About the author
James Greenblatt is one of the pioneers in the field of integrative medicine with over 25 years of experience in treating patients with mental illness. He is Medical Director of Walden Behavioral Care in Waltham, Massachusetts and Professor in the Medical School Department of Psychiatry and Dartmouth College Department of Psychiatry.


Lithium is versatile – battery, medicine and dietary supplement
When you hear the term “lithium”, you probably first think of the lithium-ion battery, which is used in almost all cell phones today because it prevents the memory effect when charging. It is somewhat better known, but usually only in psychiatric circles, as a medication.
Anna Fels, a psychiatrist who teaches at Cornell University, has described it as a “Cinderella drug”. Lithium as a natural mineral, on the other hand, is hardly known.
The book presented below is worth reading for people who are being treated with lithium, but also for those who suffer from the symptoms or diseases mentioned in the subtitle. For a long time, this information was only available in specialist literature that was difficult for laypeople to access.
The author, James Greenblatt, himself a psychiatrist, director of a private clinic and lecturer in psychiatry at Tufts University, Massachusetts, describes in his book the enormous potential of lithium. His focus is on the use of lithium in low-dose form as a dietary supplement. But he also explains how the drug lithium works – and this is very informative for people who have mental or neurological illnesses.

Lithium has enormous potential
In our modern times, in which neurodegenerative and mental illnesses such as dementia, Parkinson’s, bipolar disorders, ADHD, addiction, anxiety disorders, aggression or depression are constantly on the rise, low-dose lithium can help many of those affected – effectively and without side effects – according to the author’s core statement, which he explains in detail and with many study references.
Lithium has been used since the middle of the 20th century to treat bipolar disorder, mania or depression. As a prescription medication, it is considered the “gold standard” in the treatment of bipolar disorder. This somewhat strange, sporty-sounding classification is intended to illustrate that there are many medications that are used to treat mental disorders, but their effectiveness varies. Lithium is (still) considered the most effective, therefore the gold standard! It has both antidepressant and antimanic effects.
Professor Müller-Oerlinghausen, psychopharmacologist and former chairman of the Drug Commission, discovered as early as 1990 that lithium reduces the risk of suicide – no other drug can do this to the same extent. The problem: at high doses, lithium has severe side effects.
James Greenblatt describes,

  • that even with low-dose lithium, for example in the form of lithium orotate, effective treatment is possible in a much healthier way
  • how low-dose lithium works and its particular importance in the treatment of mental and neurodegenerative diseases
  • the importance of the trace element for our organism
  • how our mental well-being can be improved by consuming lithium – for example by drinking mineral water with a high lithium content.

Finally a book about lithium that is understandable for those affected!
However, if you talk to sufferers nowadays, other drugs are prescribed much more frequently than lithium, e.g. Seroquel or Lamotrigine. It is striking why the most effective remedy is being prescribed less and less. The reason for this probably lies in the Janus-faced nature of therapeutically used lithium: on the one hand, it can effectively combat manic states in particular and demonstrably reduce the risk of suicide; on the other hand, it can cause physical, sometimes irreversible damage. As the drug has been in use since the 1950s, it is no longer patent-protected and is therefore no longer as profitable for manufacturers as newer psychotropic drugs. That is certainly also a contributing factor.

The following side effects can occur when taking lithium in the doses prescribed in Germany, for example:

  • Poisoning, which can even be life-threatening (signs include tremor, nausea and increased blood pressure)
  • Malfunctions of the thyroid gland
  • Restriction of kidney function
  • Muscle weakness
  • Poor coordination skills
  • Tinnitus (ringing in the ears)
  • Visual disturbances
  • Weight gain

It is therefore important for both the doctor and the patient to monitor the concentration in the body by regularly checking blood levels. This is complex, because the lithium level must be within a relatively narrow range for an effect to occur or for it not to become toxic.

The author writes that even practitioners often do not know that you can Some side effects of a brain-friendly dietwhich contains essential fatty acids such as omega-3 fatty acids and vitamin E as well as brain-active vitamins such as B12 and folic acid, defuse and that flaxseed oil or ground flaxseed, for example, can already have a side effect-reducing effect. Greenblatt explains this as follows:

The brain works at a high metabolic rate and consumes a substantial proportion of all nutrients ingested. It is dependent on amino acids, fats, vitamins, minerals and trace elements. These influence both the structure and function of the brain. Diet also has an effect on the immune system, which is closely linked to mood. The antioxidant defense system relies on support from nutrients to keep inflammation and toxins at bay. Nutrition also contributes to neuronal plasticity and repair, key functions for mental health.” (S. 23)

In addition to a short introduction entitled “The misunderstood mineral”, the author describes the enormous potential of lithium when used in low doses. He refers to studies on lithium in drinking water.

A low lithium content in water correlates with higher rates of mental and emotional disorders. In 1970, a research study examined the levels of naturally occurring lithium in the drinking water of 27 Texas counties and compared them with the incidence of psychosis, neurosis and personality disorders in state and national psychiatric hospitals. … The authors found a clear trend: the higher the lithium content in the water, the lower the rate of mental illness in the country in question.” As these results were spectacular, these studies were repeated in other areas. “Studies on lithium in drinking water have been carried out in Austria, England, Greece and Japan. … The data collected in these studies have all confirmed a strong inverse correlation between violent crime and suicide and higher levels of lithium in drinking water.” (S. 36)

In other words, even low doses of lithium in drinking water have a measurable effect on mental well-being.
Incidentally, the soft drink “7-up”, which is almost as popular as cola in the USA, explicitly and intentionally contained lithium until 1950. Back then, people thought a lot of the mineral. Lithia Springs, Ga, in the USA, known for its high lithium content, was a sacred site for the Native Americans. It was used as a spa by Mark Twain and President Roosevelt, among others. Hence the product name: the “Up” refers to the mood-enhancing effect and the “7” probably stands for the rounded atomic weight of the element lithium (6.9).

The ancient Greeks were already aware of its mood-enhancing effect. It was rediscovered as a psychotropic drug in 1949 and is still used today.

In the chapter “Achieving more with less”, Greenblatt describes how he came up with the idea of conducting research with low doses of lithium. He had noticed that his colleagues focused their attention primarily on the patients’ blood levels, but less on whether and when there was symptom relief. It bothered him that the “blood level” should be more important than the patient’s well-being. Therefore he wanted to find out at what dose lithium attenuates symptoms, gradually lowered the dose further and further and finally arrived at 5 to 40 mg per day. The therapeutic dosages are between 600 – 1200 mg per day.
Fortunately, the side effects described above no longer occurred at these low doses. From this, Greenblatt developed his strategy of low-dose, highly effective lithium, primarily with lithium orotate as a dietary supplement.
Greenblatt uses low-dose lithium orotate to treat anger and aggression, mood swings or affective disorders (bipolar and depressive disorders), ADHD, substance addictions, anxiety, eating disorders, dementia and Alzheimer’s disease and headaches or hyperthyroidism.

He devotes a chapter to each clinical picture and explains in detail how and why lithium works.

The chapter on bipolar disorders and unipolar depression is particularly interesting for those affected. Here you will find a brief, understandable explanation of the causes of mania and depression and the effectiveness of lithium. Greenblatt expressly advocates the use of low-dose lithium for the treatment of severe depression, e.g. as a supplement to an antidepressant.

What is the effect of lithium in affective disorders due to?

  • Lithium strengthens the serotonergic system.
  • Lithium acts on the GSK-3 enzyme (a disorder in this enzyme is involved in the development of bipolar disorders and depression).
  • Lithium leads to an increase in gray matter in the brain.
  • Lithium protects against inflammation.
  • Lithium reduces the risk of suicide.

His presentation ends in the chapter “Integrative Psychiatry”, in which he describes his idea of orthomolecular psychiatry. A psychiatry that focuses on biochemical individuality, i.e. the unique biochemical signature that makes people unmistakable, and treats people according to their (biochemical) needs. This means identifying the individual’s nutrient deficiencies and correcting them.

In contrast, the unspoken maxim of traditional psychiatry is the principle of equality. Individuals are categorized into symptom-oriented disorder groups defined by the psychiatric classification system (DSM), even though each of us is a distinctive individual with a unique biochemical profile.” (S. 222)

Over the past century, much research has been carried out into what different nutrients mean for brain cells and how a deficiency of these nutrients is linked to certain brain dysfunctions in individual patients. However, many important research findings have not yet been incorporated into medical training. As a medical student, I was fascinated by nutrition and the possibility of preventing or treating certain diseases through nutritional interventions. But nutrition was not on the curriculum. I graduated from medical school as a psychopharmacologist, which means I was trained to treat psychiatric problems by prescribing medication. Eventually I realized that many psychiatric illnesses are not primarily psychological, but physiological problems. I realized that it was critical to address nutritional deficiencies and ensure that my patients were consuming adequate amounts of vitamins, minerals, amino acids and fatty acids to restore healthy brain function and lay the foundation for long-term recovery.” (S 223)

Lithium is not available as a dietary supplement in Germany. Since it is very inexpensive, obviously nobody is interested in bringing it to the German market, because in the USA, for example, you can buy it in any drug store.
In Germany, lithium also occurs naturally in drinking water, but only in significant quantities in certain mineral and medicinal waters, such as Heppinger or Hirschquelle medicinal water. My favorite mineral water is: “Staatlich Fachingen”. It contains 0.77 mg in one liter. That’s not very much, but it’s better than nothing. However, we also absorb the mineral in milk, eggs, meat and plant foods.

Lithium is also a “super” mineral for those not affected, as it is an effective and well-studied means of keeping neurons alive, i.e. a building block for brain health. That’s why I drink mineral water containing lithium every day.