3 replies to this topic

[offtoukraine]

This is a copy of a post I posted in another thread about my Cyclothymia. The strangeness of the situation prompted me to make it a thread as I cannot find any online references.

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Right, so for the last few weeks I have effectively removed all major sources of Choline from my diet or supplements. I was testing what effect Choline has on me since like I said supplementary Choline of 200-300mg gave me "mixed results".

 

A couple of days ago I introduced some boiled eggs back into my diet which coincided with the slow start of what seemed to be another depressive swing. Could be coincidence. Yesterday I turned it up a notch and downed 200g of rabbit liver and 2 eggs throughout the day: over 1000mg of choline from 2 ingredients alone. I was feeling particularly agitated and irritable in the afternoon, my thoughts were racing uncontrollably and songs were playing in my head on loop. At the Gym I noticed some irregular heartbeats, mild vertigo and the feeling that my breathing wasn't doing much. The trainer walked up to me twice to ask me if I was doing ok. I was also more self-conscious than usual.

 

While eating soup and looking directly into the reflection in the bowl I saw parallel lines forming across the diameter of the bowl. I looked up to see if it was a reflection but there was nothing but a clear sky. I looked back down and the lines slowly faded out.

 

At night I took a half-hour walk around the neighborhood and saw a number of things in the corner of my eye, one giving me a short panic and I became afraid a rabid dog was about to jump me. The feeling of being watched (by the people in the houses) was persistent and I was also startled and sensitive to bright lights and loud noises from passing cars.

 

Sleeping was more difficult than normal as it was impossible to stop thinking about something. The sleep itself was not restful, filled with odd fever dreams waking me up constantly.

 

This morning I had some odd bowel movements, loose stools and appalling flatulence but also experienced a symptom I haven't had in a while. Urinary retention. A difficulty squeezing out everything from the bladder. This is what prompted me to hit "choline" and "urinary retention" into google and found the wikipedia page on 'Anticholinergic' which states "Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells. The nerve fibers of the parasympathetic system are responsible for the involuntary movement of smooth muscles present in the gastrointestinal tract, urinary tract, lungs, and many other parts of the body".

 

It also lists a number of associated symptoms, many of which I experience frequently. I have color-coded the list based on my experience and the <<< indicates reemerging of symptom since reintroducing dietary Choline.

 

• Poor coordination <<<
• Dementia
• Decreased mucus production in the nose and throat; consequent dry, sore throat <<<
• Dry-mouth with possible acceleration of dental caries
• Stopping of sweating; consequent decreased epidermal thermal dissipation leading to warm, blotchy, or red skin
• Increased body temperature
• Pupil dilation (no clue); consequent sensitivity to bright light (photophobia) <<<
• Loss of accommodation (loss of focusing ability, blurred vision – cycloplegia) <<<
• Double-vision
• Increased heart rate <<<
• Tendency to be easily startled <<<
• Urinary retention <<<
• Diminished bowel movement, sometimes ileus (decreases motility via the vagus nerve) [<<<mild]
• Increased intraocular pressure; dangerous for people with narrow-angle glaucoma. (left eye has long-time astigmatism, not sure if related)

Possible effects in the central nervous system resemble those associated with delirium, and may include:

• Confusion <<<
• Disorientation <<<
• Agitation <<<
• Euphoria or (dysphoria <<<)
• Respiratory depression <<<
• Memory problems <<<
• Inability to concentrate <<<
• Wandering thoughts; inability to sustain a train of thought <<<
• Incoherent speech <<<
• Irritability <<<
• Mental confusion (brain fog) <<<
• Wakeful myoclonic jerking
• Unusual sensitivity to sudden sounds <<<
• Illogical thinking <<<
• Photophobia <<<
• Visual disturbances <<<
  • Periodic flashes of light <<<
  • Periodic changes in visual field <<<
  • Visual snow
  • Restricted or "tunnel vision"
• Visual, auditory, or other sensory hallucinations
  • Warping or waving of surfaces and edges <<<
  • Textured surfaces <<<
  • "Dancing" lines; "spiders", insects; form constants
  • Lifelike objects indistinguishable from reality
  • Phantom smoking
  • Hallucinated presence of people not actually there
• Rarely: seizures, coma, and death
• Orthostatic hypotension (severe drop in systolic blood pressure when standing up suddenly) and significantly increased risk of falls in the elderly population.

In particular, Visual Snow, Dancing Lines and Orthostatic hypotension have always troubled me. They have not resurfaced yet but I am half-expecting them to.

 

 

This is strange considering Choline is by definition the opposite of Anticholinergic, yet it seems that high intake, or even continuous moderate intake, of dietary and supplementary choline gives me clear Anticholinergic symptoms. All but the rarest in fact. Could my body be reacting paradoxically to Choline by downregulating acetylcholine or its receptors? Does that even make sense?

 

I am going to phase out all major sources of choline from my diet once more for a week and see if my symptoms improve. If so, I will consider ALCAR as an alternative to Choline supplementation.

 

Edited by offtoukraine, 19 September 2017 - 10:24 AM.

[Kinesis]

I wouldn't call what you are experiencing "anticholinergic", because as you correctly point out choline is by definition the opposite of anticholinergic.  There is a tendency though for people to look at a list of symptoms and get a "yeah, that's me" effect that amplifies identification.  Words can bear an ambiguous relationship to feelings.  It's also unlikely that it's due to receptor downregulation; as someone who has taken anticholinergic drugs (diphenhydramine, amitriptyline), adaptation is slow to nonexistent.  Anticholinergics also tend to produce foggy and drowsy mental effects, and what you describe sounds more like stimulation, arousal and difficulty sleeping.  The urinary retention could be due to nervous stimulation making it difficult to relax.  All told, it sounds cholinergic to me.

 

What is probably happening is that you are naturally on the cholinergic side of things anyway, and that taking large amounts of choline is overloading your cholinergic system and producing dysphoric symptoms.  Cholinergic status is one of those U shaped thingies where you feel lousy with either too much or too little.  It's not uncommon for people to report feeling depressed when overly cholinergic as well as insufficiently so.

 

Far as dealing with it goes, trust the feedback you're getting on choline supplementation; if you don't like the way it makes you feel, it's probably too much.  Most foods aren't that high in choline, but if eating liver and eggs bothers you, use moderation.  Some choline of course is considered essential, but as with many things, dose makes the poison.  You will die without water too, but drink six gallons of it at a sitting and it will kill you too.

[dk2011]

Did you figure out how to counteract this?  Any other supplements to use instead or use with the Choline?

[Kinesis]

It’s not at all clear that what’s bothering you is being overly cholinergic, but if we assume for the moment that’s what it is, then an anticholinergic would do the trick. I mentioned a couple already ... diphenhydramine and amitriptyline. In the US diphenhydramine is OTC and amitriptyline is prescription.

I’d recommend amitriptyline, but if this were really an issue of being overly cholinergic, you’d have to wonder why none of the doctors you’ve seen haven’t already thought of it. Just to make sure, you could ask one about it.

So if on the other hand your problem stems from being insufficiently cholinergic, then that’s easy too ... take something cholinergic like CDP choline or GPC, maybe in combination with a cholinergic racetam like piracetam or pramiracetam.

But you say you haven’t reacted well to either dietary or supplemental choline, so that seems to miss the mark too.

It’s time to consider the possibility that your issues have nothing to do with choline.

Edited by Kinesis, 09 November 2017 - 05:09 AM.