Many faces of Lithium

Over the past year I feel that I have covered a wide spectrum of proven actions of Lithium from improvement in cognitive function, reduction of violent crime, drug addiction, suicide, etc.  It was only in looking for abnormal side-effects of micro-dose Lithium that I came across considerable work clearly demonstrating a correlation between hardness in water and atherosclerotic heart disease (Voors et al Am J Epid 1970;92:164-171 and 93:259-266).  Of the six elements in drinking water causing hardness the best correlation of improving AHD is that of the Lithium content.  It is interesting that the literature in this era has Lithium in drinking water.

With the cost of ischemic heart disease (IHD) I would have thought that the article in The Lancet December 20, 1969 “Does Lithium depletion cause atherosclerotic heart disease” would have been followed even at this late date.  From the article, “it would entail a highly cost-effective means of preventing AHD and improving the quality of middle-aged life through simply enrichment of municipal water supply”.  It draws attention to the action of Lithium antagonizing five of the most potent AHD risk factors – hypertension, diabetes, tissue uric acid, type A behaviour, and serum lipid levels.  See posts on Garrod discussing lithium and gout.

Concern with tampering of water supplies is understandable but just raises the Lithium concentration in communities drawing the water from lakes, rivers, or reservoirs to that found in many countries where there is no obvious evidence of toxicity in their Lithium levels might be justifiable or warrant more research.

I suppose it is never too late to learn!

 

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A Lithium study of one

Years ago, I would have been very apprehensive of writing about this brief period of observation on the use of Lithium.  I was brought up in medicine to have great faith in the double-blind study, this was reinforced by meta-analysis which analyzed other people’s studies and applied complicated statistical formulas.  As we have seen over the last few years, this system is flawed and studies on statins, cholesterol, calcium, and anti-depressants have proven to have feet of claw and the results have been erroneous in some cases.  This excludes the fact that some studies have been faked.  It is estimated that perhaps 50% of patients on hypertensive medication could be weaned off as blood pressure can reset itself.  I really can not imagine such a study being funded so people continue to take the medication which they may not need.

For the last couple of years, I have tried to interest organizations to carry out a double-blind study on Lithium.  It suffers from a number of problems preventing financial support.  There is a great deal of confusion between Lithium used for manic depression and in a totally different field the micro amounts of 1 mg per day, the recommended daily allowance (RDA) that we are talking that interests me.  Another negative factor in Lithium studies is that it has no patent, no profitability, is extremely cheap, and natural.  Having followed the academic literature for half of a century, I can think of very few other agents that have such a wide spectrum of scientific evidence of its uses but to nail its total acceptance there needs to be a double-blind study and there is no financing for this.

Years ago, I became extremely involved in the Glucosamine story and self-funded a study in Toronto which proved positive but poorly funding the study was not outstanding.  Money is the key ingredient for funding a study.

With the above in mind and the fact that I would only be taking half of the RDA of Lithium, I started taking 0.4 mg of Lithium in water per day.  Being unable to determine a blood Lithium level through the usual channels, I found a hair analysis that was accurate to my profile which showed my Lithium level to be way below the accepted normal value. Prior to starting Lithium  basic routine blood work was carried out including creatinine.

For the first 6 weeks of daily micro-Lithium I noticed no obvious change in memory, behavior, or any effect at all.  This was rather disappointing but in retrospect Lithium is a slow working agent in micro doses, working on a physiological level rather than a therapeutic level.

The first positive effect which surprised me was it stopped a short fuse reaction or minor anger.  Many things these days are very frustrating from the answering machine, to driving where red lights are run through.  As a physician, one has to bottle up our annoyance; I found on the dose of Lithium I was much more tranquil, less sensitive to irritation, and particularly to patients who do not appreciate the problems in health care.  This has made a very significant difference and has a number of positive sequelae.  Perhaps most interesting is a reduction in my blood pressure, needing far less medication.

I suppose we should put in the fact that I have no financial or conflict in promoting Lithium other than the good I think it does.  Also, this is not giving medical advice but an attempt to draw attention to Lithium.  The observations on anger and short fuse syndrome are supported by a number of studies from Texas to Japan to Lithuania.  Many problems today are due to a short fuse reaction whether it be driving, social relationships, or suicide.

I have one addiction other than work and that is chocolate, it gives me energy, sharpness, and satisfies a craving.  After a bar of chocolate eaten in 30 seconds my work level improves!  Sugar, caffeine, and cocoa! Since being on the daily routine of Lithium, I still enjoy chocolate but I don’t have the craving for excessive consumption.  These observations just appeared, I had no idea what I was looking for so it removes the bias.

Perhaps the most impressive action I have noticed is that of memory.  As one gets older, one’s memory becomes more difficult.  For years I have always had a problem with names, spelling, etc.  I have tried various techniques by keeping thoughts in compartments, house, or filing systems – a technique that was used by Roman lawyers.  All of my World War 1 and II hero’s names and histories are put into the downstairs room and drugs are put into another room etc. and this is a proven technique.  This helped but the matrix of this system fell apart and it would be a long time when I wanted to find a name or article for my memory to grind through a matrix that seemed to be declining.  Once a fact was found from the memory bank within a few hours it would be lost again, buried in what I visualize as a matrix of cells.  On Lithium, I seemed to have developed another matrix where when I have recalled a fact it stays in this new matrix like a new filing cabinet with easy access.  This fits it and this conclusion was made in retrospect with the idea that neurons regenerate and multiple especially in areas like the hippocampus.  In passing the only error I learnt that was erroneous was that the brain didn’t regenerate and your brain function was what you were born with and led to a steady decline as we aged.  We now know this is wrong, grey matter increases, cells can multiple, and new cells appear.

Before academics jump on this article, one should point out that most of the studies on Lithium in much higher doses in patients with Alzheimer’s Disease is in treating the plaque, tangles, etc. in short term studies and these grave stones are markers of past dysfunction, inflammation, etc. that took place perhaps a decade or more ago.  This error of short term Lithium against markers of chronic inflammation is like knocking down tombstones and expecting the corpse to rise. 

Lastly the effect on anxiety has made me less uptight or over-reactive but this hasn’t effected reactions while driving or playing sports.

Could this be a placebo reaction?  Unlikely after a latent period of two months.  We have one happy patient!

As in an earlier post, if Lithium is essential we have spent the last 50 years removing it from 7UP and our water supplies!

Lithium Deficiency

The media and the authorities are full of data on the increase in crime in many western countries, crime is often associated with extreme violence.  Documentation is important; however, little thought is given to the reasons.

Most Western countries are in a stable state, not at war, no extensive poverty, or obvious reasons for this increase. It is a vicious cycle as this increasing crime results in increased police hiring, etc. and so the cycle continues.  No one ever looks at the question why?

Certainly not a major cause, but an area that should be investigated is the question of Lithium deficiency in our water, food, even in tobacco.  There have been excellent studies have been carried out from Texas, Japan, and Lithuania that low intake of Lithium in areas with low Lithium in their water is associated with a whole spectrum of crimes ranging from drug addiction, rape, suicide etc.  Little thought seems to be given to these obviously sound statistical studies.

Why are we deficient in Lithium?  It is a good question to ask.  Is our intake of Lithium lowered from our water supply?  There is an increased tendency in many countries to abandon wells and use rivers, rainfall, etc.  These are obviously very deficient in minerals, particularly Lithium.  The increase in bottled water which contains no Lithium is another explanation especially since we seem to be developing an addiction to having water with us at all times.

Certainly, some attention should be focused on why we are deficient in Lithium and it would be very easy to carry out a survey of Lithium blood levels.  If the idea doesn’t pan out, it won’t have cost a fortune, harmed anyone but if the idea works it will have saved a lot of anguish, expense, and violence.

Selected Lithium Articles

Over the past few months, I have been researching and reading many articles on Lithium.  Here are 5 articles that I have found insightful along with my brief comments.

1.

Standard and trace doses of Lithium: a systematic review of dementia prevention and other behavioral benefits.  Mauer S et al Australian & New Zealand Journal of Psychiatry 48(9):809 2014

Lithium in both standard and trace doses appears to have biological benefits for dementia, suicide, and other behavioural outcomes.  Further research of trace Lithium in dementia is warranted.

It is more than warranted it is urgent!  What more do you want?  It reduces antisocial and suicide rates, and appears to have a biological benefit for dementia.

 2.

Calcium dysregulation and lithium treatment to forestall Alzheimer’s disease – a merging of hypotheses. Wallace, J. Cellular Calcium 55(3):175 2014

This paper provides an interesting thought.  The hypothesis is that Lithium may protect against cognitive decline by stabilizing intracellular calcium through a dual synergistic mechanism of targeting both extracellular and intracellular sites by antagonizing NMDA receptors inhibiting IMP.

Would the long-time lag for development of dementia, perhaps 2 decades, and the phase of increased calcium consumption in the last 4 decades have an association?

 3.

Microdose lithium treatment stabilized cognitive impairment in patients with Alzheimer’s disease.  Nunes MA et al.  Current Alzheimer Research 10(1):104 2013

This data suggests the efficacy of a micro-dose Lithium treatment in preventing cognitive loss reinforcing the therapeutic potential to treat Alzheimer’s Disease using very low-doses.

4.

Lithium and dementia: a preliminary study.  Terao T et al.  Progress in Neuro-Psychopharmacology & Biological Psychiatry 30(6):1125 2006.

“The findings provide partial evidence to support the contention that Lithium could offer hope as a preventive treatment for Alzheimer’s Disease.” 

5.  

Journal of Trace Elements in Medicine & Biology 24th March 2017 Lithium levels in the public drinking water supply and the risk of suicide by Liaugaudaite.

This article raises a number of interesting points.  The study was carried out in Lithuania and showed, like many others, that high levels of Lithium in public drinking water is associated with lower suicide rates in men but this effect was not noted in women. The article draws attention to the 800,000 annual deaths worldwide including approximately 60,00 in Europe.   One often forgets that suicide is not the death of one person but a terrible tragedy for the family, friends, etc. and this may last for years causing destruction of the family unit in some cases.  It is interesting that in many European countries the suicide rate is 2-4 times higher in men than in women.  We draw attention to the influence of impulsiveness contributing to suicide.  This short fuse syndrome (SFS) seems to be suppressed by micro Lithium in our limited experience.  Does 60,000 deaths in the EU warrant supplementation of Lithium in micro amounts found in normal drinking water?

Selected articles on Lithium

These are some of the articles I have been reading on Lithium.

1.

Standard and trace doses of Lithium: a systematic review of dementia prevention and other behavioral benefits.  Mauer S et al Australian & New Zealand Journal of Psychiatry 48(9):809 2014

Lithium in both standard and trace doses appears to have biological benefits for dementia, suicide, and other behavioural outcomes.  Further research of trace Lithium in dementia is warranted. It is more than warranted it is urgent!  What more do you want?  It reduces antisocial and suicide rates, and appears to have a biological benefit for dementia.

 2.

Calcium dysregulation and lithium treatment to forestall Alzheimer’s disease – a merging of hypotheses. Wallace, J. Cellular Calcium 55(3):175 2014

This paper provides an interesting thought.  The hypothesis is that Lithium may protect against cognitive decline by stabilizing intracellular calcium through a dual synergistic mechanism of targeting both extracellular and intracellular sites by antagonizing NMDA receptors inhibiting IMP.

Would the long-time lag for development of dementia, perhaps 2 decades, and the phase of increased calcium consumption in the last 4 decades have an association?

 3.

Microdose lithium treatment stabilized cognitive impairment in patients with Alzheimer’s disease.  Nunes MA et al.  Current Alzheimer Research 10(1):104 2013

This data suggests the efficacy of a micro-dose Lithium treatment in preventing cognitive loss reinforcing the therapeutic potential to treat Alzheimer’s Disease using very low-doses.

 4.

Lithium and dementia: a preliminary study.  Terao T et al.  Progress in Neuro-Psychopharmacology & Biological Psychiatry 30(6):1125 2006.

“The findings provide partial evidence to support the contention that Lithium could offer hope as a preventive treatment for Alzheimer’s Disease.”

 5.  

Journal of Trace Elements in Medicine & Biology 24th March 2017 Lithium levels in the public drinking water supply and the risk of suicide by Liaugaudaite.

This article raises a number of interesting points.  The study was carried out in Lithuania and showed, like many others, that high levels of Lithium in public drinking water is associated with lower suicide rates in men but this effect was not noted in women. The article draws attention to the 800,000 annual deaths worldwide including approximately 60,00 in Europe.   One often forgets that suicide is not the death of one person but a terrible tragedy for the family, friends, etc. and this may last for years causing destruction of the family unit in some cases.  It is interesting that in many European countries the suicide rate is 2-4 times higher in men than in women.  We draw attention to the influence of impulsiveness contributing to suicide.  This short fuse syndrome (SFS) seems to be suppressed by micro Lithium in our limited experience.  Does 60,000 deaths in the EU warrant supplementation of Lithium in micro amounts found in normal drinking water?

 

 

 

 

 

Vitamin D is ruining my practice

A number of years ago, I read an article about an Australian physician who had “prescribed” Vitamin D to his whole practice which resulted in a marked reduction of 30% in office visits in the next corresponding year.  It was one of these facts that I thought I would never find important, other than the fact that I am a devotee of prescribing Vitamin D for its effectiveness and proven value in many of the problems that plague my patients especially those with chronic pain. 

Over the past few years, I have been thinking of winding down my practice since I am past the age of retirement but fascinated by the potential advances in patient care against a society that does not seem to take preventive measures to maintain their health.  Exercise is rare, hours are spent gazing at electronic screens, lack of sleep hygiene, drinking bottled water none stop etc.

For the last decade, I have been more and more convinced regarding the value of vitamins, trace minerals, and particular on the use of Vitamin D.  I have written extensively on the use of Boron and more recently on Lithium as natural agents that are ignored. 

I am grateful to Mr. Henry Lahore for his excellent computer skills through his wiki on vitamin D and providing information on 78 health problems that with the proof of randomized double-blind studies show the value of Vitamin D.  They include: diabetes, influenza, falls, hip fractures, breast cancer, pregnancy risks, chronic kidney disease, cystic fibrosis, rheumatoid arthritis, osteoarthritis, TB, rickets, ALS, respiratory tract infection, lupus, traumatic brain injury, multiple sclerosis, congestive heart failure, prostate cancer, asthma, depression, fibromyalgia, chronic hives, weight loss, COPD, vertigo, restless legs syndrome, metabolic syndrome, preeclampsia, IBS, UTI, mite allergy, perinatal depression, vaginosis, eczema, NAFLD, knee osteoporosis.

This from a non-physician spurred me to prescribe Vitamin D to a great majority of my practice.  It has had 2 positive spins.  I was quite amazed at the general improvement of health and this was reflected in a decreased number of visits – perhaps 30-40%.  With everyone screaming about the cost of health care, poor and rich countries alike, does one ever hear a voice from the government regarding the value of taking vitamin D supplements? 

It is interesting philosophically to think that Vitamin D is the only vitamin that has 2 sources – one from sunlight with the skin manufacturing Vitamin D and second from the ingestion of food.  Does this double source mean anything?  Is it a hint of what we should be doing?

In the modern world which is so geared to advertising, I have only seen 1 advert in the last 10 years in the newspaper suggesting we take Vitamin D.

Reiterating no patient, no profit, no publicity!

Is there a place for Lithium to reverse or control neurological damage induced by chemotherapy?

The buried, older literature on Lithium continues to amaze me, published in a vast array of peer-reviewed papers.  There seems to be little interaction of the medical community in applying its uses.

One of the most frustrating pains is that of post-chemotherapy neuritis especially of the lower legs.  This pain is extremely distressing as a mixture of sensory disturbances – burning, hypersensitivity, pain etc. together with at times of “epileptic bursts” of pain in the feet.  This is extremely distressing to patients as it seems to occur or is more noticed when attempting to sleep.  The use of the standard AEDs such as Lyrica, Neurontin, and Cymbalta in my experience is of limited use in severe cases.

Many cases of post-chemotherapy neuritis come on after many years, often decades.

One of the most useful treatments is the topical application of 5,10 or 15% Phenytoin in a variety of bases often of a liposomal nature.  This work has been spearheaded and raised to a level of “go to” treatment by a double-blind study by Professor Jan Hesselink.  Time will only tell how well this treatment is accepted.  The main form of topical Phenytoin is patented in Europe.  From my limited use of this product, it is of an outstanding value with continuing effect which may increase with time and break the pain cycle.

In many ways, this article was going to end at this point however readers of the various articles of mine will appreciate that Lithium has a high standing in my present view of medical problems ranging from Alzheimer’s, depression, anxiety, not to mention the potential of cell regeneration in many neurological conditions.

As far as I am aware, Lithium has not been used in the treatment of latent, over 1 or 2 decades, of post-chemotherapy neuritis.  Thus, it was with considerable interest that I read the paper by Petrini “Is Lithium able to reverse neurological damage by vinca alkaloids”.  This was an interestingly crafted paper administering Lithium in the form of carbonate to both humans and mice and measuring the neurotoxicity as in neuropathy.  Both humans and mice showed a marked improvement or abolition of neuropathic toxicity from chemotherapy.  All the human patients started Lithium after they developed symptoms of neurotoxicity.  One wonders if Lithium was given closely associated with the chemotherapy if this would have been avoided? In conclusion to their paper, “both results from animal experiments and human observation show that Lithium administered may counteract the acute or semi-acute neurotoxicity of vinca alkaloids”.  There seems to have been no effect on the decrease in chemotherapy effect on the myeloid disorders that they were treating.

The big question and the study that needs to be done especially since Lithium in the doses that were used cause no concern, the equivalent of 600 mg of carbonate, is should this be used as a routine in a series of patients receiving chemotherapy?  This seems to be no antagonism of Lithium to the chemotherapy.  This paper was mainly concerned with the semi-acute neuropathies but I think a long-term study would be rewarding and needs to be completed.  It seems that the Lithium effect from the past work of this group does not affect the inhibition of the chemotherapy agents on their lymphoid tissue targets.

The simple question to be asked is, is there a place for Lithium during chemotherapy?  I can see little downside!