original 2/7/2024; updated 2.17.2026
What is lithium orotate?
It’s a pill that can deliver lithium to the brain, perhaps better than prescription lithium (lithium carbonate). Unfortunately, research on lithium orotate stopped back in 1979 when one study in mice found it more harmful to kidneys than lithium carbonate. That research has been questioned ever since but not redone until now.
What’s it for?
- Lithium orotate might be able to prevent dementia. It might even improve cognitive abilities in a person who’s developing Alzheimer’s. Notice: “might”. But recent research, which I’ve summarized on a separate page, strongly suggests the prevention role and hints at the possibility of some recovery.
- People have been taking lithium orotate for several decades because they find that it smooths their moods. No human research on this yet. But hey, did you know that 7-Up, the soft drink, once had lithium in it? The label read “Lithiated Lemon Soda: Takes the ouch out of grouch”.
- Lithium has been prescribed for 50 years in the form of lithium carbonate. Now psychiatry has to rethink this, because new research suggests lithium orotate might be safer and work better, at least for prevention of dementia.
Should I use it?
for mood: if you wish
Thousands of people have been taking lithium orotate for mood for several decades. It’s not expensive, about $5/month depending on where you get it (grocery, health food store, or online).
How much of the perceived mood benefit is a placebo effect? That doesn’t matter if the lithium is cheap and harmless, right? And it certainly may be more than a placebo: good science shows that lithium has several direct effects on the brain that could affect mood. To know for certain would take a randomized trial of lithium orotate versus a placebo pill (probably several, to satisfy skeptics). Such studies cost thousands, even millions of dollars to do rigorously. So we probably won’t see such studies for a while, maybe a long while.
for bipolar: a little early yet
Psychiatry has 50 years of experience prescribing lithium carbonate. That allows us to be pretty certain about its benefits, its risks, and what doses are required. Now a mouse study suggests lithium orotate might work even better in bipolar mood problems: it might deliver lithium to the brain more effectively than lithium carbonate (as was suggested 50 years ago but almost ignored until now).
If so, smaller doses that cause fewer side effects might be sufficient for mood stability, and maybe even treating a manic episode. But it will take years of trying lithium orotate for these purposes and studying the results to create the certainty we have with lithium carbonate.
If I was still seeing patients I’d be discussing this option with them. Do you want or need certainty? Willing to take some risks in the name of maybe having fewer side effects? Okay with uncertain long-term risk, compared to the known risks of lithium carbonate?
There’s one group of patients with whom I’d definitely be talking about lithium orotate: people who had a great response to lithium carbonate but whose kidneys began to work less well. At some point (I favor very early) it’s time to give up on lithium carbonate for such folks. But what about lithium orotate? Answer: right now, we have no data. But it’s worth thinking about at least.
Update 2.17.26
What dose for bipolar? Still unknown, although Harvard has a study underway looking at brain lithium levels from lithium orotate versus lithium carbonate. That will help.
In the meantime, a small clue. The “anti-manic” dose for mice, at least that’s known. Whether the equivalent human dose would be antimanic in a human brain, not known. If the mouse dose was really large, that would tell us something. It wasn’t. By my calculations, which I ran past the study author, the human equivalent dose of lithium orotate is 2.6 mg per day.
This means the same dose that has been available over the counter for over a decade (5 mg) might be anti-manic. At least there’s no reason to think one has to start with 100 mg or something like that.
for dementia: learn some more; maybe?
Here’s where things are going to change the most, based on those mouse studies I’ve mentioned. If the idea of using lithium for dementia prevention is what brought you to this page — or if you’re just interested in seeing some great science that changes everything about lithium and the brain, please head on to my page about lithium and dementia.
Is it safe?
One study in mice back in 1979 basically ended research on lithium orotate for use in humans. It found that mice who were given lithium orotate had more kidney problems than those given lithium carbonate.
But a new mouse study in 2023 found the opposite. The researchers used a lower dose of lithium orotate to test the idea that it might deliver lithium to the brain as well as standard doses of lithium carbonate. Sure enough, it did — and, the lithium orotate mice had no kidney problems with it whereas the lithium carbonate mice did. The opposite result from the 1979 study.
Then came yet another mouse study, the one I’ve mentioned that looked at lithium for the prevention of dementia. Not only did lithium orotate work better, it did not cause kidney problems in those mice either (in this study, neither did lithium carbonate).
In addition, we have the experience of the thousands of people who have been using lithium orotate (in various small doses) for decades. Its potential risks haven’t been studied carefully in the way that risks of prescription medications are. But no dangerous side effects have been reported in all that time. You’d think by now we’d have heard something if lithium orotate really caused serious problems, including long-terms risks.
(There is one report of an overdose on eighteen 120 mg pills of lithium orotate. The young woman had nausea and vomiting when she arrived at the emergency room. She recovered from those symptoms in 3 hours. Here maximum lithium level was 0.4 mEq/L, which is slightly less than the therapeutic range for mania prevention.)
Thyroid, however, is a different story. Even very low amounts of lithium can lower thyroid hormone levels. We don’t yet know what lithium orotate does to thyroid function (although in the 2023 mouse study, it did not cause any changes, while lithium carbonate did). So getting your thyroid tested before you start, and again after you’re on it for a while, is probably a good idea. Might has well get a test of kidney function as well while you’re getting stuck for a blood sample.
What’s the dose for dementia prevention?
We have no studies in humans to answer that question. But here are two guides for estimating.
First, we can just look at the mouse dose in those key studies and calculate the matching dose in humans. My math says that’s 12 mg of lithium orotate per day for an average human (checked by a statistician and two physicists, haha; start from 4.3 microequivalents per liter in the mice’ drinking water, if you want to do it yourself).
Second, perhaps the dose can be lower if it is started when a person is younger, or higher if the person is already “old”. Of course we don’t have data to define those ages either!
Gene or blood tests first?
Two tests might help decide what dose to consider.
First: a family history of Alzheimer’s, especially if it started in the person’s early to mid-60’s or before, raises the risk of dementia. But now it’s possible to further define this risk, a genetic test for the protein ApoE, a carrier of fat in the bloodstream. Having one copy of the ApoE4 version of this gene increases the risk of Alzheimer’s about 300% (3 times higher than having no ApoE4 version). Having two copies, both ApoE4, increases risk about 8 to 15 times.
You might consider this test to determine whether you need to be aggressive with your lithium orotate dose (one or two ApoE4s) or can afford to take a sort of low-but-long approach. Support for the low-dose way is found in one study that showed lower rates of dementia in regions with higher lithium levels in their drinking water. Yeah, amazing isn’t it.
Second, there’s a blood test that can tell you, with about 95% accuracy, whether you have a lot of the stuff in your brain that people with Alzheimer’s have (plaques and tangles). If that test says yes, you do have that stuff, then you might consider using a higher lithium orotate dose.
The gene test can be ordered online without a prescription ($100-300); the blood test takes a doctor’s order. But wait a minute…
Risks of these tests
Doing these tests could make you worry more about dementia (worry: “paying on a debt you may not owe”; or an older phrase, “Don’t borrow trouble”). Compare the opposite approach: just do the things you can to lower your risk. If the tests were “positive” you’d do these things anyway. If the tests were negative you could still get dementia.
So why not just do what you can to lower the risk: eat smart, get physical activity, sleep, don’t smoke, don’t drink too much, don’t get deaf, and stay social. (Eat smart: everybody knows what that means, right? Same as eating to avoid heart disease and stroke — which are more common than Alzheimer’s!)
Start without testing?
You may be doing most or all of these healthy things and still be concerned about getting dementia. I am, because I’m healthy enough that I might last another decade — or two! In which case my risk of dementia is pretty high, regardless of my ApoE genes. I don’t need gene testing to make me think it might be a good idea to add a little lithium orotate. (For now, that’s 5 mg a day, while we wait for more data. I’m lucky that I don’t have to take a lot of pills every day. But one of them is thyroid, so that issue is not one I have to factor in.)
But for you? I hope you’ve learned some things here that will help you decide what to do with lithium orotate.