>> a cohort study in JAMA Network associated the use of Alpha GPC with a higher 10-year incident stroke risk in a dose-response manner

That's an interesting study. Given that they were looking at prescribed αGPC, I (probably naïvely) thought that there were looking at daily of dosage (mg per kg). They were not. The 'dose' was the number of months αGPC was prescribed; no mention of daily dose, no way to even guess about possible TMAO with associated stroke risk

The study has 'matched' cohorts - but I see no mention of mild cognitive impairment (MCI) in the list of factors being matched even though MCI is probably why those patients have been prescribed. One of the potential causes of MCI is cerebral small vessel disease. They matched for high blood pressure (a simple yes/no) but not a diagnosis of MCI or one of the drugs commonly used for it (e.g. donepezil off label).

Thanks for bringing this one up! As a sub-optimal methylator I pay attention to methyl donors and non-essential nutrients that if taken reduce the need for methyl donors (e.g. creatine, methylated forms of B vitamins) so it's of interest.