Lithium is a naturally occurring metal studied at tiny daily amounts, far below the psychiatric range, to protect the aging brain. Populations drinking lithium-richer water show less dementia and lower death rates, and it calms a brain-aging enzyme. The evidence is promising but unproven; possible thyroid and kidney effects make baseline testing and periodic checks sensible. (Full Review)

Protocol

Form & Dose

Lithium orotate, 1–5 mg elemental Li/day

Some protocols use as little as 300 µg; far below the psychiatric range

Timing

Once daily in the evening, with food

Long half-life (18–36 h) makes once-daily dosing sufficient; with food to minimize stomach upset

Baseline Labs

Check eGFR and TSH before starting

Identifies individuals for whom even low-dose use is inadvisable

Time to effect

Cognitive & Mood Effects

Months

Neuroprotection concerns long-term prevention; no immediate perceptible change at low doses

Steady-State Levels

Days to a couple of weeks

Long half-life means levels build over the first several days before reaching steady state

Benefits

High: Reduced suicide risk

Medium: Lower dementia and Alzheimer's risk; slowing of cognitive decline in at-risk groups

Low: Lifespan extension; mood stabilization and wellbeing at low doses

Speculative: Neurorestoration after stroke or injury; cardiometabolic and anti-inflammatory effects

Contraindications

Pregnancy and breastfeeding

Significant chronic kidney disease (eGFR persistently below ~45 mL/min/1.73 m²)

Uncontrolled thyroid disease

Significant heart rhythm disorders

Inability to maintain stable hydration and sodium intake

Key Interactions

Diuretics (thiazides, e.g., hydrochlorothiazide)

NSAIDs (e.g., ibuprofen, naproxen)

ACE inhibitors and ARBs (e.g., lisinopril, losartan)

SSRIs and serotonergic drugs (e.g., sertraline, tramadol)

Caffeine

Sodium/salt intake

Supplements with additive thyroid effects (e.g., high-dose iodine or kelp)

Risk & Side Effects

High: Narrow therapeutic window and acute toxicity; kidney effects; thyroid suppression

Medium: Tremor and neurological effects; weight gain and gastrointestinal upset

Low: Cardiac conduction and rhythm effects; supplement quality and dose inaccuracy

Speculative: Teratogenicity; long-term low-dose effects not yet characterized

Monitoring

Marker	Target	Why
eGFR	>90 mL/min/1.73 m² (caution if <60)	Detects reduced kidney filtering, the organ that clears lithium
Serum creatinine	0.6–1.0 mg/dL	Tracks kidney function trend over time
TSH	0.5–2.5 mIU/L	Detects lithium-related thyroid suppression
Free T4	Mid-to-upper reference range	Confirms thyroid hormone output if TSH is abnormal
Serum lithium level	<0.6 mmol/L; negligible at microgram doses	Confirms trace dosing has not produced unexpected accumulation
Serum calcium	8.5–10.2 mg/dL	Lithium can raise calcium via parathyroid effects at higher doses

Cadence: Baseline, then at around 3 months, then every 6–12 months

Qualitative Assessment

Cognitive clarity and memory (subjective focus and recall over months)
Mood stability and emotional evenness
Energy levels and absence of new fatigue (a possible thyroid signal)
Presence or absence of fine hand tremor
Thirst and urination frequency (a possible kidney/water-handling signal)
Sleep quality

Lithium for Health & Longevity

Protocol

Benefits

Risk & Side Effects

Monitoring

Qualitative Assessment