Friday, March 20, 2015

Lithium Orotate Dosage

This post is about the dose of lithium orotate I take, and how I take it.  It's not about what dose you should take.  I am not a doctor, and can not make any guess on how much, if any, would help you.

I have been taking lithium orotate for many years now to treat my bipolar disorder.  Currently, I take 3 pills of the Vitamin Research brand of Lithium Orotate. Each pill contains 4.8mg of elemental lithium.  I take 2 in the morning and 1 at night.  I don't know if a split dose is necessary - it's just how I've always done it.

If I miss a dose, I usually don't notice anything.  I only start getting increased symptoms if I go without taking it for a couple of days.  So I think it has a fairly long half-life.  But that's just a guess.

I have previously taken 4 pills a day, but now I can manage on just 3.  Some of this might have to do with the fact that I've lost some weight.  There are many medications where the required dose depends on body weight, and it's possible that lithium orotate is one such medicine, but that's also just speculation.

Lots of medicines require regular dosing before the full effect is felt.  If this holds true for lithium orotate, the full effect might not be felt until taking it for several days to a week.   I try to stick to a regular schedule.  I use a pill box to help me to remember to take it.  It also prevents accidental double dosing.  I have in the past taken the Advanced Research brand and the Doctor's Best brand (now discontinued).  I've noticed no difference in effectiveness and usually buy whatever brand is cheapest.  Both the Advanced Research brand the Vitamin Research brands have some quality control issues.  Occasionally, the Advanced Research brand had broken tablets and the Vitamin Research brand has crushed capsules.  Not a huge issue, but something I would be amiss to not mention.

The dosing for lithium orotate can be confusing because there are two numbers that are usually listed on the bottle. First, there is a higher number, like 120-130mg, which is the amount of lithium orotate in each capsule or tablet.  Then, there is a lower number, usually around 5mg, and that's the actual amount of lithium.  The orotate molecule that the lithium is attached to is heavier than the lithium, and that's why you only get about 5mg of lithium from a 125 mg pill.  

Wednesday, March 18, 2015

How to Stop Bipolar Disorder from Ruining Your Life

Fourteen years ago, I was diagnosed with Bipolar Disorder.  While some days are still a struggle, approximately 90% of the time I feel fine.  Here are my tips to surviving this illness.

1. Don't make big decisions while feeling sick

If you are suffering from depression or mania, don't make a big decision.  That means, don't end a relationship, don't make a big purchase, and don't quit your job.  So that you don't regret anything, you should try to be as normal as possible and tell yourself that you need to think about the decision when you are feeling better. 

Distorted thoughts are commonplace in mood episodes.  Even non-bipolar people make big decisions at the wrong time.   Your moods might push you into making the wrong decision. 

Instead of making that big decision, write about it in your journal, talk to a therapist about it, and sleep on it.  Get the medication and treatment you need, and when you're feeling better, reconsider it then.

2. You are not your illness

Your brain is going to lie to you.   You will have thoughts that you do not want.  These thoughts are not you.  Sometimes it might be hard to tell the difference between the real, normal you and the illness.   Someone very wise wrote something a long time ago that made a lot of sense to me.  They said that the real you is the voice in your head that says things like, "I don't want to be depressed anylonger."  The real you is fighting the illness.   The negative thoughts like "If only I were dead" are the illness.  Don't let the illness win.  

3. Plan for your mood episodes

Bipolar disorder is a cyclic illness.  You won't feel bad all of the time.  But, when you feel bad, you may not be able to do some things.  Figure out what you can't do while sick, and make a plan about those things.  Here, I'll give you some examples
  • Food. When I'm depressed, I don't feel like eating.  I also can't get the energy to cook meals and going grocery shopping is a challenge.   I plan for this by keeping some TV dinners in the freezer and a well stocked pantry so that I don't have to go shopping.  
  • Bills.  When I'm not feeling well, I sometimes forget to pay the bills.  I put them on auto-pay or pay them early when I can.  
  • Work.  I work from home so that if I don't feel good, I can take time off.  I am my own boss.  You may want to consider working for yourself, or finding a job which allows for some flexibility.  Often people with bipolar disorder have super productive hypomanic days.  If you have a job where getting the work done is important (as opposed to just putting in hours), then you can get the work done while feeling well and take off time while feeling sick. 
  • School.  Deadlines and taking tests on schedule can be difficult.  I prefer to take courses online because I can watch the lectures when it's best for me.

4. Get Help

How do you not let the illness win?  You get help.  You don't have to do this yourself.  Why not learn from those who have fought the same fight? 

Medication can be immensely helpful, but it is often a matter of trial and error.  It's normal for the first medication that you try to either not work well enough, or to stop working after awhile. Fortunately, there are lots of options.  It's important to find a doctor that you like and then you can work with them to get the right medication or combo of meds.   

You can also look into supplements that you can buy over-the-counter.  Fortunately, the internet has made that very easy.  Just google your condition and you can find all sorts of things that might help.  The downside is that you don't have a professional to consult for advice.  Plus, a doctor can give you blood tests to rule out conditions.  There is no blood test for bipolar disorder, but some other illnesses like thyroid imbalances can cause mood swings, so a good doctor would probably test for that first.  Also, doctors check for other conditions like liver and kidney problems, diabetes, etc, and will try to prescribe a medication that won't cause any problems.   So, I really recommend seeing a doctor.  It can be either a family doctor or a psychiatrist.

Therapy has also been shown to be very effective, especially when combined with medication.  There are different kinds of therapy, and I prefer Cognitive Behavioral Therapy.  

I've also found books to be very helpful.  A book is a great place to start.  They cost very little, and if you follow the exercises or suggestions, you may be able to get some of the same benefits as therapy.  Here are the ones I recommend:

Definitely my first pick.  This book teaches you how to reduce your symptoms and cope with mood swings.

Not specific to bipolar disorder, but still quite helpful.  It taught me how to recognize distorted thoughts.

I don't consider this book to be the final answer, but it is a good read, and may help you in understanding this often confusing mental illness

Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner
This is written by someone with the illness.  While its intended audience is family members, I found it to be quite insightful.  In particular, it lists some thought patterns that are common to bipolar disorder, and I had the insight "It's not just me!"


Friday, December 14, 2012

Does Lithium Orotate work for Bipolar Disorder?


It continues to puzzle me as to why doctors don't prescribe Lithium Orotate

Sure, it's not like lithium carbonate.  It doesn't cause any sustained increase in serum level.  It also is not a prescription.

However, it works, and not just for me.  If you read the reviews, you'll see that many people find it helpful for mood swings, anxiety, and depression.

How does it work for me? Well, it makes me less moody. It also prevents mania. I experience the same therapeutic effect that I had from lithium carbonate, minus the side effect of hand tremor.

I recently tried to increase the dose from 4 pills a day to 5.  It made me too thirsty, so I reduced it back to 4.

This thirst is the first definitive side effect I've experienced from it.  What's interesting about the thirst side effect, is that it didn't happen immediately after taking the pills, but rather much later in the day.  So it seems that even though the blood level is not measurable, there is some long lasting effect from the lithium orotate.

Anyway, I'm not advocating Lithium Orotate, but just wondering how come such a seemingly effective medication is ignored by mainstream psychiatry.

Friday, September 7, 2012

Lithium Orotate Blood Level Test

Good news here!

After taking lithium orotate for about 6 years, I finally got a lithium blood level test done.  I got health insurance and during my physical I told my doctor about taking lithium orotate and asked for a lithium test and a kidneys function test. She thought that was a good idea and also did a thyroid (TSH) test.  My doctor didn't know that this form of lithium was available over the counter as a supplement.

So, my results are in, and my lithium level is <0 .1, with the standard reference range between  0.6-1.2mmol.  I take 4 pills of the Doctor's Best Lithium Ororate, in a split dose (2 in the morning, 2 at night), which comes out to 20mg of elemental lithium.

(Update: Doctor's Best brand has been discontinued, but I've found both the NCI Advanced Research brand the the Vitamin Research brands to be equally effective.)

This low result is pretty much what I expected from doing research online. For some reason, lithium orotate does not stay in the blood, but rather goes into the cells.  This inability to read a lithium level makes some doctors think it doesn't work, but from my personal experience, I can sure tell you it does work for me.

In fact, it has fewer side effects..  The prescription form, lithium carbonate, causes a hand tremor that lithium orotate doesn't cause.  Lithium orotate might have the same thirst side effect - I do get thirsty often and do drink a lot of water - but can't really say for sure whether that's from the lithium orotate or whether that's just me.  It might also cause weight gain - although my weight gain is just as likely from genetics or eating habits or normal aging. So I'm not completely sure that the lithium orotate has any side effects.

The other blood tests I had done all came out normal. Normal metabolic panel, normal O TSH Reflex FT4, normal O CBC with Diff.  So it appears that the lithium is not harming my kidneys, liver, or thyroid.

By the way, the blood test was done about 3 hours after taking my morning lithium dose.  And I've been on the same dose for years.  I may consider raising it.. sometimes I feel that I could use a bit more therapeutic effect.  But not having many scientific studies, it's hard to know what the best dose is.

For more information about the importance of the lithium blood level test, check out this excellent explanation by Dr Phelps: Please explain the therapeutic range level of lithium and it's significance for  management of the illness.    (Dr. Phelps also has an excellent website on Bipolar II: PsychEducation.org)

Saturday, July 7, 2012

No Perfect Drug or Medicine for Bipolar


I woke up yesterday feeling great.  I slept well. I felt happy. I had inner calm.  

I went to the grocery store.  I was clear headed.  I remembered to buy everything on my list.  I wasn't scattered.

My brain felt at 100%...... Bipolar was gone for the day.  My thinking was fast and clear.  My mood was great.

I wasn't depressed.  I wasn't hypomanic.  So I began to think, how could I recreate this mental state, so that I could have it every day?  What supplement did I take?  What did I do differently?

Nothing......  There is no perfect drug that can bring you 100% days every day.  But there are some that may help you get closer to 100% more often.   If you get a great day, enjoy it, and try to remember it when you are depressed.

Thursday, May 3, 2012

Back from vacation: Taking Pills on the Plane


I had a ton of pre-trip anxiety, and now that my vacation is over with, so is my anxiety.

One of the things I was really anxious about was taking my medicine through airport security.  So I decided to mail my meds to my sister so that I wouldn't have to take them through security.  Even though you are allowed to take medicine through airport security (even unmarked, such as in a pill organizer), I was still nervous that they would cause a problem for me.

So I mailed them to my sister, and I asked her to bring them to the airport when she picked me up.  That worked out fine. I was also nervous that she was going to say something to me about all of these meds I take.... I was having plenty of irrational thoughts.

Irrational thought: She would think bad of me for taking all of these meds.

I tried to replace it with the rational thought: She would be glad to see me and happy that the medicine works for me.

One thing I did not plan for was that my airplane was late and I missed my connecting flight, so I was at the airport for 5 hours.  So I didn't have my morning meds to take on time, but as soon as I did arrive, I took my lithium and I felt fine.  So, in retrospect, it may have been better to have the meds with me... but I did the best thing for my nerves.

Sunrise, as seen from airplane, during red-eye flight.


On the way home, I still had some of the meds that I mailed her, and I brought them through airport security without any problem.  They did rescan one of my bags when the X-ray machine beeped, and the TSA agent thought something was funny (I don't know what.. I didn't have anything funny in my bag!), but it was fine.  The TSA agents were actually quite nice and relaxed.

By the way, I had a terrific vacation!  My mood was good the whole time!  I got to see my family and it was so wonderful. I just wish I didn't have so much pre-trip anxiety.



Wednesday, May 2, 2012

Stop lithium to see if I really am still crazy

That's a crazy thought.

I'm sure anyone who's on psych meds has had it.... Maybe if I stop taking them I'll be able to handle it.. Maybe I'll have more inspiration.. Maybe I'm not sick anymore.. Do I really need them?

Today, as I was refilling my pill box, I was thinking about which pills I need the most, and that turned into my wondering what would happen if I did lower the lithium.....

But I've been there, done that.  The lithium makes my life so much easier.  So much better.  Less arguements, less turmoil, less crisis.

And so, I do stockpile my lithium, and I rarely miss a dose.  With it, my life is better.....