I am wondering if choline status may be a critical piece of COVID morbidity, mortality, and sequelae.
I am a 46 year old mother of two who has a graduate degree in neurobiology. My graduate work involved studying the effects of estrogen on memory with Robert Colvin at Ohio University. I was sidelined by health issues and chemical sensitivity during my first pregnancy, and have been struggling off and on with my and my children's health ever since.
Back in 2012 I decided to run some consumer genetics tests on myself, and since then I have been getting to know my metabolic shortcomings rather well. It turns out that I carry multiple invisible illnesses that have been quite a liability with respect to COVID. Off and on I have struggled with expressive and receptive aphasia since I was a child, which was never diagnosed. I figured out after falling ill in the Spring of 2019 that it happened after chemical exposure, and that my water heater was partially backdrafting causing me to have panic attacks along with the aphasia. I say “partially backdrafting” because I never detected carbon monoxide, only spikes in the VOC levels whenever there was a sudden temperature drop, or certain conditions caused our home to depressurize because of inadequate fresh air supply to our utility room. A VOC meter helped me see the patterns and remove insidious sources of those and formaldehyde from our home, greatly changing everyone's mood and problem-solving ability. This had been happening for 6-14 years. I'm not sure exactly when it began because we had the furnace replaced in 2014. (It's important to note that I had those episodes at other times in my life from other exposures to chemicals even in childhood, and despite trying different ways of eating and exercising). We had the backdrafting water heater removed in October 2020, and a month later, despite taking quarantine very seriously, my daughter caught COVID when we allowed her to go out for Halloween, masked. We have had a lot of difficulty with infectious disease over the years.
At that time, I ended up developing long haul COVID. My sister who is a physician caught it in April 2020 and had been struggling with it for most of that year. Through her workup, which was being done a few weeks ahead of mine, we learned that she might have a form of hyperaldosteronism. We have both had renal issues over the course of our lives. I looked in my genetics tests and discovered that I carried a few known polymorphisms for Familial Hyperaldosteronism Type III (FHIII) and Primary Aldosteronism with Seizures and Other Neurological Abnormalities (PASNA). FHIII is associated with potassium regulation, and PASNA is associated with calcium. The gene CACNA1D, which is the 4th subunit of a voltage-gated calcium channel and the one associated with PASNA, happens to abut the gene for choline dehydrogenase (CHDH), and I discovered I have multiple polymorphisms in that, too.
Both Otto Warburg and Dr. Weston A. Price, DDS found liver extracts to be of use in health. Warburg, who won the Nobel Prize for his work on niacinamide, found that the extract was capable of inhibiting the growth of cancer cells. Price was a dentist who studied traditional cultures and was looking for something he called "The X-Factor" in the diet of those peoples which seemed to provide them with better bone structure and teeth, as well as attention and intelligence. Years ago I wondered if the X-Factor was one of the quinones. Now, after seeing the effects of choline on my own health, and reading the current research, I am wondering if choline is responsible for many of those effects.
Another part of my story is that we have a history of vaccine reactions in our home. I am wondering if this also has something to do with choline deficiency. Note that I have had at least two breakthrough infections in addition to having COVID. I had significant reactions to both doses of the vaccine. So I am not running out to get a booster, since it will likely have little effect beyond the vaccination and illness I have already had (especially for people in my age group), and I do not wish to unnecessarily expose myself in public with so many individuals going maskless or using ineffective masks due to a misguided belief that vaccination alone is enough to stop the spread of COVID. Only the WHO seems to understand the real situation, which makes me wonder about the mental capabilities of the people making health decisions for our population in the US. One of the things I learned from all of the experiences I have had with COVID, even the milder infections, is that it subtly affects cognition in a way that makes it difficult to solve complex problems. I am wondering if there are people who might have active infectious which only affect cognitive ability mildly enough that they and the people near them might not notice anything is wrong, but that it changes the order of things drastically. A person who is extremely busy might not ever notice the things they miss, or that they feel off.
The other diseases I carry besides FHIII and PASNA are cystic fibrosis (delta F508), von Willebrand Type I (higher risk for COVID), and erythropoetic protoporphyria. My standard labs are almost always normal except for hypokalemia, when I go to the doctor; I think I have been dealing with subclinical issues for most of my life brought on by the way choline deficiency, estrogen and chemical exposures help turn on those other conditions. I believe this may be a critical piece of why the medical system is failing to address the problems of so many, especially women.
The other critical parts of my care regimen are occasional methylene blue (which I use sparingly because it can be serotonergic) and benfotiamine, a fat-soluble version of thiamine, as well as wild yam. I believe I did not see a benefit from phosphatidyl choline (which is a form of choline conjugated to a polyunsaturated fatty acid) because my body is extra sensitive to unsaturated fats from my combined genetics, and that the choline is critical for sort of chelating them in the lipid bilayer or incorporating them into bile, for lack of a better description. I know that's oversimplified. People with CF have augmented metabolism of polyunsaturate.
Wild yam is what bioidentical progesterone is made from, and has been used in Asia for centuries to treat ailments involving the kidney. I believe that the synergy between choline, the diosgenin or downstream steroid compounds in wild yam, and dopamine are critical for osmotic balance in the kidney and brain, and prevent mineral loss. I was able to discontinue my blood pressure medicines on May 25, 2021. I sometimes have BP increases after exposures, but I can resolve them with CDP choline. I actually had my blood pressure resolve in January when I made the discovery, but my dishwasher had an electrical fire that filled our home with smoke in early February and so the choline I was taking was not enough. My episodes of aphasia are greatly improved as well, and my communication abilities are better than they have been for several years. I believe there has been an important effect on my memory, too. My sister is on the max dose of all her blood pressure medicines, despite weighing a lot less (she has more stress and more chemical exposure in her daily life). I was being evaluated for a bilateral renal artery stenosis which was discovered by ultrasound when my blood pressure resolved, so I never got a proper diagnosis, even though in 2004 I was diagnosed with a unilateral renal artery stenosis. At that time it was also found that I had scarring on my right kidney. I see that COVID can also cause kidney scarring, and I wonder if the effects on the kidney have to do with the hypertension and tachycardia that it can cause. My aldosterone, renin and cortisol were all found to be normal, despite being "overweight." Every effort I have ever made to lose weight has resulted in mood, memory and communication issues, so I learned to manage my catabolic vs. anabolic metabolism more intelligently.
I am aware that research on the systemic effects of choline in humans is lacking and inconsistent; I think that is because we have not controlled for chemical exposure.
I wish that the powers that be understood that "not dead" is just not good enough. They'll rush to approve vaccines, but not give the same urgency to other less expensive and sustainable treatments which might have complementary effects that would extend beyond the problem at hand.