The Case for CDP Choline

Written by Dr. William Shaw

What is CDP Choline?

Over the past 50 years, Cytidine 5'-diphosphocholine (CDP Choline) has been widely used for the treatment of different diseases of the central nervous system as well as many other organs and is available as a supplement in 70 countries. In fact, whether used as a supplement or as a drug, CDP Choline has cognitive enhancing benefits including improved learning and memory as well as showing beneficial effects in traumatic brain injury, stroke, Alzheimer’s disease, Parkinson’s disease, learning and memory disorders.

CDP Choline Protects the Brain

We hear a lot about brain health, especially related to healthy brain aging. One part of diseases related to the brain involves the breakdown of the coating of the neurons. CDP choline actually helps protect and stimulate the repair and regeneration of these important neuronal cell membranes. It also prevents the body from breaking down these protective neuronal phospholipid membranes, which it can do when levels of choline in the body become too low. CDP Choline’s protectant effect on the brain is also a direct result of its ability to inhibit Phospholipase A2 (PLA2), discussed in more detail below.

Highlight: CDP Choline helps repair and build the myelin sheath that surrounds the brain neurons needed to maintain healthy for brain support.

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CDP Choline Repairs the Brain

What happens when the brain is injured or when memory starts to fail as part of the aging process? Research has shown that CDP Choline can help with age-related memory loss, in fact one study with participants between 50 and 85 years old had improved memory after daily use for 12 weeks. This suggests that using CDP Choline daily is not just safe but also potentially beneficial in protecting against age-related memory loss.

And for those who have suffered a stroke, one study showed that CDP Choline reduced markers associated with stroke-related brain damage when taking 2000 mg of CDP Choline for 12–14 days. Another study used a Rankin scale along with the National Institute of Health Stroke Scale 12 – which are standard tests evaluating stroke recovery – to assess improvement in their general condition. It was found that when 500 mg–4000 mg of CDP Choline per day was given soon after ischemic stroke that improvement in their general condition was seen. This is exciting information for stroke victims.

Highlight: CDP Choline supports the repair and healing of the brain after traumatic injury and stroke. It also helps with age-related memory loss.

CDP Choline’s Effect on Neurotransmitters

CDP Choline also increases the neurotransmitters norepinephrine, dopamine, serotonin and acetylcholine in the central nervous system, which support healthy brain functioning and protects the brain from damage during events of both low blood flow and low oxygen. Lastly, CDP Choline lowers neuron damaging glutamate levels when they become elevated after a stroke. Elevated glutamine (brain excitotoxicity) is also sometimes seen in more severe cases of autism and in schizophrenia.

Highlight: CDP Choline prevents damage to the brain that occurs due to low blood flow, low oxygen, or high glutamine levels, often occurring following a stroke.

The Phospholipase A2 (PLA2) Connection to CDP Choline

Another reason why CDP Choline may be so beneficial is since it inhibits or stops a harmful enzyme called Phospholipase A2 (PLA2). PLA2 is a potent cause of inflammation and when elevated, can cause widespread cell death and tissue damage. PLA2 is almost identical to the toxins contained in venomous snakes. Elevated levels can be found in the spinal fluid of patients with Alzheimer’s disease and in the urine samples of patients with multiple sclerosis and autism.

Rheumatoid and osteoarthritis, sepsis, psoriasis, pancreatitis, cancer, and Crohn’s disease are also conditions that are associated with elevated PLA2.

Atherogenesis (the process of forming plaques in the innermost layer of the arteries) and the reduction of blood flow to the heart, brain, and other critical organs are all associated with elevated PLA2 enzymes. In addition, elevated phospholipase A2 is thought to increase the replication rate of many viruses including cytomegalovirus, hepatitis C virus, adenoviruses, parvovirus, West-Nile virus, and coronaviruses. Older experimental animals, when infected with coronaviruses more pathogenic than SARS-2, were more likely to die when age-related elevated PLA2 levels were also present.

Highlight: CDP Choline inhibits PLA2 which can be found in individuals with Alzheimer’s, dementia, MS, RA, Crohn’s, autism, and even some cancers. Elevated PLA2 can also increase replication rate of viruses, including coronaviruses.

CDP Choline Dosing & Safety Profile

Effective dosing of CDP Choline based on research from clinical trials ranges from 500 mg to 2000 mg per day. CDP Choline is safe for use in kids and adults. Based on evidence from trials in children as young as 5 years of age, oral doses of up to 1200 mg per day were shown to be safe when administered to children.

Studies using oral, IM, and IV dosing of CDP Choline in children and adults showed minimal occurrence of adverse events, affirming again a high-level of safety. As of today, there have been no reports of serious side effects. The mild side effects that have been reported include stomach pain, diarrhea, and headaches, which are more likely to occur when taking higher doses. Always work with your doctor on the dosing that is best for you.

References

1. Application of Citicoline in Neurological Disorders: A Systematic Review
   
   
2. Citicoline (CDP-choline): mechanisms of action and effects in ischemic brain injury
   
   
3. Long-Term Treatment with Citicoline Prevents Cognitive Decline and Predicts a Better Quality of Life after a First Ischemic Stroke
   
   
4. Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
   
   
5. The effects of citicoline on acute ischemic stroke: a review
   
   
6. The role of citicoline in cognitive impairment: pharmacological characteristics, possible advantages, and doubts for an old drug with new perspectives
   
   
7. Serum Levels of the Biomarkers Associated with Astrocytosis, Neurodegeneration, and Demyelination: Neurological Benefits of Citicoline Treatment of Patients with Ischemic Stroke and Atrial Fibrillation
   
   
8. Phosphatidylcholine and the CDP-choline cycle
   
   
9. Critical role of phospholipase A2 group IID in age-related susceptibility to severe acute respiratory syndrome-CoV infection
   
   
10. The role of citicoline in neuroprotection and neurorepair in ischemic stroke
    
    
11. Inhibition of Cytosolic Phospholipase A2α Impairs an Early Step of Coronavirus Replication in Cell Culture
    
    
12. Toxin-like peptides in plasma, urine and faecal samples from COVID-19 patients
    
    
13. Analysis of secretory group II phospholipase A2 expression in human aortic tissue in dependence on the degree of atherosclerosis
    
    
14. Efficacy and safety of oral citicoline in acute ischemic stroke: drug surveillance study in 4,191 cases