Low acetylcholine? Dysautonomia?

Perceiver

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Currently I am experiencing fatigue (mostly in the afternoons, for 5 years), palinopsia (of illusory type: seeing afterimages of high contrast objects, for 2 years), mild anxiety (specially in the morning), waking up around 5:00 with palpitations and buzzing body, tired and hollow eyes after meals, bloating after some meals, and very occasional episodes of mild dizziness (worse in hot weather). I get stressed quite easily.

A few days ago, a "precision medicine" doctor, told me I had dysautonomia with an underactive parasympathetic system and low acetylcholine and low DHEA. He thinks that sympathetic overactivity causes my fatigue. This diagnostic was partly based on the interpretation of heart rate variability, blood pressure and bioelectrical impedance measured by a computerized system (ES Teck Complex System). Although the dysautonomia diagnostic seems to match my symptoms, I don't know to what extent I can trust the low acetylcholine assumption, since it was "calculated" and not measured directly.

The doctor wants to increase my acetylcholine and DHEA levels and has prescribed me various supplement complexes (soy lecithin, L-alpha glycerylphosphorylcholine, huperzine A [cholinesterase inhibitor], L-tyrosine, phosphatidylserine, and DHEA among others) and practices for stimulating the vagus nerve. I have read the risks of promoting acetylcholine in Ray Peat's article "The dark side of stress (learned helplessness)", stating that high acetylcholine is involved in Alzheimer and Parkinson. So I am quite confused at this point.

I am also worried that these symptoms could lead to a neurodegenerative state. I don't want to mess things up

During the last year, some out of range values that have been found in my tests are: low neutrophils, low platelet count, low copper (hair and blood), top of range calcium (blood), high selenium (blood), high zinc (blood and hair), high magnesium (in hair, top of range in erithrocites), high boron (hair), low DHEA (saliva), low cortisol (only in the saliva afternoon measure), high lactate:pyruvate ratio (blood), high superoxide dismutase (blood), high glutamine (urine organic acids), high noradrenaline (urine organic acids), high adrenaline (urine organic acids) and low GABA (urine organic acids)

How does one know if there is an acetylcholine deficiency since it can not be measured directly as far as I know?
Has anybody been in a similar situation?
How can I stimulate parasympathetic activity and tame sympathetic activity?
 

mostlylurking

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doctor, told me I had dysautonomia with an underactive parasympathetic system and low acetylcholine and low DHEA. He thinks that sympathetic overactivity causes my fatigue.
Dysautonomia and underactive parasympathetic system are basically the same thing (I think). These are indicative of thiamine deficiency. I've been through it. I take high dose thiamine hcl for it.

links:
Dr. Lonsdale has written a great book about it.

The doctor wants to increase my acetylcholine and DHEA levels
Thiamine helps normalize acetylcholine levels (I think). Impairment of behavior and acetylcholine metabolism in thiamine deficiency. This involves a cycle/"metabolism" that involve acetylcholine and acetyl co-enzyme A

quote:
"Acetylcholine is an important neurotransmitter in the central nervous system, in the somatic nervous system, where it is released at the neuromuscular junction, and in the autonomic nervous system. It is released from preganglionic nerves as well as from postganglionic parasympathetic nerves and also from some postganglionic sympathetic nerves. Acetylcholine is the endogenous agonist at muscarinic and nicotinic cholinergic receptors.

Acetylcholine is synthesized from choline and acetyl Co-enzyme A by the enzyme, choline acetyltransferase. The rate-limiting step in the synthesis of acetylcholine is transport of choline into the nerve terminal via the high-affinity choline transporter."

Ray Peat says that the safest way to normalize DHEA level is to take pregnenalone. I am 72. I take pregnenalone and my DHEA level is at the healthy level. If you take DHEA itself and get a little too much, it can convert to estrogen.
I have read the risks of promoting acetylcholine in Ray Peat's article "The dark side of stress (learned helplessness)", stating that high acetylcholine is involved in Alzheimer and Parkinson. So I am quite confused at this point.
I think that Ray Peat was focused on acetylcholine getting too high (not good) whereas Dr. Lonsdale is focused on acetylcholine being too low (not good either).

Dr. Costantini successfully treated thousands of Parkinson's disease patients with high dose thiamine hcl. The fast improvement is quite remarkable. I found his website very helpful: HDT Therapy His patients' before/after videos are available here: Videos Parkinson's Patients before and after treatment - Ultima Edizione.Eu Although these short clips are in Italian, most have English subtitles.
low copper (hair and blood), top of range calcium (blood), high selenium (blood), high zinc (blood and hair), high magnesium (in hair, top of range in erithrocites), high boron (hair), low DHEA (saliva), low cortisol (only in the saliva afternoon measure), high lactate
High lactate points to a thiamine deficiency or thiamine functional blockage. Oxidative metabolism requires thiamine; without it, the process can't work and the end product is lactic acid instead of carbon dioxide. Elliot Overton has some good videos about thiamine and how it works:

View: https://www.youtube.com/playlist?list=PLZPlb2-Xf5TzYhS2h-bXD4q8TBWRjub-D


Click on the link (red, italic, small font) above to go to the list of videos on thiamine.

I think zinc blocks copper?
How does one know if there is an acetylcholine deficiency since it can not be measured directly as far as I know?
Has anybody been in a similar situation?
How can I stimulate parasympathetic activity and tame sympathetic activity?
I've been in a similar situation. I recovered via high dose thiamine hcl; I followed Dr. Costantini's protocol. I did try to use TTFD thiamine but I couldn't tolerate it, probably because I was low in glutathione. Taking thiamine hcl has corrected my low glutathione so I suppose I could try the TTFD again but I've gotten such great results from taking the thiamine hcl that I'm happy just sticking with taking it. I have been taking 1 gram of thiamine hcl 2Xday for the past 18 months.

additional links:


 
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Tim Lundeen

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Not sure the diagnosis of low acetylcholine (ACh) necessarily follows from what you've described.

* Dizziness in heat can be caused by syncope from high histamine/ACh
* Low copper, high zinc is more likely associated with high histamine/ACh
* High lactate:pyruvate suggests more anaerobic glycolysis, less mitochondrial oxphos, which could cause lower citrate (because most of it typically comes from mitochondria), lower acetyl-CoA, and hence lower ACh. But cells have other sources of citrate and acetyl-CoA, so not conclusive
* waking up around 5:00 with palpitations and buzzing body, tired and hollow eyes after meals, bloating after some meals...I get stressed quite easily: these can all be due to high ACh
* fatigue (mostly in the afternoons) can be caused by too much fat at lunch, you could try skipping lunch or eating a low-fat, lower-calorie meal

What is your pulse and blood pressure? Low pulse, low BP are indicative of high ACh, but high pulse/BP are not conclusive because they reflect the balance between parasympathetic and sympathetic

You might just try supplements that don't affect body stores of choline, because if you are actually high acetylcholine, the various choline supplements will add fuel to the fire, and can take many weeks to clear. Water soluble stuff is much safer as a diagnostic, the same is true for the fat-soluble forms of thiamine.
 
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Perceiver

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Dysautonomia and underactive parasympathetic system are basically the same thing (I think). These are indicative of thiamine deficiency. I've been through it. I take high dose thiamine hcl for it.
...
Thiamine helps normalize acetylcholine levels (I think). Impairment of behavior and acetylcholine metabolism in thiamine deficiency. This involves a cycle/"metabolism" that involve acetylcholine and acetyl co-enzyme A
...
High lactate points to a thiamine deficiency or thiamine functional blockage. Oxidative metabolism requires thiamine; without it, the process can't work and the end product is lactic acid instead of carbon dioxide.
...
I have been taking 1 gram of thiamine hcl 2Xday for the past 18 months.

Hi @mostlylurking , nice to talk to you!. Just some weeks ago I tried taking thiamine because of your posts.
I didn't experience any significative improvement, but I only went up to 420mg, and was also taking other things like taurine.
I think I will try again. I guess thiamine is safe to experiment with

What cofactors do you take along with thiamine and in which ratios?
How do you know when to stop thiamine supplementation?
 
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Perceiver

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Not sure the diagnosis of low acetylcholine (ACh) necessarily follows from what you've described.

* Dizziness in heat can be caused by syncope from high histamine/ACh
* Low copper, high zinc is more likely associated with high histamine/ACh
* High lactate:pyruvate suggests more anaerobic glycolysis, less mitochondrial oxphos, which could cause lower citrate (because most of it typically comes from mitochondria), lower acetyl-CoA, and hence lower ACh. But cells have other sources of citrate and acetyl-CoA, so not conclusive
* waking up around 5:00 with palpitations and buzzing body, tired and hollow eyes after meals, bloating after some meals...I get stressed quite easily: these can all be due to high ACh
* fatigue (mostly in the afternoons) can be caused by too much fat at lunch, you could try skipping lunch or eating a low-fat, lower-calorie meal

What is your pulse and blood pressure? Low pulse, low BP are indicative of high ACh, but high pulse/BP are not conclusive because they reflect the balance between parasympathetic and sympathetic

You might just try supplements that don't affect body stores of choline, because if you are actually high acetylcholine, the various choline supplements will add fuel to the fire, and can take many weeks to clear. Water soluble stuff is much safer as a diagnostic, the same is true for the fat-soluble forms of thiamine.

My blood pressure is usually low, my pulse is also low (50-60 bpm). My urine histamine levels were fine a year ago. So based on your points, my symptoms actually may point to low ACh.
This is one of the problems I face: since acetylcholine can not be measured I don't know whether my levels are high or low. It is confusing

I guess I need to experiment with thiamine once again
 
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Perceiver

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You need to fix your copper deficiency ASAP.

My "precision medicine" doctor prescribed me a copper supplement. However I am reluctant to take it, since I have read that copper should only be taken from foods, since supplements may cause oxidation reactions.

Aside from eating copper-rich foods (liver, shrimps, cacao, etc), what can I do to improve copper restoration/utilization?
 

mostlylurking

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Hi @mostlylurking , nice to talk to you!. Just some weeks ago I tried taking thiamine because of your posts.
I didn't experience any significative improvement, but I only went up to 420mg, and was also taking other things like taurine.
I think I will try again. I guess thiamine is safe to experiment with

What cofactors do you take along with thiamine and in which ratios?
How do you know when to stop thiamine supplementation?
Dr. Costantini warns about taking thiamine hcl with anything other than water. Fruit juice will cancel out the benefit. Coffee and tea block thiamine; I avoid both. I space anything with sugar (including carbs) at least 30 minutes before and after the thiamine intake. I space taking my thyroid med and my thiamine at least an hour apart.

I think it would be a good idea to read as much as you can about thiamine. Dr. Lonsdale and Dr. Chandler Marrs have written/said that many times the improvement from supplementing with thiamine can take months. Dr. Costantini's work pointed to using the amounts of thiamine hcl he writes about on his website (link above in my last post) because this is what works for Parkinson's Disease. I found it helpful to watch the patients' videos to see their massive improvement.

Do you have any idea where the zinc overload you have came from? Zinc blocks copper and you need copper. The zinc overload is concerning. I follow Ray Peat's advice and eat shellfish once a week to get my trace minerals. I read somewhere that high dose thiamine will deplete manganese so I used maple syrup for a manganese source for maybe six months. It tasted really good! I wound up giving myself a manganese overload via the maple syrup. Manganism is something to be avoided. I'm better now since I gave up the maple syrup (sob).

"Objectives: Zinc excitotoxicity and thiamine pyrophosphate deficiency (TD) are known pathogenic signals contributing to mechanism of different encephalopathies through inhibition of enzymes responsible for energy metabolism such as pyruvate dehydrogenase, aconitase or ketoglutarate dehydrogenase. The aim of this work was to investigate whether subclinical Zn excess and TD, frequent in aging brain, may combine yielding overt neuronal impairment.Results: Clonal SN56 cholinergic neuronal cells of septal origin were used as the model of brain cholinergic neurons, which are particularly susceptible to neurodegeneration in the course of Alzheimer's disease, hypoxia and other dementia-linked brain pathologies. Neither subtoxic concentration of Zn (0.10 mM) nor mild 20-25% TD deficits alone caused significant negative changes in cultured cholinergic neurons viability and their acetyl-CoA/acetylcholine metabolism. However, cells with mild TD accumulated Zn in excess, which impaired their energy metabolism causing a loss of neurons viability and their function as neurotransmitters. These negative effects of Zn were aggravated by amprolium which is an inhibitor of thiamine intracellular transport.Conclusion: Our data indicate that TD may amplify otherwise non-harmful border-line Zn excitotoxic signals yielding progress of neurodegeneration."

also this one: Protection of Cholinergic Neurons against Zinc Toxicity by Glial Cells in Thiamine-Deficient Media - PubMed
"Brain pathologies evoked by thiamine deficiency can be aggravated by mild zinc excess. Cholinergic neurons are the most susceptible to such cytotoxic signals. Sub-toxic zinc excess aggravates the injury of neuronal SN56 cholinergic cells under mild thiamine deficiency. The excessive cell loss is caused by Zn interference with acetyl-CoA metabolism. The aim of this work was to investigate whether and how astroglial C6 cells alleviated the neurotoxicity of Zn to cultured SN56 cells in thiamine-deficient media. Low Zn concentrations did not affect astroglial C6 and primary glial cell viability in thiamine-deficient conditions. Additionally, parameters of energy metabolism were not significantly changed. Amprolium (a competitive inhibitor of thiamine uptake) augmented thiamine pyrophosphate deficits in cells, while co-treatment with Zn enhanced the toxic effect on acetyl-CoA metabolism. SN56 cholinergic neuronal cells were more susceptible to these combined insults than C6 and primary glial cells, which affected pyruvate dehydrogenase activity and the acetyl-CoA level. A co-culture of SN56 neurons with astroglial cells in thiamine-deficient medium eliminated Zn-evoked neuronal loss. These data indicate that astroglial cells protect neurons against Zn and thiamine deficiency neurotoxicity by preserving the acetyl-CoA level."

There are recommendations online that chelation therapy will reduce zinc levels. I just want to include a heads up about info I've read that the chelating physician should always determine the patient's thiamine status before chelating because if there is a thiamine deficiency the chelation can result in death. I was chelated in 2014 for lead poisoning (EDTA by IV) and was probably thiamine deficient (nobody bothered to check). It didn't kill me but I did get rheumatoid arthritis and almost had to go into assisted living because I couldn't take care of myself. I did recover with increased thyroid medication and b vitamins, including thiamine hcl.

I take magnesium glycinate, about 1200mg/day which equals to around 600mg magnesium. I consume orange juice and bananas for the potassium. I salt my food to taste for the sodium. I take about 90mg niacinamide and 90mg riboflavin 4Xday. I drink milk for the calcium. I do take some other things but I don't think they pertain to the high dose thiamine hcl I take.

I take 1 gram of thiamine hcl 2Xday. I'm following Dr. Costantini's protocol. According to what he's written and based on my weight my dose should have been 2.5 grams/day. However, when I tried that dose, I experienced shooting electrical zapping pains in my thighs that night when I went to bed. So I reduced my dose back down to the 2 grams/day. I do not experience any negative symptoms at this dose. However there was a period of adjustment early on when I started this high dose. It turned out that my electrolytes were low so I increased my salt intake.

How to know when to stop thiamine supplementation: Dr. Costantini advises his Parkinson's Disease patients to go off of the thiamine hcl for a while after taking it for maybe 6 months. I think this is to show the patient and their family that they really do need to keep taking the thiamine because after maybe 2 months the Parkinson's Disease symptoms come back. Dr. Costantini has written that he has had some patients taking high dose thiamine hcl for as long as 7 years with no ill effects.
 
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redsun

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Currently I am experiencing fatigue (mostly in the afternoons, for 5 years), palinopsia (of illusory type: seeing afterimages of high contrast objects, for 2 years), mild anxiety (specially in the morning), waking up around 5:00 with palpitations and buzzing body, tired and hollow eyes after meals, bloating after some meals, and very occasional episodes of mild dizziness (worse in hot weather). I get stressed quite easily.

A few days ago, a "precision medicine" doctor, told me I had dysautonomia with an underactive parasympathetic system and low acetylcholine and low DHEA. He thinks that sympathetic overactivity causes my fatigue. This diagnostic was partly based on the interpretation of heart rate variability, blood pressure and bioelectrical impedance measured by a computerized system (ES Teck Complex System). Although the dysautonomia diagnostic seems to match my symptoms, I don't know to what extent I can trust the low acetylcholine assumption, since it was "calculated" and not measured directly.

The doctor wants to increase my acetylcholine and DHEA levels and has prescribed me various supplement complexes (soy lecithin, L-alpha glycerylphosphorylcholine, huperzine A [cholinesterase inhibitor], L-tyrosine, phosphatidylserine, and DHEA among others) and practices for stimulating the vagus nerve. I have read the risks of promoting acetylcholine in Ray Peat's article "The dark side of stress (learned helplessness)", stating that high acetylcholine is involved in Alzheimer and Parkinson. So I am quite confused at this point.

I am also worried that these symptoms could lead to a neurodegenerative state. I don't want to mess things up

During the last year, some out of range values that have been found in my tests are: low neutrophils, low platelet count, low copper (hair and blood), top of range calcium (blood), high selenium (blood), high zinc (blood and hair), high magnesium (in hair, top of range in erithrocites), high boron (hair), low DHEA (saliva), low cortisol (only in the saliva afternoon measure), high lactate:pyruvate ratio (blood), high superoxide dismutase (blood), high glutamine (urine organic acids), high noradrenaline (urine organic acids), high adrenaline (urine organic acids) and low GABA (urine organic acids)

How does one know if there is an acetylcholine deficiency since it can not be measured directly as far as I know?
Has anybody been in a similar situation?
How can I stimulate parasympathetic activity and tame sympathetic activity?
Both noradrenaline/adrenaline and acetylcholine are needed for reducing symptoms of dysautonomia. Nicotinic acetylcholine receptors are what trigger norepinephrine release from the adrenals. So higher acetylcholine levels are necessary for maintaining BP and heart rate as they affect catecholamines. Of course if your copper is low, acetylcholine will not be as effective as it should be. Only in severe excess could Ach be bad. But very few people have severe excess of Ach activity, most people have it low. Ray's article does not apply to you, do not worry about it. Ach is indispensable for autonomic function.

You should take the choline supplements you were prescribed. B1 does help some people but you have said you have tried it already. There are two limiting factors to acetylcholine synthesis, Acetyl-CoA and choline. Acetyl-CoA is made in the krebs cycle this is why B1 helps some people and Bs generally help since they are needed to make Acetyl-CoA. But if you already tried that then likely the chronic lack of choline is the limiting factor for you and also copper deficiency. Choline deficiency is quite bad for your health, untreated it can lead to organ and muscle damage. Its needed for very important functions, there is absolutely no need to be afraid of choline. Not too mention it is an essential nutrient.

Low copper is just as bad and will also contribute to dysautonomia. Copper bisglycinate is a safe form.

Most people due to their diets low in meat and eggs end up with poor choline status. Even you eat a decent amount of meat it is hard to meet choline needs without eggs.
 
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Tim Lundeen

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My blood pressure is usually low, my pulse is also low (50-60 bpm). My urine histamine levels were fine a year ago. So based on your points, my symptoms actually may point to low ACh.
This is one of the problems I face: since acetylcholine can not be measured I don't know whether my levels are high or low. It is confusing

I guess I need to experiment with thiamine once again
Low BP and low pulse are diagnostic for high ACh. Do not take the choline supplements, etc.

One other symptom to check is how often you have to pee. High ACh means you have to pee more often. You can use this to help titrate supplements...

For copper, you could try MitoSynergy, that's probably what you need most. Could try 1 or 2 mg/day for a couple of weeks, at some point titrate down to maintenance levels...
 

mostlylurking

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Thank you. Do you find that high of a dose to affect levels of other hormones too? Like progesterone or testosterone?
I also take about 20mg of progesterone daily. My hormone test showed my progesterone as high and my estrogen as about zero. Because I've dealt with runaway inflammation and estrogen dominance for years, and was diagnosed with rheumatoid arthritis in 2014, I am very happy with how I feel on the pregnenalone and progesterone. My DHEA is in the ideal range; my testosterone is low. I'm 72, female.
 
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Both noradrenaline/adrenaline and acetylcholine are needed for reducing symptoms of dysautonomia. Nicotinic acetylcholine receptors are what trigger norepinephrine release from the adrenals. So higher acetylcholine levels are necessary for maintaining BP and heart rate as they affect catecholamines. Of course if your copper is low, acetylcholine will not be as effective as it should be. Only in severe excess could Ach be bad. But very few people have severe excess of Ach activity, most people have it low. Ray's article does not apply to you, do not worry about it. Ach is indispensable for autonomic function.

You should take the choline supplements you were prescribed. B1 does help some people but you have said you have tried it already. There are two limiting factors to acetylcholine synthesis, Acetyl-CoA and choline. Acetyl-CoA is made in the krebs cycle this is why B1 helps some people and Bs generally help since they are needed to make Acetyl-CoA. But if you already tried that then likely the chronic lack of choline is the limiting factor for you and also copper deficiency. Choline deficiency is quite bad for your health, untreated it can lead to organ and muscle damage. Its needed for very important functions, there is absolutely no need to be afraid of choline. Not too mention it is an essential nutrient.

Low copper is just as bad and will also contribute to dysautonomia. Copper bisglycinate is a safe form.

Most people due to their diets low in meat and eggs end up with poor choline status. Even you eat a decent amount of meat it is hard to meet choline needs without eggs.

Thanks redsun.

Curiously, according to an organic acids test my noradrenaline (in urine) is high. I suspect my palpitations and mild anxiety come from high noradrenaline.

A year ago my copper (blood and hair) was in range, however my zinc was high (blood and hair). (zinc overload maybe caused by some supplement complex, I am not sure)
My last test shows low copper (blood) and zinc in range (blood).


I eat 2-4 eggs a week (not much, I know) and meat. I though this was enough.
I don't have reservations supplementing choline, but doesn't directly inhibiting acetylcholinesterase (huperzine, bacopa) seem risky?
I wonder if there is a way to know one's choline levels.

What are the downsides of high dose thiamine supplementation?


Blood test. March 2022
- Ceruloplasmin: * 15.35 mg/dL [20 - 60]
- Copper: * 60 ug/dL [75 - 145]

- Zinc (serum): 99 ug/dL [60 - 120]

Organic acids (urine). February 2022
- Copper: 6.9 mg/24H [3.6 - 15.5]
- Zinc: 183.45 ug/24h [51 - 857]
- Noradrenaline: * 42.01 ug/g creatinine [10-50]

Hair test. July 2021
- Zinc: * 323.197 mcg/g [150-272]
- Copper: 18.049 [ 10-41]

Blood test. June 2021
- Copper: 80 ug/dL [75 - 145]
- Zinc (serum): * 125 ug/dL [60 - 120]
 
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Thanks for your detailed response @mostlylurking

Do you have any idea where the zinc overload you have came from? Zinc blocks copper and you need copper. The zinc overload is concerning.

I don't know. I suspect it may be from some supplement, but not sure.

Last year I was high in zinc but in range for copper. Four months ago I was low in copper but in range for zinc. (included the test result in the previous post) A mystery to me.
 
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Low BP and low pulse are diagnostic for high ACh. Do not take the choline supplements, etc.

One other symptom to check is how often you have to pee. High ACh means you have to pee more often. You can use this to help titrate supplements...

For copper, you could try MitoSynergy, that's probably what you need most. Could try 1 or 2 mg/day for a couple of weeks, at some point titrate down to maintenance levels...

Thanks Tim

I pee about 8-12 times a day but not much quantity, however I don't sweat easily.
Good to know pee frequency as a marker for acetylcholine.
Do you know any other marker?
 

redsun

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Thanks Tim

I pee about 8-12 times a day but not much quantity, however I don't sweat easily.
Good to know pee frequency as a marker for acetylcholine.
Do you know any other marker?
Urinary frequency is a terrible indicator of acetylcholine activity. There are so many factors affecting frequency. The "normal" frequency is 6-8. You are still close to that frequency but again there are so many factors affecting frequency.

A valid indicator of excess acetylcholine is frequently experiencing wild and vivid dreams.

Do you have that or do you dream very little if at all?

Indicators of low Ach would be fatigue especially upon exertion, memory problems, low muscle tone, poor word recall when speaking.

Thanks redsun.

Curiously, according to an organic acids test my noradrenaline (in urine) is high. I suspect my palpitations and mild anxiety come from high noradrenaline.

A year ago my copper (blood and hair) was in range, however my zinc was high (blood and hair). (zinc overload maybe caused by some supplement complex, I am not sure)
My last test shows low copper (blood) and zinc in range (blood).


I eat 2-4 eggs a week (not much, I know) and meat. I though this was enough.
I don't have reservations supplementing choline, but doesn't directly inhibiting acetylcholinesterase (huperzine, bacopa) seem risky?
I wonder if there is a way to know one's choline levels.

What are the downsides of high dose thiamine supplementation?


Blood test. March 2022
- Ceruloplasmin: * 15.35 mg/dL [20 - 60]
- Copper: * 60 ug/dL [75 - 145]

- Zinc (serum): 99 ug/dL [60 - 120]

Organic acids (urine). February 2022
- Copper: 6.9 mg/24H [3.6 - 15.5]
- Zinc: 183.45 ug/24h [51 - 857]
- Noradrenaline: * 42.01 ug/g creatinine [10-50]

Hair test. July 2021
- Zinc: * 323.197 mcg/g [150-272]
- Copper: 18.049 [ 10-41]

Blood test. June 2021
- Copper: 80 ug/dL [75 - 145]
- Zinc (serum): * 125 ug/dL [60 - 120]
Urinary tests of neurotransmitters dont mean much unless it was a 24 hour urine catecholamine test.

Anxiety is tricky but low acetylcholine can cause it. But anxiety comes from your body not having the resources to handle a perceived stress. So it triggers anxiety which triggers adrenal secretions to better prepare you. A body with adequate reserves and is fed properly rarely gets anxious. Deficiencies would be a big part in dealing with anxiety. Your copper is low and I think this can be a major contributor your low BP and heart rate. Youngsinatra gets similar symptoms quite often and copper fixes it. And we can see clearly your copper is basically deficient.

I suggest you make dietary changes or take the choline that you are missing. 2-4 eggs a week is quite little if we are talking about reaching the choline RDA daily. I always recommend dietary changes and not supplements if possible. But you should try just the choline supplements first to see how you do with them. The Ach inhibitors I would not take, not right away at least.

The downside to high dose B1 supplementation is it is pointless especially since you already tried it. Like I said, acetylcholine requires two components. Based on your diet you are definitely missing the choline component. You need choline and copper.

You should be reach at least 600mg of choline a day from food. Some people do better with 800mg. I would suggest you trial 600mg.

Do the math and figure out what you get daily from your diet and then use choline supplements to close the gap to 600mg. Reminder you need to supplement copper as well. 4mg of copper glycinate daily is a good start.

Your DHEA levels may be low simply due to low copper:


"DHEA (dehydroepiandrosterone) is a hormone often taken as a dietary supplement to prevent the normal decline with age and in the hope of preventing heart attacks. Rats in two experiments were made deficient in copper by standard methods and criteria. Copper deficiency decreased DHEA in serum by approximately 50%."
 
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ivy

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Currently I am experiencing fatigue (mostly in the afternoons, for 5 years), palinopsia (of illusory type: seeing afterimages of high contrast objects, for 2 years), mild anxiety (specially in the morning), waking up around 5:00 with palpitations and buzzing body, tired and hollow eyes after meals, bloating after some meals, and very occasional episodes of mild dizziness (worse in hot weather). I get stressed quite easily.

I've read your other post and this one. If I were to focus on these symptoms alone, I don't think I would assume anything other than suboptimal thyroid levels and the adrenals kicking in more than they should. Apart from palinopsia, I have all of these, sometimes worse, sometimes milder, depending on my menstrual cycle and current stress. Orthostatic hypotension is worse if I get up fast or if there's too much heat like these days.

You could activate your parasympathetic system with any practice consisting of slow movement. I could refer you to one that's cheaper than a Porges therapist, but you could try some simple exercises on your own first and see what happens. I'm not sure supplements are the way to go if no one knows what is amiss. Your lifestyle will have to change, most likely.
 

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