Shaheen E Lakhan* and Karen F Vieira
Corresponding author: Shaheen E Lakhan firstname.lastname@example.org
Nutrition Journal 2008, 7:2 doi:10.1186/1475-2891-7-2
(2008-10-22 10:18) Independent
Lithium is not a part of the Dietary Reference Intakes, and so its classification
as a nutrient in this paper is puzzling. I'm assuming that the authors do not consider
it a nutrient, but an explicit qualification on that would have been nice. Similarly,
St. John's Wort doesn't seem to be a nutrient.
The bigger problem is that lithium orotate may be not be so much more helpful, and
Lakhan and Veira present an unfortunately one-sided view of the literature. I haven't
looked at the papers they cite because I can't afford it, but other studies don't
show conclusive evidence that lithium orotate crosses the blood-brain barrier more
easily. Kling et al in 1978 found it increased uptake to the brain in rats when injected, but in 1976 Smith
concluded that it didn't increase uptake to the brain. In 1979 Smith et al tested again, and this time he found different results. He found
that lithium orotate increased serum lithium concentrations higher, but was also deposited
in the heart and kidney. He did not comment on the brain concentrations in his abstract,
possibly because he did not want to admit that Kling was right (I only read the abstract).
Lithium orotate probably deserves more attention and comparison with lithium carbonate
than it gets. Smith seems inclined to look for the negative, and his 1976 finding
was suspiciously anomalous. Nevertheless, it seems that lithium orotate does not only
go to the brain. Even if it does go to the brain, it makes one wonder why the negative
symptoms of lithium carbonate do not apply to lithium orotate. It seems as if these
symptoms would be largely dependent upon the brain concentrations of lithium.
Thank you for the interesting paper, but please try to present a neutral view of the
facts in the future. In many cases a more focused approach is better. I am hopeful
for the future of nutrients in treating mental illness. Note that there are critical
reviews of many of the substances discussed here. For example, in January 2008 the
Current opinion in psychiatry concluded that the "evidence base for the efficacy of the majority of complementary
and alternative interventions used to treat anxiety and depression remains poor". In April 2008 a Cochrane review could only include 5 studies on omega-3 fatty acids
and bipolar disorder, and of those only 1 provided data for analysis.
Possibly these reviews are actively looking for the negative, and perhaps ignoring
legitimate literature. In that case they need to be engaged, not ignored. To be fair,
both of these aforementioned reviews were published around or after your review was
published. I noticed that one of your peer reviewers mentioned these concerns, but
somehow that reviewer dropped out of the picture.
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