My time on lithium was a nightmare. My stomach was nauseated all the time and sometimes at night I went and threw up. My doctor changed it to the time released lithium and told me to take mylanta with it. I dreaded having to take my dose every night. Instead of feeling better, I started to also develop symptoms of ADD along with memory loss. When I got a rash on my thighs and back I decided to get off of it even though the blood tests always reflected that it was not in the toxic level. After that experience I went to a naturopath and was told that I already had malabsorption from Celiac Disease. Some of the things in my body had been depleted and the stomach irritation and vomiting from the lithium just added to the problem. I have seen some mention on the internet connecting RA to gluten. It might be worth looking into. Since I have been on vitamin therapy including B-complex, I do not feel those large mood swings anymore. Also, the mention about thyroid is correct. Alot of people with bipolar also have some endocrine imbalance such as thyroid. I have had hypothyroid since the early 90's.