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Lithium Orotate Side Effects

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Lithium Orotate has not yet been studied intensively, making it more important to understand its side effects in the long term fully.

Lithium Orotate Side Effects

Most of the Lithium Orotate side effects are linked to known side effects of Lithium itself. These side effects can be mild, like excessive urination, nausea, and diarrhea, or they could be as severe as intoxication, cognitive deficits, renal impairments, and weight gain.

What Is Lithium Orotate?

As the name implies; Lithium Orotate is a combination of the salt of orotic acid and Lithium.  

Orotic acids were historically considered a component of the Vitamin B complex and were even called Vitamin B13. Recent research showed that it is not a Vitamin. It is a natural compound made by the body by a mitochondrial enzyme. It is used along with Lithium in supplements because of its proven efficiency as a minerals carrier [1]. 

Lithium is a chemical element, a silver alkali metal. 

Lithium has been prescribed and FDA approved as a mood-stabilizing agent that could be used for treating manic episodes and Bioploar disorders [2]. 

Doctors may prescribe Lithium as a dietary supplement after running some screening tests for patients who suffer mania, hypo-mania, chronic depression, and bipolar disorder [3]. It is effective in reducing aggression and self-harming behavior. 

Combining Orotoic acids with Lithium is supposed to help the disassociation of free Lithium ions to the body when the solution is dissolved after ingestion. Compared to other Lithium Carbonate prescriptions, Lithium Orotate is preferred because it can easily cross the blood-brain barrier (BBB) [4]. 

This combination is thought to be more effective than Lithium alone to treat Alcoholism and bipolar disorders. Yet, there is such an insufficient body of evidence to support these health claims.

The effect of Lithium Orotate in treating Alcoholism was evaluated in a study from 1986 [5]. The study claims that Lithium Orotate is safe and effective as the primary agent in treating Alcoholism after a significant number of their study subjects had few to no relapses during the study period. 

The FDA does not approve Lithium Orotate. Nevertheless, it became a common OTC (Over-The-Counter) supplement gaining from the lateral popularity of Lithium as a supplement used in mild mental disorder cases.


Lithium Orotate Side Effects

Most of the Lithium Orotate side effects are linked to known side effects of Lithium itself. These side effects can be mild, like excessive urination, nausea, and diarrhea, or they could be as severe as intoxication, cognitive deficits, renal impairments, and weight gain.

1. Excessive Urination (Polyuria)

You have polyuria if you urinate more than 3000 ml per day. 

Many patients might not address it as a severe side effect, but up to 70% of patients using Lithium suffer consistently from excessive urination.  

Lithium interferes with urine collection tubules, reducing the kidneys' capacity to hold water by diminishing urine concentration and increasing the production of dilute urine [6]. 

This side effect is reversible as it appears at the beginning of treatment with Lithium. When it progresses with regular intakes of Lithium, it becomes structural and irreversible.

Many factors can contribute to the magnitude of this side effect, such as:

  • High serum Lithium levels (higher serum levels are toxicity indicators
  • Long periods of treatments
  • Frequency of Lithium intoxication
  • Ingestion of multiple psychotropic medications

2. Nausea And Diarrhea

Up to 20% of patients treated with Lithium have reported nausea as a pronounced side effect in the early application stages. In the long-term, this side effect was less recognized. 

Diarrhea has been reported in only up to 10% of patients. It is expected during the first six months of Lithium treatments. A severe diarrhea side effect is linked to serum lithium levels higher than 0.8mEq/l [6].

Patients can manage to diminish nausea by using multiple Lithium doses daily only after meals. They usually do not see nausea as a worrying side effect and not a reason to discontinue the drug treatment. 

Vomiting and diarrhea are usually reported as a byproduct of Lithium intoxication, appearing along with other side effects like tremor and ataxia.

3. Hypothyroidism

Underactive Thyroid, scientifically known as Hypothyroidism, is when the thyroid gland fails to generate sufficient thyroid hormones. These hormones control how the body uses energy, affecting every organ's speed and functionality, from your heartbeats to your kidney filtering. 

People suffering from underactive thyroid usually suffer from tiredness, weight gain and depression [7]. 

Hypothyroidism is a side effect strongly linked to Lithium treatment [8]. 

You might have higher risks to get Hypothyroidism from using Lithium supplements if you have one of the following factors:

  • Female gender
  • Old age
  • Higher presence of antithyroid antibodies
  • Family history of hypothyroidism

4. Tremor

A tremor is an involuntary, regular, and rhythmic shaking in parts of your body. It can affect your vocal cords, trunks, or any of your limbs [9]. 

Suffering from hand tremors is a common side effect among Lithium patients. 

Up to 25% of patients treated with Lithium supplements reported tremor as a side effect typically arising at the early stages of the treatment [6]. 

The magnitude of the tremor side effect is affected by other forms of physiologic tremor resulting from anxiety, alcohol withdrawals, antidepressant medications, or caffeine ingestion. Higher doses of tremors tend to raise the risk of tremor prevalence.

5. Cognitive Impairment

Cognitive impairment is highly associated with bipolar disorders. While Lithium Orotate itself is used for treating bipolar disorder, cognitive impairment is reported to be one of the side effects of Lithium Orotate, Lithium treatment in general. 

It is one of the most distressing side effects among patients—those treated with Lithium associate mental slowness as a side effect resulting from taking Lithium drugs.  

Research showed that Lithium causes slow motor movement and diminished creativity. Yet, studies have concluded that Lithium has only a minor impact on cognition in the domains of memory strength and verbal learning [6].  

Fewer serum levels could be a way to decrease the negative impact on cognitive performance. Additionally, having your doctor reviewing other used psychotropic medications might contribute to lower that impact. 

Using brain stimulants like Caffeine and Ginseng, or a combination of both along with Lithium Orotate might be a final resort to manage the induced cognitive impairment side effect.

6. Lithium Intoxication

The risk of death from Lithium intoxication ranges from 9 to 25%. However, recent data suggests lower mortality rates; it is most important to follow strict regulations when taking Lithium Orotate as a supplement to avoid intoxication [6]. 

The symptoms of Lithium intoxication start with diarrhea, weakness, worsening tremor, ataxia, and loss of focus. It escalates in later stages to confusion, vomiting, gross tremor, and slurred speech.

Many factors can cause Lithium intoxication:

  • Overdosing
  • Dehydration
  • Fever
  • Interfering new medications

In mild cases of Lithium intoxication, patients should stop taking the supplements to prevent the intoxication progress. Advanced levels of intoxication might need fluid infusion with saline diuresis, gastric lavage, or whole bowel irrigation. Severe intoxication with levels of Lithium exceeding 4.0 mmol/l, extracorporeal methods such as hemodialysis will be necessary.

References:

[1] https://www.efsa.europa.eu/en/efsajournal/pub/1187
[2]https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/017812s027%2C018421s025%2C018558s021lbl.pdf
[3] https://www.nhs.uk/medicines/lithium/
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2248201/
[5] https://www.sciencedirect.com/science/article/abs/pii/0741832986900182?via%3Dihub
[6] https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-016-0068-y
[7] https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/
[8] https://pubmed.ncbi.nlm.nih.gov/22265699/
[9] https://medlineplus.gov/tremor.html

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