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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)
The right stack depends on the patient's labs, goals, and tolerance
Prebiotic Fiber : Consider supplements containing inulin, FOS, or resistant starch if dietary intake is insufficient (aim for 30-40g total fiber daily)
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