What key electrolyte consideration should accompany lithium therapy?

• A. Drink only caffeine-free beverages
• B. Maintain adequate sodium intake
• C. Limit hydration
• D. Avoid salty foods

Answer: (B)

Lithium therapy hinges on stable sodium balance because the kidneys handle lithium much like sodium. When sodium intake or status is low, the kidneys reabsorb more sodium and, inadvertently, more lithium, raising lithium levels and increasing the risk of toxicity. Keeping a consistent, adequate sodium intake helps maintain lithium within the desired range, especially during situations that cause fluid or electrolyte loss like sweating, illness, or diuretic use. Good hydration supports this balance and helps prevent fluctuations in lithium levels. If symptoms of toxicity occur—such as tremors, confusion, or GI upset—consult a clinician, and avoid drastic changes in salt intake without medical guidance.