A typical dose of lithium orotate is 5 mg of lithium from 130 mg of lithium-orotate, a typical dose of lithium carbonate is 170 mg from 900 mg of lithium-carbonate

Understanding Lithium Dosages

Lithium-carbonate contains 18.8% of elemental lithium
Lithium-orotate contains     3.83% of elemental lithium
Lithium orotate dosage
In other words:
100 mg of lithium-carbonate contains 18.8 mg of elemental lithium the rest is carbonate and
100 mg of lithium-orotate contains 3.83 mg of elemental lithium the rest is orotate.

Understanding the dosages of lithium meds can be very confusing; the problem is most websites, and doctors’ prescriptions do not distinguish between the weight of the pure elemental lithium mineral on its own compared to the weight of the lithium plus the weight of the compound (carbonate, orotate or citrate) the elemental lithium is attached to.

For example:
A typical prescription for bipolar disorder might be written as 900 mg of lithium per day but that’s 900 mg of lithium-carbonate not 900 mg of lithium, it contains 170 mg of actual lithium attached to 730 mg of carbonate.
A typical dose for lithium-orotate for comparison might be 260 mg of lithium orotate which contains just 10 mg of elemental lithium attached to 250 mg of orotate*.
A typical prescription for bipolar disorder might say 900 mg of lithium per day, but that is actually 900 mg of lithium-carbonate which is a mixture of lithium attached to carbonate, most of the 900 mg is carbonate only 170 mg is actual lithium.
For comparison the typical dose of lithium-orotate I recommend may be 260 mg of lithium-orotate, this contains just 10 mg of elemental lithium attached to 250 mg of orotate*.
*Lithium-orotate is not generally used in mainstream medicine (I discuss why this may be elsewhere).
What confusing is that generally speaking the number you see in a doctor’s prescription is the number of milligrams of lithium carbonate not just the elemental lithium it contains, however when you buy lithium-orotate supplements manufacturers typically quote the number of milligrams of the pure elemental lithium not the milligrams of lithium-orotate.

Buying lithium-orotate supplementsLithium orotate supplements buy

Lithium-orotate is typically sold in pills or capsules some say they contain 5 mg of lithium (from lithium-orotate) others may say they contain 120-130 mg of lithium-orotate.

Lithium orotate is made up of 3.83% elemental lithium the other 96.17% is orotate.

Understanding the numbers on the labelWhen you buy products that say “lithium (from lithium-orotate)” 5 or 10 mg then you know exactly how much lithium you’re getting they’ve done the calculation for you and told you how much actual pure lithium or elemental lithium is in each pill, however some labels say they contain “120 mg of lithium-orotate” and this can be confusing, the back of the label may give you the number of milligrams of pure elemental lithium but if not you can calculate the elemental lithium dosage by multiplying the number of milligrams of lithium orotate by 0.0383 to get 3.83%, so for example:
120 mg of lithium-orotate = 4.6 mg of elemental lithium (3.83% of 120)
2 x 120 mg tablets per day would give you = 9.2 mg of elemental lithium a day.
4.6 mg is sufficiently close enough to 5 mg so I prescribe both interchangeably in my clinic.

Lithium-orotate safe dosage

Typical doses I prescribe in my practice are:
For general brain health maintenance I typically recommend just 1 mg of lithium (from lithium orotate) about a quarter tablet once a day.
For stimulating neuroplasticity and regeneration in the brain 5-10 mg of lithium a day divided between 2 meals.
For bipolar treatment/maintenance 10-15 mg of lithium a day and up to 20 mg during manic phases.

I’ve seen some physicians will prescribe as much as 40 mg of lithium per day from lithium-orotate but I don’t recommend over 20 mg, but this low dosage I have never encountered any issues with kidney or thyroid toxicity and at this dosage it can be taken long-term without the need for blood tests to monitor your levels.

Comparing lithium orotate versus carbonate dosagesLithium orotate versus lithium carbonate for bipolar

As already mentioned mainstream medicine uses high doses of lithium from lithium-carbonate.
Lithium-carbonate contains a higher percentage, 18.8% of elemental lithium compared to just 3.83% for the orotate.
The typical doses of lithium-carbonates prescribed for bipolar disorder range from 900-1200 mg a day, this contains from 170-225 mg of pure elemental lithium.
The typical dose of lithium-orotate I prescribe for bipolar are 9.2 mg this is just 5.4 % or 1/18th of the lower standard mainstream dose of 170 mg of lithium from carbonate and many people find they can stabilise their condition with just 4.6-5 mg; even a ‘high’ dose of 15 mg of lithium from orotate I might recommend is still less than 6.3% or 1/16th of the mainstream doses.
The very low dose I use to maintain general brain health of just 1.15 mg of lithium from orotate (a ¼ tablet) is a minuscule 0.68 % or 1/148th of the lower standard psychiatric dose of 170mg!
As you can see the typical dosages used of lithium from lithium-orotate are much much lower than the typical doses of lithium from lithium-carbonate used in mainstream psychiatric medicine. You may wonder why mainstream medicine uses such high doses of lithium-carbonate given the potential for side-effects if low doses of lithium from lithium-orotate can be effective, I can’t explain this fully, I believe it is simply because the original scientific research performed several decades ago on the use of lithium for bipolar disorder was primarily conducted on lithium carbonate and to a lesser extent lithium citrate, lithium orotate was not researched and today there is no funding available to research lithium-orotate because lithium medicines are cheap and you can’t patent them to make a profitable return from the enormous costs of the research.

The more pertinent questions for me are those lithium orotate work and can I obtain therapeutic benefits that are strong enough to treat mental health problems from doses that are so low they are safe, non-toxic and do not produce any unpleasant side-effects such as weight gain, emotional flattening or numbness et cetera, and I believe the answer to these questions is emphatically yes.

When you research it you discover that lithium is so good for the brain especially for the brains of people with mental health problems, even microdoses ingested in regions where lithium levels are naturally a higher in drinking water have been shown to improve mental health and benefit the brain, the problem with the high doses of lithium carbonate is that the benefits it gives to the brain come with significant risk of side-effects, if only there was a way to obtain the benefits of supplemental lithium without the toxic effects on the body, well I believe there is. Elsewhere I explain why I believe low-dose lithium orotate to be effective and how you can you can make low doses of lithium-orotate even more effective to extract all the goodness by combining it with the right diet and other remedies.

Why do we need to take orotates and carbonates of lithium why not just take pure lithium?

We could never ingest pure elemental lithium on its own it, pure lithium metal reacts vigourously with water, it would produce so much heat upon contact with the water in our saliva and digestive tract that it would cause serious burns.
We need to ingest minerals like lithium, sodium, magnesium and potassium but they have to be attached to carrier compounds (carbonates, orotate, chlorides, citrates et al) to make them safe to ingest, the resultant combination of the metal and carrier compound are called salts, the most well-known of which is sodium-chloride better known as table salt or just salt. Pure unattached sodium reacts even more vigourously with water than lithium, it literally bursts into flames, splitting apart the hydrogen and oxygen in the water and then igniting the hydrogen.
The main available salts of lithium are lithium-carbonate, lithium-citrate, lithium-chloride or what I use lithium-orotate. I discuss the pros and cons of mainstream lithium carbonate versus alternative lithium orotate elsewhere, this page is about understanding the numbers.

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

It lithium-orotate and lithium-carbonate behave differently, they are both well absorbed from the intestines but lithium from lithium-orotate seems to be better absorbed into the cells of the body, it has also been shown to be more slowly excreted by the kidneys so it is retained in the body for a longer period of time compared to lithium from lithium-carbonate [insert ref].
Unfortunately there has been very little scientific research into lithium-orotate but it really does seem to be capable of delivering great therapeutic effects and at such low doses that it does not produce any side effects. I notice therapeutic benefits, so do many of my patients and you can find many people online reporting it genuinely delivers therapeutic effects. I know this is all anecdotal evidence and not rigourous science but as I’ve said many times elsewhere as long as you do it safely you can experiment to work out what remedies and what combinations help you.
If you’ve not taken lithium-orotate before I recommend starting at a very low dose of just 1-2 mg for the first week or so and gradually building up to 10 to 15 mg over the next few weeks but you should titrate the right dosage for yourself.
See How to Use Low-Dose Lithium Orotate for Mental Health Problems
on this page I also discuss how effective lithium treatments are.
Although I advocate self-medicating 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 my practice I always prescribed lithium in combination with multiple other mood stabilising remedies and treatments to achieve a sufficiently powerful mood effect; if you cannot self monitor your mania or if you have significant delusional features self-medicating may not be right for you.

Lithium Citrate
I have no clinical experience with lithium citrate so I cannot offer any guidance as to how it compares to lithium orotate or lithium carbonate. The percentage of lithium in lithium citrate is 10 (9.9) %.

Want private consultation on how to use lithium for your individual mental health problem?

If you are reading this page you probably have mental health problems and if you’d like me to look into your individual case and work out an individual programme of diet, nutritional supplements, herbs, brain training and physical exercises I’m available either at my London clinic or via Skype for people that live too far away you can find my contact details and fees in the main menu.

Why you Should Take Lithium If You Have a Mental Health Problem to Protect Your Brain from Dementia

I strongly encourage you to take lithium if you have bipolar disorder, chronic or long-term depression or schizophrenia because I’m sorry to tell you but all of these conditions significantly increase our risk of developing dementia. Untreated bipolar, schizophrenic and chronically depressed brains are almost 3 times more likely to develop dementia than the general population however the research shows that lithium treatment eliminates this increased risk and the risk of developing dementia decreases to the same as the general population [i]; actually there has been some pioneering and truly breakthrough developments showing ways to reverse the early stages of dementia and how to prevent in the first place see (preventing brain ageing)
However research has shown that people with these mental health problems that have taken long-term lithium no longer show a measurable increase risk of developing dementia {insert ref}; I explain elsewhere how to use lithium orotate and other remedies to boost neuroplasticity regenerate and protect your brain from the potentially damaging effects of a long-term mental health disorder. See [lithium and the…]
For more information on lithium orotate:
What Lithium Does to Brains with Mental Illness
Lithium Orotate Dosage for Bipolar and Depression
How to Get the Benefits Out Of Lithium without the Side-Effects
Lithium’s Multiple Wide-Ranging Health Benefits
Bipolar Disorder Neurotransmitters
How to treat bipolar mania/Hypomania without drugs:

Lithium isn’t only for bipolar disorder

Besides being a useful treatment and preventative for bipolar disorder I regularly prescribe lithium to:-
Prevent recurrent serotonin based deficiency,
Improve neuroplasticity and promote regeneration in the brain when there were signs of cognitive decline,
Improve neuroplasticity to speed up recovery with healthy brain function following recreational and pharmaceutical drug use,
Improve sensitivity in GABA receptors to speed up recovery/withdrawal from benzodiazepam type drugs,
For more information on the lithium’s many potential uses including PTSD, OCD, alcoholism, bipolar depression, unipolar depression, migraine/cluster headaches, improving low white blood cell count, juvenile convulsive disease, liver disorders, recovery from stroke, traumatic brain injury, mild cognitive impairment, Alzheimer’s disease, histamine  reactions contracting the airways in the lungs, metal toxicity, inflammatory bowel disease and hyperthyroidism see Lithium’s Many Health Benefits
[i] BRITISH JOURNAL OF P SYCHIATRY ( 2 0 0 7 ) , 1 9 0 , 3 5 9 ^ 3 6 0 . doi : 1 0 .11 9 2 / bjp . bp .1 0 6 . 0 2 9 8 6 8 SHOR T R E POR T Lithiumand risk for Alzheimer’s disease in elderly patients with bipolar disorder PAULA V. NUNES, ORESTES V. Et al.
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