My Dementia Protocol - Please improve it and offer advice

[CronosTempi]

Sorry, just to clarify, you take 5mg + 5mg=10mg/day or 2.5mg + 2.5mg=5mg/day?

[Virilius]

What about potential kidney issues with lithium supplementation?

[John_Hemming]

Oddly enough I think this arises from inhibiting the SLC13A2 and 3 citrate transports, but that happens at high doses with perhaps 1mmol

[DrFraser]

No evidence of any issue with chronic kidney disease at these doses. At therapeutic doses (as defined by blood levels depending upon condition being treated and response to therapy, 0.6-1.2 mEq/L. We know in these therapeutic levels (which generally take 600-1800 mg/day to maintain) that there is very little evidence of decrease in GFR. There is some evidence even with these therapeutic levels of tiny declines in GFR with decades long use. However this is 60-180 times more mg than I use or recommend — actually the difference is even more by a factor of >5 as lithium orotate has 3.8 mg elemental Lithium per 100 mg, whereas Lithium Carbonate has 18.8 mg/100 mg.
So essentially this 10 mg dose is about the same as 2 mg of Lithium Carbonate.
The dose makes the poison. Just not enough here to ever register any toxicity, or even a measurable level.

[adssx]

I haven’t checked the numbers, but the only potential downside of lithium orotate might be the cancer risk:

• Dietary orotic acid, a new selective growth stimulus for carcinogen altered hepatocytes in rat 1982
• Orotic acid enhancement of preneoplastic and neoplastic lesions induced in the pancreas and liver of hamsters by N-nitroso(2-hydroxypropyl) (2-oxopropyl)amine 1994

I gave the papers to ChatGPT which answered that you’d need to take a few grams of lithium orotate every day to reach the above toxicity levels. So if ChatGPT is correct then our mg doses should be safe.

[adssx]

Also @John_Hemming: what do you think is the risk with higher lithium doses?

[John_Hemming]

It depends what “higher” means.

The longevity doses of a few milligrams perhaps up to 5 a day (I take 2x10mg per week) are not I think an issue. I aim to keep my serium lithium below what my labs can measure, but only just.

The really high doses that lead to serum levels in the 1-2 millimolar are just about below the levels where you get kidney problems.

I think that is actually because of inhibiting the citrate transports.

It is interesting to look at which tissues express the most citrate transports. It shows which cells evolution believes need more citrate. The kidneys are one.

[Jay]

DrFraser,

Your answers about DoubleWood Brand Lithium Orotate have confused me. You stated, “I personally take 5 mg of Lithium Orotate twice daily and have for a few years now.” You also stated, “So essentially this 10 mg dose is about the same as 2 mg of Lithium Carbonate.”

The label on DoubleWood Brand Lithium Orotate indicates “Lithium (from Lithium Orotate) is 5 mg.” I assume the actual weight of the lithium orotate in the capsule comes in at a much higher weight. Whether it be from lithium orotate or lithium carbonate I assume that the actual lithium of 5 mg in either of these two forms is equally absorbed by the body. But, maybe not. Is this what you mean when you say your 10 mg dose is about the same as 2 mg of lithium carbonate? Is the actual 5 mg lithium in lithium orotate simply not absorbed as well as the equivalent 5 mg lithium from lithium carbonate?

[John_Hemming]

I think there is a separate topic about DW Li Orotate which concluded it was not elemental lithium that was being reported.

[DrFraser]

5 mg of lithium orotate has 0.19 mg of elemental lithium. It is only 3.8% lithium. Lithium Carbonate is 19% lithium.

[Jay]

This topic may have already been discussed ad infinitum and I may have missed parts of it in which case I apologize for re-hashing a settled discussion.

I understand your calculation thoroughly, but that’s assuming that there is only 5 mg lithium orotate per capsule. I do notice that the front of the Double Wood label indicates lithium orotate 5 mg, but the label on the back says to me that it is 5 mg elemental lithium (from lithium orotate) which means there’s a lot more than just 5 mg of lithium orotate in each capsule.

ChatGPT, being far from foolproof, I believe agrees with me on this. Here is a ChatGPT summary:

Feature	Double Wood	KAL
Label Claim	5 mg Lithium (from lithium orotate)	5 mg Lithium (from lithium orotate)
Type of Lithium Stated	Likely elemental lithium (but not clear)	Explicitly elemental lithium
Approx. Lithium Orotate Content	~130 mg	~130 mg
Approx. Elemental Lithium (absorbable)	~5 mg (assuming label refers to elemental Li)	5 mg (confirmed elemental lithium)
Other Ingredients	Hypromellose (capsule), rice flour	Vegetable cellulose (capsule), cellulose, organic rice extract blend, silica
Estimated Total Capsule Mass	~140–150 mg	~140–160 mg
Capsule Type	Vegan (hypromellose)	Vegan (vegetable cellulose)
Public Certificate of Analysis (COA)	Not publicly available	Not publicly available
Company Transparency	Generally reputable; COA may be provided on request	Company declined COA to a user (per Reddit)
Primary Use	Mood support, neuroprotection, microdosing	Same

[DrFraser]

I agree on further review that they are listing elemental which is interesting as the Rx Lithium Carbonate is listing the mg of the compound not of lithium. Either way, at 10 mg/day this is still <10% of the minimal therapeutic dose of elemental lithium and certainly nothing to monitor levels of.

Good catch though - but not clinically meaningful in this particular instance.

[amuser]

[John_Hemming]

Different lots different results

[59vw]

Double wood capsules are in mg of LiOrotate, not elemental Li according to the company. See my post here

Lithium Supplementation

I bought this brand on Amazon but then reading the reviews someone had written in to ask whether the capsules had 5 mg elemental Li or 5 mg LiOrotate. Turns out they are 5 mg LiOrotate which is a very small dose of elemental Li since ~ 130 mg of LiOrotate is ~ 5mg of elemental Li (0.1915 mg / capsule). Review pasted below… Blockquote M. Jury 1.0 out of 5 stars Dosage info is incorrect! Each capsule contains 0.1915 mg of elemental lithium, not 5 mg! Reviewed in the United States on February 24, 2025 Verified Purchase Here is an email reply I received from Double Wood Customer Support and following that is the email inquiry that prompter their response. The dosage info on the back of the label is incorrect, but the dosage info on the front of the label is correct. There is 5 mg of Lithium Orotate in each capsule which contains only 0.1915 mg of elemental lithium. If you want to get 5 mg of elemental lithium in a single capsule then you need to switch brands and get a 130 m…

[amuser]

I asked the company a couple days ago, and they said it contains 5mg elemental lithium.

I just replied with a pointer to the Amazon review. Will update with any follow up.

Update:

Still insisting that it’s elemental lithium, even after pointing out the Amazon comment.

The COA from the product web page says 5mg lithium orotate, and the third party test just says ‘lithium’, so seems ambigous.

Just buy something else.

[dicarlo2]

Wild that even the supplement manufacturer’s customer support is confused about elemental lithium vs lithium orotate.

[CronosTempi]

If a company cannot answer basic questions about fundamental aspects of their product, but instead engages in a bunch of waffling, it’s time to look for a different product/company.

[59vw]

If this is true at a minimum change the label to indicate 130 mg Li orotate, 5 mg elemental Li.

[CronosTempi]

Nice discussion of rapamycin (04/11/25) courtesy of Dr. Fraser.

Is RAPAMYCIN the KEY to LONGER LIFE and Better Health? (DrApoE4)

Is RAPAMYCIN the KEY to LONGER LIFE and Better Health?