects by decreasing the production of IL-1β and TNF-α, and increasing the production of IL-2, TGF, IL-1RA and IL-10 (http://www.if-pan.krakow.pl/pjp/pdf/ 2003/3_353.pdf, https://www.ncbi.nlm.nih.gov/pubmed/10367558).
However, studies have also shown that, under certain experimental conditions, lithium also has pro-inflammatory effects by increasing the production of IL-4, IL-6 and TNF-α (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063502 /).
Lithium increases IgG and IgM antibody levels (https://www.sciencedirect.com/science/article/pii/00
982
5).
Lithium reduces the production and activity of prostaglandins, thus preventing their negative effect on the immune system (https://www.sciencedirect.com/science/article/pii/0006295274
9).
Lithium reduces the frequency and duration of recurrent infections of labial and genital herpes, and also reduces the frequency of colds (https://www.ncbi.nlm.nih.gov/pubmed/2155671, https://jhu.pure.elsevier.com/ en/publications/suppression-of-recurrent-genital-herpes-infections-wit...). nine0003
12. Lithium has a positive effect on bone tissue

A comparative study was conducted to assess the bone density of the hip and lumbar spine in 75 volunteers who received lithium and 75 healthy volunteers who did not receive lithium; groups were normalized for age, sex, and body mass index. The study found lower rates of bone remodeling in volunteers who received lithium. Mean bone mineral density in lithium-treated volunteers was 4.5% higher at the spine, 5.3% higher at the femoral neck, and 7.5% higher at the trochanter of the femur (https://www.ncbi .nlm.nih.gov/pubmed/18992857).
Lithium use is associated with a reduced risk of bone fractures and increased osteogenesis , https://www. ncbi.nlm.nih.gov/pmc/articles/PMC1297659/).

13. Lithium can be helpful in restoring our circadian rhythm

As you know, lithium is the standard of care for the treatment of patients suffering from bipolar disorder, which is characterized by the presence of episodes of mania and depression. nine0139 One mechanism by which lithium may help with bipolar disorder is by lengthening the circadian rhythm. People with bipolar disorder tend to have a shorter circadian rhythm compared to 24 hours.
Lithium promotes a faster recovery of our circadian rhythm in response to light and darkness (http://geum.ru/next/art-91286.php).

14. Lithium improves mitochondrial function

Lithium increased the lifespan of roundworms (nematodes) and improved overall health outcomes, including mitochondrial energy production (https://www.ncbi.nlm.nih.gov/pubmed/24398558).
Lithium may improve mitochondrial function by increasing the rate of replacement of broken mitochondria (https://www. ncbi.nlm.nih.gov/pubmed/24398558).
Lithium also inhibits mir-34a, which in turn inhibits NAMPT, an enzyme involved in the formation of NAD+ (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39, https://en .wikipedia.org/wiki/Nicotinamide_phosphoribosyltransferase). Therefore, lithium likely increases free NAD+ levels.

15. Low doses of lithium increase life expectancy

The researchers found a positive correlation between life expectancy and lithium levels in drinking water. There has been a decrease in the risk of death from all diseases in areas of Japan with higher lithium levels.
Similar was noted in the situation with roundworms (nematodes). Long-term low-dose lithium exposure can delay aging and clearly reduce mortality in evolutionarily distinct species (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3151375/). The improvement in health status was accompanied by improved mitochondrial function. (https://www. ncbi.nlm.nih.gov/pubmed/24398558)

16. Lithium may improve symptoms of Tourette's syndrome

Tourette's syndrome is a neurological disorder characterized by involuntary muscle movements and uncontrolled vocal sounds (https://www.nhs.uk/conditions/tourettes-syndrome/).
In a small study of 3 patients, lithium resulted in a better outcome than haloperidol, a common drug prescribed for Tourette's syndrome. In patients who took lithium, there was a significant decrease in the number of tics and involuntary speech sounds. Patients had no side effects and were symptom-free for several months (https://www.ncbi.nlm.nih.gov/pubmed/27089four).

17. Lithium may be useful in cases of tardive dyskinesia

Tardive dyskinesia is a neurological disorder characterized by sudden, involuntary, jerky movements of the face and/or body that occur with long-term use of psychotropic drugs (https://www. ninds.nih.gov/Disorders/All-Disorders/Tardive-Dyskinesia- Information-Page).
Studies have shown that lithium significantly reduced the severity of tardive dyskinesia (https://www.sciencedirect.com/science/article/pii/S0924977X07001496, https://www.ncbi.nlm.nih.gov/pubmed/788002, https://www.ncbi.nlm.nih.gov/pubmed/804260).
Lithium reduced arousal and aggression, and reduced involuntary movements (https://www.ncbi.nlm.nih.gov/pubmed/788002, https://www.ncbi.nlm.nih.gov/pubmed/804260).
However, two large studies found no consistent effects of lithium on tardive dyskinesia (https://www.ncbi.nlm.nih.gov/pubmed/790411, https://www.karger.com/Article/Abstract/117629).

18. Lithium helps to cope with obsessive-compulsive behavior

Obsessive-compulsive disorder (OCD), or obsessive-compulsive disorder, is a mental disorder characterized by obsessive thoughts and behavior (https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index. shtml).
The addition of lithium to the diet results in a reduction in OCD symptoms resistant to standard therapy (https://www.ncbi.nlm.nih.gov/pubmed/6435460). nine0139 Compulsive and pathological gamblers have also shown a good response to dietary lithium supplementation, which may regulate dopamine imbalance in the brain (https://www.ncbi.nlm.nih.gov/pubmed/20588072).

19. Lithium may relieve headaches

Lithium can reduce the severity of both chronic and episodic cluster headache (http://scielo.isciii.es/scielo.php?pid=S0213-616320000006&script=sci_arttext). nine0139 Lithium carbonate taken before bed helped eliminate "hypnic headache" (headache that older people suffer from waking up at the same time at night) (https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC1891726/, http://pn.bmj.com/content/practneurol/5/3/144.full.pdf).

20. Lithium may be effective in treating anorexia nervosa

Patients suffering from anorexia nervosa for many years have been successfully treated with lithium carbonate (https://www. ncbi.nlm.nih.gov/pubmed/842388, https://www.ncbi.nlm.nih.gov/pubmed /6801096).
One patient gained 12 kg and the other 9 kg within 6 weeks, and the weight gain on lithium therapy was maintained for a year (https://www.ncbi.nlm.nih.gov/pubmed/842388).
However, further studies of lithium are required to evaluate its utility in the treatment of anorexia nervosa.

21. Lithium may be effective in treating alcoholism

Lithium orotate is used to treat alcoholism.
The drug has been shown to be safe, with minimal side effects such as muscle weakness, loss of appetite, or mild lethargy (https://www.ncbi.nlm.nih.gov/pubmed/3718672). nine0139 Lithium carbonate promotes alcohol abstinence, reduces subjective withdrawal symptoms, and delays time to first alcohol consumption (https://jamanetwork.com/journals/jamapsychiatry/article-abstract/494005, https://www.ncbi.nlm.nih.gov /pubmed/181193).
Patients treated with lithium were less likely to be rehospitalized for alcohol rehabilitation during 18 months of follow-up (https://www. ncbi.nlm.nih.gov/pubmed/2494686).

22. Lithium may reduce seizure frequency

Data on the effect of lithium on seizure frequency is still controversial (https://www.ncbi.nlm.nih.gov/pubmed/3379144).
Some patients with epilepsy show a statistically significant reduction in seizure frequency as well as behavioral improvement with lithium treatment (https://jamanetwork.com/journals/jamapsychiatry/article-abstract/490891).
Lithium can be used to control treatment-resistant temporal lobe epilepsy.
However, some patients with epilepsy have experienced an increase in the number of seizures during lithium treatment (https://www.healio.com/psychiatry/journals/psycann/2013-6-43-6/%7B0346b54f-2ca1-4215-8d9e-10708601ad..., http://www.academia.edu/6195616/Non-convulsive_status_epilepticus_during_lithium_treatment_at_therap..., https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.11.3.414).

23. Lithium may relieve symptoms of Meniere's disease

Meniere's disease is an ear disease that causes severe dizziness, tinnitus, hearing loss, and a feeling of fullness in the ear (https://www.mayoclinic.org/diseases-conditions/menieres-disease/symptoms-causes/syc-20374910).
In 70% of patients with Ménière's disease, a decrease in the frequency and severity of seizures was observed during lithium treatment (http://www.tandfonline.com/doi/abs/10.3109/00016487409126326?journalCode=ioto20&).
However, in a study involving patients who received lithium and placebo for 6 months, there was no difference between the two groups (https://www.ncbi.nlm.nih.gov/pubmed/790893).

Additional information

• Lithium reduces brain levels of inositol (https://www.nature.com/articles/newbio233267a0). nine0139 • Lithium increases vasopressin, which stimulates ACTH and cortisol (http://journals.plos.org/plosone/article?id=10.
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