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)
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!
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
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