Lithium is known to most people only as a component of batteries or as a high-dose psychiatric medication.

But behind this element may lie one of the most underestimated nutrients for our mental health.

In his research, the postdoctoral physician and molecular geneticist Dr. med. Michael Nehls makes a compelling case that lithium meets the criteria of an essential trace element — and that a widespread deficiency may have serious consequences for our mental and physical health.

What Is Lithium?

Lithium belongs to the alkali metals and appears in the periodic table next to sodium and potassium — elements that are unquestionably vital for our bodies.

As the lightest metal of all, it occurs naturally in rocks, mineral springs, groundwater, and therefore also in our food. Concentrations vary considerably by region, leading to major differences in the daily intake of different populations.

Lithium became known in medicine primarily through its use in bipolar disorder, where it has been used as a mood stabilizer since the 1950s.

In this application, however, very high doses are used, which require regular blood level monitoring and may be associated with side effects.

However, this therapeutic use has obscured the fact that lithium, in much smaller amounts, may play a fundamental physiological role.

Dr. Michael Nehls’ Thesis: Lithium as an Essential Trace Element

Dr. Michael Nehls, a private lecturer and postdoctoral molecular geneticist specializing in immunology, presents a provocative yet scientifically grounded thesis in his book “The Lithium Conspiracy”:

Lithium fulfills all the criteria of an essential trace element, but is not recognized as such by the responsible authorities.

Nehls’ argument is based on the following key points:

1. Lithium Regulates the Master Regulator GSK3

The protein GSK3 (glycogen synthase kinase 3) is one of the oldest evolutionary signaling regulators in living cells.

There is strong evidence that this protein has been controlling essential biological processes for around 500 million years — even the earliest single-celled microorganisms possessed GSK3.

This protein influences the function of more than 80 other proteins and plays a central role in inflammatory processes, cell regeneration, and neurogenesis.

Lithium inhibits the activation of GSK3 and therefore has anti-inflammatory effects.

Numerous studies have shown that even very low blood concentrations of lithium reduce the risk of developing chronic neuroinflammation (brain inflammation).

The fact that lithium already had a regulatory function in our evolutionary ancestors strongly suggests that it is an essential element.

2. Promotion of Hippocampal Neurogenesis

One of the most important discoveries of modern neuroscience is that new nerve cells can also form in the adult brain.

Especially in the hippocampus — the brain region that is central to memory, learning, and emotional regulation.

This so-called “adult hippocampal neurogenesis” is of crucial importance for our cognitive function and mental health.

Lithium activates this neurogenesis — among other things through the inhibition of GSK3.

When GSK3 activity is reduced, anti-inflammatory signaling molecules are activated, and the formation of new nerve cells in the hippocampus is no longer blocked but promoted.

Studies in mouse models have shown that lithium improves hippocampal neurogenesis and protects cognitive function.

3. Activation of Mitochondriogenesis

Lithium activates the production of new, healthy mitochondria — our cellular powerhouses.

Given the many functions of mitochondria, this mechanism should not be underestimated for our health and for maintaining our performance capacity.

This life-extending effect of lithium has even been clearly demonstrated in simple model organisms such as the nematode worm.

Epidemiological Evidence: Lithium in Drinking Water and Suicide Rates

Some of the most compelling evidence for the importance of lithium as an essential trace element comes from epidemiological studies.

These studies compared the natural lithium content in the drinking water of different regions with the suicide rates in those areas.

As early as 1990, a study from Texas showed that regions with higher lithium levels in drinking water had significantly lower rates of suicide, violent crime, and drug-related arrests.

Since then, numerous further studies from Japan, Austria, Greece, Italy, Lithuania, England, and other countries have confirmed this inverse relationship.

A comprehensive 2020 meta-analysis, which combined 15 studies and was published in the British Journal of Psychiatry, confirmed a statistically significant negative association between lithium content in drinking water and suicide mortality.

The association was present for both sexes, but statistically significant only for women.

An Austrian study (Kapusta et al., 2011) also showed a highly significant negative correlation (p = 0.000073) between suicide rates and lithium concentrations in drinking water.

These findings are remarkable because the amounts of lithium found in drinking water are many times lower than the therapeutic doses used in psychiatric disorders.

This suggests that even very small amounts over long periods may have a measurable effect on mental health.

Important note on scientific interpretation: These studies are epidemiological observational studies that show correlation, but do not prove causation. A more recent Swiss study (2024) found no significant association. So the scientific debate is not yet settled.

Consequences of Lithium Deficiency

Dr. Nehls describes a “Mental Immunodeficiency Syndrome” (MIDS) that may arise from chronic lithium deficiency.

According to this view, a deficiency leads not only to impaired function of the mental immune system, but also of the physical immune system.

Possible consequences include:

Mental effects: Increased risk of depression, anxiety disorders, elevated suicidality, reduced emotional resilience, more frequent outbursts of anger, and mood swings.

Cognitive effects: Brain fog, concentration problems, increased risk of Alzheimer’s disease, reduced memory performance.

Physical effects: Chronic inflammation, reduced regenerative capacity, possible shortening of life expectancy.

According to Nehls, the estimated essential daily requirement is about 1 mg of pure lithium per day for adults.

However, many people do not reach this amount through their normal diet, especially if they live in regions with lithium-poor drinking water.

Lithium Orotate: The Preferred Form for Supplementation

While lithium carbonate is used primarily in psychiatric treatment, Dr. Nehls recommends lithium orotate for low-dose supplementation.

This compound of lithium and orotic acid (formerly also referred to as vitamin B13) offers several potential advantages:

Better Bioavailability

Lithium orotate is absorbed more efficiently in the intestines and has a longer half-life in the body, resulting in more stable lithium levels.

Unlike lithium carbonate, which ionizes easily in solution, lithium orotate remains more stable and can therefore achieve the same effect with smaller amounts.

Better Transport into the Brain

Due to a special transport mechanism, lithium orotate is transported more effectively across the blood-brain barrier.

This is particularly relevant because the desired effects of lithium take place largely in the brain.

Lower Required Dosage

Because bioavailability is higher, lower dosages are required to achieve the desired effects. This significantly reduces the risk of side effects.

While therapeutic lithium carbonate dosages for bipolar disorder typically range from 600 to 1200 mg, only about 25 mg of lithium orotate is needed in the low-dose range to provide 1 mg of pure lithium.

No Binding to Alzheimer’s Plaques

New research suggests that, unlike other lithium compounds, lithium orotate does not bind to the amyloid deposits typical of Alzheimer’s disease.

It therefore remains available to the nerve cells.

In animal studies, low-dose lithium orotate was able to stop and in some cases even reverse the development of Alzheimer’s symptoms.

The Legal Situation: Why Lithium Is Prohibited as a Dietary Supplement in the EU

Here lies the paradoxical problem:

Although there is extensive scientific evidence supporting the importance of lithium as an essential trace element, it may not be sold as a dietary supplement anywhere in the European Union.

The reason lies in the Food Supplements Directive 2002/46/EC.

In Annexes I and II, this directive contains a “positive list” of all permitted vitamins, minerals, and their compounds that may be used in food supplements.

What is not on this list is prohibited — and lithium is not on it.

In addition, the Novel Food Regulation (EU) 2015/2283 comes into play.

Because lithium was not used to a significant extent as a food ingredient in the EU before 1997, it is considered a “novel food” that requires a complex approval process.

Without this approval, its sale is illegal.

The practical consequences are far-reaching:

• The sale of lithium as a dietary supplement is a criminal offense in Germany and throughout the EU.
• Lithium-containing dietary supplements ordered online are confiscated during inspections (as shown by current inspection actions in Austria in 2024).
• Low-dose lithium orotate is available only through a private prescription from a physician, filled by pharmacies that prepare it as a compounded medicinal product.

The German Nutrition Society (DGE) has not issued a reference value for lithium because it is not officially recognized as an essential trace element.

Accordingly, consumer protection agencies warn against purchasing it online.

Current Political Developments

Dr. Nehls and his supporters are actively campaigning to change this situation.

In April 2025, a public petition to the German Bundestag was launched, calling for the recognition of lithium as an essential trace element and for its approval as a dietary supplement.

With more than 56,000 signatures, the required quorum of 30,000 was clearly exceeded.

A motion for a resolution was introduced in the European Parliament (B10-0349/2025), calling on the European Commission to request that the European Food Safety Authority (EFSA) evaluate the nutritional function of lithium.

It also proposes the approval of safe, low-dose lithium salts such as lithium orotate as dietary supplements.

Practical Guidance

Given the legal situation in Germany and the EU, there are currently the following legal ways to obtain lithium orotate:

1. Private prescription from a doctor: A physician with an orthomolecular orientation can issue a private prescription for lithium orotate. Specially trained pharmacies then prepare the product as a compounded medication.

2. Dosage recommendations: According to Dr. Nehls, the essential requirement is about 1 mg of pure lithium per day, which corresponds to about 25–26 mg of lithium orotate monohydrate.

In cases of existing neuroinflammation or therapeutic use, temporarily higher doses of up to 5 mg of pure lithium may be useful — but this should only be done under medical supervision.

3. Safety note: Although lithium in the low doses mentioned is significantly safer than in therapeutic high doses, lithium levels should be checked after about 6 months of longer-term supplementation.

According to ECHA, an adult can consume up to 85 times the estimated daily requirement over the long term without needing to expect side effects.

People with kidney disease or thyroid problems should definitely consult their doctor before taking it.

Conclusion

The evidence for lithium as an essential trace element is substantial and continues to grow.

The evolutionary conservation of its regulatory function over hundreds of millions of years, the epidemiological links between lithium in drinking water and suicide rates, and the demonstrated effects on neurogenesis, inflammatory processes, and mitochondrial function all speak clearly.

The fact that lithium is nevertheless neither recognized as an essential trace element nor approved as a dietary supplement appears questionable in light of this body of evidence.

The current legal situation prevents people from independently correcting what may be a widespread deficiency.

As Dr. Nehls emphasizes: in the United States, low-dose lithium orotate has already been freely available as a dietary supplement for decades — without any significant problems becoming known.

It is time that European citizens, too, gain access to this potentially essential nutrient.

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Note: This article is for informational purposes only and does not replace medical advice. The use of lithium — even in low doses — should ideally take place under medical supervision. The theses presented here by Dr. Michael Nehls represent a scientifically grounded but not uncontested position. Official recognition of lithium as an essential trace element is still pending.

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Sources and Further Reading

• Nehls M. “The Lithium Conspiracy: A Plea for an Essential Trace Element.” Mental Enterprises Verlag, 2025
• Nehls M. “Unified theory of Alzheimer’s disease (UTAD): implications for prevention and curative therapy”. J Mol Psychiatry. 2016
• Memon A et al. “Association between naturally occurring lithium in drinking water and suicide rates: systematic review and meta-analysis”. Br J Psychiatry. 2020
• Kapusta ND et al. “Lithium in drinking water and suicide mortality”. Br J Psychiatry. 2011
• Cipriani A et al. “Lithium in the prevention of suicide in mood disorders: Updated systematic review and meta-analysis”. BMJ. 2013
• Directive 2002/46/EC of the European Parliament and of the Council on food supplements
• Regulation (EU) 2015/2283 on novel foods
• michael-nehls.de – Official website with further information