success ☼ JanCarol: Reboxetine first, then lithium

[AliG]

 J.C.

 

" I'm in tears from the inability to sleep ".  'Deep empathy with all you insomniacs, out there".  " I have fears , I will break down".

 

 Welcome to the  " nightmare" Jan.

 

 Less than 6 hrs !! O.M.G.   If I could get anywhere near that , I would be in " heaven".  1-2 hours sleep is " normal". !!   3hours is good !

 

 Thinking of you, JanC.  I hope you enjoy your trip , despite the W/D , drug crap!

 

Love ,  Ali.

[JanCarol]

Hey Ali, thanks.  That's why I was reluctant to post hours, I know many many people here who get by on far less than that.  I did finally get a 9 hour night which stopped the hollow head, snappy nerves, The night before that, however was 3.

 

This is not withdrawal or even drug related.  It's more "damage related."  I am not in my home, in my bed, in my patterns, eating my food, on my schedule.

 

This artificially induces a "daytime Jan" for awhile, but it also means that the transition time is harrowing.

 

UNLIKE you, I know it will set to rights (though I am having a lot of trouble breathing, and have been using sinus drugs and broncho-dilator drugs so that I can sleep without choking) at some point, whereas you may have more waiting than me.  I've been like this for over a decade - this, however, is the least amount of psych drugs I've been on in decades.  I don't think it's the drugs.

 

It's the weight, it's the travelling, it's the adjusting my schedule to the "rest of the world."  But I'm now more adjusted, and in a more daytime mode.

 

For the positives, this week we are staying in a lovely eco-micro-cabin, 1 br with a cathedral ceiling in the lounge room (amazing for a micro cabin!).  Yesterday we saw old growth Pacific Redwood trees, today we will see lighthouse and rugged beach.  And - a friend sent me an Inuit poem that I wish to share.

 

"And I think over again

My small adventures

When from a shore wind I drifted out

In my kayak

And I thought I was in danger.

 

 

My fears,

Those small ones

That I thought so big,

For all the vital things

I had to get and to reach.

 

 

And yet, there is only

One great thing,

The only thing.

To live and see in huts and on journeys

The great day that dawns,

And the light that fills the world."

 

–Song from the Kitlinuharmiut (Copper Eskimo), The Report of the Fifth Thule Expedition 1921-1924

[AliG]

 Hi Jan,

 

I'm glad you're having fun !  Where are you, exactly?  Are you on the West Coast ?

 

"Eco- micro cabin " sounds too cute !

 

I like your poem a lot.  "And the light that fills the world".

 

Take good care of yourself.    Love,  Ali.

[Meimeiquest]

Thanks for sharing your adventures and misadventures with us! Hope you're having a great time.

 

I'm not sure what to make of this Mercola article, but it involves rhinitis and sleep apnea without use of the C word...

 

http://articles.mercola.com/sites/articles/archive/2015/09/19/buteyko-breathing-oxygen-advantage.aspx?e_cid=20150919Z1_DNL_art_1&utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20150919Z1&et_cid=DM85596&et_rid=1130684202

[JanCarol]

Thanks MeiMei!

 

California was wonderful, I think I'm going to work up a Facebook post on how amazing it was.

 

Now with family & friends.  Met up with high school friends - I didn't know them well, but had one class with each of them for one year - so - we were comfortable, had fun together, and I was stunned at how many artists, musicians, weavers, and creators were at the table.  I guess I like arty people (even if I'm not arty myself).  Conversation was light and pleasant, very buoyant - I feel energized rather than drained (as I often do after these gatherings).  As an Australian visiting home, the best way to see people is to stay in one place - "hold court" as it were - we stayed in a restaurant for 8 hours, while 20 different people in 3 different shifts (lunch, "cocktails" & dinner) came by.

 

Normally, a day like this would leave me drained and crashed.  I still felt like I had to be invisible about my SA interests, and instead I talked and laughed about the "crazy cat lady" ones.  I did express at one point - that I was wild (it's difficult to explain why people were here from different high schools - I went to 5 high schools in 3.5 years) and used to be considered "bipolar" but really think it was about stress and allergies and trauma and am learning to walk away from the diagnosis.  That was acceptable - but if I talked about "evil drugs, awful pharmaceutical companies, and clueless doctors" I would have felt far less comfortable.

 

I'm so glad I have SA!

 

Unfortunately, I've bought more books than we can take home with us.  And no duplicates I can share with you.  FORTUNATELY, my Mom is taking an interest in the Arman Neel ("Are your Prescriptions Killing You?") and Elaine Gottschall (IBS, Crohn's, Gut stuff) books.  Every time she has a moment alone, I see her tucked into one of these books.  She is on lipitor, a PPI, .25 mg xanax per day, and a beta blocker, as well as thyroxin for hypothyroidism.  The thyroxin has been there nearly all of my life (about 40 years) and she just learned this year not to take it with food (or she's had cognitive loss and forgot this thing).  The xanax has been for at least 20 years.  She is having muscle weakness and falling down.  She recognizes that to come off of the xanax she would have to be hospitalized, and she doesn't want to do this.  I told her that's probably okay (86 is kind of old to go through withdrawal, and the ensuing panic, anxiety, and insomnia she would face, and her dose is not huge)  But I reckon she's got no need to be on lipitor, which could affect her muscles, falling, and cognitive problems, and definitely no need to be on a PPI, and perhaps her beta blocker could be not the right thing, either.  She has a pacemaker.

 

Thanks to Arman P. Neel, Jr, the author of the book above, I've found a "Consulting Geriatric Pharmacist" in a town about 2 hours away.  She could visit a niece at university while there.  My brother could take her up (he's retired, and devotes his time to taking care of her and his kids and grandkids).  AMAZINGLY because of the diarrhea and falling, she may be open to this suggestion.  Now to work on my brother, who is just thinking, "she's getting old," as he does not believe that drugs can hurt you.

 

Overall, I am finding the US people more hypnotized than the Australian people.  I can actually talk about my SA stuff there with friends and sometimes carefully selected acquaintances.  But here in the USA, our views are far less acceptable.  Some of my old hippy friends get it, but even many of them are so dependent upon "the system" that to consider otherwise is unthinkable.

[peggy]

Sounds like you are doing really well Jan and having a wonderful time!

[Altostrata]

Great to hear from you, Jan! That day at the restaurant holding court sounds like fun.

 

Also sounds like you're getting your mom better care. Win win win

[freespirit]

Love the poem JC.. your descriptions of CA make me homesick for the area. I lived for almost a year in a canvas dome at a retreat center in Big Sur...and spent another 4 years in central CA with my wife.

 

You sound good in your posts (despite some loss of sleep). I think there's a lot to be said for getting out of your own environment sometimes and broadening your horizons.

 

Happy trails.

[JanCarol]

Oh.  Buteyko.  Been there.  Done that.  It was against all of my yogic, ayurvedic and martial arts training.  Oxygen is good.  "underbreathing" is a great way to make people follow a cult or lose their capacity for impulse control, higher cognitive function, and decision making.  But the visions are good and relaxing and floaty.

 

I paid $500 for hubby and I to attend a 3 day seminar.  Their answer to sleep apnea is "tape your mouth shut" and underbreathe for 10 minutes x 2 a day.

 

Nup.  Kooky stuff.  Sorry Mercola.  Too weird.

[JanCarol]

Okay, I had a thing happen.  Being a daytime Jan, it's harder to adjust my supplement / drug schedules.  So one night I got tired before I finished my PM tray, and found them the next morning.  I noticed then, that there was no crumb of lithium.

 

At night, I usually take a half tablet of lithium (1/2 of a 450mg tablet = 225)

in the morning I usually take a 1/4 tablet (of 450 mg tablet = 112.5 for a total of 337.50 mg)

 

I remember that filling my trays was the big issue in packing my suitcases, because this was a long trip, requiring a total of 16 trays + extras.

 

PM was the last to be filled (I had just filled 12 trays, was very tired of filling trays by then, in normal life, the trays are staggered so that I only have one set a week).  I remember seeing the lithium on the table to go in the trays - but - this whole trip, I don't remember seeing that 1/2 tablet in any of my PM trays.  WTF?  Have I just done a monster drop in lithium?

 

You wouldn't know it from my mood.  Sure, I've been a little grumpy and snappy and reactive (how much of that is in my nature?) but nothing more than usual.  I've had a lot a lot of pain, but that is improving (gone from 3 doses of pain meds per day to 1).  And I'm travelling - it's always difficult to tell what is travelling pain or sleep change crabbiness, or what is a huge, 225 mg drop in my lithium?

 

Hubby thinks that I should go up to 225 when I get home.  I'm thinking - why?  If I'm "about the same" on 112.5 mg, and lithium is less likely to cause a protracted response than SSRI's, I've been holding at 112.5 for a month - I THINK.

 

I still have to check the remaining tray.  On quick glance, I see no half-tablet.  There is a possibility that one tray got missed (this tray), and I was taking it for 3 weeks prior to now.  I have no way of knowing that, other than "not remembering" taking the powdery half tablet in the evening trays.

 

Many many many people and doctors would say I'm being over paranoid and over slow about this lithium taper.  But if you have ever exploded your life, you know that you don't ever want to do that again.  Ever.  Especially now that I've rebuilt a new life and happen to love it.

[JanCarol]

I should probably note here that I have started a few sessions with my SOTA bio-tuner, ref:  http://survivingantidepressants.org/index.php?/topic/4829-alpha-stim-fisher-wallace-sota-biotuner-pons-and-similar-devices/

 

I've only done it 3 times, however, and I'm travelling, so I can report some vivid, healthy dreaming, and a reduction in pain drug usage - but it is not enough to say that the bio tuner has been the cause of this.  I won't know for sure until I'm back home in my old patterns, to see how much of this "good stuff" is from travelling and resetting my biological clock to daytime (I'm losing weight, too, almost 5 pounds!), and how much is from the bio-tuner and use of TENS.

 

The really weird factor is the possible huge drop in lithium......

[JanCarol]

Last night, falling asleep was a little weird, so I put the MP3 player in, and listened to the soothing, uplifting voice of Richard (though he goes by d*ck, which this software doesn't like) Sutphen.  He is a man with a gift, and he uses it well.  I don't believe all his stuff, but hey, he doesn't believe in all of mine, either.  It's always a positive influence.

 

Last night, it was "Turmoil is a way of telling myself that I need to make a change.  A gentle, peaceful, positive change."

 

And it was a "Zapper"  I saw stuff about Zappers on the SOTA website, and even saw d*ck Sutphen's name mentioned.  I waved at an old friend (I've been listening to him since 1985)

 

And the Zapper music was floating between my ears, caressing my brain, allowing me to smooth, and Sutphens gentle affirmative reminders got me thinking.  I do this.  This works for me.  It is what I need to do.  It is what I want to do. I can do this.

 

I can never remember what topic the Sutphen is about when I use it for Sleep entrainment.  But this was memorable.  And as I drifted off to sleep, I thought, "This would be heavenly with the Brain-Tuner."  (I call it Purr.)  I tried to imagine the purr of the brain-tuner with the twinkle of the Zapper music, and it looked like it would be fun, and pleasurable.  And coupled with Sutphen's trance-talk, could help me cognitive tweak myself a bit.  

 

Have I gone off the deep end?  Purring and Zapping?  

[peggy]

hi Jan;

 

maybe i shouldn't be, but i am excited for you! 112mg of lithium!  you are probably blazing a new trail here - not many people on here have done a slow taper off lithium and no other psych drug... I think you are going to be just fine. I do think though you should pay extra special attention to those pesky issues such as exercise and sleep hygiene.

 

when do you go back 'down under'?

[JanCarol]

Too soon, Peggy, too soon.  Now comes the really tough stuff.  A few days of  real estate, legal and other issues around my little Indiana house.  Then we have a day to pack and leave.  My special Maleny presents have been big hits - however - nothing compares to the look on a Yank's face when you hand them a bag of macadamia nuts!   It's consistently delightful!  Some even say, "are these what I think they are?"  It's like handing them a bag of gold with a smile and a giggle!

 

Still looking - have just over a week to decide.  Hubby thinks I should updose to 250 (halfway between what I should be on, and what I've ended up on) - or can I just stay at a crumb of 112.5?  Yes, this is new territory here - people have tapered off of lithium before, but that's the last one left for me!  (and here, I just bought a new milligram scale for when I got down to the last tiny bits!  I likely won't even need it now, or will only need it for a short time)

 

Brisbane girls - I'm gonna be really eager for our Brisbane coffee meet in October, after spending this time in the "land of the blind" - and - the land that is trying to blind the rest of the world, too.  (though Europe is doing her fair share, as well).  Start looking at your calendars and figure out when you are free!   My first week back will be catching up on massage and hand physio and therapy, as well as sleeping forever. 

[Meimeiquest]

Wow, exciting stuff! This is not advice at all, but you wouldn't catch me updosing before there was a problem! However, I do have an early and a late reaction to lithium drops, hope you don't. But when I have updosed, maybe once, it worked fine. I will be so cheering you on as you purr by !

[JanCarol]

Thanks MeiMei!  Early and Late?  It was the late one that has me concerned....

 

3-6 months along and woops!  I lost my life again.  I'm sure I've learned a lot since the last time it happened, but I also respect that it can sneak up on one....

 

I like your sentence.  Puts it in perspective.  If it were an SSRI, I would probably be suffering about now (3.5 weeks in!), and would be eager to updose.  It's very different with lithium.

 

It is, however, marvellous to not be toxic!

[calithebold]

Miss you lots. Can't wait for you to get back to Oz

[JanCarol]

Another way of looking at this is to hold at the 112.5 for a huge portion of the time it would've taken me to taper down to this level.

 

And only updose if I have a problem, as MeiMei suggested.

 

I'll do the maths when I get home.  I'm kind of leaning that way.

[Meimeiquest]

My late reaction is at about six weeks. Feels very much like a relapse into what I guess some would consider the ongoing issues of bipolar, not acute. Over-reactivity. Like "Don't listen to her, she's just bipolar." I haven't read of anybody having reactions that start more than three months out from a cut. Not like there's any actual data or anything, sadly.

 

Need to briefly comment on the breathing thing. I really think duct tape for mouth breathing tops "Don't worry about your insomnia, you'll sleep when you get tired." Duct tape sounds like a great way to take yourself out of the game permanently if you have sleep apnea!

[JanCarol]

LOL Not duct tape, but paper medical tape, tiny strips!  One piece from upper corner to opposite lower corner (not up and down or side-to-side!) You can "break" it if you want, and what I found was, I could still snore (i.e., airways vibrate) with my mouth taped shut.

 

6 weeks, that's even better.  IF I've already done 4 of them!

 

I'm seeing Doctor-friend today.  She's gonna share her infrared sauna with me, and I will share my bio-tuner with her.  She will have no opinions about tapers, since - well.  She's been listening to me on that one, and she has no experience with lithium (she didn't want me on it in the first place, even though she was the first person to pin me to the DSM to begin with!)

[Meimeiquest]

Enjoy! The CPAP people sell a chin strap, wide fabric, that holds your mouth in a shut position. But I was amazed to find that, for me, once the air was moving correctly, I just naturally keep my mouth shut.

[JanCarol]

And I'm saying that keeping my mouth shut doesn't stop the breathing problem.  Though naturally, it is worse with my mouth open.

 

Ancient Egyptian Magickal formula (ref: Michael Kelly, "Words of Power") for renewal and transformation:

 

"I am the serpent, long in years, sleeping, and born every day.

I am the serpent who is in the ends of the earth

As I sleep, I am born, I am renewed, I am rejuvenated every day."

 

Not a bad mantra for recovery, methinks!

[JanCarol]

Okay, so if your delayed withdrawal / effect from the cut is at about 6 weeks, if I hold for 2-3 months - it might work out! 

 

Only on the condition that I updose at the earliest signs of strain.

 

It's a plan, and I'll see what I can do to stick to it!

[Meimeiquest]

It so might. I'm really in the thick of It right now (plus stepped off benzo about a month ago), and I still think I will do bigger cuts less often. I think I would rather have big moments of awful than the low level crap all the time.

[JanCarol]

I'm so sorry to hear that MeiMei - your taper has been complex, and I don't envy you that.

 

The sauna was AWESOME.  You can even sit in there and watch movies, and the sound system is better than the one in my car!  OMG!  You can choose near, middle and far infrared, or combinations thereof.  It has set programs of temperature and combination for pain relief, insomnia, detoxification, fighting a bug, about a dozen different pre-set programs, or you can make a program of your own if you know what you need for your condition.

 

My doctor-friend has been meaning to get one for 2 years, at the request of her functional medicine doc, especially since my friend is resisting taking the antibiotics for Lyme (mixed results on the antibody tests for chronic Lyme).  She does it every day, and her husband does, too - and they love it.  They can get in there, and catch up on their favorite TV shows (NetFlix streams to the tablet) or listen to great, shamanic or brain syncing music.  I envy her that, I'm glad my hubby got to see it.  It's the Cadillac of what I've been talking about - it cost her $5k, plus she needed a 2 metre square space to put it in (that's where I think I fall short).

 

I wish we could've spent more time in it, so hubby could really experience the cleansing of the thing, without getting as hot as you do in a regular sauna.  We did a normal hot rocks sauna in California, and could only stand about 10 minutes of it.....I'm very jealous if my doctor friend indeed!  (but hey, she's a doctor, and her hubby is a lawyer, and, well.  We're just regular folks.)

 

I have done more bio-tuner sessions.  I like them.  I'm not sure what good they are, but I like them.  There seem to be no ill effects, so I will continue using it.  

[peggy]

i have tried those saunas and prefer the old style hot rocks where you can pour water on them and get the steam happening.  I like to sit in one until i feel like i am about to explode and then jump in a cold pool - it makes me feel so alive.

[JanCarol]

Ah!  The old fashioned - sweat lodge and "roll in the snow" sauna!  :-D

[JanCarol]

What I've learned about infrared is that most infrared saunas in Australia are "far infrared." It is the "near infrared" that is most healing, detoxing, and preferred for treatment.

 

The good doctor-friends posh cedar box had programming - you could choose how much near, middle and far infrared for whatever program you wanted.

 

Hubby and I researched it today - about the only way to get the near infrared in Australia (with one exception, likely so expensive I had to "request a quote" instead of them just quoting a price online) is to build it yourself.  Ugly things on wooden boards with stands that you sit in front of.

 

Nothing so posh as what the good doctor had.

 

I should put this in brain zaps, but - 

 

zlicks.

 

Tired from the loooong flight, trying to sleep, I noticed that on my exhale, with each heartbeat, my brain went zap-click - only once - "zlick" with each beat of my heart.  When I inhaled, the zlicks went away.  But of course, I had to exhale again.  This was uncomfortable, but not unbearable, and certainly unusual.

 

Still tired from the trip, feel a dark curtain waiting to drop.  I have no choice, it will drop when it does (which may be sooner rather than later).  At least I am sleeping!

[JanCarol]

OKay, D-Day.  Decision day.  What to do about the dropped lithium.

 

I have decided to reinstate.

 

I asked an oracle:  what if I reinstate, and got = syncing my rhythms to the earth (ooh!  you mean I might get to *stay* a daytime Jan for longer?), if I didn't, I could communicate with spirits and talk to God (sounds suspiciously like a "spiritual emergency," no thanks).  Then I asked:  what do I need, and I got - I need to be self-sufficient, to not burden those around me.

 

So I decided to up-dose.

 

But I also decided to take this opportunity to cross taper to lithium orotate.  It will be fiddlier to work with than carbonate, but slightly less toxic, as I can take lower doses of it.

 

I have added 1.25 mg of lithium orotate to the AM dose.  This is 1/4 of a 5 mg capsule.

 

For those of you who think that scales and dry cutting are the way to go, let me tell you - if you don't have labware, spatulas, little stainless containers, razor blades, scales, and a capsule holder (and even then, spilling can be a mess) - you are not cut out for this.  

 

I can see why the liquid syringe is the favored method for psych drug tapers.  MUCH easier than this.

 

Since this is a supplement, I don't need to be as precise, and I know myself, I am doing it the hard way.  But I certainly cannot recommend it to others.  I'm sure, after I've split a hundred capsules into 400 capsules (1/4 of a capsule each) - I will be better at it.  But.  I just don't recommend it, especially not if you need to be really, really, really precise (you benzo people come to mind).

 

Off to update the sig.

[Meimeiquest]

Good luck! What's the conversion ratio? Is it possible to out orotate into solution?

[JanCarol]

Sure, it's possible to put orotate into solution!  It would probably be easier.  But I know me.  I would just forget to take it.  

 

It's hard enough to remember the B12, because I cannot put it in my trays or it would dissolve into a gooey mess.

 

Remembering to take a solution out of the fridge would, well, eliminate that dose, pretty much.

 

I saw 5 to one.  So 1.25 mg of Orotate is roughly equivalent to 6.25 mg of Carbonate.   But John Gray, of Venus and Mars fame, did a video which said that 5-10 mg of Orotate is "therapeutic," which could be around 450 mg of Carbonate.  Hard to get facts, when a thing isn't TGA or FDA approved!

 

7-Up originally had Lithium Citrate (which if it's anything like Magnesium Citrate, would be easily absorbed) but I cannot find out HOW MUCH was in a glass of pre-1949 7-Up.  I'm thinking it's a similar amount to what I have added.  A micro-dose.

[Meimeiquest]

Thank you! And yikes...I have been giving my daughter 4.9mg. But I was thinking the daily requirement was about 3mg, just as an essential mineral. I will have to look into it...I'm just trying to make sure she has enough, not medicate her!

[JanCarol]

Well, anything up to 5 mg, and you are less likely to induce the need for kidney testing.  IT IS TOXIC, as we know, I have suffered from it's toxicity.  I don't ever want to take more than 5 mg for neuroprotective and stabilizing features.  It would be nice to stop at 2.5 mg.  Here is the John Gray vid, grain of salt, he's a psychologist, not a doctor.  He has several videos about it, and will be happy to sell it to you!  Here is one:

 

So yesterday, I went looking at blood tests and referrals for the month.  Hmmm.  Which is more critical:  sleep study?  Or colonoscopy?  I got to looking at the colonoscopy one, and saw, my "list of diagnoses and procedures."  At the top of the list was 1998 - BIPOLAR DISORDER.  Grrrr...  then - I thought about it.  Because of the constipating effects of opiate drugs, the colonoscopy doctor is a BIG FAN of Tramadol, which is less constipating.  Oh, no, sir.  Better to tell him I cannot have any serotonin enhancing drugs, so - as much as it pains me (I thought about having referring doctor remove that diagnosis, since I am undiagnosing myself), I guess I will leave it in, so that I can have my choice of drugs, rather than get the crap he gives to everyone.  (PS, another one in all caps was HYPERLIPIDAEMIA yeah.  right.  Of course she's worried about that one, too.)

[peggy]

I was intrigued by lithium orotate and did some googling and found the references to protection against Alzheimers disease... since it runs in my family I am filing it away in my memory in case i need it ..... but that's the problem with AD - i will forget what i need.

 

seriously though - could small amounts be useful and not toxic? 

[JanCarol]

Hey Peggy, John Gray seems to think so.  

 

When I was trying to choose a dose for this - I found a website where a guy was prescribed 300 mg of lithium carbonate - not for "mental illness" or mood stabilizer- but for "neuroprotection" and "mood boost"  Sheesh!  Of course I don't know this guy's history - maybe he's already suffered a TBI (traumatic brain injury) or has lots of Alzheimer's risk factors.  But the prospect of taking this toxin for "enhancement" rather than medication rather scares the heck out of me!

 

(by the way, my doctor-friend has early onset Alzheimer's in her family.  My research with her has shown that environmental factors are at least equally important in determining "who will get it," as genetic ones, and perhaps even more important than the genetic risk.  This greatly relieved my doctor-friend - who - I will add - would probably not take lithium orotate except under the most extreme circumstance.)

 

The research on it is sketchy, Peggy.  The old research (back in the 50's, 60's, and 70's, when they were still researching lithium carbonate) showed that it could be MORE toxic, but that was mg for mg.  Its uptake is extremely efficient, compared to carbonate.  You know how these drugs work - if you are on them for 3 months, a certain dose can be considered "safe" - but is it still "safe" after a year?  3 years?  5?  10?  I would suggest you ask your ortho-doc.

 

And - it's expensive here. 

 

All you non-Aussies, pay heed.  This is the kind of garbage we put up with here.  A bottle that costs me US $5 through Vitacost, here, costs AU$27 - at least 4x the cost, and probably 3x the shipping cost.  You have to buy it from an Aussie company - iHerb and Vitacost will not import it.  I think it is telling that iHerb won't even stock it anymore.

 

I cannot recommend this for anyone.  I would like to be off lithium entirely - but I am afraid of disruptive mood, or worsening sleep patterns.  So I am switching to the orotate so that I can take tiny, tiny, and efficient doses.  So when I get to around 75 mg of carbonate, I may double my orotate to 2.5 mg.  These are crumbs, micro-doses.  I don't ever want to go above 5 mg, and I'm not sure how long I would want to continue that!  I'm thinking 5 years, tops, and I will try and get by on the minimum possible dose.

[peggy]

At the 5:1 ratio of carbonate to orotate; 900mg lithium carbonate is equal to 180mg lithium orotate?

 

so 5mg really is a tiny dose