ACETYLCHOLINE

    Individuals with heterozygous and homozygous genetic variants in the PEMT gene have decreased choline production, thus increasing their need for dietary choline.

    Choline is needed to produce acetylcholine, a neurotransmitter in the vagus nerve that energizes multiple organs, including the lungs, heart, liver, stomach, and temporal lobe of the brain. Temporal lobe abnormalities have been associated with increased risk of anxiety, depression, impaired social cues, impaired short-term memory and long-term memory retrieval, and Alzheimer's disease. Approximately two-thirds of Alzheimer's patients are women. Estrogen plays a special role in PEMT gene levels in postmenopausal women, affecting memory and acetylcholine production. In one study, 80% of women homozygous for one of the PEMT polymorphisms showed signs of choline depletion, which can compromise acetylcholine levels and increase the risk of memory and reasoning impairment and increase the risk of developing Alzheimer's disease. The use of anticholinergic drugs, which include nighttime painkillers, antihistamines, sleeping pills, antidepressants, incontinence drugs, and narcotic painkillers, can block acetylcholine.

    The recommended daily intake of choline is currently between 425-550 mg and is especially important for those with PEMT variants. Eggs are one of the best sources of choline with 115 mg of choline per egg. 

When acetylcholine is low, you may feel or experience:

-muscle weakness

-difficulty learning and memory

-lack of motivation, arousal, attention, and energy

-reduced REM sleep

-risk of Alzheimer's disease.

Drugs that interact with acetylcholine

Acetylcholine Receptor Antagonist – Antimuscarinic Agents Atropine, Ipratopium, Scopolamine, Tiotropium

Acetylcholine Receptor Antagonist – Ganlionic Blockers Mecamylamine, Hexamethonium, Nicotine (high doses), Trimethaphan

Acetylcholinesterase Reactivators- Pralidoxime

Acetylcholine Receptor Antagonist – Neuromuscular Blockers Atracurium, Cisatracurium, Doxacurium, Metocurine, Mivacurium, Pancuronium, Rocuronium, Uccinylcholine, Tubocurarine, Vecuronium, Hemicholine

Acetylcholine deficiency questionnaire

Please circle the appropriate number “0 – 3” on all questions below.

0 as the least/never to 3 as the most /always.

Do you feel visual memory (shapes & images) is decreased? 0 1 2 3

Do you feel your verbal memory is decreased? 0 1 2 3

Do you have memory lapse? 0 1 2 3

Has your creativity been decreased? 0 1 2 3

Has your comprehension been diminished? 0 1 2 3

Do you have difficulty calculating numbers? 0 1 2 3

Do you have difficulty recognizing objects & faces? 0 1 2 3

Do you feel like your opinion about yourself has changed? 0 1 2 3

Are you experiencing excessive urination? 0 1 2 3