Lithium Is A Brain Nutrient Series – Part Seven: Lithium Toxicity
Majid Ali, M.D.
For about twenty years, I have considered low-dose lithium (50 to 100 mg daily) to be a useful brain nutrient in the care of patients with anxiety, depression, psychosis, and autism spectrum and related developmental challenges. I first leaned about it from Professor Oscar Krusei of Columbia University, New York, and later of Capital University of Integrative Medicine, Washington, D.C.
Lithium’s healing benefits were known to the ancients for millennia, albeit not in modern chemistry. To cite one example, the water of Lithia Springs in Georgia is lithium-enriched and many of its health benefits have been attributed to it. Lithia Springs were considered by the ancient Native American to be a sacred site. By the late 19th century Lithia Springs was a famous health destination visited by many U.S. presidents, including Presidents Grover Cleveland, William Howard Taft, William McKinley and Theodore Roosevelt. One would have thought ever itinerants Mark Twain would also have visited the place and one would be right. No surprise then that soda drinks of those times would be expected to have used lithium-rich water. That indeed was the case.
Low-dose lithium, as described in this series, has no known toxicity. Large-dose lithium therapy as is used in psychiatry to treat bipolar disorder, is an altogether different matter.
High-Dose Lithium Toxicity
The following is the Wikipedia list of adverse effects that have been attributed to high-dose lithium:
Very Common Adverse Effects
>10% incidence) adverse effects of lithium include
Leukocytosis — elevated white blood cell count
Polyuria/polydypsia — increased thirst and urination
Hand tremor (usually transient but it can persist in some people)
Muscle weakness (usually transient, but can persist in some)
ECG changes — usually benign changes in T waves.
Nausea (usually transient, but can persist in some)
Vomiting (usually transient, but can persist in some)
Diarrhea (usually transient, but can persist in some)
Constipation (usually transient, but can persist in some)
Hyperreflexia — overresponsive reflexes
Common (1-10%) adverse effects
Extrapyramidal side effects — movement-related problems such as muscle rigidity, parkinsonism, dystonia, etc.
Euthyroid goitre — i.e. the formation of a goitre despite normal thyroid functioning
Hypothyroidism — a deficiency of thyroid hormone.
Hair loss/hair thinning
Rare/Uncommon (<1%) adverse effects include
Renal (kidney) toxicity which may lead to chronic kidney failure
Renal interstitial fibrosis
Erythema multiforme — a potentially fatal skin reaction
Brugada syndrome — a potentially fatal abnormality in the electrical activity of the heart.
Sinus node dysfunction
Transient reduction in peripheral circulation as a whole
Increased intracranial pressure and papilledema
Myasthenia gravis — an autoimmune condition where the body’s own defences attack the neuromuscular junction — the gap across which the nerves communicate with the muscles — leading to muscle weakness.
Hyperthyroidism — elevated blood concentrations of thyroid hormones.
Hypercalcaemia — elevated blood levels of calcium.
Hypermagnesaemia — elevated blood levels of magnesium.
Hyperparathyroidism — elevated blood levels of parathyroid hormone.
Unknown frequency adverse effects
Sexual dysfunction including impotence, vaginal dryness, erectile dysfunction, etc.
Glycosuria — glucose (blood sugar) in the urine
Decreased creatinine clearance — a sign of impaired kidney function
Albuminuria — protein in the urine another sign of impaired kidney function.
Oliguria — low urine output although excess urine output is more likely.
Changes in taste
Hypotension — low blood pressure.
Bradycardia — low heart rate.
Nystagmus — involuntary eye movements that can interfere with vision.
Weight gain or loss (gain more common with prolonged treatment)