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Comment by nibs | Hacker News Reader

I am saddened that after reading stories like this one, people remain skeptical of fortifying water with Lithium. A study from the 90s [1] found that rates of violent crime and suicide was much lower in Texas counties with naturally occuring Lithium in their water, as opposed to demographically identical ones with less. Lithium is an element that is implicated in Bipolar Disorder and appears to affect critical brain functions. The public's experience with Flouride makes people deeply skeptical, despite the obvious objective proof [2] that it too contributes to superior quality of life. Fortifying water with Lithium would have an immense effect on the wellbeing of entire cities and cost relatively little. Huge impact potential.

[1]: http://www.ncbi.nlm.nih.gov/pubmed/1699579 [2]: http://www.cbc.ca/news/canada/calgary/tooth-decay-calgary-fl...

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> I am saddened that after reading stories like this one, people remain skeptical of fortifying water with Lithium.

You start with that, next thing you know you're crop-dusting Miranda with G-23 (and we all know how that went).

More seriously, lithium has significant side-effects, lithium toxicity can occur both acutely and chronically, and lithium toxicity isn't always much higher than therapeutic doses (especially as it's compounded by sodium depletion). And there's a significant risk of fetal toxicity.

Normalising medical lithium use sounds like a great idea (especially as part of a wider normalisation of treatment of mental distress and illness), but it doesn't sound like the best substance to spike water with.

I spent 20 minutes trying to find this reference and could not find anything convincingly close enough. It is a sci-fi reference or something that happened in our world? The only thing I could find was FireFly related. My concern in this case would be chronic toxicity, which does as you say occur in some cases at lower than pharmaceutical dosage levels. I would only be campaigning for raising Lithium in towns <25% percentile to a level found in towns in the 75% percentile. This would be relatively simple to communicate to people, and you could point to a road down the street from which people's Grandparents grew up and demonstrate that you would simply be replicating amounts found in that town naturally. I think what is more disturbing is the concept that most people have no idea what is in their water, not that we could arbitrage minerals between different towns and try to come to some kind of optimal mineral content. In the study I reference, the spread between "highest" and "lowest" Lithium content is between ~2000x and ~1000x less than is currently used in the pharmaceutical. So if <10% of Lithium patients have any signs of toxicity (real number, around 10%) and 1% have life threatening toxicity, we could (perhaps not perfect math) assume that only 0.001% of people would experience a similar issue in dosages of 1000x less. My thought is that dosages at that level are akin to living in an area with high Lithium naturally, or eating lots of seafood, and that people would at least consider it, if you could reduce the rate of suicide by 50%. I could be wrong though, lots of opposition to this thesis, including here, including among people who no doubt know far more science than I do.

> I spent 20 minutes trying to find this reference and could not find anything convincingly close enough. It is a sci-fi reference or something that happened in our world? The only thing I could find was FireFly related.

It is a scifi/firefly reference. Spoilers ahead for the Serenity movie.

Miranda is a planet on a far far "edge" of the Verse (the "known universe" in Firefly) and considered fictional before the events of Serenity as the Alliance had basically struck it from records (and it was deep in "Reaver space" where people of the Verse don't go without a serious death wish). An Alliance research program was tried there: G-23 Paxilon Hydrochlorate ("Pax") had been found to reduce aggression, and on Miranda it was tried on a large scale, spread throughout the planet via the air processors system.

The compound pacified 99.9% of the population so much they basically stopped all drive. They stopped working, talking, feeding, moving and ultimately leaving.

The remaining 0.1% blew a gasket and went the exact opposite becoming ultra-violent self-mutilating merciless and fearless animalistic — but not stupid — monsters: the reavers, which have plagued the Verse since.

Disturbingly relevant. It would be too easy to think we could just change the water and solve Bipolar, but the concept that a small percentage of people would rise up against it violently is not hard to imagine either.

The spiritual community believes that fluorinated water is toxic and damaging to the brain, causing calcification to the pineal gland (the third eye, source of DMT, the spirit molecule), suppressing the innate psychic abilities and spiritual advancement of the masses.

Believe it or not, this is a tremendously large portion of the population.

I find it fascinating how many medical "problems" we (Western medicine) have that are perceived differently by other cultures and faiths. I do believe what you say. Presumably Lithium deficiency is something which does not serve ones ability to contribute to our modern economy as much and therefore is seen as being a negative.

The reason is that those other cultures seem to have lots less of these illnesses. For schizophrenia, I can give some explanations. I believe that it's less common around the equator. Some link that to vitamin D levels, which are way too low in Europe and the US, even if you live in Florida. There may be other reasons, but it's worth noting.

Another big problem is stress, caused by competitiveness in the western world. When you have a mental illness, you can't compete, and that alone is another stress factor. (Some people will perform better, but by far the most will not.) In a low stress low competitive environment, if you can't deliver, don't have a high performance job, it's not that bad. You're one of the many, just one with a few quirks. You hear voices, so what. I guess if it's not that strange to hear voices, you don't have to hide it, and stress goes down, resulting in less voices, etc.

I upvoted your post not because I agree with it --- I think lithum in particular is a terrible idea and will reduce human potential --- but because large-scale societal engineering efforts in general are interesting, and we're too reluctant to even entertain the idea of using them due to the concomitant "ick factor" involved.

Thanks. I have read a great deal about human biology and come to understand that there are systems that reliably stop working across such a material percentage of the populationt that something like water fortification of the elements in question could have immense, permanent, positive impact on the residents. And we could likely find a city in the world with concentrations at that level to regress the data and find any lurking downsides. Since Lithium is already in so many water and food sources, and can be clinically significant at dosages of <1000x the pharmaceutical drug, it seemed like a good place to start!

This is such a bad idea.

Lithium has horrible side effects. It's mechanism is to dampen transmission throughout your entire nervous system. We don't know how it works exactly but we think it occupies some of the bandwidth through sodium ion transport channels (Li and Na are similar ions).

Anyway. We don't want an entire population on this.

I think you perceived this in the context of the medication Lithium, of which I am familiar and have close friends who take it, as opposed to the element. My understanding is that in the Texas study, quantities <1000x those used in the medication in the existing natural source of drinking water still demostrate statistically significant improvements in the mental health of the local residents. Lithium the pharmaceutical is about as high a dose as you can reasonably give people where Lithium the element is effective (seemingly) at <1000x that level. The only other water study was done in Japan and replicated the results but only specifically with respect to suicide [1]. I agree that Lithium in large quantities could be profoundly negative for all those exposed, but that there is probably a poorly understood but clinically viable amount that would improve quality of life without risking toxicity. Various parts of the world including Japan and Bolivia are working on further research to find a more conclusive answer. [1] http://www.ncbi.nlm.nih.gov/pubmed/19407280

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