Q. I have been taking 1 milligram of lithium orotate for four months. Within days, I noticed I was sleeping better. Slowly, I realized I was remembering names of the people I knew 40 years ago.

I still occasionally walk into a room and have to ask myself, “Why am I here?” But now, if I pause for a bit, the answer pops in my head.

As I watch my younger sister declining with Alzheimer’s disease, I wish I had known about lithium 10 years ago.

A. Psychiatrists prescribe lithium carbonate at high doses (900 milligrams to 1,800 milligrams) to treat bipolar disorder. Recently, scientists have begun to examine the possibility that low-dose lithium, such as what you are taking, might help ward off cognitive decline (Nature, September 2025). Some research even suggests that lithium might protect the bones as well as the brain (Current Osteoporosis Reports, Feb. 10, 2026).

This research is still very preliminary, however. One study found that low-dose lithium appeared to be as effective as well as safer than the Food and Drug Administration-approved Alzheimer’s disease drugs aducanumab, lecanemab and donanemab (Ageing Research Reviews, February 2024).

Q. I had migraines beginning in my early teens, which eventually stopped after menopause. l assume that they were partly related to hormonal changes. They also could be triggered by flashing lights, smoky rooms (before smoking in public spaces was banned), red wine or stress.

I found a helpful herbal supplement that seemed to make attacks less frequent and intense. It came as tablets and contained feverfew and other herbs to be taken every day as a preventive.

A. When you have identified migraine triggers, it makes sense to avoid them. Feverfew, by itself or in combination with magnesium and coenzyme Q10, might help prevent migraines. In addition, it is considered safe (American Family Physician, May 2025). Safety is very important if you will be taking something every day.

You can learn more feverfew, riboflavin, ginger, butterbur and other nondrug approaches in our “eGuide to Headaches and Migraines.” This online resource may be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. My wife found an ad for astaxanthin and its “miraculous” benefit to lower A1C in diabetics. When searching for more information, I found nothing about blood sugar. I did find warnings about interactions with blood thinners (Plavix) and blood pressure meds (lisinopril), which I’m on, but no research on A1C.

The exception is the manufacturer’s website, which brags about lowering A1C to under 6 within 30 to 60 days. I’m skeptical.

My doctor prescribed metformin and glipizide and insists I must stay on them. I would love to discontinue due to concerns about kidney damage.

After reading your column about berberine, I started taking it. My blood sugar went too low when I took two per day. I cut back to one per day and it helps without causing low blood sugar.

A. Astaxanthin is an interesting reddish carotenoid derived from algae. This marine compound has antioxidant activity that might be helpful for people with diabetes. However, most of the research so far has been done in animals (Marine Drugs, July 9, 2020). A meta-analysis of randomized clinical trials concluded that astaxanthin can raise beneficial HDL cholesterol and lower C-reactive protein, a marker of inflammation (Pharmacological Research, November 2020). However, these 14 studies showed no evidence of benefit for fasting blood sugar or HbA1c. You may need to stick with your current regimen, especially since you are taking drugs that might interact badly with astaxanthin.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”