This test measures the amount of lithium in your blood to help manage treatment for mood disorders like bipolar disorder. Lithium is a naturally occurring element used as a mood stabilizer, especially for controlling mania and preventing mood swings. Because lithium has a very narrow therapeutic range, levels must be carefully monitored to ensure the dose is effective—not too low (ineffective) and not too high (toxic).
Monitoring lithium levels helps:
Ensure treatment for bipolar disorder is working
Adjust dosage safely
Prevent lithium toxicity, which can be dangerous
Your doctor may order this test if you're taking lithium and experiencing symptoms like:
Fatigue or drowsiness
Dizziness or confusion
Muscle weakness or tremors
Nausea, vomiting, or diarrhea
Slurred speech or lack of coordination
Unusual restlessness
Lithium is fully absorbed within 6–8 hours after oral intake.
Its effects may take 5–10 days to become noticeable.
The drug is processed almost entirely by the kidneys, and its half-life (how long it stays in your body) ranges from 17 to 36 hours.
Lithium is distributed in total body water and accumulates differently in various tissues, including the brain.
In steady state, cerebrospinal fluid levels are about 40% of serum levels.
Lithium is not protein-bound, meaning it moves freely in the body.
Sodium balance: Low sodium levels can cause the body to retain lithium, while high sodium levels increase its excretion. Regular plasma sodium checks are recommended.
Kidney function: Since lithium is cleared by the kidneys, variations in kidney health can affect blood levels.
Intracellular activity: Lithium acts inside cells, so red blood cell (erythrocyte) levels may better reflect its activity than serum levels in some patients.
Digestive symptoms (nausea, vomiting, diarrhea) can happen at any stage and at any serum level.
Nephrogenic diabetes insipidus (a kidney-related condition affecting water balance) occurs in about 33% of patients.
Thyroid effects: Lithium can slightly lower thyroid hormone (T4) levels and raise TSH levels. About 4% of patients may develop goiter or hypothyroidism.
These effects are often manageable with dose adjustments or additional treatment.
Because of its narrow therapeutic window, lithium therapy requires regular blood tests to balance effectiveness with safety. Always follow your doctor’s instructions for timing your dose and test, and report any unusual symptoms. With proper monitoring, lithium can be a highly effective treatment for mood stabilization.
References:
Gelenberg AJ et al. N Engl J Med. 1989;321(22):1489–1493. PMID: 2811970
American Medical Association, Drug Evaluations Subscription, 1992.
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Intoxication never occurs suddenly. Several days to a week before full-blown symptoms develop, a patient will experience lethargy, drowsiness, tremor, muscle twitching, dysarthria, anorexia and vomiting or diarrhea. A fully developed case of intoxication shows coma to semicoma, rigidity, hyperactive reflexes and seizures at times. There is a high incidence of pulmonary complications.
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What does a low lithium level mean?
Low blood levels of lithium typically mean the medication is not at a high enough level in your body to be effective. This can reduce its ability to manage conditions like bipolar disorder, mania, or as an add-on for depression. Lithium needs to stay within a specific therapeutic range (usually 0.6–1.2 mmol/L) to work properly and safely.
Missed or irregular doses
Starting lithium recently or having a recent dose change
Fast kidney clearance (some people naturally eliminate it faster)
Drug interactions (like with caffeine, certain diuretics, or NSAIDs)
Too much or too little fluid intake (affects lithium balance)
Malabsorption issues (e.g., GI conditions that affect absorption)
If your lithium level is too low, it may not provide its full mood-stabilizing benefits. This can increase the risk of relapse, mood swings, or worsening symptoms. Regular blood tests are important to make sure your level stays in the right zone—not too low, and not too high.
Talk to your doctor: They may adjust your dose or repeat the test in a few days.
Check the timing: Lithium blood tests should be done 12 hours after your last dose. Testing too early can give a falsely low reading.
Take your medication consistently: Same time every day, no skipped doses.
Mention all medications: Let your doctor know if you're taking any new prescriptions, over-the-counter drugs, or supplements—these can impact lithium levels.
Stay hydrated: Drink a steady, moderate amount of water daily. Avoid extremes.
Low lithium levels are common and often easy to fix with a dose adjustment or lifestyle tweaks. Always follow your doctor’s guidance and tell them if your mood changes or if you notice any side effects. Keeping your lithium in the right range is key to staying well.
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I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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