In vitro gastrointestinal digestion and bioavailability of lithium from processed lithiated and nonlithiated white Agaricus bisporus mushrooms

Aim: In order to avoid side effects of lithium doses in some patients, some commonly cultivated mushroom species including A. bisporus have been successfully lithiated, with the potential to provide more acceptable sources of Li. This study assessed the in vitro release (potential bioaccessibility) and possible intake of Li using the action of artificial gastrointestinal juices on lithiated and nonlithiated (control) button mushrooms (Agaricus bisporus) that were subjected to certain modes of culinary processing.  
Methods: In the in vitro release study, mushrooms were processed using a number of routinely used domestic treatments including rehydrating dried mushrooms, blanching and blanching followed by pickling of fresh or frozen mushrooms. The in vitro digestion procedure used artificial gastrointestinal juices in a two-stage methodology that was adapted from ‘The Bioaccessibility Research Group of Europe’ method.  
The Li concentrations were determined using an inductively coupled argon plasma–dynamic reactive cell–mass spectrometer.  
Results: Lithium was found to be more bioaccessible from caps of lithiated mushrooms compared with nonlithiated. Releases from the caps and stipes of blanched or blanched and then pickled mushrooms through gastric digestion ranged from 32 ± 2 to 50 ± 1% relative to the dried product and was lower for gastrointestinal digestion, which ranged from 16 ± 1 to 20 ± 1%.  
Conclusion: Losses of Li sustained through blanching or blanching followed by pickling of fresh mushrooms (41–87% wet weight) combined with limited accessibility during gastrointestinal release (16–55%) result in much lower bioavailability of the dose from lithiated products. A 300-g meal would provide <5% of the Li (6 mg) required for potential preventative treatments, such as reducing suicide rates and lowering dementia risk.