Anxiety Disorders Tied to Low Levels of Choline in the Brain
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Anxiety Disorders
Choline Levels
Nutrition and Mental Health
A study found lower choline levels in brains of people with anxiety disorders, sparking debate about correlation vs causation and the potential effectiveness of choline supplements in alleviating anxiety.
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> This suggests that chronically elevated arousal in AnxDs may increase neurometabolic demand for choline compounds without a proportionate increase in brain uptake, leading to reduced tCho levels. Reduced cortical NAA suggests compromised neuronal function in AnxDs. Future studies may clarify the clinical significance of reduced cortical tCho and the possibility that appropriate choline supplementation could have therapeutic benefit in anxiety disorders.
It’s also ready sold OTC.
Instead people just sit around and do meta studies on meta studies on correlation and publishing whatever statistical anomalies they can find.
Choline a key component in Acetylcholine is the primary neurotransmitter used in your hippocampus. Its an excitatory neurotransmitter meaning it turns neurons on. The hippocampus is a massive parallel feedback circuit that when over stimulated can and will begin to seize. In fact many people who suffer from seizures have over active hippocampal circuitry. Simply "flooding" the brain with more choline could have very very bad effects.
Likewise, taking choline might not work as the brain actively controls and regulates the contents of the cerebral spinal fluid. Unlike the rest of your body, the capillaries in the brain are not leaky, but instead are enshrouded in the blood-brain barrier and there are active transport proteins for anything that isn't lipid soluble.
Choline is actively transported into the brain and the brain has additional internal mechanisms to regulate the levels of choline.
Lastly, neurotransmitters aren't just floating around in the soup of your brain. They are released by specific neurons which are integrated into specific circuits. Parkinson's disease is a perfect example here. There is tiny region of the brain involved in regulating voluntary movements that is rich in dopamine neurons. For Parkinson's these neurons die off while the rest of the brain remains relatively strong. Simply putting dopamine into the brain doesn't fix the issue you need to up the dopamine released by these specific neurons.
The treatment here is l-dopa which is a precursor to dopamine which does this, but once those neurons are gone they're gone and there is little we can do to stop the disease.
So if this works for l-dopa why won't it work for choline? My guess is because of the tight regulation the brain has around choline levels as its needed to prevent the hippocampus from seizing up.
Trials cost millions and in this case would require a number of different expertise, meta studies on the other hand is just reading and statistical analysis with knowledge of the biases of papers and assessing them critically and they don't cost millions.
"Dietary Choline Supplements, but Not Eggs, Raise Fasting TMAO Levels in Participants with Normal Renal Function: A Randomized Clinical Trial"
https://pmc.ncbi.nlm.nih.gov/articles/PMC8410632/
> Choline is a dietary precursor to the gut microbial generation of the pro-thrombotic and pro-atherogenic metabolite trimethylamine-N-oxide (TMAO).
Brown ones, too.
I haven’t looked, but I bet that tracks with nutritional value.
Best get back to just painting them brown.
You can get diagnosed with ‘anxiety’ when you’ve been in a hard circumstance for a while, since it’s simply a self-reporting questionnaire on levels of concern. That’s not a way to determine pathology - how do they tell when it’s appropriate behavior, eg when you’re actually in a dangerous situation.
This economy, since the financial crisis, has had weak employment (when you factor in not-in-workforce trends over the last 50 years), being under-employed for a long time is a threat to life. You can be in a location or situation where you’re blind to a loss of economic opportunity because there is so much misinformation. Anxiety is not maladaptive then.
This happened to me, and when my situation finally began to improve after a change in direction, my anxiety went down. Before I made that change, I found anti-anxiety meds put me in a dysfunctional ‘happy’ state, that made it harder to course correct or care about my reality. So I quickly stopped taking them last year, shortly after receiving them. And yet a diagnosis was made then, and looking at my medical report, this so called disease remains on my medical record. Ridiculous. All that self-reporting showed was normal human behavior.
Luckily, at the worst time, I also hedged by seeing separately a psychologist who helped me understand through a series of interviews that all my behavior was appropriate to my situation.
Uh.
I went to another doc who diagnosed me with and started treating me for ADHD. Boom. Anxiety gone. Turns out I was just super anxious about having a hard time working on the un-shiny things I needed to be working on.
However, I'm glad things are working out for you :)
Since I was little I suffered from terrible schizotypal anxiety which somehow cleared up completely in middle age [1] I never got along with a person I knew who had panic disorder despite trying hard: some if it is that my anxiety makes me move towards dangerous things (I've been seen going into a building when the fire alarm was on) and his anxiety makes him want to banish every possible source of anxiety from his life but the more he does that the more fragile it gets.
[1] I don't know if it was Gabapentin, or a few years of attempting business developer, or meeting my "evil twin" or discovering my schizotypy or just getting old enough that I don't give a fuck.
If you think a doctor is wrong, they very well might be, particularly if you have already done your homework. This is not the old days, where medical knowledge is exclusively available to doctors. In fact, it is a huge risk to go in unprepared and ignorant of the possibilities, because misdiagnoses are not uncommon if critical symptoms get overlooked due to the patient not presenting them.
Ask yourself not how many doctors graduated with honors. Ask yourself how many barely graduated after cheating their way through the program and are now faking their way through life.
id probably still have to take his word over yours. and didnt these same doctors discover ADHD in the first place? at once theyre reliable and "dangerously bad"
My child was the same way due to a wheat allergy (U.S. wheat is heavier than European wheat, and the flour comes out differently. It's actually tougher to digest for many).
As for letting the doctor tell you... The last few decades, I find I've been making the diagnosis first. Chronic fatigue, adult chicken pox, whooping cough... In each case, the medical history I gave was a reasonable path for ordering tests to get the correct diagnosis, but in each case the doctors missed it.
The whooping cough one was particularly annoying. I had traveled to Amsterdam, which had an outbreak a couple of years ago. I told the doctors this, and they still diagnosed me as having an ordinary sinus infection and gave me the wrong antibiotics. My wife looked up the medical alerts in Amsterdam, I messaged the doctor asking for the correct antibiotics (just in time).
Doctors in the U.S. follow protocols. When they don't they have to file extra paperwork. The entire system is designed to punish deviation from protocol, and the protocols don't get adjusted based on evidence or circumstance. They're handed down from a committee that the insurance companies take as law. Insurance companies in particular are geared to denying payment for deviation from protocol without prior approval. So doctors adjust their behavior to go with the flow... unless you find a great doctor, who knows better.
These days, you really do need to take your health in your own hands. Doctors become a path to confirmation and treatment, at least on the illness side of things. Injury tends to be a little more cut-and-dried, but even there you have to find the right experts. For example for sports injuries, you likely want doctors that see many patients that play that particular sport because they have experience with how things can go wrong.
Sorry for the rant. I've just seen the need for shopping a lot more in recent years.
Also, a good doctor won’t take issue with this, so long as you don’t insist that your 5 minutes on WebMD is right and they’re wrong.
Analogy: If someone at work says they can’t log in, and also that their already logged in password queries don’t work, it could mean that the login service is down and the database is down. It could also mean that AWS is down, and rebooting those other services isn’t going to fix the common root cause.
If you trust a general doctor’s read of you in 11 minutes a year more than your own, it’s time to look within way more often.
Double-check yourself with your practitioner, but don’t sleep at the wheel.
Because it is YOU at the wheel - regardless what anyone wants!
I received both of these diagnoses,
and then ended up finding mold toxicity, Lyme, high levels of EBV, mycoplasma pneumoniae, and staph in some dental work.
Resolving all of those (a long process!) has left me cool as a cucumber, in comparison. Higher bandwidth, effective.
No easy feat - but it was better to work on that list than a permanent list of conditions like I was left with!
Mold exposure drives immune dysfunction (including gut dysbiosis, and weakness of important barrier-type tissues) that allow these common infections to really thrive.
The environment described above leads to impaired cognitive function, and, if the glymphatic impact (detox inefficiency) is left unaddressed long enough, stuff like Alzheimer’s, dementia, more.
What you believe to be rare, reading my case, is quite common - but simply yet to be fully understood.
Slowly the lonely anecdata of hidden, missed chronic illness is being joined by data, and scientific fact:
ChangeTheAirFounation.org
It almost sounds like you were anxious?
Anecdotally I see a high correlation between taking antianxiety meds and having health issues that require doctoring. Plus I see a lot of abnormal self-diagnosis of ADHD going on in my social circles.
Rationality is hard when it comes to labels.
The only slightly unusual thing I did was get a second opinion from a qualified, in-network physician instead of taking the first result at face value.
Choline gives me a severe stiff neck and makes me unable to sleep. I have experimented with many supplements and it was one of the most consistent and unfortunate effects I ever got from one.
They aren't magic zombie pills, at worst they turn you mostly fearless and consequently slightly unhinged (and make you feel like shit due to the low blood pressure).
Mindfulness meditation also helps with consistent action to understand where my mind and body are at each day.
Research - Functional properties of bioactive compounds from Spirulina spp.: Current status and future trends (https://pmc.ncbi.nlm.nih.gov/articles/PMC9513730/)
I like to take it with Psyllium Husk Fiber / Metamucil to help increase the fiber in my diet since the higher dosage is like eating a lot of kale at one time, it can move through you super quickly.
Here are some studies that I commented before that I have read that has helped with learning more about the supplements and the dosages depending on what you are experiencing:
- High-dose supplementation of Chlorella and Spirulina increases beneficial gut Bacteria in healthy ICR mice: A 90-day feeding study (https://doi.org/10.1016/j.jff.2025.106796)
- Spirulina in Clinical Practice: Evidence-Based Human Applications (https://pmc.ncbi.nlm.nih.gov/articles/PMC3136577/)
- Effect of spirulina and chlorella alone and combined on the healing process of diabetic wounds: an experimental model of diabetic rats (https://pmc.ncbi.nlm.nih.gov/articles/PMC8212205/)
- Beneficial Effects of Spirulina Consumption on Brain Health ( https://doi.org/10.3390/nu14030676) This is a new study that I found, that I'm going to read, but it shows the impact on neuroinflammation, and from experience the supplement has helped me with inflammation, and why I think it has helped with my ADHD/Anxiety.
On a meta note, I have a deep love and appreciation for people like yourself who share this kind of info. It's been quite helpful for me on my own health journey.
The studies listed as part of this thread show people taking 3-4 grams per day for 8 weeks... that's less than 1% of choline RDI. Not very relevant to our conversation.
It's something that should be watched as you take it and/or discussed with a doctor if you are dealing with other health conditions.
Neither spirulina nor chlorella are good sources of choline. For example if you had to take spirulina you'd need about 6 cups per day to reach RDI. Way to risk getting elevated uric acid, vitamin A overload or a slew of other intestinal issues.
Compare with 3-4 eggs... or 90g of beef liver I know what I would take.
I thought vegatables = good? You can never eat too many greens I think youll find is the prevailing wisdom
Like 120 eggs a month, 1400 eggs a years. That is what you envision as the healthier alternative?
However if you don't like the idea of trying new things, and just want something in pill form, honestly lecithin or even better citicoline is the way to go in my opinion
In 2015, the U.S. Dietary Guidelines shifted from implying that one egg a day is “probably a bit much” to saying “one egg a day is fine if you don’t fry it.” This coincided with the removal of the quantitative cap of 300 mg/day on dietary cholesterol (a single egg basically maxes that out).
EDIT: The calorie count used to compute the portion of the comment below were incorrect. I'm leaving it unchanged for posterity, but want to clarify that an egg has about 80 cals.
Four eggs a day is almost 1,000 calories of egg, roughly half of many people’s total daily calorie intake.
Like most things I’m sure you can overdo it. But if you’re choosing between cereal and a bagel or a couple of eggs, I think most would be better off with the eggs.
Sitting on ass does.
If you are looking to the landing page of any of those major bodies to figure out how to fuel your body, good luck.
(1) In your most authoritative tone, state something as fact without citation.
(2) Say major testing-based orgs are never going to give you the real truth.
We have a system for knowledge. I think it is an absurd mess, but I trust it way more than anything presented in the format you’ve just used.
Maybe this is just a formatting issue and you have credible information to back your claim, but as it is currently presented it does not pass the sniff test.
So, as politely as possible, pass.
Read other people's experiences, and feel your own body.
Or, politely as possible: don't, I don't care.
It's truly up to you.
Heck, you still are; "Read other people's experiences and feel your own body." That is a mode of interacting with the external world and processing knowledge. You didn't even suggest I do it; your sentence was a directive. Furthermore, it was packaged in that cool detached "above it all" way that humans sometimes use to convince others.
It's good/okay/whatever to try and sell people on your worldview. I was engaged and conversing that is the social cue to do so. The fact that you didn't convince me is whatever on the internet. But playing it off like you weren't doing that... why?
I'm pretty sure the number of times someone has been convinced on the internet wouldn't even correctly round in IEEE double-precision floating point.
Incentive structures matter.
I'm "above it all" because it's a casual internet comment; I've got nothing on the line.
Reading matters, too...I never said "never", and everything you've been saying since then has been a weird dress down.
https://www.youtube.com/watch?v=AHAFMFFQlkI
It's more that that's a shit ton of eggs. Money aside, this just contributes even more to the incredibly polluting factory farm industry.
A suppliment synthesized in a lab has far less ecological impact. Also it's far cheaper.
Back when I was in college I would eat 6 eggs plus some fruit for breakfast because I was flat broke and they kept me full all day.
What’s up with you?
This is like fifth grade biology.
that's how most people never experience anxiety in most parts of the world.
no need for drugs, medicines etc.
But yeah, our ancestors lived in constant danger of getting eaten by sabre tooth tigers, freezing in the snow, catching maalria, and, in general, watching terrible things happen to their tribe.
They had no therapy, no supplements, no self help section on the cave wall art.
They were forced into a continual outward focus with no time for navel-gazing.
They carried on through all exigencies, and succeeded mightily.
Citation needed? And how much is 'most'?
Dammit.
<puts down spoonful of choline>
I feel like a lot of the studies coming out lately are trying really hard to corelate information and join the meta-studies wagon.
"Meta-analysis finds people with anxiety disorders have lower levels of choline in their brains"
There's no evidence (yet) of anything being "tied to" anything else.
So be careful trying supplements, and monitor your mental/physical state.
Choline from normal food sources isn’t typically a problem, but supplements and additives like lecithin can push people over the edge.
This looks like a decent summary of why it may cause depression: https://pdfs.semanticscholar.org/6fdb/adf596271afea393659cbf... (World Nutrition 2019;10(1):54-62 “Too much of a good thing? Lecithin and mental health”)
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