Lithium Orotate: Is This Supplement Safe?

Key Findings

This 2007 observational case report documents mild acute lithium toxicity in an 18-year-old woman after ingesting 18 tablets of a lithium orotate-containing supplement ("Find Serenity Now"). Each tablet contained 120 mg of lithium orotate, equivalent to 3.83 mg of elemental lithium per 100 mg (compared to 18.8 mg elemental lithium per 100 mg in lithium carbonate). The patient exhibited nausea, emesis, and mild tremor, with serum lithium levels rising from 0.31 mEq/L to 0.40 mEq/L within 90 minutes post-ingestion. Symptoms resolved after intravenous fluids and anti-emetic treatment. The study highlights that lithium orotate, despite being marketed as a dietary supplement, can cause toxicity at high doses, with pharmacokinetics and clinical effects similar to lithium carbonate.

Study Design

The study is an observational case report published in 2007, analyzing a single clinical incident. Methodology included patient history, physical examination, serum lithium testing, urine drug screening, and ECG monitoring. No formal sample size or duration data apply, as this was a single-patient acute toxicity assessment.

Dosage & Administration

The patient ingested 18 tablets of "Find Serenity Now," each containing 120 mg lithium orotate (total dose: 2,160 mg lithium orotate). The supplement was administered orally in a single acute exposure. Elemental lithium content was calculated as 3.83 mg per 100 mg of lithium orotate, resulting in an estimated 82.7 mg of elemental lithium ingested.

Results & Efficacy

The study did not evaluate efficacy or therapeutic benefits. Toxicity outcomes included:
- Serum lithium levels: 0.31 mEq/L (initial) → 0.40 mEq/L (after 90 minutes).
- Symptoms: Nausea, single episode of emesis, mild tremor without rigidity.
- Treatment response: Symptoms resolved within 3 hours of observation after IV hydration and anti-emetic administration.
- ECG findings: Normal sinus rhythm; no cardiac abnormalities detected.
Levels remained subtherapeutic (therapeutic range: 0.6–1.2 mEq/L) but still caused transient toxicity, suggesting individual sensitivity or rapid absorption kinetics.

Limitations

1. Single-case design: Findings are limited to one patient and cannot be generalized.
2. Lack of controlled data: No comparison group or long-term follow-up to assess chronic toxicity risks.
3. Self-reported dosage: Accuracy of ingested amount relies on patient recall.
4. Manufacturer data dependency: Elemental lithium content calculations were based on product labeling, not independent verification.
5. Short observation period: Chronic toxicity potential (e.g., renal or neurological effects) remains theoretical and untested.

Clinical Relevance

This case underscores critical risks of unregulated lithium-containing supplements:
- Toxicity potential: Even "natural" lithium orotate can cause adverse effects at high doses, mirroring risks of prescription lithium carbonate.
- Bioavailability concerns: Lithium orotate’s elemental lithium content is lower than carbonate, but overdose (e.g., 18 tablets) still led to measurable toxicity.
- Regulatory gaps: Online supplements may lack clear dosing guidelines or warnings, increasing misuse risk.
- Monitoring necessity: Users and clinicians should recognize that lithium supplements, regardless of formulation, require careful dosing and serum level monitoring.
- Psychiatric implications: The patient was transferred to psychiatric care, highlighting the need for professional oversight in self-medication attempts.

Takeaway: Consumers should exercise caution with lithium-containing supplements, particularly when self-administering high doses. Healthcare providers must consider supplement sources in lithium toxicity cases and educate patients on risks of unregulated products.