This is an utterly fascinating area of study! As a therapist, I’m well aware of the negative side-effects of lithium for people with BP - and the understandable non-compliance among patients - but finding a use for lithium in treating the frightening scourge of dementia is exciting.
My concern is that this, along with so many other areas of scientific research, will be shut down by the idiocy of Kennedy and his band of pseudo scientists who understand nothing about the valuable work you and so many others are doing.
The Harvard article I cited in a separate post had this subheader:
"Work described in this story was made possible in part by federal funding supported by taxpayers. At Harvard Medical School, the future of efforts like this — done in service to humanity — now hangs in the balance due to the government’s decision to terminate large numbers of federally funded grants and contracts across Harvard University."
That is utterly tragic. At a micro level, my daughter is an epidemiologist doing research at a major university, and expects to lose her job. At a macro level, we will all lose out. I am deeply grateful for the work you are doing, and for the time you take to share your knowledge with others.
The work reported in the elegant scientific paper re Lithium deficiency and AD-in NATURE, Aug 6-may be the most important medical discovery in many years.
A reputable manufacturer has bottles labeled “Lithium (orotate)” 1mg or 5mg/ capsule that is a confusing description to me at least. Does the mg amount refer to the compound or the element, Li ?
The work reported in the elegant scientific paper re Lithium deficiency and AD-in NATURE, Aug 6-may be the most important medical discovery in many years.
A reputable manufacturer has bottles labeled “Lithium (orotate)” 1mg or 5mg/ capsule that is a confusing description to me at least. Does the mg amount refer to the compound or the element, Li ?
I echo those who are frustrated by having to wait for the imperious “we” to tell us it’s okay to try a supplement that has been determined safe at low doses. Precision medicine is here now & AI is increasing access to it. Blood tests have let me know I am APOE4 (like my dad who passed from AD at 81) & I can now monitor my plasma amyloid plaque levels (confirmed by PET in a trial) over time while trying various interventions like blood pressure meds, Flecainide for AFIB & GLP1’s. Now I plan to measure my endogenous lithium & then try a low doses to see if it impacts my amyloid levels, which have already dropped BTW :) Easy peasy! I understand no medical person wants to support me in my prevention endeavor without the appropriate “guidelines” because they could risk their license I guess? Private companies will do it instead if they can profit & be protected (see Function Health eg) & the healthcare system will just become more & more obsolete if it doesn’t change soon. Thanks for being part of the change Dr. Topol!!! 🙏
Hi, sorry just saw your note! My doctor prescribes the blood tests for tracking my amyloid plaque levels. Problem is comparing apples to apples on these tests. I plan to try the new FDA approved blood test that I believe Quest is or plans to offer. I think docs mostly just follow general guidelines & many don’t like to recommend “supplements” in general so it’s your choice to take lithium or not or you could move to a place where the water has naturally high levels, lol. I use AI agents to help with following the research. Good luck with your journey! Best, Ann
My wife has begun, and I am in full support mode, the journey with AD.
Her PET scan was positive, in January.
I have a few questions on your journey, to date:
Does your doctor(s) order the tests, you describe?
- Or, are you self ordering?
After asking our health care providers (primary, neurology, cardiology) about taking Lithium Orotate supplement? They replied with a single voice of “until there are largescale human studies, I cannot prescribe lithium for AD.”
Please share any references, studies, etc. for our reading!
New dementia therapies, like the anti-amyloid antibodies lecanemab (Leqembi) and donanemab are fraught with controversy over efficacy, substantial safety concerns, and stratosphere pricing. The first anti-amyloid antibodies medication to be approved was in a trial that negative until a subgroup analysis limped passed the FDA with the panel recommending not to approve it, but the FDA approved it anyways.
Donepezil and other older therapies are analogous to giving someone an organic hotdog. What difference does it make?
Lithium as a nutrient and supplement is tantalizing, cheap, safe and almost homeopathic in its dosing. Readily available, as Lithium Orotate. At this juncture, waiting on more substantial evidence, I am hard pressed why low dosing as a supplement shouldn’t be entertained for MCI. I do have the advantage of being an old osteopath practicing in a one traffic light town. So a rare supplement recommendation like Taurine or a little Lithium Oroate, makes me even more endearing.
Lithium is a nutrient, not a drug. Nutritional deficiencies of vitamin D3, lithium, vitamin K2, boron and perhaps magnesium significantly increase the risk of dementia / neurodegeneration. All these deficiencies can easily be corrected. It would be worth doing so just because of their impact on dementia, and even if if there was no such impact, for multiple other reasons.
The barriers to adoption of proper supplementation for these nutrients are largely due to the medical profession's excessive focus on drugs vaccines and, with some reason, suspicion of over-hyped nutritional supplements. There's nothing patentable or profitable about these preventive approaches, so they will be discouraged and maligned (https://orthomolecular.org/resources/omns/v14n22.shtml) by the pharmaceutical industry which has hundreds of billions of dollars in revenue to lose from their successful, population wide, well-informed, voluntary, adoption.
Thank you Eric for this summary and content. A year ago a colleague suggested I trial Lithium Orotate at bedtime to assist with sleep. It remains the supplement with the most reproducibility and consistency in terms of sleep for me personally.
Very excited to learn about this research.
I am curious about testing levels for the average person.
"If replicated in further studies, the researchers say lithium screening through routine blood tests may one day offer a way to identify individuals at risk for Alzheimer’s who would benefit from treatment to prevent or delay disease onset.
Studying lithium levels in people who are resistant to Alzheimer’s as they age might help scientists establish a target level that they could help patients maintain to prevent onset of the disease, [Bruce] Yankner [who in the 1990s was the first to demonstrate that amyloid beta is toxic.] said."
"Since lithium has not yet been shown to be safe or effective in protecting against neurodegeneration in humans, Yankner emphasizes that people should not take lithium compounds on their own. But he expressed cautious optimism that lithium orotate or a similar compound will move forward into clinical trials in the near future and could ultimately change the story of Alzheimer’s treatment.""
Who is going to do the clinical study? NIH is cutting funding. Pharmaceutical companies won’t be interested since I can buy the drug on Amazon for $14/bottle. Associations don’t have the money or expertise for such a large, probably long trial. Who is this”we” you speak of?
When I tried to get good information on supplements 35 years ago ago, my English friend told me that US government doesn’t do much in the way of studies on supplements that studies that exist were done in Europe.
That’s not entirely true. For example there is a collection of minerals called “AREDS2” that purportedly prevents or at least delays macular degeneration and which the American Opthalmology Society recommends. I don’t know if the NIH will do such a study again
Once again, I hope you are communicating or facilitating communication with researchers in the UK where a study such as you propose might be granted a more favourable reception, particularly as the NHS is publicly funded and quite worried about the costs associated with neurodegenerative diseases.
Since you are now a best selling (!) author specialising in gerontology, your involvement could quite possibly speed things along to all our benefit.
Let someone know at either one of the Oxbridge colleges or someplace in London like UCL or King's College, or even the Wellcome Trust. Unfortunately, I don't have conacts in that world or I'd flag them.
DrTopol: I took a psychopharmacology course about 3 to 4 years ago in which the use of Lithium for dementia prevention was discussed. Dr Nassir Ghaemi, a Psychiatry professor at Tufts taught the course. He is an accomplished academic and clinician. Simply the best. He would be great to know and interview about Lithium. Phillip A Cohen MD (Adult Psychiatrist)
Fantastic article, thank you!! The paper is potential Nobel-level if things prove out..
Not sure whether this has been commented on yet, but the statement "10 mg of lithium orotate is equivalent to about 0.4mg of elemental lithium" is not correct. The 5 mg and 10 mg lithium orotate supplements are amounts of elemental lithium, so a 10 mg tablet would be 10 mg of elemental Li.
The 5-10 mg Li supplement is roughly an order of magnitude higher than used in the study and a little under two orders of magnitude below BD prescribed doses. Notably, there is a 2002 paper where nutritionists recommended a daily dose of 1 mg per day of lithium for health reasons. (Lithium: Occurrence, Dietary Intakes, Nutritional Essentiality Gerhard N. Schrauzer (from UCSD), Journal of the American College of Nutrition, Vol. 21, No. 1, 14–21 (2002)
Given the increased risks of getting AD as people age, one could reasonably make a recommendation that everyone over 45 take at least the nutrition-recommended 1 mg elemental lithium daily now and let the science play out over the upcoming years/decades. The risks of this are far lower than the risk of waiting until getting final scientific evidence. In fact, municipal water supplies probably need to starting thinking about be adding lithium at low levels soon since it has already been shown to decrease suicide risk.
In view of what we now know, I think scientists are doing a tremendous disservice to the public, particularly the most vulnerable population, by recommending not to start taking lithium supplements until the science learns more. We are already have far more than enough information to justify the much higher benefit to risk ratio for immediate Li supplementation at the 1 mg daily level.
This is an utterly fascinating area of study! As a therapist, I’m well aware of the negative side-effects of lithium for people with BP - and the understandable non-compliance among patients - but finding a use for lithium in treating the frightening scourge of dementia is exciting.
My concern is that this, along with so many other areas of scientific research, will be shut down by the idiocy of Kennedy and his band of pseudo scientists who understand nothing about the valuable work you and so many others are doing.
The Harvard article I cited in a separate post had this subheader:
"Work described in this story was made possible in part by federal funding supported by taxpayers. At Harvard Medical School, the future of efforts like this — done in service to humanity — now hangs in the balance due to the government’s decision to terminate large numbers of federally funded grants and contracts across Harvard University."
That is utterly tragic. At a micro level, my daughter is an epidemiologist doing research at a major university, and expects to lose her job. At a macro level, we will all lose out. I am deeply grateful for the work you are doing, and for the time you take to share your knowledge with others.
The work reported in the elegant scientific paper re Lithium deficiency and AD-in NATURE, Aug 6-may be the most important medical discovery in many years.
A reputable manufacturer has bottles labeled “Lithium (orotate)” 1mg or 5mg/ capsule that is a confusing description to me at least. Does the mg amount refer to the compound or the element, Li ?
The work reported in the elegant scientific paper re Lithium deficiency and AD-in NATURE, Aug 6-may be the most important medical discovery in many years.
A reputable manufacturer has bottles labeled “Lithium (orotate)” 1mg or 5mg/ capsule that is a confusing description to me at least. Does the mg amount refer to the compound or the element, Li ?
I echo those who are frustrated by having to wait for the imperious “we” to tell us it’s okay to try a supplement that has been determined safe at low doses. Precision medicine is here now & AI is increasing access to it. Blood tests have let me know I am APOE4 (like my dad who passed from AD at 81) & I can now monitor my plasma amyloid plaque levels (confirmed by PET in a trial) over time while trying various interventions like blood pressure meds, Flecainide for AFIB & GLP1’s. Now I plan to measure my endogenous lithium & then try a low doses to see if it impacts my amyloid levels, which have already dropped BTW :) Easy peasy! I understand no medical person wants to support me in my prevention endeavor without the appropriate “guidelines” because they could risk their license I guess? Private companies will do it instead if they can profit & be protected (see Function Health eg) & the healthcare system will just become more & more obsolete if it doesn’t change soon. Thanks for being part of the change Dr. Topol!!! 🙏
I fully understand your position and plan.
Hi, sorry just saw your note! My doctor prescribes the blood tests for tracking my amyloid plaque levels. Problem is comparing apples to apples on these tests. I plan to try the new FDA approved blood test that I believe Quest is or plans to offer. I think docs mostly just follow general guidelines & many don’t like to recommend “supplements” in general so it’s your choice to take lithium or not or you could move to a place where the water has naturally high levels, lol. I use AI agents to help with following the research. Good luck with your journey! Best, Ann
Hi Ann,
My wife has begun, and I am in full support mode, the journey with AD.
Her PET scan was positive, in January.
I have a few questions on your journey, to date:
Does your doctor(s) order the tests, you describe?
- Or, are you self ordering?
After asking our health care providers (primary, neurology, cardiology) about taking Lithium Orotate supplement? They replied with a single voice of “until there are largescale human studies, I cannot prescribe lithium for AD.”
Please share any references, studies, etc. for our reading!
Thank you and all the best,
Will & Cheryl C.
New dementia therapies, like the anti-amyloid antibodies lecanemab (Leqembi) and donanemab are fraught with controversy over efficacy, substantial safety concerns, and stratosphere pricing. The first anti-amyloid antibodies medication to be approved was in a trial that negative until a subgroup analysis limped passed the FDA with the panel recommending not to approve it, but the FDA approved it anyways.
Donepezil and other older therapies are analogous to giving someone an organic hotdog. What difference does it make?
Lithium as a nutrient and supplement is tantalizing, cheap, safe and almost homeopathic in its dosing. Readily available, as Lithium Orotate. At this juncture, waiting on more substantial evidence, I am hard pressed why low dosing as a supplement shouldn’t be entertained for MCI. I do have the advantage of being an old osteopath practicing in a one traffic light town. So a rare supplement recommendation like Taurine or a little Lithium Oroate, makes me even more endearing.
Lithium is a nutrient, not a drug. Nutritional deficiencies of vitamin D3, lithium, vitamin K2, boron and perhaps magnesium significantly increase the risk of dementia / neurodegeneration. All these deficiencies can easily be corrected. It would be worth doing so just because of their impact on dementia, and even if if there was no such impact, for multiple other reasons.
The barriers to adoption of proper supplementation for these nutrients are largely due to the medical profession's excessive focus on drugs vaccines and, with some reason, suspicion of over-hyped nutritional supplements. There's nothing patentable or profitable about these preventive approaches, so they will be discouraged and maligned (https://orthomolecular.org/resources/omns/v14n22.shtml) by the pharmaceutical industry which has hundreds of billions of dollars in revenue to lose from their successful, population wide, well-informed, voluntary, adoption.
Please see the research cited and discussed at: https://vitamindstopscovid.info/00-evi/. Low 25-hydroxyvitamin D is a huge risk factor for neurodegeneration: https://vitamindstopscovid.info/00-evi/#3.3 and (in pregnancy and early childhood) preeclampsia, pre-term birth, mental retardation, ADHD and autism: https://vitamindstopscovid.info/00-evi/#3.2.
https://scholar.google.com.au/scholar?hl=en&as_sdt=0%2C5&q=%22vitamin+D%22+dementia
Low dose, 5mg/day, non-prescription lithium (orotate) supplementation may reduce dementia risk: https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-024-00348-5, https://www.nature.com/articles/s41586-025-09335-x (as discussed above), https://chandramd.com/low-dose-lithium-supplements/, https://pubmed.ncbi.nlm.nih.gov/35236261/ and https://www.nytimes.com/2014/09/14/opinion/sunday/should-we-all-take-a-bit-of-lithium.html.
https://scholar.google.com.au/scholar?hl=en&as_sdt=0%2C5&q=lithium+dementia
Vitamin K2 AD prevention and treatment, Popescu 2021 https://www.mdpi.com/2072-6643/13/7/2206,
https://link.springer.com/article/10.1007/s11033-022-07925-w, https://link.springer.com/article/10.1007/s11481-024-10156-4 and https://www.researchgate.net/publication/378839625_The_Role_of_Vitamin_K_in_the_Development_of_Neurodegenerative_Diseases
https://scholar.google.com.au/scholar?hl=en&as_sdt=0%2C5&q=%22vitamin+K2%22+dementia
Boron is a neglected nutrient which is deficient in modern diets since it is washed from repeatedly used agricultural soils and is not replenished by industrial fertilizers. Its mechanisms of action in animals is not understood. It does not appear to form compounds and is excreted in urine within a day or so. Most likely the borate ion subtly affects numerous other chemical reactions, as suggested by https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=e1aab611857f70311c0eff673a387afdfcb68378 and https://scholar.google.com.au/scholar?cites=2796858776624621335.
Boron and neurodegeneration: https://journals.tubitak.gov.tr/biology/vol44/iss4/9/, https://www.sciencedirect.com/science/article/pii/S0197018624002249,
Further research: https://aminotheory.com/cv19/#08-boron. Typical intake ~1mg/day. Safe upper limit 20mg/day, benefits bone but concerns about sex hormone and other interactions: https://sci-hub.se/https://doi.org/10.1016/j.mehy.2018.06.024, https://supp.ai/i/boron-estradiol/C0006030-C0014912 and https://www.researchgate.net/publication/317191668_Boron_-_A_potential_goiterogen.
https://scholar.google.com.au/scholar?hl=en&as_sdt=0%2C5&q=boron+dementia
Low, high but not moderate magnesium levels associated with dementia: https://academic.oup.com/clinchem/article/67/6/899/6224353, https://sci-hub.se/https://doi.org/10.1212/WNL.0000000000004517 and https://www.sciencedirect.com/science/article/pii/S2324242624000019.
https://scholar.google.com.au/scholar?hl=en&as_sdt=0%2C5&q=magnesium+dementia
Thank you Eric for this summary and content. A year ago a colleague suggested I trial Lithium Orotate at bedtime to assist with sleep. It remains the supplement with the most reproducibility and consistency in terms of sleep for me personally.
Very excited to learn about this research.
I am curious about testing levels for the average person.
Thank-you for sharing your N=1 experience.
I think we need more accurate ways of assessing whether any particular individual might benefit from various types of supplementation.
Absolutely agree Janet
and the impetus to my question
Funny timing, just read this article yesterday from Harvard, sounds promising:
https://hms.harvard.edu/news/could-lithium-explain-treat-alzheimers-disease
Excerpts:
"If replicated in further studies, the researchers say lithium screening through routine blood tests may one day offer a way to identify individuals at risk for Alzheimer’s who would benefit from treatment to prevent or delay disease onset.
Studying lithium levels in people who are resistant to Alzheimer’s as they age might help scientists establish a target level that they could help patients maintain to prevent onset of the disease, [Bruce] Yankner [who in the 1990s was the first to demonstrate that amyloid beta is toxic.] said."
"Since lithium has not yet been shown to be safe or effective in protecting against neurodegeneration in humans, Yankner emphasizes that people should not take lithium compounds on their own. But he expressed cautious optimism that lithium orotate or a similar compound will move forward into clinical trials in the near future and could ultimately change the story of Alzheimer’s treatment.""
Who is going to do the clinical study? NIH is cutting funding. Pharmaceutical companies won’t be interested since I can buy the drug on Amazon for $14/bottle. Associations don’t have the money or expertise for such a large, probably long trial. Who is this”we” you speak of?
When I tried to get good information on supplements 35 years ago ago, my English friend told me that US government doesn’t do much in the way of studies on supplements that studies that exist were done in Europe.
That’s not entirely true. For example there is a collection of minerals called “AREDS2” that purportedly prevents or at least delays macular degeneration and which the American Opthalmology Society recommends. I don’t know if the NIH will do such a study again
Once again, I hope you are communicating or facilitating communication with researchers in the UK where a study such as you propose might be granted a more favourable reception, particularly as the NHS is publicly funded and quite worried about the costs associated with neurodegenerative diseases.
Since you are now a best selling (!) author specialising in gerontology, your involvement could quite possibly speed things along to all our benefit.
would be eager to do the trial with colleagues in the UK
Let someone know at either one of the Oxbridge colleges or someplace in London like UCL or King's College, or even the Wellcome Trust. Unfortunately, I don't have conacts in that world or I'd flag them.
DrTopol: I took a psychopharmacology course about 3 to 4 years ago in which the use of Lithium for dementia prevention was discussed. Dr Nassir Ghaemi, a Psychiatry professor at Tufts taught the course. He is an accomplished academic and clinician. Simply the best. He would be great to know and interview about Lithium. Phillip A Cohen MD (Adult Psychiatrist)
Fantastic article, thank you!! The paper is potential Nobel-level if things prove out..
Not sure whether this has been commented on yet, but the statement "10 mg of lithium orotate is equivalent to about 0.4mg of elemental lithium" is not correct. The 5 mg and 10 mg lithium orotate supplements are amounts of elemental lithium, so a 10 mg tablet would be 10 mg of elemental Li.
The 5-10 mg Li supplement is roughly an order of magnitude higher than used in the study and a little under two orders of magnitude below BD prescribed doses. Notably, there is a 2002 paper where nutritionists recommended a daily dose of 1 mg per day of lithium for health reasons. (Lithium: Occurrence, Dietary Intakes, Nutritional Essentiality Gerhard N. Schrauzer (from UCSD), Journal of the American College of Nutrition, Vol. 21, No. 1, 14–21 (2002)
Given the increased risks of getting AD as people age, one could reasonably make a recommendation that everyone over 45 take at least the nutrition-recommended 1 mg elemental lithium daily now and let the science play out over the upcoming years/decades. The risks of this are far lower than the risk of waiting until getting final scientific evidence. In fact, municipal water supplies probably need to starting thinking about be adding lithium at low levels soon since it has already been shown to decrease suicide risk.
In view of what we now know, I think scientists are doing a tremendous disservice to the public, particularly the most vulnerable population, by recommending not to start taking lithium supplements until the science learns more. We are already have far more than enough information to justify the much higher benefit to risk ratio for immediate Li supplementation at the 1 mg daily level.