What Are The Benefits of Citicoline Supplementation?
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@member_31

Can you summarize the health benefits of citicoline supplementation, especially for neuroprotection and glaucoma? I also want to know about the potential risks.

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david 4.3k
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Benefits of Citicoline in Glaucoma

Citicoline has emerged as one of the most promising supplements for managing glaucoma while also providing other health benefits. Below, we explore testimonials, scientific findings, and strategies to mitigate potential side effects, ensuring its safe and effective use.


A Testimonial: Restoring Vision with Citicoline

Many glaucoma patients have shared positive experiences with citicoline. A compelling testimonial from a FitEyes member recounts:

"I started at 300 mg per day late last year. I’ve been at 1000 mg per day for about six months now. I’m no longer legally blind."

The patient described dramatic improvements in vision after starting citicoline, transitioning from 20/400 vision to better than 20/100. They also regained their ability to perceive colors like bright red, triggering emotional relief.

Until reading about citicoline on this very forum I had spent the prior six years shuffling through life as best I could.

After starting citicoline my vision is so much better. Just today I saw the bright red frame of my reading glasses clearly out of my right eye.

Red is my favorite color. One day, a few months after starting citicoline, I could see it again and started crying.

NOTE: the testimonial was condensed from the original, but no facts were changed.

Such cases highlight the neuroprotective potential of citicoline for glaucoma management. We'll cover the science below.


Citicoline: A Neuroprotective Powerhouse

What is Citicoline?

Citicoline, also known as cytidine-diphosphocholine (CDP-choline), is a naturally occurring nutrient that serves as a precursor for the synthesis of phosphatidylcholine, a critical component of neuronal cell membranes. It plays a vital role in brain health by:

  • Enhancing neuroplasticity and cognitive function.
  • Stabilizing cellular membranes.
  • Reducing oxidative stress and neuroinflammation.

Benefits of Citicoline

Citicoline has been extensively studied for its neuroprotective properties in various conditions, including:

  • Glaucoma: Citicoline may protect retinal ganglion cells (RGCs) and slow visual field loss progression.
  • Stroke Recovery: It improves cognitive outcomes and neurological recovery post-stroke.
  • Cognitive Decline: It supports memory and executive functions in age-related and vascular cognitive impairments.
  • Traumatic Brain Injury: Citicoline aids in neuronal repair and recovery.

Studies show that citicoline enhances neurotransmitter synthesis (e.g., acetylcholine and dopamine), which are essential for cognitive processes. Furthermore, it has a favorable safety profile, making it suitable for long-term use without significant adverse effects.

You can find additional Ask FitEyes articles with content about citicoline, such as:


The TMAO Challenge with Citicoline

What is TMAO?

Trimethylamine N-oxide (TMAO) is a metabolite produced when gut bacteria convert dietary choline, carnitine, and betaine into trimethylamine (TMA), which is then oxidized in the liver. Elevated TMAO levels have been linked to:

  • Increased risk of cardiovascular diseases such as atherosclerosis, myocardial infarction, and stroke.
  • Promotion of cholesterol deposition in arterial walls.
  • Heightened platelet reactivity and systemic inflammation.

Citicoline’s Role in TMAO Production

Compared to other choline sources like phosphatidylcholine or free choline, citicoline produces less TMAO due to differences in its metabolic pathway. However, it can still contribute to elevated TMAO levels, particularly in individuals with specific gut microbiota profiles or pre-existing cardiovascular risks.


Berberine: A Natural Solution to TMAO Risks

What is Berberine?

Berberine is a bioactive compound derived from plants such as Berberis. Known for its broad range of health benefits, berberine has been widely studied for its ability to modulate gut microbiota and improve metabolic health.

How Does Berberine Reduce TMAO Levels?

Berberine counteracts the potential rise in TMAO levels associated with citicoline supplementation through two primary mechanisms:

  1. Inhibition of CutC Enzyme Activity: Berberine suppresses the microbial enzyme choline utilization C (CutC), which converts choline into TMA -- a precursor of TMAO. This directly reduces TMA production.
  2. Gut Microbiota Remodeling: Berberine promotes the growth of beneficial bacteria such as Lactobacillus while reducing harmful strains that contribute to TMA production. This modulation further protects against TMAO-induced complications.

The Synergy Between Citicoline and Berberine

The pairing of berberine and citicoline has emerged within the FitEyes community as a promising strategy for optimizing neuroprotective benefits while mitigating potential cardiovascular risks. Drawing on extensive prior research, including findings from PMC6683073, we will discuss why this combination may be beneficial.

Why Combine These Two?

The co-administration of berberine with citicoline offers a balanced approach to maximizing benefits while minimizing risks:

  • Neuroprotection from Citicoline: Enhances cognitive function, supports brain health, and provides essential nutrients like choline and cytidine.
  • Cardiometabolic Protection from Berberine: Reduces TMAO production by modulating gut microbiota and suppressing CutC enzyme activity.

This combination allows individuals to leverage citicoline’s neuroprotective effects without increasing their risk of cardiovascular diseases due to elevated TMAO levels.


Scientific Evidence Supporting the Combination

Citicoline’s Safety Profile

A key study highlighted in PMC6683073 underscores citicoline’s unique advantages:

  1. Reduced Toxicity Compared to Choline: On a molar basis, citicoline is significantly less toxic than free choline due to differences in metabolic pathways.
  2. Lower Propensity for TMA Production: Citicoline resists enzymatic hydrolysis in the intestinal lumen better than other choline derivatives like phosphatidylcholine. This reduces its conversion to TMA and subsequently to TMAO.
  3. Procognitive Effects: Citicoline consistently improves cognitive performance in clinical trials involving vascular cognitive impairment and post-stroke recovery.

Berberine’s Role in Mitigating Risks

Berberine’s ability to inhibit CutC enzyme activity has been well-documented. By reducing microbial conversion of choline into TMA, berberine effectively lowers circulating TMAO levels. Additionally, its gut microbiota remodeling properties enhance overall metabolic health.


Who Can Benefit from This Combination?

The combination of berberine with citicoline may be particularly beneficial for:

  • Individuals at risk of cardiovascular diseases who require choline supplementation.
  • Those seeking cognitive enhancement without increasing cardiometabolic risks.
  • Patients managing insulin resistance or metabolic syndrome.
  • Individuals with glaucoma or at risk for neurodegenerative diseases.

Practical Considerations

  1. Dosage Recommendations:

    • Citicoline: Typical doses range from 500 mg to 2000 mg per day, depending on the condition being treated.
    • Berberine: Commonly recommended doses are 500 mg taken two to three times daily.
  2. Safety Precautions:

    • Both supplements are generally well-tolerated but may cause mild gastrointestinal discomfort in some individuals.
    • Always consult a healthcare provider before starting any new supplement regimen, especially if you have pre-existing conditions or are taking medications.
  3. Monitoring Outcomes:

    • Regular monitoring of cardiovascular markers (e.g., lipid profile, inflammatory markers) can help assess the effectiveness of this combination.
    • Cognitive assessments may help track improvements in mental clarity and memory.

Conclusion

It's not clear why others are not highlighting the combination of berberine with citicoline. However, the FitEyes community was one of the first to recognnize it as an innovative approach to enhancing brain health while addressing potential cardiovascular and other risks associated with elevated TMAO levels. As highlighted by research findings -- including those detailed in PMC6683073 -- citicoline offers significant neuroprotective benefits with a favorable safety profile. When paired with berberine’s ability to reduce TMAO production through gut microbiota modulation, this duo becomes a powerful tool for supporting both cognitive function and cardiometabolic health.

By understanding the science behind these compounds, individuals can make informed decisions about their health strategies -- leveraging the synergy between citicoline and berberine for optimal results! Always consult your healthcare provider before beginning any supplement regimen tailored to your specific needs.


Selected References:

  1. Unveiling Citicoline's Mechanisms and Clinical Relevance in the Treatment of Neuroinflammatory Disorders.: https://pubmed.ncbi.nlm.nih.gov/39221499
  2. Citicoline: Neuroprotective Mechanisms in Cerebral Ischemia.: https://pubmed.ncbi.nlm.nih.gov/11796739
  3. The Role of Citicoline in Cognitive Impairment: Pharmacological Characteristics, Possible Advantages, and Doubts for an Old Drug With New Perspectives.: https://pubmed.ncbi.nlm.nih.gov/26366063
  4. Application of Citicoline in Neurological Disorders: A Systematic Review.: https://pubmed.ncbi.nlm.nih.gov/33053828
  5. Effectiveness and Safety of Citicoline in Mild Vascular Cognitive Impairment: The IDEALE Study.: https://pubmed.ncbi.nlm.nih.gov/23403474
  6. Long-Term Treatment With Citicoline May Improve Poststroke Vascular Cognitive Impairment.: https://pubmed.ncbi.nlm.nih.gov/23406981
  7. Efficacy of Citicoline as an Acute Stroke Treatment.: https://pubmed.ncbi.nlm.nih.gov/19351232
  8. Citicoline: A Superior Form of Choline?.: https://pubmed.ncbi.nlm.nih.gov/31336819
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