In my last post, I reviewed one of the four ingredients in Parasym Plus,  Acetylcholine-Esterase Inhibitors, the patented supplement sold by the Driscoll Protocol. In this post, I will move on to a second ingredient (with the other two reviewed over the next two days).

Low choline levels appear to come into play with some CFS patients. This can be exposed from headaches using piracetam etc. The question of supplementation arose — and it does not look like it is a simple question to answer.

• “The MR spectroscopy (MRS) study revealed remarkable elevation of the choline/creatine ratio in the patients with CFS.” [2000]
• “Patients with hepatitis C virus (HCV) infection frequently complain of symptoms akin to the chronic fatigue syndrome… we have shown elevations in basal ganglia and white matter choline/creatine ratios in patients with histologically-mild hepatitis C, compared with healthy volunteers and patients with hepatitis B. This elevation … suggests that a biological process underlies the extrahepatic symptoms in chronic HCV infection.” [2001]
• Relative increase in choline in the occipital cortex in chronic fatigue syndrome[2002] “The mean ratio of choline (Cho) to creatine (Cr) in the occipital cortex in CFS (0.97) was significantly higher than in the controls (0.76; P=0.008).”
• Proton magnetic resonance spectroscopy of basal ganglia in chronic fatigue syndrome. ” A highly significant increase in the spectra from choline-containing compounds was seen in the CFS patient group”
• ” the regional brain areas in CFS have shown increased peaks of choline derived from the cell membrane phospholipids.” [2004]
• “The choline/creatine ratio of the GWS group was not different from that for either control group.” [2004] Suggesting that Gulf War Syndrome and CFS are different….
• “Radiological imaging studies (SPECT, Xe-CT, and MRS) revealed decreased blood flow in the frontal and thalamic areas, and accumulation of choline in the frontal lobe.” [2004]
• ” The findings produced by neuroimaging techniques are quite similar in both illnesses[CFS and MS]  and show decreased cerebral blood flow, atrophy, gray matter reduction, white matter hyperintensities, increased cerebral lactate and choline signaling and lowered acetyl-aspartate levels.”

There are some web pages worth reviewing on

• PhoenixRising [2005]  – no clinical trials of possible treatment
• “it sounds as though you have an unusual response to choline supplementation. Elevated acetylcholine in the central nervous system can cause depression. My guess is that your body may overproduce acetylcholine, or it may not be able to break acetylcholine down as rapidly as normal, and one or the other of these may account for the depression on supplementing choline. This sounds like a genetic issue…” Rick van K
• Dr. Myhill advocates supplementation if your temperament indicates it.

Bottom Line

It appears individual genetics may be the key factor in supplementation (or not to supplement). If you supplement and things improve — good, if things get worst, stop.

The root cause appears to be believed to due to phages / immune response /etc.  In my model, likely the microbiome shift.