Lithium and AD
Lithium salts have been used for centuries as a popular health tonic. Lithium springs were once sought-after health destinations, visited by authors, political figures and celebrities. Throughout the 19th and into the 20th century, lithium was used as a mineral supplement to fortify a variety of foods and beverages, including the popular soft drink Seven-up (the beverage contained lithium citrate until 1950, and was originally known and marketed for its potential to cure hang-overs after a night of drinking alcohol, and to lift mood).
In modern medicine, lithium is widely used to prevent episodes of mania in patients with bipolar disorders – it promotes mood stability by decreasing the abnormal activity in the brain that causes the excited mood. The therapeutic dose used to achieve the benefits is, however, very close to the toxic dose (high risk of intoxication). For this reason, lithium is considered a dangerous drug. Patients using lithium as a medication (doses between 150mg to 1800mg/day), must be regularly tested (blood test) and frequently have the dose adjusted. Symptoms such as confusion, headache, vomiting and tremor are the most common side effects and intoxication (seizures, lethargy and coma) can occur if blood level is not under control.
Based on observations about the lower incidence of dementia in bipolar patients treated with lithium and taking to account that in the elderly, lithium toxicity threshold is even lower, a group of doctors from Brazil designed a study published in 2013 using microdose of Lithium (300 MICROgrams = mcg) in AD patients for 15 months. They observed a better performance in memory tests within the treated group compared to the control group.
More evidences have been reported: studies using animal models have found that long term lithium treatment improves learning and memory. Populational studies in humans, in different parts of the globe, have also found that increased lithium exposure in drinking water may be associated with lower incidence of dementia and beneficial behavioral outcomes: places with higher level of lithium in drinking water had lower rates of psychiatric hospital admissions, suicide, homicide, crimes and dementia. It is important to note that the amount of lithium found in drinking water in such studies was very small (around 0,7 – 60 mcg/l, i.e., even smaller than the microdose used in the study with dementia patients).
There are several mechanisms by which lithium wields its effect on human physiology. By upregulating neurotrophins, brain-derived neurotrophic factor (BDNF), and nerve growth factors, lithium has the ability to enhance the growth of neurons.
Lithium ions induce stem cell production and can therefore stimulate blood cell proliferation as well as formation of neural stem cells. It can increase the density of grey matter, promote enlargement of the hippocampus and inhibit the amyloid promoting enzyme, glycogen synthase kinase-3 beta.
By modulating the expression of clock genes (TIMELESS, ARNTL1, PER3, NR1D1, CLOCK), lithium can re-synchronize circadian rhythms. It can also normalize the functioning of the hypothalamo-pituitary-adrenal axis by affecting the expression of corticotropins in the adrenal glands and help controlling stress.
How to increase lithium intake?
Dietary vegetables can cover from 60 to over 90% of the daily lithium consumed. Cereal grains (specially beans) and nuts have the biggest amount. The rest comes from food of animal origin and from drinking water.
Lithium is a naturally occurring element in surface waters, mainly in its ionic form and its concentration differ depending on geographical region. Therefore, lithium in various concentrations, can be detected in drinking water. However, its assessment is not a part of the standard analysis of drinking water.
Bottled mineral water can be a good source: In Germany, mineral waters were reported to contain 1.5–1320 μg/L of lithium (take a look at the label or contact the supplier).
CAUTION: high exposure to lithium through drinking water DURING PREGNANCY seems to reduce 25-OH vitamin D blood levels!
Ultra-low dose lithium is not to be confused with pharmaceutical lithium. This is lithium as a nutrient, not as a drug. Nutritional lithium, consumed through drinking water, plant-based foods or low-dose supplementation (talk to your healthcare provider) is a well-tolerated naturally occurring nutrient that shows neuroprotective and neurotrophic effects.
By increasing your daily intake of vegetables (specially beans and nuts) and lithium-rich drinking water, you can get the benefits: boost your mood, concentration and memory and prevent dementia.
Nunes M.A., Viel T.A., Buck H.S. Microdose Lithium Treatment Stabilized Cognitive Impairment in Patients with Alzheimer’s Disease. Current Alzheimer Research (2013) 10: 104. https://www.ncbi.nlm.nih.gov/pubmed/22746245
Forlenza OV, De-Paula VJ, Diniz BS. Neuroprotective effects of lithium: implications for the treatment of Alzheimer’s disease and related neurodegenerative disorders. ACS Chem Neurosci. 2014;5(6):443–450. https://www.ncbi.nlm.nih.gov/pubmed/24766396
Kessing LV, Gerds TA, Knudsen NN, et al. Association of Lithium in Drinking Water With the Incidence of Dementia. JAMA Psychiatry. 2017;74(10):1005–1010. https://www.ncbi.nlm.nih.gov/pubmed/28832877
Florenza O, Diniz B, Radanovic M, Santos F, Talib L, Gattaz W. Disease-modifyning properties of long-term lithium treatment for amnestic mild cognitive impairment: Randomised controlled trial. British Journal of Psychiatry, 2011. 198(5): 351-356 https://www.ncbi.nlm.nih.gov/pubmed/21525519
Szklarska, D., Rzymski, P. Is Lithium a Micronutrient? From Biological Activity and Epidemiological Observation to Food Fortification. Biol Trace Elem Res 189, 18–27 (2019) https://www.ncbi.nlm.nih.gov/pubmed/30066063
Harai F, Akesson A, Casimiro E, Lu Y, Vahter M. Exposure to lithium through drinking water and calcium homeostasis during pregnancy: A longitudinal study. Environ Res 2016 May, 147:1-7. https://www.ncbi.nlm.nih.gov/pubmed/26828622