Lithium, a chemical element represented by the symbol Li, is both a therapeutic agent and a potential toxicant, prominently featured in Toxic and Essential Elements panels for whole blood testing. Medically, lithium is primarily used in the treatment of bipolar disorder, effectively stabilizing mood and reducing the extremes of mania and depression. In such therapeutic use, monitoring lithium levels in whole blood is crucial, as the therapeutic range is relatively narrow and closely borders on toxicity. Symptoms of lithium toxicity include nausea, tremors, confusion, and in severe cases, renal impairment and neurotoxicity. In a Toxic and Essential Elements panel, the concentration of lithium in the blood is measured to ensure it remains within a safe and effective range for patients undergoing lithium therapy. This testing is also significant in occupational and environmental health, as lithium exposure can occur through various sources, including batteries and certain industrial processes. By assessing lithium levels in whole blood, healthcare providers can manage appropriate dosing in therapeutic contexts, monitor potential occupational or environmental exposure, and prevent the adverse effects associated with lithium toxicity.
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Li occurs almost universally in water and in the diet, and Li has essential functions in the body. Intracellularly, Li inhibits the conversion of phosphorylated inositol to free inositol. In the nervous system this moderates neuronal excitability. Li also influences monamine neurotransmitter concentrations at the synapse (this function is increased when Li is used therapeutically for mania or bipolar illness). Recent studies suggest that long-term, low dose Li supplementation is neuroprotective and may help preserve integrity of the central nervous system with aging.
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