If you put pure lithium into water, it will explode into crimson flames, but mixed with acids, lithium forms stable salts. Lithium compounds also dissolve uric acid, which doctors in the mid-1800s believed to be the cause of many illnesses. Physicians began using lithium to treat “a wide range of ailments, including headaches, diabetes, asthma, indigestion, obesity, skin disorders, rheumatism,” Walter Brown wrote in his book Lithium: A Doctor, a Drug, and a Breakthrough. By the end of the century, lithia water (water with a trace amount of lithium) was marketed as a patent medicine. (In that era, patent medicines—trademarked, proprietary cure-alls, many of which contained alcohol or opium—were a popular alternative to going to the doctor.) 7 Up was originally named Bib-Label Lithiated Lemon-Lime Soda, contained lithium citrate, and was marketed as a health tonic and hangover cure. Sears sold Schieffelin’s Effervescent Lithia Tablets, which were marketed for a variety of health concerns, including gout.
In 1949, lithium chloride, a table-salt alternative marketed to people with heart conditions, caused an outbreak of lithium poisoning in which at least two people died. The FDA, which had already started cracking down on patent medicines, quickly banned lithium in food products; later, researchers found that high doses of lithium can cause kidney failure, thyroid damage, tremors, and nausea. In 1970, the agency approved lithium carbonate for bipolar disorder; today, it’s also used off-label mostly for major depressive disorder. Then, in 1994, the FDA created the category of “dietary supplements,” which it does not evaluate, ushering lithium—mostly in the form of lithium orotate—back into a patent-medicine-like gray zone.
For decades, scientists have debated whether the lithia-water craze had any truth to it—if low doses of lithium might benefit a larger population than people with mental-health conditions, maybe even everyone. Some researchers think it's worth investigating whether lithium is an essential micronutrient, like calcium or magnesium, with a recommended daily minimum of some yet-to-be-determined amount. Lithium carbonate is typically given at 600 to 900 milligrams a day for mood disorders. We get minuscule amounts of lithium from foods such as grains, potatoes, tomatoes, and cabbage. Depending on where you live and what mineral deposits are nearby, your tap water may also contain lithium. A 2024 review paper led by Allan Young, a psychiatrist at King’s College London, determined that most lithium orotate supplements on the market today contain a “micro” dose of 5 to 20 milligrams, and many have a “trace” dose of just 1 milligram. (The Sads Smashing Anti-Stress Bath Treatment contains 127 milligrams of lithium orotate, but it’s meant to be absorbed through the skin, not ingested.)