Dr. Andy Galpin

One gram per day for 30 days has been found in at least mild TBI to produce statistically significant improvements in recognition memory, which is obviously an important downstream behavioral problem that's associated with TBIs. And that study was actually repeated about 20 years after the initial one. And they used a pretty similar protocol design and found actually no difference in TBI symptoms.

One gram per day for 30 days has been found in at least mild TBI to produce statistically significant improvements in recognition memory, which is obviously an important downstream behavioral problem that's associated with TBIs. And that study was actually repeated about 20 years after the initial one. And they used a pretty similar protocol design and found actually no difference in TBI symptoms.

I think it was headaches, sleepiness, dizziness, and concentration and things like that. However, what's really important to note here is in this study, the majority of the participants had really minor TBIs, meaning their cholinergic pathways were probably not affected. This is a classic case of something I warned out at the beginning or earlier in our conversation.

I think it was headaches, sleepiness, dizziness, and concentration and things like that. However, what's really important to note here is in this study, the majority of the participants had really minor TBIs, meaning their cholinergic pathways were probably not affected. This is a classic case of something I warned out at the beginning or earlier in our conversation.

If you're not actually giving a supplement or taking a food that the mechanism of effect is not the mechanism of injury, then you shouldn't expect a benefit. So I think this is really a case of that.

If you're not actually giving a supplement or taking a food that the mechanism of effect is not the mechanism of injury, then you shouldn't expect a benefit. So I think this is really a case of that.

I actually do feel like the strength of the evidence for choline is okay and reasonable, but that 2023 follow-up study to me is not an indication that the original study was flawed or didn't work, but simply you had mild... injuries that didn't result in damage to that pathway. So the supplement provided very limited or mixed benefits.

I actually do feel like the strength of the evidence for choline is okay and reasonable, but that 2023 follow-up study to me is not an indication that the original study was flawed or didn't work, but simply you had mild... injuries that didn't result in damage to that pathway. So the supplement provided very limited or mixed benefits.

In addition, I know of two meta-analyses that reported generally positive benefits here, regardless of TBI severity. So that's some more information on positive benefit. And the probably landmark study in this area came out fairly recently. It was called the COBRIT study. I think it stands for like cytokoline brain injury treatment trial.

In addition, I know of two meta-analyses that reported generally positive benefits here, regardless of TBI severity. So that's some more information on positive benefit. And the probably landmark study in this area came out fairly recently. It was called the COBRIT study. I think it stands for like cytokoline brain injury treatment trial.

You know how scientists always like to make these acronyms for our big studies. Again, honestly, I feel like this is being misinterpreted in my opinion. And so I want to touch on this just really briefly. But in that, they found no evidence of benefit for cognitive function or cognitive status 90 days post-injury with two grams a day of acetylcholine.

You know how scientists always like to make these acronyms for our big studies. Again, honestly, I feel like this is being misinterpreted in my opinion. And so I want to touch on this just really briefly. But in that, they found no evidence of benefit for cognitive function or cognitive status 90 days post-injury with two grams a day of acetylcholine.

Now, a lot of people have used that to say, we told you it doesn't work, it doesn't work, and that's fine. People can interpret how they will. My personal opinion on this study, though, is that it's highly flawed. And I'm saying that because in it, they considered adherence to be 75%, meaning if the people in the study took their acetylcholine 75% of the time, they were considered to be adherent.

Now, a lot of people have used that to say, we told you it doesn't work, it doesn't work, and that's fine. People can interpret how they will. My personal opinion on this study, though, is that it's highly flawed. And I'm saying that because in it, they considered adherence to be 75%, meaning if the people in the study took their acetylcholine 75% of the time, they were considered to be adherent.

Only 44% of their participants met that 75% mark. 40% were considered to be non-adherent. So that means they took it less than 75%. And the rest, they don't even know. So for me, it's hard to suggest that it didn't work when the vast majority of people didn't actually take it most of the time, and those that did was still only 75% of the time.

Only 44% of their participants met that 75% mark. 40% were considered to be non-adherent. So that means they took it less than 75%. And the rest, they don't even know. So for me, it's hard to suggest that it didn't work when the vast majority of people didn't actually take it most of the time, and those that did was still only 75% of the time.

So, cool study, helped add a lot of information, in my opinion, to the database, but I don't think it should be interpreted as saying that choline then therefore doesn't work, or it's a myth, or any of those other more extreme interpretations of these data.

So, cool study, helped add a lot of information, in my opinion, to the database, but I don't think it should be interpreted as saying that choline then therefore doesn't work, or it's a myth, or any of those other more extreme interpretations of these data.

More directly for the context of our show today, been done on football players where brain choline, specifically in the primary motor cortex, is known to diminish across the season, similar to what we saw earlier with creatine. Probably as a result of those continuous head impacts, so it couldn't be inferred directly from this study, but pretty easy to make a guess that's likely scenario.

More directly for the context of our show today, been done on football players where brain choline, specifically in the primary motor cortex, is known to diminish across the season, similar to what we saw earlier with creatine. Probably as a result of those continuous head impacts, so it couldn't be inferred directly from this study, but pretty easy to make a guess that's likely scenario.