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Factors influencing likelihood of developing a choline deficiency on a low vA diet
I just thought I’d write a post about the various factors that could mean someone develops choline deficiency. I realise now that I tick several of these and that by end of 2020 (2 years on vA detox diet) I was likely dramatically low in choline. My ALT was dangerously raised and my triglycerides had doubled from my normal level (I’d plotted since 2004). These are both red flags for choline deficiency I now know. Thank you to Andrew and Jessica for all their research on this.
1. Diet.
Meat contains choline but you have to eat substantial amounts to reach the choline RDA. (Let me emphasise that big meat eaters should be getting adequate choline, this is a big clue I think). Eggs are an excellent source of choline but are often removed on the vA detox diet. I removed eggs and didn’t eat more than 200g of meat a day, meaning I was eating only half the RDA for choline most days.
2. Gender and age. Women make more choline endogenously via the PEMT enzyme because it is upregulated by oestrogen. Postmenopausal women make less. Men make less.
3. Genetics. Common SNPs on the PEMT mean that it isn’t upregulated by oestrogen and younger women with PEMT SNPs need to rely more on the diet.
4. Dysbiosis. Certain gut bacteria can turn choline into TMAO meaning it is lost from the system. Choline normally undergoes enterohepatic circulation. This can be another way that people develop choline deficiency.
5. Stress. Stress burns through choline.
6. Other dietary factors. A diet low in folate or B12 or betaine can put more pressure on choline for methylation.
7. More choline required during a detox. A strong detox may require more choline as it’s needed to liquidise bile (needed for phase 2.5, hepatocyte to bile canaliculi) and make bile less toxic.
These are my current thoughts. I’m sure there are more. These individual differences can explain why some people are vulnerable to choline deficiency and others are not. In 2018 I was a highly stressed, menopausal women who didn’t digest meat well and carried heterozygous PEMT SNPs. Should I have been cutting out eggs? I’d say a big NO. We live and learn I guess. Is choline deficiency behind my seizures? Idk. I’m guessing the problem is multifactorial. However, damaging cell membranes and myelin, via choline deficiency, is never going to improve one’s neurological health is it?
The possibility of choline deficiency at the start of the low Vit A diet seems to increase with levels of vitamin A toxicity and non alcoholic fatty liver disease. It's not clear whether this is absolutely correct in a completely linear fashion but then we dont always have a liver disease diagnosis at the start. Other factors that might also lead to this are:
- Celiac disease. I also suspect gluten intolerance will also lead to loss of choline and other nutrients in the medium to long term.
- Alcoholism can lead to low choline. Alcohol can increase the choline requirement.
Other factors during the detox would be:
- Increased cell membrane repair and replacement if healing is taking place or liver cells being replaced and/or reduced of fat.
- Continued consumption of gluten when there's a problem.
- Excess fibre intake may increase choline requirement. Hence you eat loads of beans and run into leaky gut problems.
- Moderate to high alcohol consumption. Difficult to know exactly where the line is drawn. Someone with high choline needs might need to be more careful about intake.
Ah yes the membrane repair I forgot to say that. Very important point. Choline is essential for cell membranes. This includes mitochondrial membrane health.
Yesterday I had a consult with a nutritional therapist who has specialised knowledge of cell membrane health. The first thing she said to me, before I explained my suspected choline deficiency, was that I’ve got cell membrane issues. Eggs and PC are the cures. She has confirmed my suspicions. A low choline vA detox diet is dangerous. Do not do it.
Either eat A LOT of meat and fish or if you can’t do that, keep in x2 eggs. That would be my advice. Now to see if I can get myself out of this big mess.
@rachel Well seizures were one thing and my minerals on my HTMA - in particular low potassium. She’s an expert in this area and personal friends with Patricia Kane, who saved her life. It could be why people on the vA detox seem to need so much potassium. It’s a sticking plaster because the cells can’t hold onto it. Poor cell membrane health is the real root cause. Poor cell membrane health is a lack of PC. All fits. Theory is becoming fact imo.
She was bought back from the brink of death with cell membrane support so I’m hoping I can reverse my issues. I just want to warn other people. Don’t do this to yourself. If you are needing loads of potassium ask why??
Thank goodness for a forum where we can discuss these things openly. And people actually willing to read the science and attempt the eggsperiment. Censorship is another reason that raises the likelihood of a choline deficiency on a low Vitamin A diet. A post I did in the other network got taken down with 25 references at least in it. That deprives 1,500 members from having the opportunity to read about the accepted science. There is little doubt about choline deficiency in connection with fatty liver disease. Discussion of science by twitter thread. Jessica debunked at least 14 of those studies yet the censor acts as if they are still perfect.
Interesting about the potassium. I've started having palpitations and wondered if that was potassium related. Found it hard to imagine it was though as get so much in my diet.
@rachel I think you were eating a lot of potatoes which had the potential to give you a lot of potassium. The choline from eggs will improve absorption of potassium and a friend did need to reduce his potassium supplement after a few weeks on eggs.
Quote from Rachel on February 2, 2023, 8:31 amInteresting about the potassium. I've started having palpitations and wondered if that was potassium related. Found it hard to imagine it was though as get so much in my diet.
@Rachel maybe you needed some extra magnesium? There was a point where I thought I had low potassium but then I thought maybe I am actually getting TOO MUCH, from food like potatoes and parsnips, bananas and soaked raisins. On the days where I didn't eat a banana I felt better and had less anxiety. But I do notice I've been constantly worried about getting enough potassium :/