We have recently made the connection in our practice between the stress hormone, epinephrine, and liver imbalance.
Stress creates an increase in the fight or flight hormone epinephrine, also known as adrenaline. It gets us ready to handle stress by increasing heart rate and blood pressure. Epinephrine is made in the adrenal gland and it is created when norepinephrine is methylated, meaning an enzyme adds a methyl group to norepinephrine.
Sometimes the body enters a state of chronic fight or flight and epinephrine is constantly secreted. When this happens, other substances that donate methyl groups to epinephrine may become depleted (1). Choline is one of these substances.
Interestingly, carriers of the the 5,10-methylene tetrahydrofolate dehydrogenase-1958A gene allele polymorphism were more likely to develop signs of choline deficiency than non-carriers (2). (This gene allele is involved in the folate methylation cycle.) This means that those with the MTHFR gene expression may be more likely to be affected. One consequence of a choline deficiency is the development of a fatty liver. A lack of phosphatidylcholine (precursor to choline) limits the export of excess triglycerides (fats) from the liver.
Also, choline deficiency can cause liver cells to leach alanine aminotransferase, an important enzyme in breaking down protein, into the blood (2). Some people who suffer choline deficiency develop muscle damage and increased creatine kinase activity in the blood (2). This effect may occur because cell membranes lose rigidity due to the lack of phosphatidylcholine, which is integral in the structure of cell membranes (2).
Choline rich foods include eggs, broccoli, and spinach. Choline inositol is also a great supplement to support liver function
1. Bjelland I, Tell GS, Vollset SE, Konstantinova S, Ueland PM. Choline in anxiety and depression: the Hordaland Health Study. Am J Clin Nutr. 2009 90(4):1056-60.
2. Kohlemeier M, da Costa K, Fischer LM, Zeisel SH. 2005. Genetic Variation of Folate-Mediated One-Carbon Transfer Pathway Predicts Susceptibility to Choline Deficiency in Humans. PNAS 102(44). 16025-16030.
Photo from here, with thanks.