Q: I remember reading about lithium supplementation in your newsletter, and noticed you recommend 5 mg doses. When I started doing some online shopping, though, I found that there are several options, like Lithium Aspartate (5 mg) and Lithium Orotate (120 mg). Which is the right type and amount?
Dr. Wright: Either form of lithium is fine: What you want to look for on the labels of the lithium supplements you’re choosing between is the amount of “elemental lithium” each one contains. Research indicates that taking 10 to 20 milligrams of elemental lithium per day can help keep your brain functioning at peak performance. Many lithium supplements contain 5 milligrams of elemental lithium (though, again, you should read labels carefully to be sure), so you would need two to four tablets or capsules to achieve the brain-protecting dose.
Lithium aspartate supplements containing 20 milligrams elemental lithium per capsule (manufactured by Bio-Tech Pharmacal) are also available at many compounding pharmacies.
Even at a quantity of two low-dose tablets three times daily (for a total 30 milligrams of elemental lithium), patients’ serum lithium usually stay in the “non-detectable” or range, which means that they’re very safe. In my 30 years of practice, I’ve never had a patient report symptoms of lithium excess. But just to be on the safe side, I always recommend taking extra quantities of essential fatty acids to prevent any possibility of lithium toxicity.