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)