Anxiety disorders tied to low levels of choline in the brain

Correlation vs causation and headline criticism

• Multiple commenters argue the headline is misleading: the study only shows that people with anxiety disorders have ~8% lower brain choline, not that low choline causes anxiety.
• Several note that chronic fight-or-flight states could increase neurometabolic demand for choline, lowering measurable levels as a consequence of anxiety.
• An 8% difference is questioned as possibly not clinically meaningful.

Why not “just test choline”?

• Some are frustrated that no simple RCT has been run: give anxious and non‑anxious participants choline vs placebo, measure brain choline and symptoms.
• Others reply that:
  • Clinical trials are expensive (millions), logistically complex, and a different skill set from imaging/meta‑analysis.
  • Choline neurobiology is nontrivial: it’s tied to acetylcholine, an excitatory neurotransmitter heavily used in the hippocampus; dysregulation can provoke seizures.
  • The brain tightly regulates choline via the blood–brain barrier and active transport, so oral supplementation may not straightforwardly raise relevant brain pools.

Supplement experiences and risks

• Several anecdotal reports that choline supplements worsen mood: “viciously depressed,” insomnia, neck stiffness.
• Others warn about:
  • Many antidepressants being anticholinergic, so choline may interact poorly.
  • Excess choline → increased TMAO (linked to thrombosis/atherosclerosis) from certain supplements but not eggs or phosphatidylcholine in one cited trial.
  • A paper is linked on lecithin/over-cholinergic states and depression.
• Food vs supplement debate: some advocate eggs/liver; others prefer low-impact supplements or dislike eggs ethically or viscerally.

Other interventions and anecdotes

• Omega‑3 (fish oil, salmon) and algae (spirulina/chlorella) are cited as helpful for some people’s anxiety/ADHD, though others point out these are poor choline sources and raise concerns for autoimmune conditions.
• Beta blockers (propranolol) are reported as very effective for situational anxiety, with some concern they might blunt danger responses at higher doses.

Diagnosis, overpathologizing, and self‑advocacy

• Several posts criticize how easily “anxiety disorder” can be diagnosed in the US via self‑report questionnaires, potentially pathologizing rational responses to economic or life stress.
• Examples:
  • Anxiety resolving once life circumstances improved or ADHD was treated.
  • Experiences of misdiagnosis, protocol‑driven care, and the need to seek second opinions and self‑advocate.
• One commenter frames anxiety as a symptom with many different underlying causes, not a single disease.

Lifestyle vs biomedical framing

• Some argue most anxiety could be prevented with diet (protein, eggs, vegetables), exercise, sunlight, social connection, and meaningful work, with skepticism toward drugs and supplements.
• Others challenge claims that “most people never experience anxiety” historically or globally, and push back on romanticized views of ancestral life.