Understanding the Differences Between Lithium and Lithium Orotate

Understanding the Differences Between Lithium and Lithium Orotate

By Melissa Quinn, MD

Marcia (not her real name) sat across from me in my office at Amen Clinics in Los Angeles. She felt good about the tremendous gains she had made in terms of her mood stability, sleep patterns, and anxiety level. Yet, according to her family, she remained short-tempered and easily irritated.

She’d been prescribed nearly every combination of medications but had experienced significant side effects on many of them. After I ordered genetic testing for her, we were finally on the right track.

When I suggested adding lithium orotate as part of her wellness plan, she looked at me stunned. Having a doctor recommend lithium brought up feelings of fear and confusion for Marcia. These sentiments are understandable, given that prescription lithium has significant risks, including hand tremors, increased urination, hair thinning, decreased thyroid function (over time), and more.

Lithium has been approved for the treatment of bipolar disorder and may also be helpful when prescribed “off-label” for conditions, such as treatment-resistant depression with suicidal thinking. When treating these illnesses, dosages of lithium can reach 1,800mg daily.

The supplement lithium orotate, however, contains much smaller quantities of lithium than the prescription form, generally ranging from 5mg to 10mg daily and in some cases, up to 20mg daily. Some clinicians are skeptical that such a low dosage can provide much support, but many clients have reported feeling benefits.

The Basics of Lithium and Lithium Orotate

Here’s some background on lithium orotate and some examples of how clinicians are using it. Lithium orotate is an over-the-counter nutraceutical that consists of orotic acid (a compound produced naturally in the body) and lithium (an alkali metal). Lithium is present in the diet, mainly in grains and vegetables, which is why the supplement is often called “nutritional lithium.”

In fact, lithium is so important to our health that it has been added to the World Health Organization’s list of nutritionally essential trace elements. The orotate compound is important because it delivers the lithium in its bioactive form so your body can absorb it.

Lithium is found in the drinking water in many cities, and research shows that there is an association of lowered incidence of crimes, suicides, and arrests related to drug addictions in these areas. Some researchers are even suggesting we should put lithium in drinking water as a way to reduce suicide. The research indicates that lithium at a low dosage has a beneficial effect on behavior. 

Prescription-strength lithium is regarded as a neuroprotective agent. It’s being studied in certain neurodegenerative disorders, namely, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), and Parkinson’s disease. It’s been shown to disrupt glycogen synthase kinase-3, a key enzyme responsible for the development of amyloid plaques and neurofibrillary tangles associated with Alzheimer’s disease. A study in the 2015 issue of the Journal of Alzheimer’s Disease concluded that lithium treatment may have beneficial effects on cognitive performance in people with mild cognitive impairment and Alzheimer’s disease.

Findings suggest that the supplement lithium orotate can promote a positive mood and supports cognitive function in the elderly.

Clinicians should be aware of the very important differences between full-dose prescription lithium and the low-dose supplement lithium orotate. When recommended appropriately, the supplement can be a beneficial addition to the clinical toolbox.

About the Author: Melissa Quinn, MD, Amen Clinics Los Angeles

Dr. Melissa Quinn is a psychiatrist who is double board-certified by the American Board of Psychiatry and Neurology. Her passion is to help people heal, get psychologically well, find the relief they deserve, and help them to become the best version of themselves. She helps children, adolescents, adults, and families get their lives back on track with a whole-person—and when appropriate—a whole-family approach. By developing her clients’ inner strengths, she shows them how to reach their highest potential.

She knows that people are seeking a range of solutions for prevention, health, and healing. As a result, Dr. Quinn became passionate about learning integrative approaches and was subsequently board-certified in Integrative and Holistic Medicine through The Academy of Integrative Health and Medicine. She later went on to peruse a fellowship in Transcranial Magnetic Stimulation (TMS) through Duke University. She enjoys working with a variety of clients, but she specializes in working with patients with ADHD, developmental and intellectual delays, anxiety, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and mood disorders.



  1. Does Lithium Orotate cause some individuals to gain weight, lose hair, lose libido, and experience other side effects that Lithium, the prescription, does?

    Comment by Dee Schwartz — February 19, 2020 @ 7:25 AM

  2. Question: I’m taking Lithium Orotate for anxiety and it seems to be helping. I’m very light at 110 lbs. what dose should I take?

    Comment by Vicki Grieshaber — February 26, 2020 @ 12:13 PM

  3. The easiest way to understand why that difference matters most is to explain how it works rather than list a bunch of “research shows” with no references that can be checked.
    1- the uses of lithium metal in the body’s biochemistry: list them, what does it do, and compare to what the Bipolar drug does (and it’s side effects) and 2- explain clearly and simply the molecular weight differences between lithium orotate NUTRITIONAL supplement and lithium CARBONATE DRUG, a much larger molecule: to get the same amount of Li, the second inflicts major amounts of carbonate, not so good for you, and nutrition does not require the same amounts as bipolar. Adding this to what you say, which has to do with dose-related effects, which can end up being opposite.

    Comment by Marika — March 10, 2020 @ 2:17 AM

  4. Would you please share your list of references? I’ve searched PubMed regarding nutritional lithium/lithium orotate, and I can’t find much.

    Comment by Leigh — April 8, 2020 @ 12:05 PM

  5. I would start at five mg and slowly go up to 20mg. Twenty is the Max probably. That is what my psychiatrist told me to do and I’m around the same weight as you.

    Comment by Layla — April 24, 2020 @ 3:14 PM

  6. Hello!
    Thank you so much for a trustworthy post. I have been trying to get lithium oratate to work for me for years and I finally think that microdosing it seems to get me results that I understand. A better understanding on what bipolar feels like to me and microdosing 2.5 mg at night and another in the morning is noticeable. I can say I feel more even and less erratic. I sometimes miss the good mania swings but I’d rather feel steady these days. Almost boring but in a good nice way.
    Not feeling amazing how some people stated as their experience. Just normal, and I’m satisfied with that.

    Comment by Kim — May 4, 2020 @ 2:38 AM

  7. I am becoming more suicidal between May and September inclusive. I have been in 3 mental units during thiose months including twice last year. What level of lithium orotate do I need to take during the high and increasing risk months of the year?

    Comment by Cerys Brangwyn — May 9, 2020 @ 4:03 AM

  8. I take 15mg a day for my BPD, but I’m slowly increasing it to 35mg. I have a Bipolar friend that takes 40mg a day and it keeps her regulated.

    Comment by Rochelle H — May 12, 2020 @ 7:44 AM

  9. Does lithium oratate cause weight gain or hair loss. Also i am on tiptoe and lexapro is it safe to use with these meds

    Comment by Cheryl — July 7, 2020 @ 3:26 AM

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