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Comment by _jgvg | Hacker News Reader

Maybe we should just add lithium to the water supply, although that would drive conspiracy theorists crazy!

http://www.ncbi.nlm.nih.gov/pubmed/1699579

"Using data for 27 Texas counties from 1978-1987, it is shown that the incidence rates of suicide, homicide, and rape are significantly higher in counties whose drinking water supplies contain little or no lithium than in counties with water lithium levels ranging from 70-170 micrograms/L; the differences remain statistically significant (p less than 0.01) after corrections for population density."

Edit: on a second thought, it wouldn't drive them crazy, it would literally calm them!

Edit 2: I'm not proposing adding therapy-level doses of lithium to the water, just equalizing it to the water in other regions.

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You'd be literally adding chemicals to change people's brain chemistry to the water. The conspiracy theorists would be pretty justified I'd say. I think this is the sort of thing you should really decide for yourself individually.

What about all those cancer causing chemicals we allow companies to dump into the water or fluoride? I guess the conspiracy theorists are already onto fluoride.

> I guess the conspiracy theorists are already onto fluoride.

They are. I hope however that we can agree that they are in fact conspiracy theorists.

Why would you hope that? What do you gain by polarizing an entire group of people based on something as inconsequential as fluoride? Are you unable to brush your own teeth and would suffer great harm if they stopped profiting from companies who pay to dump their fluoride waste into our water supply?

Crazy ideas only get crazier when you don't calmly address them with education and instead find some weird necessity to ostracize those with differing viewpoints.

also vaccines..

Hmm, vaccines are in a slightly different camp as they are most effective when everyone uses them. I will say that the anti-anti-vaccine crowd does much more harm than good by spreading pro-vaccine propaganda. Believe it or not, not every vaccine created has been effective and harmless and by generalizing your hate speeches (on both sides) instead of educating you only cause people to make emotional decisions rather than rational decisions.

We already remove chemicals from the water that change people's brain chemistry (e.g., lead). Adding something entirely helpful doesn't seem that different from removing something entirely harmful.

It does seem entirely different. In one case we're removing a toxin, something that doesn't need to be in water at all. In the other case we're adding something that isn't normally in the water in order to benefit a few people. We do this with fluoride in many places already, but I think this takes it to a far different level by affecting your brain chemistry.

You're giving many people who really don't need it a mood stabilizer, if it's enough to affect those who are at risk of suicide, it's surely still having an influence in the minds of those who don't need it. Why should the entire population have this alteration performed when only a few will benefit. Seems better to go and seek out those few. Personally I'd take the increased suicide risk.

Point is, people will disagree about this, the optimal solution is to just let people who want it add it or take it as a supplement in their own homes.

Lithium might be an essential micronutrient, so it may simply be treating a common problem. Much like how milk is fortified with Vitamin D.

PS: There is little (ed: zero) evidence that Lithium is and the human body puts effort into removing it. But, it's also common in the environment and may have positive impacts at low levels so it's more debatable than you might think.

Perhaps, but if it's having a mental effect of notable size it still causes me concern. If you're happy with your current behaviors I don't see why you'd want it. Wouldn't it be better for individuals to just opt to take it themselves, encourage usage of those already existing environmental sources, etc?

one of the signs of depression is poor self maintenance, people get into a rut where they stop showering, cleaning etc.

They wont always seek help.

My close experience with depression (not myself) is that it can takes years for someone to accept the thought of being depressed, and even more time to seek help.

Sadly, there's too much prejudice and taboo over mental health in our society. People treat it as a badge of shame, not a disease.

Iodine is added to table salt for the same effect. Although I am no fan of too many additives, I do approve this practice. I wonder if it would be feasible to institute today...

https://en.wikipedia.org/wiki/Iodised_salt

Iodised salt is easy to opt out of though, many salts come without it still. Your municipal tap water is much harder to opt out of. Which is why I'd suggest you simply allow people to add this themselves if they'd like.

We don't know that lithium is entirely helpful.

I made that argument in a prior thread and people were really, really against it. Despite the abundance of evidence, from that study and the Japanese one [1]. I think Zinc would make a good addition too re: suicide [2]. There are two other large scale studies like this for lithium, both confirming the findings. One from Greece [3] and one from Argentina (can't find it...) [1]: http://www.ncbi.nlm.nih.gov/pubmed/19407280 [2]: http://www.jad-journal.com/article/S0165-0327(13)00626-5/abs... [3]: http://www.ncbi.nlm.nih.gov/pubmed/24072668

Are these available as supplements and, if so, is it safe to take them?

This may not apply to you, but I must mention it: Anyone suffering from suicidal ideation should seek professional help. These aren't the kinds of things you want to try to self-medicate away.

That said, there is a form of lithium that is available over the counter: Lithium Orotate. The amount of elemental lithium per dose is lower than you'll find in prescription lithium carbonate treatment, but you wouldn't want to attempt to self-medicate in to the prescription range anyway. Lithium has a notoriously narrow therapeutic window, and it would be too easy to dose yourself into the toxic range.

I've tried lithium orotoate myself out of curiosity for circadian rhythm modification. Although the dose is lower than that of prescription lithium, the effects and side effects were still palpable. Personally, I found no positive benefits but substantial cognitive slowing and general feelings of malaise. It's also worth noting that lithium is moderately toxic to the kidneys over time.

Having tried low-dose lithium orotate myself, I would never advocate for any amount of supplemental lithium in water supplies. Let's leave the medication to those who need it, rather than forcing it upon the entire population.

> I would never advocate for any amount of supplemental lithium in water supplies.

Would you remove the lithium from other water supplies?

Not meaningfully. I think PragmaticPulp captured it well. You can increase the amount of lithium you consume, but mostly what lithium does is improve B12 metabolism. Regardless of suicidal ideation status, taking B12 and improving diet/sleep would be better than taking lithium. B12 is consistently and significantly lower in those with clinical bipolar than controls, so it is the real problem. Superdosing lithium ensures an ideal environment for B12 metabolism, hence the benefits.

It's available as a prescription in the US. A psychiatrist can prescribe it. There are other drugs that have less side effects that can be tried first though. I wouldn't take it without doctor supervision as it's very easy to reach toxic levels in your blood. Even while on it with a doctor you need blood work regularly. It is one thing that did finally start to help me after about 10 years of dealing with bipolar 2 (which included symptoms of not wanting to live).

https://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Lithium

Do take varying diets and local culture in consideration when you push for such stuff. Lithium is almost certainly harmless, but adding zinc to the water will probably cause health problems for some people.

It may be a case of doing it, and warning people not to eat too much of it. But you need actual research to discover that.

It's fine if you want to medicate yourself with lithium, but it's not acceptable to forcibly medicate everyone else.

The studies you linked to show an interesting correlation between lithium in water supplies and reduced suicide levels, but you can't judge the net benefit on a single metric alone. Lithium is not without side effects, and it's unreasonable to suggest that the vast majority of the population that is otherwise healthy be subjected to those side effects for the incremental benefit of a select few. The magnitude of these side effects may be relatively small in the levels we're talking about, but the net effect is likely not negligible when applied to entire populations over the course of their lifetimes.

To add to this, I think there are many people who just plain wouldn't like do this. Even if they're unhappy or depressed they'd rather not have that feeling taken away by a mood stabilizer.

I'm not going to argue with the fact that it results in "better" outcomes in some people's minds, but personally I'd rather accept an increased suicide risk. I'm sure I could take any number of mind-altering substances every day and I'd feel great, but that doesn't mean it's something I want to do.

Lithium is an element, not just a medication. The element is used to medicate people with bipolar, in huge dosages. You and I both consume lithium every day. We may consume slightly more or less than others. The ones who consume slightly more kill themselves significantly less, with no side effects. Lithium the medication is in 100-1000x the dosages, hence the side effects. If it is bad in high (but naturally occurring, and much lower than the medication) doses, we should filter it out.

> Lithium is an element, not just a medication.

It doesn't matter if you call it an element or a medication, it has non-negligible medical effects and side effects. If it had no relevant effects, we wouldn't be discussing it here.

> The ones who consume slightly more kill themselves significantly less, with no side effects.

"No side effects" is an impossible claim to make. The studies we do have show a correlation between lithium in the water supply and suicidal frequency in the population. The side effects have not been studied.

For some hard evidence: Lithium in drinking water is correlated with changes of thyroid function: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114818/

Lithium most certainly does have side effects that are dose- and time-dependent. The side effects may be minimal at low concentrations, but when applied to a population over the course of a lifetime, they would certainly add up. Especially for those who are most susceptible to the negative effects.

It's also not hard to imagine that lithium's suicide rate reduction effects (which are purely correlation at this point, FWIW) are due to it's tendency to mellow people out. The cognitive dulling of even small amounts of lithium orotate in healthy (non-bipolar and non-suicidal) people are palpable. Would you still advocate for lithium in the water if it reduced the average intelligence of the population by, say, 1%? I'm picking hypothetical numbers here, but the reality is that there are certainly downsides to mass-medicating people with small doses of lithium.

In that study, the water the people were drinking was up to 20x what was on the high end of the other study. If you are drinking water that is 20-100x higher in lithium, that is more like taking the lithium pills than it is like getting it from water. Further to that, the study proved nothing statistically significant... So if 20x higher lithium concentration causes no statistically significant downsides, what could the harm of being on the upper bound of what is typical in areas that are not lithium mines be?

Then we should also think about whether governments in areas where lithium is naturally higher have an obligation to remove it from their citizens' water.

Iodine is added to table salt in a lot of countries in the world. Why is preventing "physical" diseases ok, but mental diseases not?

You can still buy many kinds of salt without iodine, it's easy to opt out.

Additionally, when you talk about mental "diseases", things get a lot more iffy. We have a terrible understanding of the brain, our diagnoses for those diseases are literally check lists, without any proper tests, many people would rather have their natural mental performance than a modified version of it, which is what something like this would force you into whether you like it or not.

Per my sibling comment, are you saying water fluoridation wasn't kosher either? It's similarly "forced medication".

https://news.ycombinator.com/item?id=12167455

While you're at it, you might as well add magnesium, potassium, sulfate, phosphate, iodide, L-selenomethionine, copper, manganese, chromium, molybdenum, orthosilicic acid, and ascorbate, too.

While you can't make people exercise and eat their vegetables, they will usually drink the tap water.

But you then have to provide a way for people to opt out without any de facto penalty, which is the problem. So this would so something more suited for a dedicated drinking water system in an apartment building or complex. The mineralized water on tap goes to sinks, drinking fountains, and refrigerators, and regular old municipal water to sinks, toilets, showers, and laundry machines.

Iodine is already added, to salt.

Ludicrous. Let people decide that for themselves. I can't believe anyone is seriously suggesting force medicating us because it seems to be correlated (note, correlation, not necessarily causation) with a drop of suicide, homicide and rape. We don't even know how lithium would cause such a thing and its exact effect on the psyche.

I have been following the field of psychology and psychiatry closely and let me tell you, they are not only far from understanding and curing the causes of mental disorders, they are also prescribing very harmful medication based on biased research funded by pharma. What you are arguing for is very dangerous.

And even if it was shown to be beneficial beyond doubt, why not make these supplements available in another form, cheaply and conveniently? State mandated force medication is not only infantilizing to the extreme, it also violates essential liberties of the people.

You're already medicated. Fluorine is added to water, and iodine to salt.

Your point being? I am opposed to that too. I just think it should be people's own decision to medicate themselves however they see fit. At least with the salt you can buy whatever salt you please,with or without iodine. The water supply, on the other hand, cannot be chosen.

You can buy whatever water you choose to drink, done pretty frequently around the world.

Ethically, what's the difference between that and water fluoridation? Atomic number?

In both cases, you're forcing a chemical on people that the evidence says would be to their benefit, but with a Knightian ("unknown unknown") risk of really hurting them.

The point of dumping lithium would be explicitly behavioral modification which is a different kind of thing entirely to the effects of fluoride in the water.

Lithium can cause severe problems for those who have hypothyroidism (a significant portion of women). For these people, the lack of thyroid hormone would likely worsen their depression.

How about a compromise: make some form of lithium available OTC, without any patents involved?

Or perhaps people should start taking more cod-liver oil, like people did in the old days.

You realize there are seriously negative side effects to lithium, right? Kidney disease, extremely bad for nursing babies, etc

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