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

  10. Have a son 41 years old diagnosed with ADHD & OCD. & mood disorders. Has been on many meds for over 20 years now. Lots of negative side effects! He is now on lithium and clozapine. Would like to get him detoxed and on natural supplements but too dangerous to do on my own! We live in Colorado. Do you know of a Doctor who could help this happen safely or a place he could go to have this done?
    Thanks so much for any help in this very difficult process!

    Comment by KATEY WELCH — January 20, 2022 @ 11:22 AM

  11. Hello Katey, thank you for reaching out. Amen Clinics currently has 9 locations: https://amenclinics.com/locations/. For more information about scheduling, please contact our Care Coordinators: https://amenclinics.com/schedule-visit/

    Comment by Amen Clinics — January 21, 2022 @ 3:36 PM

  12. Hello, I have used Lithium Orotate 1 mg to assist intermittent insomnia. It works great for this purpose but leaves me drugged feeling and depressed feeling in the morning. Does anyone have any suggestions? Also, I took it close to my thryoid RX at 5:00 one morning and I started to feel a fainting feeling, and my bp was erratic when it is normally stable at 118/58. My bp was anywhere from 91/72 to 144/72 and my heart rate was 144 when normally it is 63. The only variable I can see is that we had a sewer leak in the house which was fixed asap but at that time it may have been circulating in the air. So, my symptoms were eitherfrom that or from the taking of thryoid RX at the same time as 1 mg Lithium Orotate. I am considering taking very low mcg dose of Ionic Lithium or low mcg dose of Lithium Orotate. Thank you for any suggestions. Jan

    Comment by Jan — February 17, 2022 @ 8:30 AM

  13. My psychologist mentioned I may wish to take Lithium 5 mg for anxiety exacerbated by the pandemic. I should mention I am 71. I took it for 1 month and experienced weight gain, hair loss and tremors in my left hand. I therefore started titrating down to 3 times a week and then 2 times a week. A couple days ago I went to a new ophthalmologist to get a prescription for Restasis (for dry eyes). He said I seemed to have some symptoms of Bell’s Palsy, Left eye not completely closing, eye blinking erratic. My eyes were feeling very fatigued. Anyway I want to now completely stop the Lithium. Is that ok. Sorry so lengthy.

    Comment by Suzi — March 9, 2022 @ 10:55 AM

  14. is lithium orotate habit forming ? i take serequel for sleep . i take the lithium 10 mg in the morning. been on it for 3 months . i think it helps

    Comment by Sharon Gregoire — March 11, 2022 @ 3:30 AM

  15. I did well on prescrip lithium at 75mg daily but my hair started falling out, my thyroid went off and I gained weight. If I change to lithium oralate will I experience these same symptoms?

    Comment by Annette — May 25, 2022 @ 5:17 PM

  16. Currently taking 300mg of lithium carbonate, what would be an equivalent dose of lithium orotate? Would an even lower dose of lithium orotate be more beneficial?

    Comment by Susan Dobbs — May 29, 2022 @ 8:30 PM

  17. For the past year I have taken a supplement that contains lithium orotate 5 mg.
    I recently donated a kidney. Can I still take the lithium orotate?

    Comment by Shelley Eatherly — May 31, 2022 @ 7:14 AM

  18. My son was diagnosed with psychosis (Paranoid Schizophrenia) and ADD. He takes Amphetamine-Dextroamphet er 15 mg and he also takes aripiprazole – 20 mg . Would it be safe to take Lithium Orotate with these drugs?
    He has difficulties at work because he gets annoyed/agitated quickly. Coworkers often tell him to pay attention, he is high strung and to calm down. 🙁 Help!

    Comment by Lisa — October 22, 2022 @ 9:53 PM

  19. could you please provide references for findings in this statement?:
    “Findings suggest that the supplement lithium orotate can promote a positive mood and supports cognitive function in the elderly.”

    also, how can clinicians know what levels are safe given the lack of human clinical studies on the orotate supplement form?


    Comment by sean — November 18, 2022 @ 1:53 PM

  20. Hi
    I suspect my 35 year old son is bipolar. It runs in the family. He is away . He is about to take ayahuasca in few days. Should I tell him what I suspect?

    Comment by Mania — January 1, 2023 @ 11:58 AM

  21. What is the right dose of lithium Orate to prevent suicidal thoughts? In a malen180 pounds and 6’11 inches

    Comment by Gina — January 13, 2023 @ 6:55 PM

  22. Hello Gina, thank you for reaching out. For more information please contact BrainMD: https://brainmd.com/contact. Here is additional information about Lithium Orotate: https://brainmd.com/lithium-orotate. If you have concerns for yourself or someone you know, put the National Suicide Prevention Lifeline numbers in your phone directory: 800-273-8255 and 988. It is staffed 24/7 by trained counselors who provide compassionate and knowledgeable support as well as connections to helpful resources.

    Comment by Amen Clinics — January 19, 2023 @ 8:13 PM

  23. A nurse friend recommended lithium orotate for depression. I work in mental health as well and am aware of lithium carbonate for bipolar depression. There is not too much research on lithium orotate. Have you had much success with it in use for depression? Anything in particular to be aware of? Thanks.

    Comment by Patti — March 18, 2023 @ 7:27 PM

  24. I am a 73 yr woman, who has taken licarbonate since 1984. I had suffered an un- diagnosed manic episode in 1974, with no incidence of bipolar disorder for 10 years. I now have 3 B kidney disease, for which my nephrogist is bringing in a psychiatrist for consult in changing meds. I have taken 450 mg of am/ pm (900 mg per day) lowered to 450 mg once a day. I do not want to change prescription , I want off of chemical intervention! Is lithium prorate in small dose the direction I should pursue? I should add that I also take 50 mg of lamotrigine for TGA or transit global amnesia, no incidents since 2006 or 7 . For me this is my last chance to get get off of this medicine. Thank you from Cami

    Comment by Camilla Ritter — March 20, 2023 @ 9:02 AM

  25. Hello Patti, thank you for reaching out. For more information about Dr. Daniel Amen's recommended, brain-directed supplements, visit https://brainmd.com/.

    Comment by Amen Clinics — March 21, 2023 @ 9:43 AM

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