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Spokane, Washington  Est. May 19, 1883

People’s Pharmacy: Can low-dose lithium alleviate depression?

By Joe Graedon, M.S., and Teresa Graedon, Ph.D. King Features Syndicate

Q. My young adult daughter has been taking Zoloft for depression. She recently weaned off of it and her new doctor put her on 5 milligrams of lithium orotate.

She first tried to take bupropion but couldn’t tolerate the higher 300 milligram dose. What’s more, her pills smelled like rotten eggs. I think it’s interesting that one pharmacist said this smell is normal and another said it is not. Your article confirmed the bad smell is not normal for this pill. I hope you can give us some information about lithium orotate.

A. There is growing interest in low-dose lithium for both mood disorders and cognitive impairment. This mineral was introduced in the U.S. as a treatment for bipolar disorder in 1970. That condition was called manic depression in those days.

The problem with lithium treatment has been its toxicity. At the high doses that have been used (900 to 1,800 milligrams of lithium carbonate daily), there are several serious side effects. They include thyroid disorders, kidney damage, hand tremor, digestive upset, heart rhythm changes, confusion and visual difficulties.

The low-dose lithium orotate your daughter is now taking has not been studied as carefully, but it appears to be safe (Brain and Behavior, August 2021). The limited evidence that exists suggests that low-dose lithium may be helpful for depression or bipolar disorder (Neuroscience and Biobehavioral Reviews, January 2023). The dose of lithium orotate your daughter is taking (5 milligrams) is very low. As long as she is being monitored, this should pose little risk.

Q. I really like the flavor of soy milk, but I’ve found that drinking it interferes with my thyroid treatment. I’ve been taking the same dose of Armour thyroid for more than a decade. After I started drinking a couple of glasses of soy milk every day, I noticed symptoms of hypothyroidism. I would feel cold and not be able to warm up.

Once I stopped the soy milk, my hypothyroid symptoms went away. Now I stay away from all soy. I think I could tolerate small amounts here and there, but not a lot every day. I make sure to take my thyroid medicine separately from any food intake.

When I mentioned this to my doctor, she gave me the side eye. How well-known is this interaction?

A. It sounds as if you have done your own N of 1 experiment to determine how soy products affect your thyroid function. There are relatively few randomized controlled trials addressing a potential interaction.

In 2002, scientists found that certain natural compounds in soy called isoflavones can inactivate an enzyme crucial for thyroid hormone regulation (Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences, Sept. 25, 2002). This led some researchers to suspect that soy isoflavones might interfere with thyroid function (Environmental Health Perspectives, June 2002).

A few case studies have confirmed that some individuals react as you do (Endocrinology, Diabetes & Metabolism Case Reports, July 19, 2021). A meta-analysis revealed some contradictory findings (Scientific Reports, March 8, 2019).

Soy is not the only food that might affect thyroid hormones, however. You are smart to take your medicine well away from mealtime, since coffee, tea and supplements containing iron or calcium can reduce absorption.

You can learn more about this from our “eGuide to Thyroid Hormones.” This online resource may be found under the Health eGuides tab at

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla., 32803, or email them via their website: Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”