The purpose of this report is to direct attention to lithium intoxication as a complication of the use of lithium chloride as a salt substitute for flavoring low sodium diets. We shall describe the syndrome as it was observed in 7 cases, in 2 of which the intoxication seems to have been a contributory cause of death. The salt substitute used by these patients was westsal,® which is a solution of lithium chloride with citric acid and a small amount of potassium iodide. That the cause of the intoxication was lithium ion, and not sodium depletion as such, seems evident from a study of these cases, in 1 of which the intoxication was induced as a clinical trial. Nevertheless, the data indicate that sodium depletion, incident to treatment with low sodium diets, increases the susceptibility to intoxication from orally ingested lithium salts.
The suspicion that lithium might be the cause
CORCORAN AC, TAYLOR RD, PAGE IH. LITHIUM POISONING FROM THE USE OF SALT SUBSTITUTES. JAMA. 1949;139(11):685–688. doi:10.1001/jama.1949.02900280001001
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