Is It Dangerous to Take Lithium While Doing Sports?
Weightlifter Kate Nye, former NFL football player Keith O'Neil, and a former WNBA star Chamique Holdsclaw – all of them are elite athletes who have publicly spoken about having bipolar disorder. They are a few of the approximately 6 million people in the U.S. who are diagnosed with bipolar disorder. One of the first-line treatments for this condition is lithium.
Kate Nye has been outspoken about her condition and treatment: “I'm proud of myself for being able to recognize that I need medication to function at my best. I'm proud of myself for understanding that my diagnosis doesn't own me, but it's a part of me.”
What Does Science Say?
A study published in 2019 in the British Journal of Sports Medicine analyzed how side effects of medications can be altered by intense exercise. The concern is that excessive activity can lead to sweating, which may then affect lithium levels in the blood, making it too high or too low.
The research also emphasized the need to monitor athletes on lithium. One reason is that lithium has a narrow therapeutic window — the difference between an effective dose and a potentially harmful one. To stay within this window, patients need regular blood tests to measure lithium levels.
The research stated that lithium is effective in preventing mood lapses in people with bipolar disorder, but for acute treatment, it is recommended to combine lithium with the anticonvulsant lamotrigine. As the study states: “Sports psychiatrists have expressed preferences for these two drugs.”
Another study published in 2022 in the Journal of the International Society of Sports Nutrition compared levels of lithium in the blood between athletes and people who do not exercise much. The study showed that physical training did not cause changes in lithium levels in the blood.
What Does It Mean for You?
If you are taking lithium and exercising, make sure you drink enough water, especially in the heat. It is unlikely that lithium will cause major adverse side effects if you stay in the therapeutic window and have regular follow-ups with your doctor. If you have any concerns, talk to your healthcare provider.