Why aim to keep reducing lithium rather than aiming to stop taking it altogether?

The above is a question I was asked this morning. I have been asked this several times before. I rapidly typed the answer below. Not saying it is anything like a perfect answer. I put it here as it may help.

Hi A, Here is my answer…

Often, it seems, people get put on lithium because doctors and psychiatrist know so little about nutrition and do not realize how many mood troubles are caused by eating fake foods (foods with added sugar, toxic oils and so on)…

It is the last little bit of reduction that causes the biggest shock to the system.

This is my understanding, although be warned that I am speaking as a scientist, nutrition-expert and expert-by-experience-of-taking-prescribed-lithium rather than a pharmaceutical person, therefore I am sharing what I believe and not offering advice.

Dropping from say 800mg/day to 650mg/day makes little difference because your blood and cells are still flooded with a lot of lithium and your kidneys are still working hard to detox. Whereas, dropping down just from 20mg/day to zero may make a huge difference.

Here is a different way of looking at mineral supplements. We require only about 10mg/day of zinc (I’ve not looked up precise value)… If you are consistently consuming between say 20mg/day down to 10mg/day from real foods you’ll probably be okay. If though you were to go from 10mg/day down to zero-ish then symptoms of shortage will start to occur.

Supposing we consider lithium to be a nutrient… (it has not been proved that lithium is essential as it comes in real foods (less or none in fake foods) and so most people get plenty most days.  This makes it hard to work out what would happen to people who do not get enough as people start to run out of other nutrients, such as magnesium before anyone would notice a shortage of lithium.)

Supposing an adult human needs 1mg/day of lithium (this is quoted in at least one reputable book on nutrition). Then if consuming several hundred mg/day from tablets goes along with our concerns over the slight long-term toxic effects from lithium carbonate tablets. Reducing your lithium intake down to just a few mg will be matching any natural requirements (we are assuming there is a requirement), while stopping altogether could be a bit like choosing to eat only foods that contain close to zero zinc.

I do hope that makes sense. Sorry, it is a bit waffly.

By the way, zinc is a nutrient MOST people do not get enough off, which not only causes emotional troubles (extreme shortages can be associated with psychosis as zinc needs to be balanced with copper to avoid psychosis) Getting enough zinc is easier when we stick to ‘real food’. Very topical at this time; low zinc also makes people vulnerable to viruses.

Dear A, If you would like me to do some nutritional analysis for you to help identify for which nutrients you may have low intakes and which ones you may have excessively high intakes – I can do that.

Can Real Food Eliminate Cramp? / Might Magnesium From Food Prove Better for Stabilizing Mood Than Lithium Tablets?

I have debated before whether the mood stabilizing successes attributed to lithium are due to it helping people who have been magnesium deficient.

Here however, I seem to have left bipolar a long way behind me. I am now, on a lower carbohydrate diet, having the steadiest moods I have ever had. It is great to be sleeping well, getting lots of work done and spending time with lots of lovely positive people. Yet, as one of my bipolar clients said to me, years ago, “Even when moods are steady, it is never just right.” It seems life always involves some things that cause some discomfort.

In 2019, I think I only had cramp in my leg (calf) once. It was early in the morning and it hurt at lot! Early on 28th January 2020, I had a similar occurrence of cramp in my calf. It was over in less than a minute but left me hobbling a bit for a few hours.

As a teenager, when fell-walking in hot weather, I would get this kind of cramp the next morning and was told, and believed, this happened because I was sweating out sodium and failing to add salt to my food. Putting a little salt in the palm of my hand and licking that off seemed to stop it happening the next morning. Yet, was this real biochemistry or simply placebo?

These days, most people say that most cramp in legs is related to low magnesium and it does seem that taking a good magnesium supplement or a bath in Epsom salts (magnesium sulphate) makes cramp far less likely.

So what might be the truth about my cramps that may be of use to others wanting to avoid this pain?

Well, I had just completed a study on myself where I recorded everything I ate over 6 days. This has allowed me to plot my intake of 4 minerals. This reveals that (compared with what I usually eat) my consumption of Calcium, Magnesium and Sodium were all low leading up to the morning I got the cramp.

Cramp due to low magnesium

Was that cramp, to some extent due to low sodium, magnesium and calcium intake?


I am aware of another factor. The day before, I had cycled up a steep-ish hill I do not normally  cycle up and so may well have been using my calf muscles in a different way. I can well believe this will have increased my risk of cramp. Overall, though I currently believe the cramp was induced mainly by a mineral imbalance.

Having considered the above graph, what will I do now?

In a moment, I am going to cycle to a local supermarket, fill my rucksack with fresh veg and cycle home (up a moderate hill). I need the exercise and I need to get back to eating lots of veg. I can do this while keeping my carbs low (surprisingly easy to do when avoiding bread) as that will get these minerals back in balance. I have taken a magnesium citrate tablet 2 nights since the cramp. I am not keen on supplements – dare I stop taking the extra magnesium?

Lithium, Magnesium and Overcoming Fatigue

Lithium, Magnesium and Overcoming Fatigue

In the video below Dr Rhonda Patrick says that we all need to be able to re-absorb magnesium from our urine to avoid magnesium deficiency. (Listen from 2m 00s).

When taking lithium tablets “…dehydration is due to lithium inhibition of the action of antidiuretic hormone, which normally enables the kidney to reabsorb water from urine. This causes an inability to concentrate urine, leading to consequent loss of body water and thirst.from Wiki

With lithium disrupting the hormone, that allows our kidneys to reabsorb water, does this also decrease our ability to re-absorb Magnesium?

Looking at what I can find on this subject it does not seem clear cut (see this medical textbook), but just supposing excess lithium can make a magnesium deficiency worse. With less magnesium we will have less energy levels (and tend to feel older), while bursts of energy, that could be seen as mania will be less frequent. Unfortunately, low magnesium is associated with more rapid aging, more illnesses and earlier death, so this may just be another reason to only take as much lithium as needed and no more.

As I have said again and again, it is so very important not to suddenly stop taking lithium. Talk with experts. If you are going to reduce your use of lithium you need to do this very gradually. Well designed withdrawal programs with many small downward steps over many years tend to work well. I came off lithium over a period of several years and have now been free of all prescribed drugs for more than 4 years. It is not easy to go ‘med-free’. With the right help I believe most people can do it.

In the meantime, as the doctor in the video says, you may wish to get your magnesium level checked. Possibly the only Magnesium test worth having is for the Magnesium that is inside your red blood cells. The test I have had in the past for the Magnesium between the blood cells (in the plasma) does not provide any useful information.


Getting this test privately in the UK is likely to cost you £34: http://drmyhill.co.uk/wiki/Magnesium_test_-_red_cell

I am going to ask my GP about getting this test paid for by the NHS because so many people lack magnesium and this has been a known driver for mood disorders for decades.

You can watch and learn more about the importance of Magnesium in this short video:

I do not have much free-time but if you are serious about getting rid of disorder from your life and going on to help others then please feel free to contact me.


If you know more about things like:

Mechanism of Li inhibition of vasopressin-sensitive adenylate cyclase in cultured renal epithelial cells.“:

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