Spike protein, zinc excess, and the erosion of nemory, motivation, and identity — why low-dose lithium orotate has become a cornerstone in our PASC and vaccine-Injury treatment
Scott, between you and Pierre it is almost impossible to keep up with your writing (just got my copies of War on Chlorine Dioxide). What you are doing is amazing, the patient care, research and writing about it. When I was a kid in the 60s and 70s we had some genuine hero's in the US. It's been a long time but we again have true hero's now. Thank you!
Thanks for your question Michelle. The short answer is maybe, but that isn't born out by controlled study. The medium answer is that at The Leading Edge Clinic, we have only used orotate in our practice, based upon Dr Michael Nehls' recommendations. My quick search shows that we have treated at least 553 patients with this, and although that is not the same as an RCT, it's a real-world, real-time evidence base. We have observed a strong safety signal, tremendous clinical benefit, and very few side effects. I have one patient, who I know will read this, who had diarrhea with a dose that had 5mg of active lithium. He solved this issue by lowering his dose to 1mg of active lithium. I have another patient who lives in Canada, and his functional medicine doctor uses 5mg of lithium carbonate, with good clinical benefit and lack of toxicity. This is compounded, and of course requires a prescription, which limits access. The longer answer from my query of Perplexity. I'll try to attach it as a separate comment. It makes me chuckle, because it is so circumspect and dubious about the benefits of low-dose elemental lithium in PASC and injury from the Covid shots, when for me as a clinician, the evidence in terms of patient benefit is overwhelming. BTW, Peter McCullough weighed in on this a while back, behind the paywall of his Substack. He essentially said that lithium orotate alone doesn't work, but that if you use one of his proprietary combo products, then it will work. I had written a Substack about his stance, but decided to hold back, because I don't want to pick a fight with someone who many revere, even if I think he's wrong.
When I first tried to stop daily zinc supplementation about 6 months ago my hair started falling out so I restarted zinc. Then I started drinking water treated with Aurmina or Adya Clarity for 6 months and again tried to stop zinc and this time I was successful, no hair loss !
Perplexity AI on Different Forms of Lithium, Part 3
### Lithium aspartate (OTC, used in PASC trials)
- The long‑COVID RCT confirms that common US OTC lithium aspartate products contain bioavailable elemental lithium that produces measurable serum levels (≈0.10–0.49 mEq/L in the dose‑finding work). [cdn.clinicaltrials](https://cdn.clinicaltrials.gov/large-docs/87/NCT05618587/Prot_SAP_000.pdf)
- General supplement‑safety discussions flag the same organ systems as for other lithium salts (kidney, thyroid) and caution about long‑term or excessive use, especially given unregulated manufacturing and dosing precision. [jamanetwork](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824334)
## Neurologic benefit vs risk in PASC / vaccine injury
- Potential benefits relevant to PASC and post‑vaccine injury (as framed by Nehls and broader literature) include: promotion of hippocampal neurogenesis, modulation of microglial activation, attenuation of neuroinflammation, and possible antiviral effects (e.g., inhibition of replication for several viruses related to herpesviruses and others). [lindgren](https://lindgren.health/covid-long-covid-mrna-vaccine-injuries-herpes-hiv-alzheimers-disease-and-lithium/)
- Nehls extrapolates these mechanisms to spike‑mediated neurotoxicity, arguing that low‑dose lithium can support brain repair and resistance to “spikeopathy” in both infection‑ and injection‑derived injury, though direct comparative clinical data between PASC and post‑vaccination syndromes are lacking. [chaucersbooks](https://chaucersbooks.com/book/9781510784031)
- On the risk side, all salts share: cumulative renal and thyroid effects, interaction liabilities (diuretics, ACEi/ARB, NSAIDs), and acute neurologic toxicity at elevated serum levels; carbonate is best characterized but carries the clearest risk profile, while aspartate/orotate at low dose appear safer short‑term but lack long‑term, high‑quality monitoring data in non‑psychiatric populations. [sciencedirect](https://www.sciencedirect.com/science/article/pii/S0273230021001136)
From a clinical‑strategy standpoint in complex PASC / vaccine‑injury patients, lithium *as a molecule* has intriguing mechanistic and early‑phase data for neuroinflammation and neurogenesis, Nehls makes an aggressive case that trace‑dose lithium is an under‑recognized tool in spikeopathy, but only lithium aspartate has been studied in an RCT for neurologic PASC—and that trial was negative at low doses, with safety but only exploratory benefit at higher exposure; any salt choice (carbonate, orotate, aspartate) therefore needs individualized risk‑stratification, renal/thyroid considerations, and, if targeting serum levels near those seen in dose‑finding work, periodic lithium monitoring similar to low‑dose psychiatric practice. [michaelnehls.substack](https://michaelnehls.substack.com/p/the-efficacy-of-lithium-in-the-treatment)
Perplexity AI on Different Forms of Lithium, Part 2
## Safety profile by salt form
Mechanistically, all three salts deliver **lithium ion**; pharmacodynamic effects and toxicity are driven by serum lithium, not the anion. The key differences are dose, regulatory status, and monitoring.
### Lithium carbonate (Rx)
- Used in psychiatry with robust data for suicidality reduction, mood stabilization, and some neuroprotection; therapeutic serum range commonly ≈0.4–1.0 mEq/L depending on indication. [nhs](https://www.nhs.uk/medicines/lithium/side-effects-of-lithium/)
- Safety: narrow therapeutic index, with cumulative kidney and thyroid risk, tremor, cognitive slowing, and overt toxicity (GI upset, coarse tremor, confusion, ataxia, dysarthria, seizures) at higher levels. [nhs](https://www.nhs.uk/medicines/lithium/side-effects-of-lithium/)
- For PASC/spikeopathy, Nehls and others focus on **sub‑therapeutic** trace ranges; however, even low‑dose carbonate requires awareness of renal function, concurrent nephrotoxic/diuretic drugs, and sodium status, especially in complex, polypharmacy patients. [michaelnehls.substack](https://michaelnehls.substack.com/p/the-efficacy-of-lithium-in-the-treatment)
### Lithium orotate (OTC, supplement)
- Toxicology work in animals using lithium orotate at up to 400 mg/kg/day found no identified target‑organ toxicity, establishing a NOAEL at that level in rats, suggesting that occasional human supplemental doses are unlikely to produce overt organ toxicity in isolation. [sciencedirect](https://www.sciencedirect.com/science/article/pii/S0273230021001136)
- Practical safety: in integrative practice, orotate is typically used at microgram‑to‑low‑milligram elemental lithium doses, which in otherwise healthy adults are unlikely to reach psychiatric serum ranges, but the lack of standardization and monitoring in OTC products introduces variability and risk, especially in patients with reduced GFR or interacting drugs. [parchem](https://parchem.com/news/article/the-science-behind-lithium-aspartate-enhancing-brain-function-naturally)
Perplexity AI on Different Forms of Lithium, Part 1
Lithium appears to have plausible neuroprotective and anti‑inflammatory mechanisms relevant to PASC/spikeopathy, and Nehls argues strongly for low‑dose elemental lithium as an “essential” trace nutrient for brain repair; however, controlled data in long‑COVID so far show no clear clinical benefit at low doses of lithium aspartate, and all salt forms ultimately share the same narrow safety margin of lithium itself, with carbonate having the largest evidence base but also the tightest monitoring requirements. [michaelnehls.substack](https://michaelnehls.substack.com/p/the-efficacy-of-lithium-in-the-treatment)
## What Nehls is actually claiming
- Nehls frames lithium as an *essential* trace element for humans, animals, and plants, important for hippocampal neurogenesis, epigenetic regulation, and resilience against neurodegeneration and “spikeopathy.” [chaucersbooks](https://chaucersbooks.com/book/9781510784031)
- In his writing on lithium for spike‑mediated disease, he emphasizes: microglial modulation, reduction of inflammatory cytokines/cytokine storm risk, and support of neurogenesis as the rationale for PASC and vaccine‑injury use. [pmc.ncbi.nlm.nih](https://pmc.ncbi.nlm.nih.gov/articles/PMC9046673/)
- He highlights low‑dose lithium experience from Guttuso’s group in long‑COVID and interprets the dose–response data (minimal benefit at 10–15 mg lithium aspartate, more signal at 40–45 mg) as support for therapeutic use in spikeopathy, while criticizing premature dismissal of lithium after the first RCT. [jamanetwork](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824334)
- Long‑COVID RCT: a randomized trial of lithium **aspartate** 10–15 mg/day for 3 weeks (n≈52) found no significant improvement in fatigue or cognitive dysfunction vs placebo; a subsequent tiny open‑label dose‑finding extension (40–45 mg/day) showed numerically larger symptom reductions and reduced neuroinflammation biomarker “free water” in a few patients, but sample size and design preclude firm conclusions. [cidrap.umn](https://www.cidrap.umn.edu/covid-19/lithium-aspartate-didnt-relieve-long-covid-fatigue-brain-fog-trial-participants)
- Clinically, this means there is currently *negative* controlled evidence at low dose, plus weak, exploratory signal that higher lithium exposure might help a subset of patients with PASC‑related brain fog and fatigue. [jamanetwork](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824334)
Both aspartate and carbonate can work, but I haven't used them and am very comfortable with the safety of orotate. Lithium orotate likely has higher CNS penetration and bioavailability. This is the form which Dr Michael Neils recommends.
We have only used orotate at the Leading Edge Clinic, and have observed excellent tolerance and almost no side effects. One of my patients, who is a Lightning Bug reader, had diarrhea from the 5mg dose of active lithium from orotate, which resolved at a lower dose, I think 1mg. In Canada, I have a patient whose psychiatrist used very low doses of carbonate, compounded at 5 or 10mg I think, and achieved similar benefit with much lower risk of the toxicity.
I read Nehl's fascinating books several years ago. Comparing the different doses of lithium products is really difficult. There appears to be a huge difference between "elemental lithium" and "lithium Orotate". But the difference is not clear to me and not easily explained even by the producer Of the various brands. A huge span of costs per pill. I would like to find the proper 5 mg product. For instance one product advertises a "123 mg of lithium" but then when you look at the ingredients it says 5 mg of elemental lithium. The ingredients on each product have looked at are very confusing. So we are looking for 5 milligrams of pure "elemental lithium" or 5mg of " lithium orotate"? Thanks!
It’s a series in zinc. Go back in tge Substack and you’ll see Part 1,2,3, and 4. The Zinc Paradox was published on Jan 10th, and was the first in the series.
Scott, between you and Pierre it is almost impossible to keep up with your writing (just got my copies of War on Chlorine Dioxide). What you are doing is amazing, the patient care, research and writing about it. When I was a kid in the 60s and 70s we had some genuine hero's in the US. It's been a long time but we again have true hero's now. Thank you!
Thanks for your question Michelle. The short answer is maybe, but that isn't born out by controlled study. The medium answer is that at The Leading Edge Clinic, we have only used orotate in our practice, based upon Dr Michael Nehls' recommendations. My quick search shows that we have treated at least 553 patients with this, and although that is not the same as an RCT, it's a real-world, real-time evidence base. We have observed a strong safety signal, tremendous clinical benefit, and very few side effects. I have one patient, who I know will read this, who had diarrhea with a dose that had 5mg of active lithium. He solved this issue by lowering his dose to 1mg of active lithium. I have another patient who lives in Canada, and his functional medicine doctor uses 5mg of lithium carbonate, with good clinical benefit and lack of toxicity. This is compounded, and of course requires a prescription, which limits access. The longer answer from my query of Perplexity. I'll try to attach it as a separate comment. It makes me chuckle, because it is so circumspect and dubious about the benefits of low-dose elemental lithium in PASC and injury from the Covid shots, when for me as a clinician, the evidence in terms of patient benefit is overwhelming. BTW, Peter McCullough weighed in on this a while back, behind the paywall of his Substack. He essentially said that lithium orotate alone doesn't work, but that if you use one of his proprietary combo products, then it will work. I had written a Substack about his stance, but decided to hold back, because I don't want to pick a fight with someone who many revere, even if I think he's wrong.
Best regards,
Scott
When I first tried to stop daily zinc supplementation about 6 months ago my hair started falling out so I restarted zinc. Then I started drinking water treated with Aurmina or Adya Clarity for 6 months and again tried to stop zinc and this time I was successful, no hair loss !
Perplexity AI on Different Forms of Lithium, Part 3
### Lithium aspartate (OTC, used in PASC trials)
- The long‑COVID RCT confirms that common US OTC lithium aspartate products contain bioavailable elemental lithium that produces measurable serum levels (≈0.10–0.49 mEq/L in the dose‑finding work). [cdn.clinicaltrials](https://cdn.clinicaltrials.gov/large-docs/87/NCT05618587/Prot_SAP_000.pdf)
- At 10–15 mg/day for 3 weeks, no lithium‑attributable serious adverse events occurred, and tolerability was good; even at 40–45 mg/day in the small open‑label group, no lithium‑linked adverse events were reported. [cidrap.umn](https://www.cidrap.umn.edu/covid-19/lithium-aspartate-didnt-relieve-long-covid-fatigue-brain-fog-trial-participants)
- General supplement‑safety discussions flag the same organ systems as for other lithium salts (kidney, thyroid) and caution about long‑term or excessive use, especially given unregulated manufacturing and dosing precision. [jamanetwork](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824334)
## Neurologic benefit vs risk in PASC / vaccine injury
- Potential benefits relevant to PASC and post‑vaccine injury (as framed by Nehls and broader literature) include: promotion of hippocampal neurogenesis, modulation of microglial activation, attenuation of neuroinflammation, and possible antiviral effects (e.g., inhibition of replication for several viruses related to herpesviruses and others). [lindgren](https://lindgren.health/covid-long-covid-mrna-vaccine-injuries-herpes-hiv-alzheimers-disease-and-lithium/)
- Nehls extrapolates these mechanisms to spike‑mediated neurotoxicity, arguing that low‑dose lithium can support brain repair and resistance to “spikeopathy” in both infection‑ and injection‑derived injury, though direct comparative clinical data between PASC and post‑vaccination syndromes are lacking. [chaucersbooks](https://chaucersbooks.com/book/9781510784031)
- On the risk side, all salts share: cumulative renal and thyroid effects, interaction liabilities (diuretics, ACEi/ARB, NSAIDs), and acute neurologic toxicity at elevated serum levels; carbonate is best characterized but carries the clearest risk profile, while aspartate/orotate at low dose appear safer short‑term but lack long‑term, high‑quality monitoring data in non‑psychiatric populations. [sciencedirect](https://www.sciencedirect.com/science/article/pii/S0273230021001136)
From a clinical‑strategy standpoint in complex PASC / vaccine‑injury patients, lithium *as a molecule* has intriguing mechanistic and early‑phase data for neuroinflammation and neurogenesis, Nehls makes an aggressive case that trace‑dose lithium is an under‑recognized tool in spikeopathy, but only lithium aspartate has been studied in an RCT for neurologic PASC—and that trial was negative at low doses, with safety but only exploratory benefit at higher exposure; any salt choice (carbonate, orotate, aspartate) therefore needs individualized risk‑stratification, renal/thyroid considerations, and, if targeting serum levels near those seen in dose‑finding work, periodic lithium monitoring similar to low‑dose psychiatric practice. [michaelnehls.substack](https://michaelnehls.substack.com/p/the-efficacy-of-lithium-in-the-treatment)
Perplexity AI on Different Forms of Lithium, Part 2
## Safety profile by salt form
Mechanistically, all three salts deliver **lithium ion**; pharmacodynamic effects and toxicity are driven by serum lithium, not the anion. The key differences are dose, regulatory status, and monitoring.
### Lithium carbonate (Rx)
- Used in psychiatry with robust data for suicidality reduction, mood stabilization, and some neuroprotection; therapeutic serum range commonly ≈0.4–1.0 mEq/L depending on indication. [nhs](https://www.nhs.uk/medicines/lithium/side-effects-of-lithium/)
- Safety: narrow therapeutic index, with cumulative kidney and thyroid risk, tremor, cognitive slowing, and overt toxicity (GI upset, coarse tremor, confusion, ataxia, dysarthria, seizures) at higher levels. [nhs](https://www.nhs.uk/medicines/lithium/side-effects-of-lithium/)
- For PASC/spikeopathy, Nehls and others focus on **sub‑therapeutic** trace ranges; however, even low‑dose carbonate requires awareness of renal function, concurrent nephrotoxic/diuretic drugs, and sodium status, especially in complex, polypharmacy patients. [michaelnehls.substack](https://michaelnehls.substack.com/p/the-efficacy-of-lithium-in-the-treatment)
### Lithium orotate (OTC, supplement)
- Toxicology work in animals using lithium orotate at up to 400 mg/kg/day found no identified target‑organ toxicity, establishing a NOAEL at that level in rats, suggesting that occasional human supplemental doses are unlikely to produce overt organ toxicity in isolation. [sciencedirect](https://www.sciencedirect.com/science/article/pii/S0273230021001136)
- Nevertheless, orotate delivers bioavailable lithium; accumulated case reports with high‑dose or chronic use of various OTC lithium salts show the same potential for renal, thyroid, and neurologic adverse effects as carbonate if serum levels are allowed to climb. [parchem](https://parchem.com/news/article/the-science-behind-lithium-aspartate-enhancing-brain-function-naturally)
- Practical safety: in integrative practice, orotate is typically used at microgram‑to‑low‑milligram elemental lithium doses, which in otherwise healthy adults are unlikely to reach psychiatric serum ranges, but the lack of standardization and monitoring in OTC products introduces variability and risk, especially in patients with reduced GFR or interacting drugs. [parchem](https://parchem.com/news/article/the-science-behind-lithium-aspartate-enhancing-brain-function-naturally)
Perplexity AI on Different Forms of Lithium, Part 1
Lithium appears to have plausible neuroprotective and anti‑inflammatory mechanisms relevant to PASC/spikeopathy, and Nehls argues strongly for low‑dose elemental lithium as an “essential” trace nutrient for brain repair; however, controlled data in long‑COVID so far show no clear clinical benefit at low doses of lithium aspartate, and all salt forms ultimately share the same narrow safety margin of lithium itself, with carbonate having the largest evidence base but also the tightest monitoring requirements. [michaelnehls.substack](https://michaelnehls.substack.com/p/the-efficacy-of-lithium-in-the-treatment)
## What Nehls is actually claiming
- Nehls frames lithium as an *essential* trace element for humans, animals, and plants, important for hippocampal neurogenesis, epigenetic regulation, and resilience against neurodegeneration and “spikeopathy.” [chaucersbooks](https://chaucersbooks.com/book/9781510784031)
- In his writing on lithium for spike‑mediated disease, he emphasizes: microglial modulation, reduction of inflammatory cytokines/cytokine storm risk, and support of neurogenesis as the rationale for PASC and vaccine‑injury use. [pmc.ncbi.nlm.nih](https://pmc.ncbi.nlm.nih.gov/articles/PMC9046673/)
- He highlights low‑dose lithium experience from Guttuso’s group in long‑COVID and interprets the dose–response data (minimal benefit at 10–15 mg lithium aspartate, more signal at 40–45 mg) as support for therapeutic use in spikeopathy, while criticizing premature dismissal of lithium after the first RCT. [jamanetwork](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824334)
## Evidence in PASC / “spikeopathy”
- Acute COVID: small clinical data suggest that adjunctive low‑dose lithium in hospitalized COVID‑19 patients reduced length of stay and severity, consistent with antiviral and immunomodulatory properties. [lindgren](https://lindgren.health/covid-long-covid-mrna-vaccine-injuries-herpes-hiv-alzheimers-disease-and-lithium/)
- Long‑COVID RCT: a randomized trial of lithium **aspartate** 10–15 mg/day for 3 weeks (n≈52) found no significant improvement in fatigue or cognitive dysfunction vs placebo; a subsequent tiny open‑label dose‑finding extension (40–45 mg/day) showed numerically larger symptom reductions and reduced neuroinflammation biomarker “free water” in a few patients, but sample size and design preclude firm conclusions. [cidrap.umn](https://www.cidrap.umn.edu/covid-19/lithium-aspartate-didnt-relieve-long-covid-fatigue-brain-fog-trial-participants)
- Clinically, this means there is currently *negative* controlled evidence at low dose, plus weak, exploratory signal that higher lithium exposure might help a subset of patients with PASC‑related brain fog and fatigue. [jamanetwork](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824334)
Both aspartate and carbonate can work, but I haven't used them and am very comfortable with the safety of orotate. Lithium orotate likely has higher CNS penetration and bioavailability. This is the form which Dr Michael Neils recommends.
We have only used orotate at the Leading Edge Clinic, and have observed excellent tolerance and almost no side effects. One of my patients, who is a Lightning Bug reader, had diarrhea from the 5mg dose of active lithium from orotate, which resolved at a lower dose, I think 1mg. In Canada, I have a patient whose psychiatrist used very low doses of carbonate, compounded at 5 or 10mg I think, and achieved similar benefit with much lower risk of the toxicity.
What about Lithium Aspartate? Could it also work?
I read Nehl's fascinating books several years ago. Comparing the different doses of lithium products is really difficult. There appears to be a huge difference between "elemental lithium" and "lithium Orotate". But the difference is not clear to me and not easily explained even by the producer Of the various brands. A huge span of costs per pill. I would like to find the proper 5 mg product. For instance one product advertises a "123 mg of lithium" but then when you look at the ingredients it says 5 mg of elemental lithium. The ingredients on each product have looked at are very confusing. So we are looking for 5 milligrams of pure "elemental lithium" or 5mg of " lithium orotate"? Thanks!
Please go to the last section of this Substack which I wrote previously. There is detailed discussion of lithium orotate and dosing. https://lightningbug.substack.com/p/little-grey-cells?utm_source=publication-search
what would be considered a low dose of Li orotate?
1mg of active lithium. The amount of lithium orotate depends on the source and manufacturere. Please see my response to the comment above, and read the last section of this Substack which I wrote previouslyl.https://lightningbug.substack.com/p/little-grey-cells?utm_source=publication-search
Hi, where can we find the other parts of the hippocampus series? I don’t see them on the Substack page. Thanks so much.
It’s a series in zinc. Go back in tge Substack and you’ll see Part 1,2,3, and 4. The Zinc Paradox was published on Jan 10th, and was the first in the series.
Have you read the 2025 Nature article that suggests lithium orotate for Alzheimer’s prevention? It’s a turning point for functional psychiatry!
I haven’t, but Dr Nehls discussed this with us two years ago.
Friend of RY I’m MD. Question about lithium Orotate vs Ketamine SL. Losing memory 3 jabs
How does an ordinary person find out if this is a problem? I have a daughter with severe depression. Had one Moderna vax.
I am sorry your daughter is suffering.