Lithium in lithium carbonate, 18.8% is lithium the rest is carbonate, lithium orotate contains 3.83% lithium

Understanding Lithium Dosages

Lithium carbonate contains 18.8% lithium. 
Lithium orotate contains 3.83% lithium. 

Understanding the different numbers you see for lithium dosages can be very confusing, the problem is people including doctors often don't distinguish between the weight of the elemental lithium on its own versus the weight of the lithium plus the weight of the compound the lithium is attached to, so 100 mg of lithium-carbonate only contains 18.8 mg of elemental-lithium.

Lithium carbonate is the most commonly used form of lithium used in mainstream psychiatry, your physician and pharmacist will typically write down the dosage of lithium-carbonate but this does not tell you the milligrams of the actual lithium it contains. A typical prescription for bipolar syndrome may say:
900 mg of lithium a day but this is 900 mg lithium-carbonate of which 170 mg is lithium and the other 730 mg is carbonate. Carbonate is made up from carbon and oxygen weighs a lot more than the lithium.

You never consume free unattached lithium metal on its own, bare lithium metal reacts vigorously with water it would produce so much heat on contact with the water in your saliva that it would burn your mouth, lithium is very volatile there are many examples of lithium batteries exploding and catching fire. 
Minerals like lithium and sodium have to be attached to carrier compounds to make them safe to ingest, we consume them as salts; so we ingest sodium as sodium-chloride or normal table salt and we can ingest lithium in the form of lithium-chloride, lithium-carbonate, lithium-citrate or what I use lithium-orotate.
It was back in the 80s when high quality supplement brands began to make a point of specifying the elemental weight of the mineral in a tablet as opposed to the total weight of the salt so for example on a supplement bottle you might see 200 mg elemental magnesium (from magnesium-citrate), but in mainstream medicine this typically isn’t made clear when lithium is prescribed; to be fair a prescription of lithium is presumed to be lithium-carbonate, but not specifying the weight of the lithium can lead to confusion about the numbers.

Lithium carbonates side-effectsLet’s look at the numbers
Unfortunately not all lithium salts contain the same percentage of lithium so it can be difficult to compare the dosage of one lithium salt versus another say lithium carbonate versus lithium orotate. 
Lithium Carbonate
In psychiatric medicine a typical dose of lithium carbonate prescribed for bipolar syndrome is from 900-1200 mg a day. 

Lithium carbonate contains approximately 18.8% lithium the rest is carbonate so: 
900 mg of lithium carbonate = 170 mg of elemental lithium
1200 mg of lithium carbonate = 225 mg of elemental lithium
Lithium Orotate
In my practice I typically prescribe as little as 30 mg (1/4 tablet) for general brain health and up to 120-240 mg for bipolar management (I personally take 120 mg twice a day).
Lithium orotate dosage
Lithium orotate on the other hand contains approximately 3.83% lithium so:
120 mg of lithium orotate = 4.6 mg of elemental lithium
240 mg of lithium orotate = 9.2 mg of elemental lithium 

So the lower dose of lithium I prescribed for bipolar management is 4.6 mg compared to 170 mg used in mainstream medicine, that’s just 2.7% or 1/37th of the standard dose.
The higher dose of lithium for bipolar management work out at 9.2 mg from lithium orotate compared to 1200 mg from lithium carbonate.
So the highest dose I typically prescribe is just 5.4% or 1/18th of the lowest dose typically used in mainstream psychiatry and just 3.8% or 1/26th of the high dose used in psychiatric medicine (9.2 compared to 240). As you can see lithium orotate is used at much lower doses

The very low dose I recommend to maintain general brain health is just 30 mg of lithium orotate (a ¼ tablet) this is 1.15 mg of elemental lithium which is a minuscule 0.68 % or 1/148th of the minimum standard psychiatric dose of 170mg.

These very low doses of lithium from lithium orotate appeared to no toxicity whatsoever to the kidneys; I watched a YouTube video describing a woman that was able to keep her bipolar syndrome under control with lithium carbonate for many years until eventually her urologist (kidney doctor) said that she had to discontinue using lithium carbonate because it was poisoning her kidneys. She then had to face the dilemma of choosing the physical health of her kidneys over her mental health; what she did without telling her urologist is switched to using lithium from lithium orotate, she found a dosage of just 40 mg a week an average 5.7 mg a day was sufficient to stabilise the condition and urologist was completely happy with the results.

[P.S. I’ve also seen the figure 18.92% for lithium in lithium carbonate, my inorganic chemistry is very rusty are there any chemists out there that could verify the correct figure?] 

Just to make matters more confusing the lithium from one salt doesn't have exactly the same effect as the lithium from another salt

Ok now that I’ve clarified the numbers I’m going to confuse you again, it seems lithium orotate and lithium carbonate behave differently.  Lithium from lithium orotate is more slowly excreted by the kidneys and better absorbed into the cells than lithium from carbonate so you cannot just compare the amount of lithium delivered from different products. To be honest there has been very little scientific research into lithium orotate but in the alternative nutrition community we believe lithium orotate to be more efficient and hence effective at lower doses, my patients and myself included notice feeling better on low-dose lithium orotate and do not experience any unpleasant side-effects when starting at a very low dose and building up over a couple of weeks. 
I advocate and practice self-medicating myself, but it’s not appropriate for everyone if you have bipolar with pronounced mania don’t expect low-dose lithium orotate to be able to control your symptoms on its own or to be a direct substitute for any mood stabilisers you may currently be on, in myLithium orotate for sale UK practice I start people on a very low dose typically 1 mg and build up gradually over a few weeks, furthermore I always prescribed low-dose lithium in combination with multiple other mood stabilising approaches to achieve a sufficiently powerful mood stabilising effect.
To learn more about the health benefits and conditions that may be helped from supplementing low-dose lithium orotate see:
Lithium Nutritional Friend or Toxic Foe
To learn how to enhance the effectiveness of low-dose lithium see:
How to Use Low-Dose Lithium Orotate Effectively
To learn how to treat bipolar mania without drugs see:
Managing Mania
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