“Low-dose lithium orotate is safe to take long term.”
No study has tested whether taking low-dose lithium orotate for years is safe in people.
Whether years of low-dose lithium orotate is safe is unknown: it has not been shown to be harmful, and it has not been shown to be safe. What is known is that lithium interacts with many common medicines, so anyone taking it should check with a doctor or pharmacist. If you use it for a mood problem, that is a reason to involve a clinician, not to treat it on your own.
Before you start or keep taking lithium orotate, show the bottle and your list of medicines to your doctor or pharmacist.
Safety note: Lithium in any form leaves the body through the kidneys. Medicines that slow this can raise lithium levels: water pills (diuretics, such as thiazides), anti-inflammatory pain relievers (NSAIDs such as ibuprofen and naproxen), blood pressure medicines called ACE inhibitors and ARBs, and the antibiotic metronidazole. Lithium taken with some antidepressants (SSRIs, SNRIs), triptans for migraine or tramadol can raise the risk of serotonin syndrome. People with kidney, thyroid or heart disease, people who are pregnant or breastfeeding, and anyone already prescribed lithium should not take lithium supplements unless their doctor approves. Dehydration from long-lasting diarrhea, heavy sweating or fever also raises the risk of lithium toxicity.
Talk to a healthcare professional if: you are thinking about taking lithium orotate for mood, sleep or memory, you take any of the medicines named above, you have kidney, thyroid or heart problems, or you are pregnant or breastfeeding. Get care right away if you have vomiting, diarrhea, shaking, unsteadiness or confusion while taking it.
No study has followed people taking lithium orotate supplements for years, so there is no direct evidence that long-term use is either safe or harmful. Animal studies disagree with each other, and what is known about prescription lithium comes from much higher doses.
No study has tested whether taking low-dose lithium orotate for years is safe in people. Supplement doses are far lower than prescription lithium, and serious harm has rarely been reported, but no one has tracked users over time.
A 120 mg lithium orotate tablet contains about 4.6 mg of lithium itself, much less than prescription lithium carbonate tablets. Animal studies disagree on whether the orotate form is harder or easier on the kidneys. A 1979 rat study found worse kidney filtration with orotate than with carbonate at equal high doses, while a 14-day mouse study in 2023 found kidney and thyroid changes with carbonate but not orotate. Neither tells us what happens when people take it for years. A 2021 review that favors lithium orotate notes no reported deaths or serious side effects in decades of use, but it also says short- and long-term safety studies have not been done. Prescription lithium can affect the kidneys and thyroid with long-term use, and because a harmful level is close to a helpful one, doctors check blood levels.
Supplement labels often list the weight of the whole lithium orotate compound, not the lithium in it. About 3.8 mg of every 100 mg of lithium orotate is lithium, compared with about 18.8 mg of every 100 mg of lithium carbonate, the prescription form. Taking several tablets or combining products raises the dose, and an 18-year-old who swallowed 18 tablets went to the emergency room with nausea, one episode of vomiting and a mild tremor.
- Pacholko AG, Bekar LK. Lithium orotate: A superior option for lithium therapy? Brain and Behavior. 2021;11(8):e2262. DOI: 10.1002/brb3.2262. PMID: 34196467
- Pacholko AG, Bekar LK. Different pharmacokinetics of lithium orotate inform why it is more potent, effective, and less toxic than lithium carbonate in a mouse model of mania. Journal of Psychiatric Research. 2023;164:192-201. DOI: 10.1016/j.jpsychires.2023.06.012. PMID: 37356352
- Pauzé DK, Brooks DE. Lithium toxicity from an Internet dietary supplement. Journal of Medical Toxicology. 2007;3(2):61-62. DOI: 10.1007/BF03160910. PMID: 18072162
- Lithium carbonate tablets, USP 300 mg. Prescribing information (FDA-approved label), revised October 2022, DailyMed set ID d20ed2aa-aa56-4709-9e7a-9243c71465c9