Hi, Cometcatcher. Like the name! I'm a science nerd.

Choline is a B vitamin. Most B vitamins are good for you, depending upon the dose. B6, for example, is not one you should have too much of, especially if you have a neuropathy.

Choline, and B12, are precursors to acetylcholine. Technically, I suppose you could get too much choline and that might lead to too much acetylcholine, which is not good for anyone, MG or not.

Cholinergic "shock" is not really the right term. It's called a cholinergic crisis or cholinergic toxicity.

You might want to talk to your doctor about dose amount or frequency. Also, since gastroparesis is the issue, you may want to talk to them about Mestinon syrup. You can titrate it more easily and it absorbs in the GI tract better.

More isn't necessarily better with Mestinon because you can get too much acetylcholine. Perhaps taking it every 4 or 5 hours. Do not change anything unless you talk to your doctor. An MG expert can give you more advice on dosing, even if you don't have MG. It might be a good idea to consult once with one!

Did they ever figure out why you have dysautonomia?

I hope that answers your questions. Just supplement sensibly. You don't want to do more harm than good.

Annie