Citicoline: Better Than Dietary Choline?
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Citicoline: Better Than Dietary Choline?
Citicoline, also known as cytidine diphosphate-choline (or CDP-Choline, to its friends, or cytidine 5′-diphosphocholine if it wants to get fancy) is a dietary supplement that the stomach can metabolize easily for all the brain’s choline needs. What are those needs?
Choline is an essential nutrient. We technically can synthesize it, but only in minute amounts, far less than we need. Choline is a key part of the neurotransmitter acetylcholine, as well as having other functions in other parts of the body.
As for citicoline specifically… it appears to do the job better than dietary sources of choline:
❝Intriguing data, showing that on a molar mass basis citicoline is significantly less toxic than choline, are also analyzed.
It is hypothesized that, compared to choline moiety in other dietary sources such as phosphatidylcholine, choline in citicoline is less prone to conversion to trimethylamine (TMA) and its putative atherogenic N-oxide (TMAO).
Epidemiological studies have suggested that choline supplementation may improve cognitive performance, and for this application citicoline may be safer and more efficacious.❞
Source: Citicoline: A Superior Form of Choline?
Great! What does it do?
What doesn’t it do? When it comes to cognitive function, anyway, citicoline covers a lot of bases.
Short version: it improves just about every way a brain’s healthy functions can be clinically measured. From cognitive improvements in all manner of tests (far beyond just “improves memory” etc; also focus, alertness, verbal fluency, logic, computation, and more), to purely neurological things like curing tinnitus (!), alleviating mobility disorders, and undoing alcohol-related damage.
One of the reasons it’s so wide in its applications, is that it has a knock-on effect to other systems in the brain, including the dopaminergic system.
Long version: Citicoline: pharmacological and clinical review, 2022 update
(if you don’t want to sit down for a long read, we recommend skimming to the charts and figures, which are very elucidating even alone)
Spotlight study in memory
For a quick-reading example of how it helps memory specifically:
Keeping dementia at bay
For many older people looking to improve memory, it’s less a matter of wanting to perform impressive feats of memory, and more a matter of wanting to keep a sharp memory throughout our later years.
Dr. Maria Bonvicini et al. looked into this:
❝We selected seven studies including patients with mild cognitive impairment, Alzheimer’s disease or post-stroke dementia
All the studies showed a positive effect of citicoline on cognitive functions. Six studies could be included in the meta-analysis.
Overall, citicoline improved cognitive status, with pooled standardized mean differences ranging from 0.56 (95% CI: 0.37-0.75) to 1.57 (95% CI: 0.77-2.37) in different sensitivity analyses❞
The researchers concluded “yes”, and yet, called for more studies, and of higher quality. In many such studies, the heterogeneity of the subjects (often, residents of nursing homes) can be as much a problem (unclear whether the results will be applicable to other people in different situations) as it is a strength (fewer confounding variables).
Another team looked at 47 pre-existing reviews, and concluded:
❝The review found that citicoline has been proven to be a useful compound in preventing dementia progression.
Citicoline has a wide range of effects and could be an essential substance in the treatment of many neurological diseases.
Its positive impact on learning and cognitive functions among the healthy population is also worth noting.❞
Source: Application of Citicoline in Neurological Disorders: A Systematic Review
The dopamine bonus
Remember how we said that citicoline has a knock-on effect on other systems, including the dopaminergic system? This means that it’s been studied (and found meritorious) for alleviating symptoms of Parkinson’s disease:
❝Patients with Parkinson’s disease who were taking citicoline had significant improvement in rigidity, akinesia, tremor, handwriting, and speech.
Citicoline allowed effective reduction of levodopa by up to 50%.
Significant improvement in cognitive status evaluation was also noted with citicoline adjunctive therapy.❞
Source: Citicoline as Adjuvant Therapy in Parkinson’s Disease: A Systematic Review
Where to get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
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Who Initiates Sex & Why It Matters
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In an ideal world, it wouldn’t matter any more than who first says “let’s get something to eat” when hungry. But in reality, it can cause serious problems on both sides:
Fear and loathing?
The person who initiates gets the special prize of an n% chance of experiencing rejection, and then what? Try again, and again, and risk seeming pushy? Or leave the ball in the other person’s court, where it may then go untouched for the next few months, because (in the most positive scenario) they were waiting for you to initiate at a better time for them?
The person who does not initiate, and/but does not want sex at that time, gets the special prize of either making their partner feel unwanted, insecure, and perhaps unloved, or else grudgingly consenting to sex that’s going to be no fun while your heart’s not in it, and thus create the same end result plus you had an extra bad experience?
So, that sucks all around:
- Initiating touch (sex or cuddling) can feel like a test of being wanted, whereupon a lack of initiation or response may be misinterpreted as a lack of love or appreciation.
- Meanwhile, non-reciprocation might stem from exhaustion or unrelated issues. For many, it’s a physiological lottery.
10almonds note: not discussed in this video, but for many couples, problems can also arise because one partner or another just isn’t showing up with the expected physical signs of physiological arousal, so even if they say (and mean!) an enthusiastic “yes”, their body’s signs get misread as a “not really, though”, resulting in one partner feeling rejected, and both feeling inadequate—on account of something that was completely unrelated to how the person actually felt about the prospect of sex*.
*Sometimes, physiological arousal will simply not accompany psychological arousal, no matter how sincere the latter. And on the flipside, sometimes the signs of physiological arousal will just show up without psychological arousal. The human body is just like that sometimes. We all must listen to our partners’ words, not their genitals!
The solution to this problem is thus the same as the solution to the rest of the problem that is discussed in the video, and it’s: good communication.
That can be easier said than done, of course—not everyone is at their most eloquent in such situations! Which is why it can be important to have those conversations first outside of the bedroom when the stakes are low/non-existent.
Even with the best communication, a more general, overarching non-reciprocity (real or perceived) of sexual desire can cause bitterness, resentment, and can ultimately be relationship-ending if a resolution that’s acceptable to everyone involved is not found.
Ultimately, the work as a couple must begin from within as individuals—addressing self-worth issues to better navigate love and intimacy.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Relationships: When To Stick It Out & When To Call It Quits
Take care!
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Astaxanthin: Super-Antioxidant & Neuroprotectant
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Think Pink For Brain Health!
Astaxanthin is a carotenoid that’s found in:
- certain marine microalgae
- tiny crustaceans that eat the algae
- fish (and flamingos!) that eat the crustaceans
Yes, it’s the one that makes things pink.
But it does a lot more than that…
Super-antioxidant
Move over, green tea! Astaxanthin has higher antioxidant activity than most carotenoids. For example, it is 2–5 times more effective than alpha-carotene, lutein, beta-carotene, and lycopene:
Antioxidant activities of astaxanthin and related carotenoids
We can’t claim credit for naming it a super-antioxidant though, because:
Astaxanthin: A super antioxidant from microalgae and its therapeutic potential
Grow new brain cells
Axtaxanthin is a neuroprotectant, but that’s to be expected from something with such a powerful antioxidant ability.
What’s more special to astaxanthin is that it assists continued adult neurogenesis (creation of new brain cells):
❝The unique chemical structure of astaxanthin enables it to cross the blood-brain barrier and easily reach the brain, where it may positively influence adult neurogenesis.
Furthermore, astaxanthin appears to modulate neuroinflammation by suppressing the NF-κB pathway, reducing the production of pro-inflammatory cytokines, and limiting neuroinflammation associated with aging and chronic microglial activation.
By modulating these pathways, along with its potent antioxidant properties, astaxanthin may contribute to the restoration of a healthy neurogenic microenvironment, thereby preserving the activity of neurogenic niches during both normal and pathological aging. ❞
That first part is very important, by the way! There are so many things that our brain needs, and we can eat, but the molecules are unable to pass the blood-brain barrier, meaning they either get wasted, or used elsewhere, or dismantled for their constituent parts. In this case, it zips straight into the brain instead.
See also:
How To Grow New Brain Cells (At Any Age)
(Probably) good for the joints, too
First, astaxanthin got a glowing report in a study we knew not to trust blindly:
…and breathe. What a title that was! But, did you catch why it’s not to be trusted blindly? It was down at the bottom…
❝Conflict of interest statement
NOVAREX Co., Ltd. funded the study. Valensa International provided the FlexPro MD® ingredients, and NOVAREX Co., Ltd. encapsulated the test products (e.g., both FlexPro MD® and placebo)❞
Studies where a supplement company funded the study are not necessarily corrupt, but they can certainly sway publication bias, i.e. the company funds a bunch of studies and then pulls funding from the ones that aren’t going the way it wants.
So instead let’s look at:
Astaxanthin attenuates joint inflammation induced by monosodium urate crystals
and
Astaxanthin ameliorates cartilage damage in experimental osteoarthritis
…which had no such conflicts of interest.
They agree that astaxanthin indeed does the things (attenuates joint inflammation & ameliorates cartilage damage).
However, they are animal studies (rats), so we’d like to see studies with humans to be able to say for sure how much it helps these things.
Summary of benefits
Based on the available research, astaxanthin…
- is indeed a super-antioxidant
- is a neuroprotective agent
- also assists adult neurogenesis
- is probablygood for joints too
How much do I take, and is it safe?
A 2019 safety review concluded:
❝Recommended or approved doses varied in different countries and ranged between 2 and 24 mg.
We reviewed 87 human studies, none of which found safety concerns with natural astaxanthin supplementation, 35 with doses ≥12 mg/day.❞
Source: Astaxanthin: How much is too much? A safety review
In short: for most people, it’s very safe and well-tolerated. If you consume it to an extreme, you will likely turn pink, much as you would turn orange if you did the same thing with carrots. But aside from that, the risks appear to be minimal.
However! If you have a seafood allergy, please take care to get a supplement that’s made from microalgae, not one that’s made from krill or other crustaceans, or from other creatures that eat those.
Where can I get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
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The Truth About Chocolate & Skin Health
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝What’s the science on chocolate and acne? Asking for a family member❞
The science is: these two things are broadly unrelated to each other.
There was a very illustrative study done specifically for this, though!
❝65 subjects with moderate acne ate either a bar containing ten times the amount of chocolate in a typical bar, or an identical-appearing bar which contained no chocolate. Counting of all the lesions on one side of the face before and after each ingestion period indicated no difference between the bars.
Five normal subjects ingested two enriched chocolate bars daily for one month; this represented a daily addition of the diet of 1,200 calories, of which about half was vegetable fat. This excessive intake of chocolate and fat did not alter the composition or output of sebum.
A review of studies purporting to show that diets high in carbohydrate or fat stimulate sebaceous secretion and adversely affect acne vulgaris indicates that these claims are unproved.❞
Source: Effect of Chocolate on Acne Vulgaris
As for what might help against acne more than needlessly abstaining from chocolate:
Why Do We Have Pores, And Could We Not?
…as well as:
Of Brains & Breakouts: The Neuroscience Of Your Skin
And here are some other articles that might interest you about chocolate:
- Chocolate & Health: Fact or Fiction?
- The “Love Drug”: Get PEA-Brained!
- Enjoy Bitter Foods For Your Heart & Brain
Enjoy! And while we have your attention… Would you like this section to be bigger? If so, send us more questions!
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The Not-So-Sweet Science Of Sugar Addiction
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One
LumpMechanism Of Addiction Or Two?
In Tuesday’s newsletter, we asked you to what extent, if any, you believe sugar is addictive; we got the above-depicted, below-described, set of responses:
- About 47% said “Sugar is chemically addictive, comparable to alcohol”
- About 34% said “Sugar is chemically addictive, comparable to cocaine”
- About 11% said “Sugar is not addictive; that’s just excuse-finding hyperbole”
- About 9% said “Sugar is a behavioral addiction, comparable to video gaming”
So what does the science say?
Sugar is not addictive; that’s just excuse-finding hyperbole: True or False?
False, by broad scientific consensus. As ever, the devil’s in the
detailsdefinitions, but while there is still discussion about how best to categorize the addiction, the scientific consensus as a whole is generally: sugar is addictive.That doesn’t mean scientists* are a hive mind, and so there will be some who disagree, but most papers these days are looking into the “hows” and “whys” and “whats” of sugar addiction, not the “whether”.
*who are also, let us remember, a diverse group including chemists, neurobiologists, psychologists, social psychologists, and others, often collaborating in multidisciplinary teams, each with their own focus of research.
Here’s what the Center of Alcohol and Substance Use Studies has to say, for example:
Sugar Addiction: More Serious Than You Think
Sugar is a chemical addiction, comparable to alcohol: True or False?
True, broadly, with caveats—for this one, the crux lies in “comparable to”, because the neurology of the addiction is similar, even if many aspects of it chemically are not.
In both cases, sugar triggers the release of dopamine while also (albeit for different chemical reasons) having a “downer” effect (sugar triggers the release of opioids as well as dopamine).
Notably, the sociology and psychology of alcohol and sugar addictions are also similar (both addictions are common throughout different socioeconomic strata as a coping mechanism seeking an escape from emotional pain).
See for example in the Journal of Psychoactive Drugs:
On the other hand, withdrawal symptoms from heavy long-term alcohol abuse can kill, while withdrawal symptoms from sugar are very much milder. So there’s also room to argue that they’re not comparable on those grounds.
Sugar is a chemical addiction, comparable to cocaine: True or False?
False, broadly. There are overlaps! For example, sugar drives impulsivity to seek more of the substance, and leads to changes in neurobiological brain function which alter emotional states and subsequent behaviours:
The impact of sugar consumption on stress driven, emotional and addictive behaviors
However!
Cocaine triggers a release of dopamine (as does sugar), but cocaine also acts directly on our brain’s ability to remove dopamine, serotonin, and norepinephrine:
The Neurobiology of Cocaine Addiction
…meaning that in terms of comparability, they (to use a metaphor now, not meaning this literally) both give you a warm feeling, but sugar does it by turning up the heating a bit whereas cocaine does it by locking the doors and burning down the house. That’s quite a difference!
Sugar is a behavioral addiction, comparable to video gaming: True or False?
True, with the caveat that this a “yes and” situation.
There are behavioral aspects of sugar addiction that can reasonably be compared to those of video gaming, e.g. compulsion loops, always the promise of more (without limiting factors such as overdosing), anxiety when the addictive element is not accessible for some reason, reduction of dopaminergic sensitivity leading to a craving for more, etc. Note that the last is mentioning a chemical but the mechanism itself is still behavioral, not chemical per se.
So, yes, it’s a behavioral addiction [and also arguably chemical in the manners we’ve described earlier in this article].
For science for this, we refer you back to:
The impact of sugar consumption on stress driven, emotional and addictive behaviors
Want more?
You might want to check out:
Beating Food Addictions: When It’s More Than “Just” Cravings
Take care!
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5 Ways To Beat Afternoon Energy Slumps
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This is Nisha Vora, of Rainbow Plant Life fame. After graduating from Harvard Law School, she realized she hated being a lawyer, and pivoted completely to become what she now is 12 years later, a chef and health coach.
Here are her tips for boosting energy through the day:
Caffeine timing
If you don’t do caffeine at all, no need to change that, but if you do, Vora advises that midday is the best time for it, with a very good rationale:
- of course it should not be too late in the day, because the elimination half-life of caffeine (4–8 hours to eliminate just half of the caffeine, depending on genes, call it 6 hours as an average though honestly for most people it will either be 4 or 8, not 6) is such that it can easily interfere with sleep for most people
- because caffeine is an adenosine blocker, not an adenosine inhibitor, taking caffeine in the morning means either there’s no adenosine to block, or it’ll just “save” that adenosine for later, i.e. when the caffeine is eliminated, then the adenosine will kick in, meaning that your morning sleepiness has now been deferred to the afternoon, rather than eliminated.
Another reminder that caffeine is the “payday loan” of energy. So, midday it is. No morning sleepiness to defer, and yet also not so late as to interfere with sleep.
See also: Calculate (And Enjoy) The Perfect Night’s Sleep
Simplify what can be simplified
This one’s not from a physiological basis, but rather, that a lot of the time most of us have much of our energy being taken by constant task-switching (what gets called multitasking, but as our brain is a single processor, it really means switching rapidly between different kinds of cognition, which is not efficient). In order to avoid that energy drain, try to streamline things and make a particular effort to not only single-task, but to do so without distractions.
Counterpoint: if you have unmedicated ADHD, then chances are you’ll do better with a single small distraction chosen by you, than trying to go without distractions, because your brain will find distractions anyway, so you might as well choose one (for many people it is background music, or a podcast or TV show that one doesn’t may attention to but it’s there) as a matter of harm reduction, and that way you’ll do better at focusing on your primary task than if your brain were reaching out for every and any possible distraction.
Manage your blood sugars
In particular, she advocates for avoiding sugary breakfasts, opting instead for protein, fat, and fiber-rich options. For more in this regard, see:
10 Ways To Balance Your Blood Sugars
Walk after meals
You don’t have to don hiking boots and “I am just going outside and may be some time“; rather, even a 2–5 minute walk after a meal helps regulate digestion and glucose levels, avoiding postprandial energy slumps.
So,
- if you have a treadmill, after eating is a great time to use it for a few minutes
- if you have stairs, now’s a great time to go up and down them a few times
One last technique for when everything else fails
We’ll quote her directly on this one:
❝Despite my best efforts, soemtimes I just have one of those days. Maybe I didn’t sleep well or I’m distracted by my never ending thoughts. If I need to be productive or energized on those days, I will do something that I absolutely hate:
I will take a cold shower.
And I hate it because I’m already always cold all the time, so why would I want to get a cold shower?
Well, it’s because cold water immersion has been shown to dramatically boost your dopamine levels, which gives you more energy and motivation.
In the moment though, it’s mostly painful and I hate everything and everyone around me.
But I know that if I can suffer through two minutes of a cold shower, I will feel so refreshed.❞
There are more benefits than just that, though, see:
A Cold Shower A Day Keeps The Doctor Away?
Want more from Nisha Vora?
We reviewed one of her books a while back:
The Vegan Instant Pot Cookbook – by Nisha Vora
Enjoy!
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Is Unnoticed Environmental Mold Harming Your Health?
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Environmental mold can be a lot more than just the famously toxic black mold that sometimes makes the headlines, and many kinds you might not notice, but it can colonizes your sinuses and gut just the same:
Breaking the mold
Around 25% of homes in North America are estimated to have mold, though the actual number is likely to be higher, affecting both older and new homes. For that matter, mold can grow in unexpected areas, like inside air conditioning units, even in dry regions.
If mold just sat where it is minding its own business, it might not be so bad, but instead they release their spores, which are de facto airborne mycotoxins, which can colonize places like the sinuses or gut, causing significant health issues.
Not everyone in the same household is affected the same way by mold due to genetic differences and varying pre-existing health conditions. But as a general rule of thumb, mold inflames the brain, nerves, gut, and skin, and can negatively impact the vagal nerve, which is linked to the gut-brain connection. Mycotoxins also damage mitochondria, leading to symptoms like fatigue, brain fog, and cognitive issues. To complicate matters further, mold illness can mimic other conditions like anxiety, chronic fatigue, fibromyalgia, IBS, and more, making it difficult to diagnose.
Testing is possible, though they all have limitations, e.g:
- Home testing: testing the home for mold spores and mycotoxins is crucial for effective treatment; professional mold remediation companies are a good idea (to do a thorough job of cleaning, without also breathing in half the mold while cleaning it).
- Mold allergy testing: mold allergy testing (IgE testing or skin tests) is often used, but it doesn’t diagnose mold-related illnesses linked to severe symptoms like fatigue or neurodegeneration.
- Serum antibody testing: tests for immune reactions (IgG) to mycotoxins may not always show positive results if the immune system is weakened by long-term exposure.
- Urine mycotoxin testing: urine tests can detect mycotoxins in the body, though are likely to be more expensive, being probably not covered by public health in Canada or insurance in the US.
- Organic acid testing: this urine test can indicate mold colonization in areas like the sinuses or gut. Again, cost/availability may vary, though.
For more information on all of this, enjoy:
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Want to learn more?
You might also like to read:
Take care!
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