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Effect of strenuous exercise on serum lithium level in man
The American Journal of Psychiatry
|December 1, 1982
Summary
Strenuous exercise and dehydration in athletes did not increase serum lithium levels. Lithium loss through sweat was substantial, suggesting a lower risk of lithium intoxication than previously believed.
Area of Science:
- Exercise Physiology
- Clinical Pharmacology
- Environmental Medicine
Background:
- Lithium carbonate is a mood stabilizer with a narrow therapeutic index.
- Concerns exist regarding lithium toxicity risk during strenuous exercise and dehydration.
- Sweat composition and electrolyte loss during intense physical activity require further investigation.
Purpose of the Study:
- To investigate the impact of strenuous exercise and dehydration on serum lithium levels in athletes.
- To quantify lithium loss in sweat during prolonged physical exertion.
- To assess the risk of lithium intoxication under conditions of heavy sweating.
Main Methods:
- Four healthy athletes on lithium carbonate underwent a 20-km race in hot, humid conditions.
- Serum lithium levels were monitored before and after exercise.
- Dehydration levels were assessed.
- Sweat lithium and sodium concentrations were analyzed.
Main Results:
- Athletes experienced significant dehydration during the race.
- Serum lithium levels decreased post-exercise.
- The sweat-to-serum lithium ratio was four times higher than the sweat-to-serum sodium ratio.
- Substantial lithium loss via sweat was observed.
Conclusions:
- Heavy sweating during strenuous exercise may lead to significant lithium loss.
- Contrary to previous assumptions, dehydration and heavy sweating may not elevate the risk of lithium intoxication.
- These findings challenge the conventional understanding of lithium pharmacokinetics during intense physical activity.