Lithium is a drug widely used to treat bipolar disorder. It has been shown to inhibit the total activity of phosphoglucomutase from rat brains. The evidence in favour of beneficial effects of low levels of lithium on human behaviour is already strong, and since lithium is close to be officially recognised as a nutritionally essential trace element, emphasis should be placed on assuring adequate lithium intakes in populations at risk of developing lithium deficiency.

Bathing ladies and gentlemen in the spas that are in water contained lithium in 14^th century was the real source of good mood, and since ancient times, physicians have used lithium to calm their patients.

Lithium is one of the elements of whose role in the body is little known but we do know a lot about its role in medicine.

Physiological role of lithium

One of the most important roles of lithium in the body is regulation of serotonin and that's one of the reasons why the people change a mood. The latest information is considered to be a major regulator of serotonin level. Under the influence of lithium serotonin effect on increasing the peaceful mood and is therefore serotonin is regarded as a natural antidepressant.

Lithium also affects the transport of sodium in the body, increases lympholitic proliferation and thus increases immunity.

Some of the possible role of lithium (not yet proven) are increasing and protecting gray matter of the brain (it is considered that lithium increases gray matter up to 3%) and the protective role of brain from glutamate.

Metabolism

Lithium is naturally found in all tissues. It is absorbed in the intestinal tract (small intestine) through the sodium channel, and is excreted through the kidneys.

In the human body there are two proteins for whose activity is necessary lithium. Protein Bcl-2 protects brain cells from a variety of damage, including chemical oxidants and ionizing radiation. Lithium is the most important component which increases the concentration of this protein in the brain.

On the other hand, glycogen synthase kinase 3b (GSK-3b) participates in the creation of neurofibrillary knots that are commonly found in patients with Alzheimer's disease. Lithium reduces the levels of this enzyme.

Lithium is almost entirely excreted by the kidney from the body, and this secretion is closely associated with sodium (if there is less sodium, ie. salts in the body less of lithium is secreted).

Food sources of lithium

Lithium is present in almost all foods but their level varies significantly from region to region. It is believed that the greatest amounts of lithium are in the eggs, milk, tomatoes, cucumbers, mushrooms, seaweed, apples, bananas, carrots, cauliflower, cinnamon, lemon, lentils, pepper, cabbage, seafood, sugar cane, seeds.

Plant foods are richer in lithium than that of animals.

Many waters (especially spring and spa) contain lithium.

Recommended daily allowance

In the various sources are given different amounts of lithium that are recommended. Some authors recommend a value of 0.1 up to 3.42 mg of lithium daily, but most of them recommended 0.2-1.1 mg of lithium daily. In patients with bipolar disorder is recommended 200-400 mg of lithium daily.

Lithium deficiency

The consequences of the lack of lithium in the body may include violent behavior, suicide, crime, drug abuse, heart disease, reproductive problems, shorter life expectancy, poor lipid metabolism, behavioral abnormalities, depression, mania, abuse, pain in the joints, paronoid schizophrenia.

Overdose

Symptoms of lithium excess can occur during lithium therapy. Initially, most patients do not experience serious side effects, but there may be mild nausea, stomach cramps, diarrhea, thirst, muscle weakness, fatigue, dizziness, drowsiness, sweating, headache, anxiety. As the dose increases it begin to emerge mild shaking hands. These effects are minimal and usually recede after a few days of treatment.

The first serious disorders can be caused by a longer treatment and they can be identified as shaking hands, patient drink more fluids, urinating more often, a gain in body weight (which can be controlled by diet), skin disorders (acne, psoriasis), edema, swelling, weight loss, abnormal movements, slurred speech, blurred vision, dizziness, confusion, numbness, lethargy, coma. In these cases, the patient should immediately contact a doctor.

The excess of lithium may occur due to alterations in the kidney when the kidney is unable to excrete this mineral, which leads to its accumulation.

When using diuretics kidney ejected sodium, leading to increased levels of lithium

Note: Treatment with lithium should always be under the supervision of a doctor!

Lithium in medicine

Note: Lithium treatment should always be under the supervision of a doctor! Patients who suffer from kidney patients with various heart diseases, as well as pregnant women should not use the drug with lithium without consulting a doctor.

Patients with mood disorders, also known as the "affective disorders" are suffering from depression. For each person appearing brief depression but in these cases someone suffer from depression for a long period. This type of depression is called "clinical depression". Some people also experience manic states and irritability and require immediate hospitalization. Although mania state is popularly considered as state with an excess of euphoria, patients in fact often suffer from depressed mood accompanied by great irritability. Because of the mixture of symptoms (mania and depression), this disorder is called bipolar disorder (or manic-depressive illness).

Most of these diseases can be avoided by lithium treatment, which regulates the level of serotonin in the body, but it should be noted that this disorder may occur due to malfunctioning of the thyroid gland and then is treated with tyroid hormones, not lithium.

Lithium is used to treat other mental illnesses: schizophrenia, alcoholism, quitting smoking, caffeine, cannabis, depression, premenstrual depression, dementia (forgetfulness), periodic aggressive behavior and frequent changes of mood, enhance memory.

Preparations containing lithium are also used to treat hyperthyroidism and other thyroid disorders as it helps in the flow of iodine in the body.

It is believed that products with lithium have a positive effect in the treatment of Alzheimer's disease.

Using certain drugs e.g. 3,4-Methylenedioxymethamphetamine (MDMA, also known as ecstasy, nails, candy, happy pills, etc.) the level of serotonin in the blood is increasing, which leads to mood swings, and after the effects of these drugs serotonin levels in the body decline. This leads to depression in users that can last several weeks. In these cases lithium is used to regulate serotonin levels to the normal range.

New researches are conducted in the examination of the role of lithium in the prevention and treatment of cancer, but researches in this field are not completed yet.

Lithium is recommended to patients in the form of its salt, especially as lithium carbonate, lithium citrate, lithium aspartate and lithium orotate, and pharmaceutical companies give it their own trade names. It is considered one of the most powerful drugs for the treatment of mood disorders.

References

Albert U., et al., 2013, “Lithium-associated hyperparathyroidism and hypercalcaemia: a case-control cross-sectional study,” Journal of affective disorders; 151(2): 786-790. [Web Reference]

Bhalla P., Garg M.L. and Dhawan D.K., 2010, “Protective role of lithium during aluminium-induced neurotoxicity,” Neurochemistry International; 56(2): 256-262. [Web Reference]

de Assunção L.S., et al., 2012, “Enrichment of mushrooms: an interesting strategy for the acquisition of lithium,” Food Chemistry; 134(2): 1123-1127. [Web Reference]

Fakhri H., et al., 2014, “Regulation of mineral metabolism by lithium,” Pflügers Archiv-European Journal of Physiology; 466(3): 467-475. [Web Reference]

Mark H.A. and Stanley J., 2010, “Lithium in drinking water,” The British Journal of Psychiatry; 196(2): 159-159. [Web Reference]

Schrauzer G.N. and Shrestha K.P., 2010, “Lithium in drinking water,” The British Journal of Psychiatry; 196(2): 159-160. [Web Reference]

Souza A.A., et al., 2010, “Glycogen synthesis in brain and astrocytes is inhibited by chronic lithium treatment,” Neuroscience Letters; 482:128–132. [Web Reference]

Yuksel C., et al., “Abnormal high-energy phosphate molecule metabolism during regional brain activation in patients with bipolar disorder,” Molecular Psychiatry; 20(9): 1079-1084. [Web Reference]