9.3 Low-Dose Lithium for COVID (+ other viruses) and Personal Experiences

[00:00:00] In this segment, Sudir and I talk about some of the immune benefits of low doses of lithium. It appears to help keep the immune system within the guardrails so that there's not too much of an immune response mounted but there is an aggressive initial response. We talk about its impact in HIV and herpes simplex virus. And then Dr. Gad tells us about a study that he co-authored with some Spanish researchers evaluating the level

[00:00:30] cytokines which are markers of inflammation in COVID hospitalized bipolar patients, some of which are on lithium, some of which are not on lithium. We later talk about our own personal experiences with taking low dose lithium about how SSRIs and other psychotropics have numbing effects.

[00:00:51] And then come back to a common theme of the podcast talking about what Sudir calls studyism or an over reliance on randomized controlled trials and neglecting any other information from non-RCT studies we may garner.

[00:01:07] And of course, we talk about more problems with the FDA. Enjoy!

[00:01:21] Yeah, I have no problem convincing or talking to patients about this when you talk to especially in the substance use community. There's a significant amount of HIV associated with IV drug use and when I can put in there that hey, this also will help with your management of your HIV. It'll help prevent COVID probably the most interesting virus that lithium is able to combat

[00:01:50] is the herpes virus. And this is a very straightforward and simple way to explain this to either a patient or a provider that secondarily tells you what that stabilizing effect is in the brain because that herpes virus lies dormant in the nerve root and it doesn't cause any problems when it doesn't sense any distress in the brain.

[00:02:12] Well, when you're physically or emotionally ill or stressed that virus comes out to the lips or to the genital area and tries to escape because it senses that chaos.

[00:02:24] And with people on lithium, they don't have the same frequency or intensity of herpes virus outbreaks which I use that to say okay, well this means that lithium makes a brain situation that is not at all chaotic.

[00:02:41] That the herpes virus believes is stable and safe for it to remain dormant in there.

[00:02:48] That's an excellent and under appreciated concept, right? It's antiviral component. So there's not a lot of doctors who would along with a cyclovier or Val cyclovier provide lithium as well.

[00:03:02] Looked out the short of it if I can say it that way is that most of psychiatry will think of lithium just as intensely and rigidly as the rest of medicine.

[00:03:14] It will consider it to be 600 to 1200 milligrams of lithium carbonate for patients with bipolar manic episodes that are elated not even bipolar, but elated mania.

[00:03:30] That's how pigeonhole it has become. And I think that's the influence of market forces and very powerful market forces in this country which are ruining a lot of things.

[00:03:41] I'm no socialist but I'm no terrorist capitalist either. Okay, so that aside, this is how psychiatry thinks about it when you're a psychiatrist that is working in the system and finding it really difficult to achieve good results for your patients.

[00:03:59] You got to start taking outside the box. You got to start acting outside the box. I don't want to keep providing bags of medicine to my patients for them to not even know what they're taking having side effects or to not be working for today having interactive effects.

[00:04:16] This was just silly. So I said if lithium works well for this subset, maybe it'll work for suicideality that's presenting differently right instead of the bipolar individual who presents with self harm and they have the highest risk for suicide what about someone PTSD or borderline personality or substance induced issues or depression that presents with suicide reality.

[00:04:44] I'm just going to give them the cocktail and wait weeks or should we try less lithium to see how that helps. And that's what I started doing back at Bellevue, and it worked to the ignorance or to the shock both of my doctors of pharmacy of the attendings beside me.

[00:05:06] But I said look guys you want to talk about levels, you want to talk about safety or danger patients doing fine. They're okay. They're actually doing better and they're on less medicine. The only thing that doesn't fit is this diagnosis but this mineral. There's something to this.

[00:05:21] So like you I started digging as well and I saw that there were publish papers on using smaller amounts of lithium for adjunctive applications for depression.

[00:05:32] And that's when I said well if this is working how low can we go? And it's also natural, it is in certain water and soil. It was in seven up when it was created all bottled water is a hundred years ago.

[00:05:45] But water started because of lithium water actually because it's so rare and special. And that the best waters that you can get are actually a little bit of lithium and it pelagrino has 200 micrograms of lithium.

[00:05:59] Five of those equal the amount that you need nutritionally per day. It's hard to do but there's other ways we'll talk about the nutritional component of how to get lithium.

[00:06:09] That's in a nutshell how I got to use it and then investigated but the antiviral effects. Now we're looking at it and we're seeing that there are influences of the cytokine system right why does lithium result in fewer outbreaks like you mentioned of HHSV right and HIV because when we look at the data, it's less viral load and more CD4 count in both of these conditions.

[00:06:37] And it was replicated in SARS-COVID-1 and 2. That's exactly what happens in viruses. It's not going after one specific virus. What it's doing is helping the body's own immune system to be balanced so not over reactive, not under reactive.

[00:06:58] Both of them you're going to have either infections or you're going to have autoimmune conditions. That's too hot, too cold. It's helping it be more measured in its attack and consistent in its attack against these hiding viruses.

[00:07:13] I really liked the Spanish study. The 28th, I think it was bipolar patients hospitalized with COVID half of which correct me if I'm wrong had been on lithium and the other half were not on lithium.

[00:07:25] They were on another mood stabilizer antidepressant or whatever cocktail. And I'm listening and I'm like, okay, well this isn't enough patience. This doesn't really inform us very much.

[00:07:37] Okay, two of the 14 that were in the non lithium group died but then you dropped these cytokine findings.

[00:07:43] And the fact that was at 18 different cytokines that were all at lower levels and just for a little bit of background when we talk about COVID.

[00:07:55] The infection itself is not what kills people it is the over active immune response. People tend to have their respiratory tree flooded between days five and 15 and that causes impaired oxygen carbon dioxide exchange.

[00:08:10] And that's what kills somebody it is this thing that we call the cytokine storm and that study I thought was so cool. It demonstrated that all of these different inflammatory markers were reduced in the lithium group compared to the non lithium group.

[00:08:28] Yeah, really one of the best things that I've been a part of with Dr. Sputge and colleagues at Galicia sore which is just north of Portugal and northwest Spain.

[00:08:37] And it's weird that I have to conduct research with this Spanish research group while living in New York among some of the best research institutions.

[00:08:50] But again, I'm not going to go off on that just yet but it really had to be because I was asking if you want me a time for that.

[00:08:58] I'm talking about the concept that I hope your listeners can take into account providers or patients. It's that when COVID was happening, you're absolutely right it's the excess inflammation that is going to that was going to hurt people right no one really talked about that they talk about preventing exposure to the virus.

[00:09:18] But Dr. Fauci nor anyone really talked about this is the time guys to get as healthy as you can to reduce your residual inflammation if you're smoking please talk to your doctor about that if you are having a lot of hyperbiscformed syrup and alcohol and not exercising things like that.

[00:09:37] This is the time to get healthier because when you get this and you will get this somehow, you want a body that is balanced enough a little bit better off than it is now to help survive this.

[00:09:49] It is going to be a tough fight but this is the test. This is how we can come out of this. It's not to hide it's not to welcome this virus either.

[00:09:58] When we do get this vaccine, it is not going to be the end of this thing either. It will keep changing and this is probably going to keep happening now.

[00:10:08] So until we learn this lesson that we literally infected the earth in a way it uses viruses which are its own antibodies against the antigen which is us.

[00:10:19] That sounds like a little bit of wacky poetry. There's really no better way to explain this globally that the inflammation set upon the earth by our habits is affecting us now.

[00:10:32] So now on a more pragmatic level, I went and talked to a lot of people about this and said guys I'm using microdose lithium in every COVID patient that pops positive even in the ones that are not yet positive.

[00:10:44] I'm telling them you're going to reduce residual inflammation. There's no problem with this. You can take this with your outer wall, you can take this with your magnesium whatever you want.

[00:10:52] Take this. There's no virus vaccine right now. Take this and you will reduce chances for hospitalization because I got this thing fresh out of the bat or whatever the hell it was from.

[00:11:04] I got it on week one and before New York City was even closed down, I had recovered. So I was feeling pretty good about it but it was really tough.

[00:11:13] I'm a fit guy. I can run and lift with anyone but I felt like I'd glass in my lungs at that time and it took weighted jump ropes for me to come out of that for a long time.

[00:11:25] So I said, please use this. I got no traction from doctors everywhere except Dr. Spooch who said you know what we're thinking about a study like this can you help us with that?

[00:11:36] And I said definitely and even there they had to only recruit bipolar patients.

[00:11:42] Spain's health system wouldn't allow you to give lithium to non bipolar patients. A lot of people died around the world because they simply wouldn't use assault that was so effective.

[00:11:54] All 14 of the patients that we gave lithium to discharge within a week. It isn't just a two died in the other group everyone survived within a week they left there was no long COVID and all 18 cytokines randomized control trial reduced but the other group.

[00:12:13] I see you admissions as well longer stays in the hospital long COVID is a mess it's still going on today all over the world.

[00:12:22] So for us to simply add this to the regular treatment enhanced survival a great deal. So now it's being studied from long COVID we've got 2% of the global population more than schizophrenia right 1% is schizophrenia 2% dealing with a residual viral syndrome.

[00:12:41] People who used to run people use the work people used to do anything they wanted. Now our shells of themselves they basically have chronic fatigue syndrome and same approach is going on bags of medicine anti histamines migraine medicine antidepressants quackery left and right or just nothing or being told it's in your head dismissal all that that senator marshal breaking down in tears he's a doctor from Kansas talking about this a few days ago.

[00:13:09] And we don't want to look at something so obvious and evident because it's not because it's natural.

[00:13:20] I want to hear more about your personal journey with taking lithium a couple of years ago I was doing guardianship evaluations determine if they cognitively or psychiatrically needed a guardian.

[00:13:33] I'm driving to this guardianship evaluation and I just am overwhelmed. I didn't feel right all morning and I'm overwhelmed with just grief and sadness that something that has reared its ugly head in my family before I see it in my father I see it in myself and I said my gosh I got to do something.

[00:13:54] I started to take a low dose lithium supplement since then I'm much more comfortable experiencing my emotions.

[00:14:03] I would actually say that I have cried more times in the last couple of years than probably in the 18 years since my mother's death but it's not anything that I am afraid of now.

[00:14:17] I don't want to say I enjoy the experience but I understand the importance of expressing all of those emotions and making sure that the emotions that I do express are targeted in the right areas.

[00:14:30] I also have not had any culture outbreaks since I've had a significant level of lithium in my system overall I still have ups and downs and there's not been a change in my cognition I'm not sedated or anything like that.

[00:14:45] I'm just able to ride the waves of life a little easier. I've had the idea to start doing this reaching out interviewing people whose opinions that I respect for probably five years it wasn't until I'd been taking lithium for six months that I said you know what why am I letting fear of how others are going to praise my work.

[00:15:10] Prevent me from ever engaging in doing it and be productive and not be afraid of how others view my work or my opinions.

[00:15:19] The concept you're talking about in terms of being comfortable with one's emotions is important because a lot of the methods we use now SSRI specifically will numb emotion with the use of low dose lithium you get to safely explore emotion rather than be overwhelmed by it.

[00:15:39] We're not feeling at all or being toxicated like we are doing with the benzodiazepine class that could most commonly use medicine and psychiatry is Xanax.

[00:15:51] This is an indictment on its own of the entire field that kind of like saying the most commonly used internal medicine practice is opiates that would be problematic to what we don't see with benzos are that they are the opposite of no.

[00:16:08] The opposite of neurotrophic right the neurotoxic they're going to basically put holes in the electrical blanket of the brain it will create cold spots and that will create neuronal death and that will lead to memory issues dementia acceleration.

[00:16:27] Leap problems more anxiety more depression but used safely in the control setting when you're withdrawing from alcohol or benzos were in a seizure those are life saving medicines so they're useful but we can't use them indefinitely the way we've seen with opiates we've seen that crisis there's a space for them.

[00:16:49] Unfortunately right so back to lithium the amount is really important for people listening we keep saying low dose lithium what does that really mean real lithium or bipolar disorder 600 to 1200 milligrams maybe even a touch less of lithium carbonate that's equal to about 100 to 200 milligrams of actual elemental lithium.

[00:17:13] Now if you go to the web and you search low dose lithium you'll find lithium or rotate that's a different molecule you can find 5 10 120 milligrams of lithium or rotate and you want about 1 milligram of elemental lithium per day.

[00:17:31] You can get that in about 20 milligrams of lithium or rotate or about 10 milligrams depending on how you metabolize that so that's the nutritional level if you lived in

[00:17:42] in the new zones of the world these regions that have ultra high longevity statistics from Japan to parts of Europe, France, Northern Spain most of Italy, Sardinia, the Mediterranean.

[00:17:56] Yeah they have piazza as they have people coming together they're laughing they're eating together there's connection there but there's also better soil and water and the key ingredient in all those but it's not just connection it is lithium it's in all those soils.

[00:18:10] That's the amount you'd get 1 milligram or more if you live there and ate their broccoli, ate their tomatoes, drank their water.

[00:18:18] In the term that I've been prescribing that is a little bit higher than the nutritional and much much lower still than the bipolar is 150 milligrams of lithium carbonate.

[00:18:28] That's about 20 milligrams of actual lithium doctors I would say if you want to try this you can prescribe this to yourself the DEA is not going to come after you for that

[00:18:37] you know it's like prescribing yourself vitamin D but you can try that way and you would see within a week or less changes in sleep patterns heart rate variability resilience to stress

[00:18:51] and I think doctors more than ever we need that because we're also under assault in terms of being skilled labor and how we're treated from the top down bottom up.

[00:19:00] When did you start taking lithium for yourself what was the impetus and what is your experience with it?

[00:19:06] My experience with the 150 milligram was that I also suffered from migraines.

[00:19:12] I was stressed at times and they would come on and I would have to take a sum of trip tan and if I couldn't get that I was incapacitated even if I did take it I couldn't really work or read or talk and I'd be out of it for 12 hours

[00:19:26] I'd have to go to bed and I'm like yeah I want to look at stress I want to look at other things that I do things that I eat, drinking is an important factor in reducing that

[00:19:36] and I said I'm going to add this and I saw changes right away every night I took it I dreamt more and deep sleep and REM sleep are so important the longevity and brain health.

[00:19:48] REM sleep decreases as we age it's very high that's baby it's very low post age 65 and that is very linked to cognitive capacity to brain health.

[00:20:01] If this increases it I said I'm going to keep taking this I notice change I don't have migraines anymore

[00:20:09] and then other studies started coming out about the benefits of it review of articles I was no longer at the top of that Google and PubMed search about Lotus lithium which is a good thing.

[00:20:20] Well the more I researched the more I drank the water in fact once I realized that this was working for a lot of migraines the 150 milligram prescription version I started researching more and I said okay there is this Texas A&M study that shows certain amounts of lithium in Northwest Texas north of El Paso

[00:20:38] has significant amounts of lithium and those regions are very healthy and they are not significantly elevated or in fact reduced in health measures.

[00:20:51] So we said homicide crime violence those regions are doing pretty well so I went and bottled that water and I said let's start a bottled water company called third element water it'll be fun it wasn't that much fun

[00:21:06] it was very exhausting and money and time sucking but it was a cool concept because it was the only sparkling with the added water and we did well enough to get it out there and create our name.

[00:21:20] And then I said look this is impossible to make a business on let's create a supplement version because the ones that I get I don't know where they're coming from I don't know what I'm getting from Amazon

[00:21:33] I want to create one that I can stand behind that has a different combination as well because I think many of them had the wrong combination of exactly the amount of lithium or take and the other vitamins that were in my mind

[00:21:46] a better electrolyte powder I saw the ones that were available and Gatorade is no longer Gatorade it's now just a vessel for high fructose corn syrup there's nothing that is that great as an electrolyte powder.

[00:21:58] So then we created that.

[00:22:00] Yeah I saw some research on cluster and vascular headaches I wouldn't say the quality of the research was that great but you know when you see so much manipulated research in what we do these articles or these papers trying to convince you that a two point reduction in a 54 point scale is supposed to be clinically significant

[00:22:23] you really start to call into question a lot of the research and some of it is not very obvious you don't have access to the original clinical trial data.

[00:22:32] So for me and my clinical experience I do rely a lot on what I see with my patients what I experience myself in what people that I have a certain level of trust in that do the same thing what they see anecdotally

[00:22:51] yet we're told not to rely on our anecdotal experience it's really hard for me to ignore that.

[00:22:58] It's this concept called studyism not like racism but studyism that only double blind placebo control trials matter observation doesn't matter anecdotal doesn't matter perspective doesn't matter as a whole all of this cannot and should not be ignored it can't be when you look at lithium as a whole

[00:23:18] you see the historical aspect of it that Hippocrates and Galen would take patients to these waters this was replicated in sacred springs in Georgia and Ashland Oregon.

[00:23:29] Right this is all over the world happening you see the power of it when it's utilized and sold and safely enjoyed by millions in the 1920s through the 1930s right let the added water steven up

[00:23:47] there's never any issues they started to have issues when they started putting in assault right when they created salty salt and you just had lithium chloride you said something on a podcast how you know there were too many Bostonians I always tell people

[00:24:01] there were too many good old boys from southern Kentucky who are putting too much lithium chloride on their meals night in and night out and they eventually became toxic.

[00:24:12] Yeah the debts up in New England that brought this more to a problematic place but we threw out all of the good stuff because we went too far the devil is the dose the angel is the dose two and this is such a simple concept that we have something good you wouldn't take potassium and use it excessively you know potassium deficiency will kill you you go there because of Colorado into a hospital you have a lot of people

[00:24:40] potassium deficiency they will give you an IV and a bag of that will help you get back to normal rhythm survive and you will feel better if it's given over an hour if they give you that same amount in an injection it's a lethal injection so all of these minerals on the periodic table that we have in our bodies that we need

[00:25:02] a little bit of good too much about it's the same concept here historically we see it in the absolute is a lot of bipolar is best treated with lithium to a side of the best treated with lithium you figured this out but it took America about 30 years

[00:25:20] to step this by the FDA which goes to show how open they are how honest they are how affected they are by the system of bear back then and Bristol Myers and Pfizer remember else was pulling strings more so now and now you're seeing the most state of the art research ever conducted on this concept and pharma is stepping into this now

[00:25:44] they used to tell us we don't know how lithium works literally said this in capa and satok we don't know what do you mean you don't know I'm like this is ridiculous that you don't know it's just 2007 you don't know what's in this but they do know now that it is the only inhibitor of GSK3

[00:26:02] and every psychiatrist that we neurologist needs to understand the sense on we're still understanding it but we know that it has a hundred different substrates throughout the body that have to do with inflammation second messenger pathways neuronal death apoptosis basically aging

[00:26:20] it is the master aging enzyme that is higher as we age and you need it early on because you're pruning excess but once you've built your brain you needed to slow down the things that accelerate GSK3 are the things that ages drug abuse alcohol abuse accelerates GSK3 concussions at head injuries accelerate GSK3 severe chronic inflammatory illness same thing

[00:26:47] so that enzyme then is cutting up neurons the only inhibitor is lithium the only known one we do know how it works it is inhibiting that enzyme along with some others that have to do with aging and neuronal death it's right in front of us and a lot of the research that we're looking at now don't have to do with humans even they have to do with organoids or they have to do with mice or they have to do with kilometers

[00:27:11] we look at it all as a big picture I'll finally tell you that the latest coolest research on low dose lithium came out of Kansas City a couple of nurse practitioners just spoke with them last week they looked at the presence of a specific allele when detected and given low dose lithium for that patient 65% response in terms of depression scores that number is very high

[00:27:38] and if we're looking at that for the future now where you can get a blood test the blueprint and see that you have certain alleles lead you to be more responsive to certain medicines I think you're going to see that lithium is very high on these and then it's going to be up to doctors to have some faith have some courage and write it absolutely man i would really love to get your opinion on the all or nothing thinking that I see on the

[00:28:08] societal level as you said right you can have too much potassium and it can stop your heart you can have too little potassium and it can stop your heart you've got to have nuance in understanding of a lot of these concepts and really in life you have to appreciate nuance I am convinced that our minds the way they utilize language is in a very black and white way it's in a very all or nothing way

[00:28:33] and it focuses on problems therefore it tends to be a really harsh critic but only so much because of the way that your mind understands language and I say the mind compared to the conscious self that frontal lobe center of consciousness that humans have that's much larger and more complex and understands all the gray area

[00:28:55] I don't think as a society we realize how much were influenced by the mind and the subconscious in that desire to create order uncertainty so that I can follow away lithium is something that is dangerous and that should not be used as opposed to the more reasonable rational argument that yes too much lithium should not be used but also too little lithium should not be a treatment

[00:29:24] we need to find the middle area.

[00:29:54] I am a doctor and many of my guests have extensive medical training and experience nothing stated in this podcast nor materials related to this podcast including recommended websites, texts,

[00:30:18] or graphics images or any other materials should be treated as a substitute for professional medical or psychological advice diagnosis or treatment all listeners should consult with a medical professional licensed mental health provider or other healthcare provider if seeking medical advice diagnosis or treatment or put more simply.