Category: Nutrition and Health

  • Danger! L-Carnitine Causes Heart Disease!

    That’s What The Headline Said, So It Must Be True – Right?

     

    By Nurse mark

     

    Our recently featured supplement ALA / ALC caught the attention of our eagle-eyed readers, who also have the memory attributed to elephants – who never forget.

    We received a few “heads-ups” and questions about a news article that made the rounds a few years ago, reporting on a study from the Cleveland Clinic.

    The article, written by a very prolific freelance writer by the name of Cari Nierenberg goes to great lengths to stress the evils of eating red meat (which contains carnitine) and concludes with this ominous warning:

    Pass it on: A compound called carnitine found in in red meat and supplements may increase the risk of heart disease.

    Yikes! This is scare-tactics journalism at its worst – just like my title for this article. But it worked, because Cari’s article was picked up (read: purchased) by dozens of different outlets from The Huffington Post to LiveScience.com and more. It also has taken on a life of its own on the internet, and is being reproduced and quoted in endless emails and blogs, all dedicated to warning us poor unwary and uneducated folk about the dangers of meat…

    I’m not going to rebut Cari’s article – it is a sensationalized but moderately accurate report of a very limited study done by the Cleveland Clinic that looked at the gut bacteria of people who ate red meat and found that in some of those people carnitine (and l-carnitine) could be broken down into a compound called trimethylamine-N-oxide (TMAO). The researchers then pointed to very preliminary and unproven research that suggested that TMAO might be bad for the heart. They then wrapped up this grand study of 10 subjects by concluding that meat eaters had gut bacteria that took carnitine and created TMAO which caused heart disease.

    I wonder if the researchers were a little out-of-breath after jumping to all those conclusions…

    I won’t try to rebut the research article or its conclusions either, since I would not be able to do any better than the doctors and research staff at Life Extension Foundation who produced a very thorough, well-researched, and quite readable rebuttal to the study in this article of August 2013:

    Rebuttal to Attack Against Carnitine
    By William Faloon, Steven V. Joyal, MD, Luke Huber, ND, MBA, Blake Gossard, and Richard A. Stein, MD, PHD

    The L.E.F. Report concludes:

    In the wake of a single negative study, deceptive media headlines have generated concern that supplemental forms of L-carnitine may be detrimental to heart health. This notion flies in the face of numerous published, peer-reviewed studies showing L-carnitine promotes cardiovascular health in a variety of ways. The media’s effort to generate outrageous headlines has undermined decades of scientific research on the heart-health benefits of carnitine.

    Carnitine is a vital nutrient for health. The discovery of carnitine’s ability to maximize cellular fuel efficiency and minimize the impact of normal cellular metabolism on delicate cellular machinery has led to a revolution in the way scientists think about some of the most troubling age-related conditions. Supplementing with carnitine can help preserve cell energy levels, enhance heart muscle strength, reduce the impact of obesity and diabetes, and protect heart attack victims from dying.

    I hope you will read the Life Extension Report – it offers valuable information on the many benefits of carnitine and l-carnitine as well as debunking the sensationalist news reporting of a flawed study.

    Oh, and feel free to enjoy a nice juicy steak – in moderation of course – that red meat really is good for you!

  • About Those “Expiry Dates”…

    Ask Dr. Myatt: How long will vitamins and herbs keep?

     

    Q: There are numbers and dates on my supplements. Are these important? Should I be worried about my supplements "expiring"?

    A: That depends on the product and the form that it is in. Most quality herbal and nutritional supplements have an expiration date on the label, but this date does not reflect the whole story.

    Herbal tinctures and fluid extracts, especially if made from potent herbs to begin with, are the longest lasting of any product. Dr. Sharol Tilgner, former CEO of Wise Woman Herbals, our primary herbal provider, now dates tinctures with a 7 year expiration date. Dr. Tilgner believes that this is a conservative dating process, and I concur. A well-made tincture is potent and useable for up to 20 years from the time it is made.

    Now, "here’s the rub." Many herbal products – and I do mean many – are made from dried herbs that have lost their potency BEFORE the tincture is made. These products are weak to begin with. Although they will "keep" for many years, their strength is questionable. The herbal tinctures that we select for Wellness Club are some of the most potent products available. These liquid tincture formulas will be fully potent 10 years from now (conservatively) and I wouldn’t hesitate to use them 20 years hence.

    Any encapsulated product, whether herbal or nutritional, has a much shorter shelf-life. This is because of a process called "oxidation." Individual particles in herbs or nutrients are exposed to air. This is true for both gelatin capsules and tablets.

    A super potent herb formula in capsule form (remember, many are not potent to begin with) will be potent 2-3 years from the date of manufacture. (On our products, this date is stamped.) In other words, the product will be potent 1 year beyond the expiration date.

    Nutritional supplements are a bit trickier, because different vitamins have different shelf-lives. Dr. Jaques at Tyler Encapsulations (one of our major supplement suppliers) offers this:

    • Vitamin C: up to 5 years
    • Vitamin B’s: 3 years
    • Vitamin A: unknown
    • Vitamin D: indefinitely
    • Vitamin E: 2 years (except mixed tocopherols, which may last 3-5 years)
    • Mineral formulas: 10+ years
    • Enzymes: 2 years

    All supplements, whether herbal or nutritional, will last longer if frozen. So… if you stock up, keep unopened products in your freezer or in a cool, dark, moisture-free place to extend shelf life up to 3 times the stamped expiration date.

    Nurse Mark Comments:

    This is a subject that we get a lot of questions about. Please be assured that the “Best By” date on most products does not infer that the product suddenly becomes unusable upon that date, or even at any time thereafter within reason.

    A “Best By” date represents the minimum time at which the manufacturer can be assured that the product will still be usably fresh under average consumer storage conditions – which are often less than ideal, to say the least.

    We occasionally have products here at the Wellness Club which pass their “Best By” date. What do we do with them? Throw them out? Certainly not – Dr. Myatt and I happily use them for ourselves! All our products are carefully stored in a climate controlled facility and because of that we expect them to be fine to use well after any arbitrary “Best By” date. Unopened bottles are much more stable than bottles that have been opened and thus exposed to air to begin oxidizing.

    So, if you have a supplement that is a bit past it’s “Best By” date and you know that it has been carefully stored, chances are very good that it is fine to use. If it hasn’t been carefully stored, say kept on a sunny windowsill (we like to joke about “kept on the dashboard of your car” – but it has happened!) then all bets are off, of course.

  • Robin Williams: A Tragic Death That Might Have Been Prevented

    By Nurse Mark

     

    The tragic death of comedian Robin Williams underscores the importance of maintaining a healthy neurotransmitters (brain hormones). Although Williams’ death was reportedly caused by hanging (suicide), Dr. Myatt and Nurse Mark know differently. The facts of Williams’ life and death support our thesis — that Robin Williams suffered from a severe but quite likely correctable neurotransmitter imbalance. Here are the facts of the case:

     

    Neurotransmitters (NT’s) are chemicals that affect the brain in addition to numerous other physical functions. Think of NT’s as "brain hormones," because they are. A dopamine deficiency leads to depression and is also the primary problem in Parkinson’s. Alcohol and cocaine further deplete dopamine; Williams was known to have a substance abuse problem with both. Prescription "head meds" (SSRI’s, SNRI’s and other anti-depressants) further deplete dopamine.

     

    Dopamine is an important neurotransmitter because it regulates physical actions such as movement. It is also a "feel good" brain hormone. When it’s deficient, either because we don’t have enough of the chemical or because our damaged neurons require higher-than-normal amounts to function normally, we feel bad – typically depressed, and movement suffers – Parkinson’s disease.

     

    A primary cause of dopamine deficiency is lack of appropriate precursor amino acids in the system. Nutrients involved in the production of dopamine may also be deficient. Alcohol, cocaine and even prescription anti-depressants stimulate and then deplete dopamine stores.

     

    Poor Robin was in a "perfect storm" for the travails that led him to commit suicide.

     

    The recent tragic death by suicide of Robin Williams has touched us all.

     

    Robin was a comedic genius – but like many who have the gift of genius, Robin had a dark side as well.

    It is well-known that Robin Williams struggled with drug and alcohol use for many years, and wrestled with the demons of depression.

    His widow has revealed that he had recently been diagnosed with early stage Parkinson’s disease.

    It is easy to say, as some have suggested, that in his sixties, still struggling with alcohol and drug problems, and suddenly given a bleak diagnosis of a debilitating neurological disease, the demons of his depression became too powerful and he sought relief in suicide.

    It is easy to say that, but we here at The Wellness Club don’t believe it.

    We believe that there is more to it than simply the despair of addiction, depression, and illness and that while Robin Williams may have succumbed it need not have happened. The story could have had a much different ending, and perhaps Robin’s great legacy will be a life-saving change in the way we look at the relationship between drugs and alcohol and depression and neurological diseases such as Parkinson’s.

    Consider these points:

    Dopamine is essential to much of our brains workings – but most importantly it is the “feel-good” neurotransmitter. When we have plenty of it we feel good. When we are deficient, either because we don’t have enough of the chemical or because our neurons don’t use it right, we feel bad – depressed.

    Chronic alcohol use or abuse – alcoholism – depletes the brain chemical dopamine.

    Drug abuse stimulates dopamine release. When dopamine remains in the synapse longer, it is degraded.

    Here is a quote from a noted expert in brain chemistry, Dr. Marty Hinz:

    All drugs of abuse target the brain’s reward system by increasing dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation and feelings of pleasure. The overstimulation of this system, which rewards our natural behaviors, produces the euphoric effects sought by people who abuse drugs and teaches them to repeat the behavior. When some drugs of abuse are taken, they can release two to 10 times the amount of dopamine that natural rewards do. The effect of such a powerful reward strongly motivates people to take drugs again and again.

    So here is a possible scenario for someone like Robin Williams:

    Feeling a little “down” (depressed) as everyone does at some time or other, Robin doesn’t know that his dopamine levels are not what they might be. He just knows that he feels down. “Have a drink – that’ll cheer you up!” says a well-meaning friend, and Robin does, and the friend was right – he felt better. That worked so well in fact that the next time he felt a bit down he had another drink – and felt better. And the next time, and the next time…

    After a while though, the alcohol is depleting his stores of dopamine and there just isn’t enough of the “feel-good” chemical available even with a few drinks to “help.” Not even with a lot of drinks…

    So, another well-meaning “friend” says “Here – try a little cocaine – it’ll make you feel great!” Robin tries it and his friend was right – he felt great! On top of the world! He suddenly flooded his brain so much dopamine that he felt better than he had for a long time – and able to face whatever problems were bedeviling him. Who wouldn’t want to experience that, over and over again…

    Meanwhile, Robin might be concerned enough about feeling depressed that he would see a doctor. The doctor would most certainly prescribe antidepressant drugs. Unfortunately, antidepressant drugs also deplete dopamine. Robin might have felt better briefly, but the antidepressant drugs don’t work well for long – and he would likely have entered into an endless search for “the right drug” – the one that would bring him some long-term relief to the depression that was making life a misery. But in the end, all the antidepressant drugs do is further damage neurotransmitter function – especially dopamine.

    But our human bodies are tough, adaptable, and forgiving organisms. All these insults to our neurotransmitters – especially to that important feel-good neurotransmitter dopamine – we “deal with” and carry on, compensating, adapting, managing. Like a boxer who becomes inured to being hit, bruised, concussed, and worse, or a rodeo cowboy whose profession provides him with more trauma, bruises and broken bones than anyone should have to bear, people battering their neurotransmitters with alcohol, recreational drugs, and prescription head-meds ride the ups and downs of neurotransmitter depletion and they adapt and they manage – often by self-medicating with more alcohol and drugs. For a while.

    But like the boxer or rodeo cowboy, there comes a time when there just aren’t any more reserves.

    There comes a time when the neurotransmitters – like dopamine – just aren’t there any more, or what is left isn’t working.

    They are tapped out – empty.

    Parkinson’s disease is a condition in which dopamine, which in addition to being the “feel-good” neurotransmitter is also a neurotransmitter that is important to regulating movement, is either not there or the nerve cells are unable to use it properly.

    For someone who has spent many years abusing their neurotransmitters with alcohol, recreational drugs, and prescription psychiatric drugs like SSRI’s, “early Parkinson’s” may be their warning that they have reached the end of their rope when it comes to their ability to “bounce back.”

    Many people regard affliction with Parkinson’s disease to be only slightly less devastating than Alzheimer’s disease. To be given a diagnosis of “early Parkinson’s” conjures up visions of shaking, shuffling, helpless people, ultimately unable to speak or care for themselves. I remember one patient who said to me “Give me a clean death – not that!” when we were discussing his recent diagnosis of Parkinson’s. I found myself agreeing with him.

    Robin Williams knew about Parkinson’s, and about the mainstay drug used to treat it – L-dopa; a precursor to the neurotransmitters dopamine, norepinephrine, and epinephrine or adrenaline – our catecholamines. As a skilled actor who had a starring role in the film “Awakenings” (1990) he would have researched his character and the drug and he would have known that while L-dopa has a miraculous effect on Parkinson’s and other such movement diseases, the side effects are serious and the benefits are not all that long-lasting. Sufferers are given a reprieve, not a cure, and when the drug stops working the disease symptoms return with a vengeance.

    Running out of dopamine is a bad business, and Parkinson’s is a very visible, tangible result of years of abusing one’s dopamine stores.

    But must this always be what happens? Is there no hope for someone who becomes depressed and self medicates to feel better? Must the results always be this tragic?

    No.

    Our bodies, and our brains, are very well-designed organisms; resilient and hardy. Things don’t usually “go wrong” for no good reason. When things do “go wrong” it is often an outside influence – a stressor – to our systems. Infection, injury, mental stress, can all precipitate unwanted changes to our finely balanced biology. So can the failure to provide our bodies with the nutrients needed to sustain and heal and grow.

    The neurochemicals that our brains rely on to function are made by our bodies from raw materials called amino acids – from proteins.

    When we deprive our bodies of the essential amino acids required for the manufacture of vital hormones and neurotransmitters we can compensate for a while – but not forever. We need to begin to supply these essential amino acids in generous quantities or we set ourselves up for serious problems.

    The standard answer of conventional doctors for problems such as those experienced by Robin Williams is to prescribe drugs. Those drugs either hide the symptoms or, in the case of SSRI drugs, make the few remaining supplies of neurochemicals work a little better for a while. But as Robin discovered, not for a long while. Like the drug L-dopa for Parkinson’s sufferers, the helpful effects of antidepressant drugs wear off all too soon and the symptoms, those dark demons of depression and despondency, return with a vengeance to torment the sufferer.

    A better approach is to ensure that the person has plentiful supplies of amino acids for his (or her) body to work with in creating vital neurotransmitters such as dopamine. If the body is able to make plentiful dopamine – the “feel-good” neurotransmitter – then there is less need, less desire for the person to seek the dopamine rush that comes from alcohol or drugs. Many cases of “addiction” can be “cured” by careful replenishment of amino acids in the diet.

    Although neurotransmitter balancing or repletion is best accomplished through natural means, it is NOT a do-it-yourself project. There are too many intricacies best managed by a natural physician who is highly trained in NT restoration. Primary treatment for these brain-hormone disorders include diet modification, supplementation and other lifestyle interventions. This is not a theory; the statistics for long-term treatment of Parkinson’s (dopamine depletion), depression and addiction show that these are are known to be little-helped by drugs while natural methods of neurotransmitter support have much higher success rates.

    Had we only known, we could have helped.

    Godspeed Robin Williams – you are loved and you are missed. If your untimely passing spurs even one person in similar circumstance to seek natural help then your death will not have been in vain.

    If you, or someone you care for is experiencing depression or battling addiction PLEASE, seek the help of a doctor qualified to test and replete neurotransmitters naturally.

    Q. Which comes first: depression then neurotransmitter depletion, or is it neurotransmitter depletion then depression?

    A. It doesn’t matter – all that really matters is that when neurotransmitters are plentifully replenished the demons of depression and addiction seem to go away and the sunny days of life return.

    PLEASE SEEK HELP – a Brief Telephone Consultation with Dr. Myatt is the easy way to get started.

  • Vitamin D and Liver Cancer: More Reasons Love Vitamin D

    By Nurse Mark

     

    In our modern world filled with wondrous, even miraculous offerings of synthetic drugs so benevolently given to us by Big Pharma it is comforting to know that Mother Nature is still on our side looking out for us and giving us simple things that actually do work. They do work that is, if we can just avert our eyes from the seductive glitter of patent drugs for long enough to actually get back to basics and try the natural solutions…

    Such is the case with vitamin D.

    Long dismissed by conventional medicine and Big Pharma as being only needed in miniscule amounts to prevent the ancient disease rickets and derisively called “the sunshine vitamin” so as to suggest that we get all we need from minimal exposure to daylight, vitamin D has recently forced it’s way into the spotlight as being not just valuable to our health, but essential to us in preventing some of our most feared diseases.

    We have been singing the praises of vitamin D here at The Wellness Club for many years. Over 4 years ago we offered our readers Dr. Myatt’s Special Report On Vitamin D. Now it appears that conventional medical researchers are finally catching up with us.

    Emory University has recently announced the results of research showing that vitamin D intake can lower the risk of developing hepatocellular carcinoma (HCC). For those who didn’t know, HCC is the main form of liver cancer.

    According to the article:

    Findings indicated that higher levels of vitamin D in the body cut the risk of HCC in half

     

    Let’s repeat that: higher levels of vitamin D cut the risk of liver cancer in half.

    If it were a new patent medicine that this was being said about we would be hearing all about it. The FDA and Big Pharma would be trying to convince us to add it to the drinking water. Politicians would be demanding mandatory consumption of it “for the children.”

    But it’s not a patent medicine – it’s lowly, simple, natural vitamin D and until Big Pharma can figure out how to patent it and sell it for a profit they will continue to regard it with contempt.

    We will continue to give vitamin D the respect it deserves here at The Wellness Club, and we invite you to learn more:

    Dr. Myatt’s Special Report On Vitamin D

    Vitamin D Deficiency is common – find out if you are deficient with a simple lab test: Our vitamin D, 25-OH, Total (Blood Spot) – uses a FINGER STICK blood spot test that you collect at home

    Vitamin D supplements are inexpensive and available in both capsules and liquid drops. 

    And please read our other articles on vitamin D in HealthBeat News.

  • The Amazing Brain Nutrient You Don’t Know About

    By Nurse Mark

     

    Citicoline: The Amazing Brain Health Nutrient You’ve Probably Never Heard Of.

    You know about vitamin C, you’ve heard about vitamin D, you know that CoQ10 is important – but it’s a good bet that you’ve never heard about citicoline. This little-known substance – a member of the vitamin B family  -may just be one of the most important supplements for brain health that we know about.

    How important? It turns out that citicoline is sold in over 70 countries as a drug for cognitive impairment (memory loss) (1) and is approved for treatment in cases of head trauma, stroke, and neurodegenerative disease in Japan and Europe – researchers have found improved clinical outcomes following ischemic strokes. (2)

    So, what else is is good for?

    Clinical and laboratory research show citicoline supports memory function and healthy cognition and there is clinical evidence suggesting that citicoline can improve memory problems associated with aging. (3, 4)

    Citicoline is being studied and found to be very useful in the treatment of Parkinson’s disease, allowing significantly reduced doses of levodopa to be used to greater effect.(5) Citicoline enhances brain and nerve cell communication by increasing the availability of neurotransmitters, including dopamine, norepinephrine, and acetylcholine.

    Our eyes can benefit from citicoline: it improves visual function in patients with glaucoma, amblyopia (lazy eye), and optic neuropathy. (6, 7)

    Given the powerful effect citicoline has on brain chemistry and health it is no surprise that scientists and researchers are exploring other uses for this supplement. Cocaine addicts found their cravings were reduced and mood improved with the use of citicoline. (8)

    Cocaine addicts aren’t the only ones to benefit however – obesity is a huge problem in America and researchers are finding that citicoline has positive effects on the parts of the brain that tell us that we are satisfied and can stop eating – the so-called satiety centers of our brain. High-tech imaging showed that subjects using high dose citicoline (2000mg per day) had much greater responses in the areas of the brain related to satiety and they further reported significant reductions in appetite and hunger. (9)

    Those suffering from depression and even schizophrenia may benefit from citicoline according to two different small but impressive studies. Both studies showed positive improvements occurring within a few weeks of beginning treatment with citicoline. (10, 11)

    And it’s not just brain function, or eye health – citicoline has been investigated and found helpful in treating non-alcoholic fatty liver disease. (Non-alcoholic fatty liver disease, or NAFLD is increasing in scope as Americans become more and more obese – it may soon be called an “epidemic, the way Type II diabetes is now.) (12)

    So, in summary:

    • Citicoline is essential to the synthesis of phosphatidylcholine which is a major constituent of brain tissue.
    • Citicoline helps to maintain normal levels of acetylcholine, an important brain chemical that regulates memory and cognitive function.
    • Citicoline supports and enhances brain metabolism and healthy brain activity by sustaining the health of mitochondria – the energy generators inside the brain cells.
    • Citicoline helps brain cells communicate by keeping cell membranes in good condition and protecting neural structures from free radical damage.

    Perhaps the best summary can be found in the abstract from the research paper “Citicoline: pharmacological and clinical review, 2006 update.” (13)

    Abstract

    Cytidine 5′-diphosphocholine, CDP-choline, or citicoline is an essential intermediate in the biosynthetic pathway of structural phospholipids in cell membranes, particularly phosphatidylcholine. Following administration by both the oral and parenteral routes, citicoline releases its two main components, cytidine and choline. Absorption by the oral route is virtually complete, and bioavailability by the oral route is therefore approximately the same as by the intravenous route. Once absorbed, citicoline is widely distributed throughout the body, crosses the blood-brain barrier and reaches the central nervous system (CNS), where it is incorporated into the membrane and microsomal phospholipid fraction. Citicoline activates biosynthesis of structural phospholipids of neuronal membranes, increases brain metabolism, and acts upon the levels of different neurotransmitters. Thus,citicoline has been experimentally shown to increase norepinephrine and dopamine levels in the CNS. Owing to these pharmacological mechanisms,citicoline has a neuroprotective effect in hypoxic and ischemic conditions, decreasing the volume of ischemic lesion, and also improves learning and memory performance in animal models of brain aging. In addition, citicoline has been shown to restore the activity of mitochondrial ATPase and membrane Na+/K+ATPase, to inhibit activation of certain phospholipases, and to accelerate reabsorption of cerebral edema in various experimental models. Citicoline has also been shown to be able to inhibit mechanisms of apoptosis associated to cerebral ischemia and in certain neurodegeneration models, and to potentiate neuroplasticity mechanisms. Citicoline is a safe drug, as shown by the toxicological tests conducted, that has no significant systemic cholinergic effects and is a well tolerated product. These pharmacological characteristics and the action mechanisms of citicoline suggest that this product may be indicated for treatment of cerebral vascular disease, head trauma (HT) of varying severity, and cognitive disorders of different causes. In studies conducted in the treatment of patients with HT, citicoline was able to accelerate recovery from post-traumatic coma and neurological deficits, achieving an improved final functional outcome, and to shorten hospital stay in these patients. Citicoline also improved the mnesic and cognitive disorders seen after HT of minor severity that constitute the so-called post-concussional syndrome. In the treatment of patients with acute ischemic cerebral vascular disease, citicoline accelerates recovery of consciousness and motor deficit, achieves a better final outcome, and facilitates rehabilitation of these patients. The other major indication of citicoline is for treatment of senile cognitive impairment, either secondary to degenerative diseases (e.g. Alzheimer disease) or to chronic cerebral vascular disease. In patients with chronic cerebral ischemia,citicoline improves scores in cognitive rating scales, while in patients with senile dementia of the Alzheimer type it stops the course of disease, and neuroendocrine, neuroimmunomodulatory, and neurophysiological benefits have been reported. Citicoline has also been shown to be effective in Parkinson disease, drug addictions, and alcoholism, as well as in amblyopia and glaucoma. No serious side effects have occurred in any series of patients treated with citicoline, which attests to the safety of treatment with citicoline.

    Usual doses of this supplement range from 500 mg to 2000 mg per day – it is extremely safe with no known toxicity and very minimal side effects at even the highest doses – usually mild G.I. upset that resolves with continued use.

    I predict you’ll be hearing a lot more about this important supplement – and yes, Dr. Myatt and I  are both using it!

     

    References:

    1.) Citicoline (Cognizin) in the treatment of cognitive impairment. Fioravanti M., Buckley A.E. Clin Interv Aging. Sep 2006; 1(3): 247–251. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695184/

    2.) Warach, S; Pettigrew, LC; Dashe, JF; Pullicino, P; Lefkowitz, DM; Sabounjian, L; Harnett, K; Schwiderski, U; Gammans, R (November 2000). "Effect of citicoline on ischemic lesions as measured by diffusion-weighted magnetic resonance imaging. Citicoline 010 Investigators.". Annals of neurology 48 (5): 713–22. http://www.ncbi.nlm.nih.gov/pubmed/11079534

    3.) Spiers PA et al. Citicoline improves verbal memory in aging. Arch Neurol. 996;53:441-48.

    4.) Alvarez XA et al. Citicoline improves memory performance in elderly subjects. Meth Find Exp Clin Pharmacol. 1997;19(3):201-10.

    5.) Citicoline in the treatment of Parkinson’s disease. Eberhardt R1, Birbamer G, Gerstenbrand F, Rainer E, Traegner H. Clin Ther. 1990 Nov-Dec;12(6):489-95.
    It is concluded that the levodopa-saving effect of citicoline could be used to decrease the incidence of side effects and retard the loss of efficacy of levodopa in long-term treatment. http://www.ncbi.nlm.nih.gov/pubmed/2289218

    6.) Parisi, V; Coppola, G; Centofanti, M; Oddone, F; Angrisani, AM; Ziccardi, L; Ricci, B; Quaranta, L; Manni, G (2008). "Evidence of the neuroprotective role of citicoline in glaucoma patients.". Progress in brain research 173: 541–4. http://www.ncbi.nlm.nih.gov/pubmed/18929133

    7.) Parisi, V.; Coppola, G.; Ziccardi, L.; Gallinaro, G.; Falsini, B. (1 May 2008). "Cytidine-5′-diphosphocholine (Citicoline): a pilot study in patients with non-arteritic ischaemic optic neuropathy". European Journal of Neurology 15 (5): 465–474. http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2008.02099.x/abstract;jsessionid=FA96263B2BE6D0726B206E970BF6AF45.f03t01

    8.) Renshaw PF1, Daniels S, Lundahl LH, Rogers V, Lukas SE.
    Psychopharmacology (Berl). 1999 Feb;142(2):132-8. Short-term treatment with citicoline (CDP-choline) attenuates some measures of craving in cocaine-dependent subjects: a preliminary report. http://www.ncbi.nlm.nih.gov/pubmed/10102764

    9.) William D. S. Killgore, Amy J. Ross, […], and Deborah A. Yurgelun-Todd. Citicoline Affects Appetite and Cortico-Limbic Responses to Images of High Calorie Foods. Int J Eat Disord. Jan 2010; 43(1): 6–13. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378241/#!po=4.16667

    10.) Salvadorini F, Galeone F, Nicotera M, Ombrato M, Saba P. Clinical evaluation of CDP-choline (Nicholin): efficacy As antidepressant treatment. Curr Ther Res Clin Exp. 1975 Sep;18(3):513-20.http://www.ncbi.nlm.nih.gov/pubmed/810312

    11.) Deutsch SI, Schwartz BL, Schooler NR, et al. First administration of cytidine diphosphocholine and galantamine in schizophrenia: a sustained alpha7 nicotinic agonist strategy. Clin Neuropharmacol. 2008;31(1):34-39.

    12.) Guerrerio AL, et al.Choline intake in a large cohort of patients with nonalcoholic fatty liver disease. Am J Clin Nutr. 2012 Apr;95(4):892-900. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302364/

    13.) Secades JJ1, Lorenzo JL.. Citicoline: pharmacological and clinical review, 2006 update. Methods Find Exp Clin Pharmacol. 2006 Sep;28 Suppl B:1-56. http://www.ncbi.nlm.nih.gov/pubmed/17171187