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In acid sphingomyelinase knock-out mice, which mimic a neurovisceral acid sphingomyelinase deficiency (ASMD) characterized by cellular accumulation of sphingomyelin, the effects of a choline-free diet decreased the activation of liver macrophages and microglia, but it did not significantly alter sphingomyelin levels due to compensatory mechanisms involving methionine metabolism (101)

2014;3:e01498

Relieves Fatigue Appropriate supplementation of L-carnitine also has a significant effect on chronic fatigue syndrome

However, the levels of the compound it is made from, L-carnitine, decline with age

Curr Med Res Opin 1990;11:638-47