Small Dose, Big Impact: The Science of Low-Dose Lithium for Leadership Performance, with Dr. Sudhir Gadh

Speaker A: Hello everyone, and welcome to another episode of Imperfect Leaders. One of one of the most powerful tools for recovery, resilience and brain health has been hiding in your drinking water all along. And we've been ignoring it for over a century. My guest today is Sudhir God, a board certified psychiatrist, Navy veteran, and co founder of Third Element, a company pioneering lithium microdosing as a supplement for peak performance and long term brain health. Something obviously all leaders need. Sudhir trained at Bellevue, taught at New York University, and has spent decades pushing the frontier of low dose lithium from indigent patients in the Bronx to elite NBA and NFL athletes. Today he's here to explain what lithium actually does in your body, why it disappeared from your water, and why it's coming back. This is Imperfect Leaders and I'm Jeff.

Speaker B: Enough.

Speaker A: Let's go.

Speaker B: Lithium has been sold over the counter in the United states since the mid-90s. And of course this is an ancient concept that people are aware of, but we were not frequently publishing or using this in medicine. But now the evidence is mounting, it's compelling and we're seeing it from randomized control trials, we're seeing it in observational studies and case studies, continued epidemiology, pharma is getting involved and that all, that's all a layer cake of credibility.

Speaker A: Lithium used to be in drinking water, in Perrier, the original version and 7up. How did something that common become something that scares doctors and patients and has this really awful stigma with some people even still?

Speaker B: Yeah, it's a fascinating story how it went from mineral to medical to something scary, you know, and about again, before a hundred years ago, let's say a thousand years ago or 500 years ago, people would go to lithium springs. Uh, I think I've mentioned this before. In Saturnia, in Baden Baden, Vichy, France, springs from around the world. Even Hippocrates himself took patients to ancient springs to take the waters. And this was both. Lithium, magnesium, potassium, calcium, sodium, they all, that's the starting five. They live together, so it's, it's been known. Ponce de Leon, sorry to say. Last one, fountain of youth, northern Florida, St. Pete. Okay. That's where it is. And that geologic bed has lithium in it. Recently discovered. So it's, it's continued to be part of ancient history. Right. And then about a hundred years ago, nearly all bottled waters, the first bottled waters were lithiated waters from those very springs. So people realized, okay, there's a something, there's something to going there, I feel better. And they said, okay, that's the lithium you take it and they just thought it did something more. It wasn't for bipolar, it was that it calm the bones and the spirit. You know, it was very holistic sounding hokey even at times. And there were a lot of, there was steak oil back then. There was a lot of things that were claimed that you know, now are no longer used. This is one of those things that still should be continued. But how did it go from that? Well, I think like scientists were human and they got greedy. And what happened was there was all these products, bare lithia water 7 up which was M atomic mass of lithium is 7 made you feel up. Okay. It was the cure for the hangover of Coca Cola. That's what it was designed for because Coca Cola had cocaine in it. And the next day you felt kind of down. So people went for 7 up in the morning. Anyway, uh, good times back in the twenties. That's why they call it the roaring twenties I think. Yeah.

Speaker A: And I also love talking to you because not only are you this amazing medical doctor, an amazing psychiatrist, but it turns out, you know, with these stories you're also a pretty darn good historian as well.

Speaker B: It's fascinating, you know, and, and they came out with this product called salty salt. Whoops. I mean they, they just, they went too far and so they put the lithium that was just perfect in these waters. Even 7Up didn't have too much and they put too much into a packet, almost like little packets of sugar. It was packets of salt substitute instead of NaCl, it was LOL. And so when you do that, you're probably sprinkling too much lithium on whatever you're eating. And a couple of people got hurt. They were already elderly and they sprinkled too much on their meat or seafood or whatever it was. And that was around the time the FDA was born. And so they said we've got new drug companies telling us that a lot of the stuff that people are using is non proven and that we should allow only drug companies to sell cures and such. So this is one of those things. We're going to not allow this. So you know, I think.

Speaker A: Mhm.

Speaker B: I don't want to get into the conspiracy world but you know, there's a connection. There's no incentive at that time there was not enough knowledge and not enough incentive but really to understand the benefits of it. And then I think it got even worse with something like One who Flew the Cuckoo's Nest. Right. This movie from 1976, Oscar award winning Jack Nicholson. I uh, think it Was anti psychiatry in general. And yeah, we have our warts, there's no doubt, I think. And you know, I'm in, in touch with APA leaders frequently and I'm talking about how we evolve this, the science around in psychiatry. Uh, but I think that also was a setback.

Speaker A: So let's talk about the science, uh, for us non doctors like myself, what is actually happening inside the body or inside a cell when low dose lithium is present?

Speaker B: Yeah, that is a remarkable, uh, area of research. And the thing that I can point to as a theme is efficiency and resilience, uh, versus acceleration of damage. Okay, so there's animal model studies, organoid studies, cellular studies on mitochondria, on apoptosis, even on the telomeres of DNA. Okay, so what is transcribed into rna, what is translated into proteins depends on the environment, right? Genetics and epigenetics. When you take in just the right amount of lithium, what you're telling the brain actually centrally is to cool the GSK3 enzyme. This is a major enzyme. It's not glaxosmithkline, it's glycogen synthetase kinase. And this enzyme is a master aging enzyme with 200 different substrates, 200 different, um, employees, so to speak. And it was only discovered in the 90s. And it has one inhibitor it lithium. But the key has been how much, because too much can be problematic. And so when you're dampening that enzyme a little bit with the lithium on board, you're telling the other 200 enzymes to not age as fast. And that leads to uh, a balance really of defense. So the immune system is not overreactive so that the body isn't in over stressed or cortisolic states. Okay, this translates all the way down to the cell because then you've got mitochondria that are either overdoing it or under. Right. We want balance within the cell. And within the cell what happens is what happens within the organ, within the system, within the body, within the population. When you think about it more poetically for a second, lithium is in batteries, right? It, it is burned by stars. It is one of the first elements to uh, the first solid, right? It's hydrogen, helium, lithium. It's almost like the dynamite that ignited the big bang. It's electrical. It's electrical. It's an electrolyte, maybe the premier electrolyte. And when you have more electrical flow, you have more balance. If you have traffic jams in the brain, in the fight or flight area, dead center right in the middle of the brain. That means you're in a fear state. If it's spread. If you spread that electricity out, you're more in a calm and balanced state. So that's what we're seeing downstream in tiny areas that we keep detecting, whether it's mitochondria or DNA or, uh, proteomics, that lithium is leading to more balance. We call it a mood stabilizer, but it's really a neurostabilizer.

Speaker A: But when you talk about balance, it kind of scares me as a patient, to be totally honest, because, so, you know, I know the psychiatric lithium is, what, 600 to 1200 milligrams a day? You're talking about one to five or somewhere around there. And, you know, again, it's that debate of how do you get that balance right? Because I'm sure, again, people don't, uh, want to take too much because they're still scared from stories they've heard in the past. And they, you know, they watched reruns of One Flew over the Cuckoo's Nest, so they're still scared. But if it's too small an amount, then they're thinking, well, okay, is this really having an effect on my mitochondria? So how do I get that balance right?

Speaker B: Yeah, I think the first thing to understand is that it's already in you, but it cannot be made by you, right? We have certain amount of copper in us. We don't need to be scared about copper, but we're not gonna be licking pans, right? We have iron in us, and we can't make that. So there are certain minerals that we actually need to be taken in. And then when we, secondly, look at it as wherever it's in good water, and what determines that to be good water? You're taking it in. Those people are benefiting from it. They're not harmed by it, despite, you know, smoking rates being higher in some of those countries and other things being, uh, more or less the same. So if we look at it as a trace element that is already in us, that is in nature, you're just not getting enough.

Speaker A: But then how do I balance that against, say, my existing stack of vitamins and supplements right now? Should it replace something else, or should it just be a, um, natural part of the stack of anyone that, um, you know, wants to improve their. Their mitochondria functioning?

Speaker B: When I speak with athletes, when I speak with other doctors about this, people are taking supplements, right? In the supplement world, there's a lot of noise, and we want to parse out the signals here. Uh, I don't, I don't dismiss, you know, supplements that are molecules that I'm not 100%, uh, educated on. What I do say is that we have a certain array of recommended vitamins and minerals, many of which we're actually not getting anymore because of that polluted and diluted food supply. Uh, you know, nearly 20% of people of color in this country don't have adequate vitamin D. Right. And it goes down the list. Iodine, magnesium, iron, vitamin B1, uh, B6.

Speaker A: And lithium is on that list.

Speaker B: Well, lithium I think is on that list, but the top nine that the CDC reported that we are missing, that's where I started with when I, when I was creating third element water as a powder. We first bottled it and sold actual water from West Texas. But when I said I want to create a supplement, but I don't want it to just have lithium, it has to actually be synced with what lithium lives with those five minerals like magnesium, potassium, calcium, sodium. And it has to have some things that we're already not getting. So let's load in the things we're not getting so that we fill in the cracks. And people can still take amino acids and creatinine, creatine and glutathione if they need to. It's not going to antagonize them. It's not going to antagonize medicine either, because we're not talking about dosing at psychiatric ranges. It's not going to affect, uh, whether you take NSAIDs or whether you take thyroid medicine, because we're looking at micro dosing. So it's in the 1% range. It would be like saying, well, you went to Italy for a week. Did you take a different medicine regimen? No. But you came back feeling better because the food and produce was actually cleaner and elevated.

Speaker A: It makes sense. So if someone like me started taking low dose lithium today, or your product from third element, uh, with this, this beautiful blend at the right dose, what would change in their blood work and when?

Speaker B: Yeah, blood work is slower to change and the subjective and some objective measures beyond blood work, we can talk about. First of, it depends on where you are. Right. Uh, when we did our, our study in started with, uh, the paper that I wrote, low dose lithium in an addiction treatment setting. We looked at patients who were very, very ill. Right. They were coming off the street and we offered it to some, uh, offered to all of them. Excuse me. But when we studied the ones who took it and looked at the safety data, there was no changes in safety that was important primary. Right. That no one's creatinine rose, no one's thyroid, uh, level was affected. And in fact what it led to was improvements in liver function tests, thyroid tests, kidney function and uh, a 1C.

Speaker A: Right.

Speaker B: So they're the array of. And even cholesterol. Right. These are common labs that people do at the doctor's office and they're often a product of inflammatory chronic lifestyle. Right. So if you're. The smoking went down, so hence uh, a lot of atherosclerotic parameters improved. The snacking went down because we reduced the need for so much appetite improving medications in psychiatry. So their weight went down and so their a, uh one C went down. That it was indirect effects that synergize with behavior. Now if you and I take the 1% range or the 10% range, there's a difference. What we would feel is subjective improvements in sleep and rest. Right. Recovery, as I mentioned, you'll sleep better.

Speaker A: Mm.

Speaker B: You'll sleep deeper without issues on feeling tired. Right. Or feeling like you've been limited. Uh, because I think you want recovery without any kind of hangover and sleep you want just improved depth of sleep and more REM sleep. So sleep hrv, uh, potentially crp. These kinds of CRP is a C reactive protein, is a cardiac marker. And the proteomics surrounding wellness biomarkers is what we're trying to study more in depth and how they respond.

Speaker A: So. So again for um, the uneducated in this, like myself, um, you know, right now I have been told to take magnesium before I go to sleep, which seems like a very good idea. Uh, but I still have some problems getting a good night's sleep these days. Uh, whether that's stress or cognitive load, you know, I just know that I get up in the middle of the night. Um, should I also be taking a low dose lithium to help me sleep in addition to the magnesium?

Speaker B: Yes.

Speaker A: Why?

Speaker B: The magnesium and lithium are interesting. They are more like the gas and the brake on some of the same receptors in the brain. So if we're taking magnesium, uh, you're benefiting certainly. Right. With an anti inflammatory effect. If you took the lithium, you'd get even more of that. And it depends of course on if you took that 1% zone. If you took third element, which has both lithium and magnesium in it, you'd get that benefit over 24 hours and potentially be able to prove and see it on data monitoring regarding your sleep.

Speaker A: But when you say the break in the um, gas pedal, to me that feels like it's going to offset, but I don't think that's what you're saying.

Speaker B: No, I'm saying that to win a race, you need power and control.

Speaker A: Right.

Speaker B: There are turns. Okay. It can't just be one. So it is that combination, really. And so when I say stabilizer, the floor is a stabilizer, Jeff. Right. I mean, it's not. It's not the roof. Uh, I'm talking about not going too far down. That stabilizes you so that you can rise off of it. And that. That connotation of mood stabilizer implies that you're not going to be feeling happy or that the highs won't be as high. Actually, they're higher. It's because you don't have lows that are as low.

Speaker A: So.

Speaker B: And it's not artificial.

Speaker A: So if I take third element, do I also need to take magnesium, theoretically?

Speaker B: No, you don't. Because if you, you know, third element has those nine ingredients, right. And if you individually broke them apart, it's. It's actually seven times more expensive to take those individually than to just take third element. But you wouldn't want to take redundancy in vitamins either, so.

Speaker A: No, I don't. So if I take third element, I do not need to take magnesium on top of that, most likely.

Speaker B: Correct. Yeah, correct.

Speaker A: In what way does this product, third element, help someone that's already performing at the top of their game? Uh, like an elite athlete, like somebody in the NBA or NFL? Because I have heard through the grapevine that you guys are actually in discussions with some of these professional teams. And I know that they're skeptical and they're discerning and they're getting pitched by different products all the time. So the fact that you're in deep discussions with them tells me something. How can it help them?

Speaker B: Yeah, I think we've gotten to that place because of the credibility of the science. Right. So. Well, how would this improve, you know, someone who's taking in stress and pushing their limits? I think they want recovery and resilience without a cost, really, Without a, uh, without an unnatural interaction. So when I tell athletes, you can keep doing what you're doing, that is helping you stay at this level. But if you add this, you're going to get greater neuroprotection, especially if you're a combat athlete. But even if you're not, if you fly, if you have, you know, nights where you don't sleep, if you have nights, uh, or, you know, are affected by stress and a cold or, you know, life in general, These days is probably more existentially stressful than ever. Uh, so to offset that stress that affects all of these concepts of mitochondrial telomeres all the way up to GSK3 and biomarkers of aging, if you have something that is got the evidence surrounding it from all of these different slices that you're not taking, I think that is wind at your back.

Speaker A: M. Ah. And I know it's too early to have some sort of cross sectional research on athletes in general, but have you heard anecdotal stories from individual athletes where this has really helped them?

Speaker B: There was a study done on innate lithium levels in endurance athletes that were runners. Okay, you can take your lithium level. Got about 7 milligrams in each of us by a hair sample. And they analyzed 1 college team, NCAA Division 1 hair samples. The faster runners had higher innate lithium levels. Okay. The same kind of hair sample study was done in prisoners. Okay. And people in prison had a lower lithium level. Uh, so what we see is, you know, it is performance enhancing and when you don't have it, it can lead. It can be associated rather, I should say, with, uh, mood and impulsivity and trauma that's displaced. They, they've done a similar study with horses in terms of endurance. And now the Horse Racing Federation is adding lithium to m. The list of potential doping m interventions. So they're going to be testing horses for lithium levels that are not. That are above their expected normal. Because when they, when they did the same kind of endurance athlete testing on them, the ones that were faster also had higher lithium levels innately.

Speaker A: So some of the faster horses innately produce more lithium or were the trainers, were their trainers actually giving them lithium?

Speaker B: Well, it's both. Right. So their, their ability to retain it and respond to it is connected to their genealogy.

Speaker A: Right.

Speaker B: Their who has sired them, so to speak. Right. And to their feed. So it's both. Right. Just like our, you know, my iron levels are connected to my mom and dad, but also to how I'm eating. Uh, so it's both. And so I think it's, it's something that if we can offset, if a horse has not had great lineage, we can put lithium in their feed to make them more resilient and maybe faster too. That's great.

Speaker A: But, but now they're, they're not going to let them do that.

Speaker B: They're not going to let them do too much of it. They, they just say that there's a, there's a ceiling on it.

Speaker A: But what happens if the horse just naturally produces it well, they don't produce

Speaker B: it, remember, they're taking it in. This uh, is so it's, it's something that is in grain, right? Ah, high quality grain and vegetables. But when they see that it goes above a certain level, then they're going to think that you're giving them capsules or something.

Speaker A: So, so it's not like iron where the body can actually make too little or too much of it. Like even through genetic functioning it's, it's different with lithium.

Speaker B: Yeah, I mean even iron has to be taken in. Right. And the uh, the same applies with lithium. The same applies with iodine. Um, iodine is a necessary, um, mineral that we're not often getting enough of that. It is in third element. Oddly enough when we stopped using that, that we saw a rise in that. And it's not a good thing for society to have iodine deficiency because you have IQ effects, uh, from it.

Speaker A: And another area of promise for this low dose lithium is uh, something you and I have talked about before, but even with people or children with um, autism. How does lithium affect the brain of the autistic child? And how could it actually help?

Speaker B: Yeah, so I want to be careful. It's uh, not a cure, a treatment, but it is something important for us to investigate as a supportive part, um, of the supportive framework. Because autism, the spectrum is remarkable and important because it gives us a glimpse into human potential and human limitation. Right. They're gifted in so many ways and they at times have trouble accessing those gifts. You know, you and I have talked about the superpower analogy that uh, that we saw, you know, in that man of Steel movie, beautiful, ah, movie in which he was trying to tune out the, the different sensory assaults upon his uh, upon his mind. And his mother urged him to, you know, filter and apply his power. And I think for us to be able to do that with kids, we have to measure first. Right. And that's why the biomarker inflammatory work that I'm talking about, that other doctors are as well, is so important.

Speaker A: And just to use your beautiful example of uh, the young Clark Kent locking himself in a closet at school because the kids laughter, the teacher's voice, all the noises that Clark Kent heard were overwhelming because he had this super hearing, this ability to hear like Superman. He could hear everything, but he was not yet able to control all of those different senses, those human senses coming at him, the things he felt, the things he heard, the things he saw. And I think that was part of the reason why he was in the closet too. Because when he looked at people he didn't realize that he had X ray vision and he was seeing their skeleton underneath the skin. So it was freaking him out and he was just overwhelmed with this sensory overload. And so are you saying that this low dose lithium and the autistic child that also is overwhelmed sometimes by senses, um, can um, help soothe that overwhelmed feeling?

Speaker B: Yeah, I think he can soothe it and I think he can give him the kind of encouragement and confidence of her that can help delineate and, and give them the courage to face these differences and know that, okay, I'm different, this feels overwhelming, but I can maneuver through this without reacting. Overreacting is consistently the, the theme that I see with lithium. Okay, overreaction. And so even sensory overreaction to the uh, over stimuli and to be able to be appropriately reactive, whether it's your immune system or whether it's you, that's what I've seen even clinically when using uh, low dose lithium in autistic children. I'll give you an example of uh, a mom. I, uh, used to work at a school in the Bronx called the New Life School. Tough place right up in Tremont Avenue. And these were kids that were not allowed to go to certain schools that we needed, ah, a great deal of supervision. And I was their on site psychiatrist. So I would go there twice a month and the doctors in, I would take over the principal's office and kids and their parents would come to me. I think it was a pretty innovative program. One of the kids I saw there in Spanish, I was at times, uh, connecting with parents and their kids. He had obvious behavioral disruptions and um, mannerisms and uh, learning. And in the history that was clinically documented, uh, of difficult, very disruptive behaviors in class, uh, more sexual than, than violence. And he was put on risperidone, a very useful antipsychotic. But for people who are dealing with psychosis, okay, now if you give it to a child, you're going to snow them and you're going to increase their appetite and yet it's not going to provide the kind of mood elevation or lift that he uh, was certainly going to benefit from. And so what we did was we applied less than 150mg lithium carbonate and slowly cross tapered. Right. By the end of a month he was on just lithium carbonate,150.0 of Risperdal risperidone. And his mom was in tears of joy because he was no longer fraterizing himself in class. And he was smiling again right and that's about as far as we could go. But that's far because then that ripples into the rest of the class and into his life, that he gets pride from this. And he's not just given a chemical straightjacket.

Speaker A: Yeah, that's a beautiful example. Thank you for sharing it. You already have a thriving Park Avenue practice in New York City and a distinguished military career and a distinguished academic career. What made you want to become an entrepreneur on top of that, you know, starting this. Helping to start this third element company that's doing well. But what gave you the entrepreneurial bug in the first place?

Speaker B: I don't think this could be known and realized if I just continue to write papers, uh, and if I. If I continue to battle this one on one, right, with patients and maybe on the grassroots, create some kind of art about this, right? Whether it's a book or whether it's something else. I needed to create something that was usable, that wasn't available, right? This was, uh. Mountains are there to climb because they're there. This was absent, and it had to be created. If I didn't do this, someone's going to figure this out. So I said, if I'm the only one talking about this, why don't we create something that is a powder that connects all of these dots in as ecologic and effective way as possible, and then I can do both, right? I can have a translatable product that can scale even into water systems.

Speaker A: Uh, so if everything goes right, or if most things go right, where do you want to see third element? You know, in two, three, five years, or even in 20 years, or where do you want to see third element? And where do you want to see lithium?

Speaker B: Yeah, I mean, the long game is that we're looking at lithium as an essential trace element that we should have been applying in nutrition and medicine all along. Okay? That's what they do. They first call you crazy, they laugh at you, and then they say, you were right. We knew it all along. We knew it anyway. You know, that's what I'd like, is for it to be in cereal in 20 years in water. Even better, right? That we look at water as not just supposed to be clean, but it's supposed to have the best optimized minerals that you can get. And not none of the junk, but in five years and in one year, I'd, uh, like to see this used in lockers, uh, in locker rooms and sidelines. We want to look at this and say, you know, let's begin to show the proof. Like, like Gatorade showed proof for the Gators. Okay. In season one, let's show proof that we can improve the health of your players and wins at the same time and protect the game and improve concussion care and fund the science that goes along with that, whether that's at ARPA or Karolinska.

Speaker A: Uh, this has been a fascinating discussion. And you and I, um, just for the listeners, we met at a gym at Equinox in New York, and, you know, I started asking you questions and we started talking about health and, um, lithium and, you know, entrepreneurship. And so to be able to have you on this podcast is really a personal pleasure of mine. And I just think you have such an amazing background. I, um, am now sold on this low dose lithium, and I have already tried it a little bit. I'm going to try it even more. I think it's something that should be in my stack, and I think it's probably something that's going to be in a lot of other people's stacks over time. So thank you very much for sharing your wisdom and your insight on our show today.

Speaker B: Thank you, Jeff. It's been a pleasure being on. And, uh, you bring together so many remarkable leaders. Uh, this is called the Imperfect leader, right? And imperfect actually comes from Latin, means completely done. So I'm not completely done. I'm certainly imperfect. Uh, and I'm not going to be done until I'm dead. So, uh, here's to Godspeed your life and, um, the people that you're around. Thank you M.

Speaker A: Thanks everyone for listening and we hope you enjoyed the episode and we'll see you next week on another episode of Imperfect Leaders.