Choline is your nutrient for brain power, liver health, fat digestion, muscle strength and strong cell membranes.

Choline is getting more attention in nutritional circles but still many people do not realize how important it is for their health. So, let’s get choline basics clear. 

What’s choline?

Choline resembles B-vitamin, serves as a unique and essential nutrient required for many processes in the body, including structural, metabolic, and regulatory functions. It is especially important for proper function of your liver, your muscles, and your brain; is involved in lipid metabolism and cellular membrane composition and repair. 

Humans can make only small amounts of choline therefore we need to consume this nutrient through the diet to prevent deficiency. 

Choline tasks in your body 

Choline has a wide range of functions including:

  1. Acts as a methyl donor which is needed for methylation to promote DNA repair, detox and to regulate many processes 
  2. Is used for the synthesis of sphingomyelin and phosphatidylcholine; both compounds are elements of our cell membranes and support their function 
  3. Phosphatidylcholine also helps digest fats
  4. Is used as a precursor for acetylcholine synthesis, a neurotransmitter which helps us contract muscles, helps us to “rest and digest”, and in the brain it helps us to concentrate, to learn, to form memories, and even to get REM sleep   
  5. Choline works in a close collaboration with vitamin B12 and folate and suboptimal levels any of the trio can affect the levels and function of the other two
  6. Participates in the formation of platelet aggregating factor
  7. Supports secretion of very low-density-lipoprotein from the liver
  8. Is essential for proper brain development and function

Low choline levels and choline deficiency

Choline deficiency is real and causes clinically evident disease in humans. 

If you don't have sufficient choline levels, you are at higher risk of fatty liver disease, hepatic necrosis and inflammation. 

 choline deficiency - liver

You will probably be surprised to find out that if the brain needs neurotransmitter acetylcholine and is not getting choline from dietary sources, then it can breakdown the brain tissue for phosphatidylcholine and phosphatidylserine, two fat-based components of neuron tissue from which acetylcholine can be synthesized. 

Because choline is found predominantly in animal-derived foods, vegetarians, vegans, and people with certain food allergies (eggs) and people on the autoimmune diet may have a greater risk for inadequacy

Symptoms of choline deficiency may include

  • Feeling anxious or restless
  • Feeling tired and fatigued 
  • Fatty liver (non-alcoholic fatty liver disease NAFLD)
  • Muscle damage and aches
  • Poor memory and poor cognitive function
  • Hyperhomocysteinemia
  • Hemorrhagic kidney necrosis
  • Nerve tingling and pain

Since choline is essential for brain development and its function, poor choline levels might be a contributing factor in neurodegenerative diseases. Studies in mice show that adequate choline levels may reduce Alzheimer’s disease pathology.  

Choline deficiency - alarming signals

Watch out for red flags: if you experience brain fog, poor attention and memory, muscle twitching, unpredictable moods, or nerve tingling, your body might be telling you to get more choline.

The importance of choline in pregnancy, lactation and early childhood

Recent evidence suggests that maternal choline intake during pregnancy and lactation has long-term beneficial neurocognitive effects on children and is often insufficient. 

Adequate maternal choline intakes during pregnancy and breastfeeding are associated with better child attention, memory, and problem solving whereas low maternal choline intakes have been shown to increase the risk of both neural tube defects and cleft palates, as well as memory issues and other cognitive impairments in the child later in life. 

choline in pregnancy

Food sources of choline

Our body can make choline after methylation of the amino acid serine using S-adenosyl methionine (SAM). Choline is also present in foods; in small amounts in a free form and more commonly as part of the phospholipid lecithin (phosphatidylcholine) therefore foods rich in lecithin such as egg yolks, organ meats, muscle meats, shrimps, cod, salmon, wheat germ, soybeans, and peanuts are a good choline source. Lecithin is also added to many foods as an emulsifier. The best choline sources are egg yolks, liver and wheat germ. For example, 100 gram of liver contains approximately 350-400 mg of choline. Best plant foods as a source of choline include Brussel sprouts, wheat germ, soybeans, peanuts, almonds, peas, broccoli and cabbage.  

Food sources of choline - eggs

If you eat a diverse diet with whole-foods including animal products and foods containing fats, you are likely to get enough choline from your diet. The best is to consume the choline rich foods out evenly across your meals.

If you do not eat animal products, the simplest way to add more choline is to consume wheat germ (150 grams daily), to have nuts, seeds, and beans. 

Eating betaine rich foods such as red beets, spinach and wheat germ can support your choline levels because betaine supports methylation and reliefs choline’s methylation responsibility, making choline more available to turn it into phosphatidylcholine or acetylcholine.

Choline supplementation 

If you suspect that you are not getting enough choline from the diet, a supplement such as Alpha-GCP, phosphatidylcholine, lecithin, or TMG might be the right choice to prevent choline deficiency. Always best to consult it with a professional. 

How much choline is too much?  

Choline toxicity from foods is less likely to happen but high choline intakes from supplements are associated with a fishy body odor due to the accumulation of trimethylamine (TMA), vomiting, excessive sweating and salivation, hypotension, and liver toxicity. Approximately 3500 mg choline per day is considered an upper tolerable (maximum) daily dosage for adults, and typically the daily recommended intake ranges between 400-500 mg choline. 

Too much choline can lead to the following symptoms:

  • Fishy body odor (trimethylaminuria)
  • Lower blood pressure (hypotension)
  • Sweating
  • Salivation
  • Gastrointestinal distress
  • Diarrhea
  • Nausea and vomiting

Information provided here is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional.

Reference list: 

  1. Wallace, Taylor C. PhD, CFS, FACN; Blusztajn, Jan Krzysztof PhD; Caudill, Marie A. PhD, RD; Klatt, Kevin C. MS; Natker, Elana MS, RD; Zeisel, Steven H. MD, PhD; Zelman, Kathleen M. MPH, RD, LD Choline, Nutrition Today: 11/12 2018 - Volume 53 - Issue 6 - p 240-253
  2. Korsmo HW, Jiang X, Caudill MA. Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients. 2019 Aug 7;11(8):1823. 
  3. Bekdash RA. Neuroprotective Effects of Choline and Other Methyl Donors. Nutrients. 2019 Dec 6;11(12):2995. 
  4. Velazquez R, Ferreira E, Winslow W, Dave N, Piras IS, Naymik M, Huentelman MJ, Tran A, Caccamo A, Oddo S. Maternal choline supplementation ameliorates Alzheimer's disease pathology by reducing brain homocysteine levels across multiple generations. Mol Psychiatry. 2020 Oct;25(10):2620-2629. 
  5. Wiedeman AM, Barr SI, Green TJ, Xu Z, Innis SM, Kitts DD. Dietary Choline Intake: Current State of Knowledge Across the Life Cycle. Nutrients. 2018 Oct 16;10(10):1513.
Category: Nutrition icon July 22 2021
Author: Dr Joanna Krzeslak-Hoogland

Being inspired by the effect of nutrition, lifestyle and mind on our health, I am dedicated to help people on their journey to wellbeing.

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