Estrogen and choline

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
Post Reply
Quantifier
Contributor
Contributor
Posts: 95
Joined: Sat Feb 20, 2021 3:48 pm

Estrogen and choline

Post by Quantifier »

According to Perspective: Estrogen and the Risk of Cognitive Decline: A Missing Choline(rgic) Link? there is evidence that the main way estrogen treatment prevents or slows down cognitive decline is by increasing expression of the PEMT gene (encoding phosphatidylethanolamine N-methyltransferase), an enzyme that catalyzes the rate limiting step in endogenous choline synthesis.

As I was unable to get doctors to prescribe me HRT (in part due to my history of breast cancer, but also because I am several years post menopause and they don't believe there is evidence supporting HRT at this stage), I see this as very good news. It means as long as I get enough choline, either via food or supplements I don't need to worry too much about estrogen.

So how much choline is needed?

According to Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial a dose of 3 times 400mg of choline alfoscerate (alpha-GPC) improved cognitive performance (at 90 days, with further improvement at 180 days). The patients in this study were mostly women and were in the 60-80 years age range, so I can assume the women among them were postmenopausal and were relying on external choline. 1200 mg of alpha-GPC are the equivalent of 485 mg choline (about 3.5 eggs) or 2.3 grams of citicoline. I don't know how much choline they were already getting via diet.

According to Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study among middle-aged Finnish men there was a significant positive association of cognitive performance after 4 years of follow-up with dietary choline. In this cohort the low consuming quartile ate less than 374 mg choline per day whereas the highest quartile ate over 482 mg per day.

My plan at the moment is to retest my TMAO and if it is still OK increase my choline supplementation (and stop worrying about estrogen).
TLS
Contributor
Contributor
Posts: 29
Joined: Thu Jan 05, 2017 6:29 am

Re: Estrogen and choline

Post by TLS »

You might like this study by MIT on the impact of choline on APOE
https://news.mit.edu/2021/study-offers- ... imers-risk

As to estrogen, breast cancer, and menopause, I prefer to eat phytoestrogens with flax meal which also has a lot of fiber. As a survivor of breast cancer, I am leery of HRT. There have been studies showing the benefits of flax meal for BC. I like to make a muffin using flax meal and eggs. Hopefully that way get the benefits of eggs and flax.
apoe 3/4
User avatar
floramaria
Support Team
Support Team
Posts: 1317
Joined: Tue Jul 04, 2017 11:22 am
Location: Northern New Mexico

Re: Estrogen and choline

Post by floramaria »

Quantifier wrote: Sun Jul 17, 2022 10:13 pm According to Perspective: Estrogen and the Risk of Cognitive Decline: A Missing Choline(rgic) Link? there is evidence that the main way estrogen treatment prevents or slows down cognitive decline is by increasing expression of the PEMT gene (encoding phosphatidylethanolamine N-methyltransferase), an enzyme that catalyzes the rate limiting step in endogenous choline synthesis.
interesting information! Thank you for posting it.
Functional Medicine Certified Health Coach
IFM/ Bredesen Training in Reversing Cognitive Decline (March 2017)
ReCODE 2.0 Health Coach with Apollo Health
circular
Senior Contributor
Senior Contributor
Posts: 5489
Joined: Sun Nov 03, 2013 10:43 am

Re: Estrogen and choline

Post by circular »

floramaria wrote: Tue Jul 19, 2022 11:04 am
Quantifier wrote: Sun Jul 17, 2022 10:13 pm According to Perspective: Estrogen and the Risk of Cognitive Decline: A Missing Choline(rgic) Link? there is evidence that the main way estrogen treatment prevents or slows down cognitive decline is by increasing expression of the PEMT gene (encoding phosphatidylethanolamine N-methyltransferase), an enzyme that catalyzes the rate limiting step in endogenous choline synthesis.
interesting information! Thank you for posting it.
Yes, I appreciate this too, especially the summary for now since I haven't read the paper. I have PEMT rs7946(T;T), about which Rhonda Patrick's DNA report says:
This genotype, rs7946(T;T), has been associated with lower phosphatidylcholine production in the liver.

There are common polymorphisms in the PEMT gene, which codes for the phosphatidylethanolamine­-N-­methyltransferase enzyme. The variant form (T) of the rs7946 polymorphism is located in the coding region of the gene and results in an enzyme with partial loss of activity.
What's concerning is that estrogen may be less effective in women with this genotype or require higher amounts to get past the 'partial loss of activity, and of course higher amounts could backfire. We really don't know what optimal doses are.

I do use bioidentical HRT, but I don't shoot for very high levels in dosage or blood work, and lately I've decided to supplement that with introducting pressure cooked soy products into my diet for a two-pronged approach and other reasons. I have the flax seeds too, but I haven't gotten around to grinding them up yet. I caught wind that they may be better than soy, so I'll have to try to learn more (as always).

Rhonda indicates these PEMT polymorphisms are 'common'. So just think … A probably significant proportion of post-menopausal women 1) have these PEMT polymorphisms, 2) aren't supplementing with estrogen, and 3) continuously use some amount of anticholinergic medications (benzos, "gotta go" pills, antihistamines esp. 1st gen …) It would be fascinating to research this suspicious trifecta!
ApoE 3/4 > Thanks in advance for any responses made to my posts.
User avatar
Sara
Support Team
Support Team
Posts: 249
Joined: Mon Jul 03, 2017 4:44 pm
Location: Between PA and FL
Contact:

Re: Estrogen and choline

Post by Sara »

If you are interested you might read the book Estrogen Matters. It has been recommended by Dr. Hathaway and it discusses estrogen after breast cancer. I think a shortcoming of the book however (if my memory serves) was that it did not emphasize bio identical hormone replacement therapy. About 5 or 6 years ago I left my family practitioner who was opposed to hormone replacement and found a functional medicine doctor who strongly supported BHRT.
Certified ReCODE 2.0 Practitioner/Health Coach
MBA, Functional Medicine Certified Health Coach, National Board Certified Health & Wellness Coach
Supporting loved one diagnosed with AD
Post Reply