Table of ContentsView AllTable of ContentsAbout CholineCholine DeficiencyCholine Supplement BenefitsIndicationsSide EffectsPrecautionsDosage
Table of ContentsView All
View All
Table of Contents
About Choline
Choline Deficiency
Choline Supplement Benefits
Indications
Side Effects
Precautions
Dosage
Choline is an essential nutrient important for liver, muscle, and brain function, as well as fat metabolism and cell repair. The human liver can make small amounts of choline, but it does not make all the choline your body needs, so you must consume the rest from your diet.
Choline is found in numerous foods, including meat and eggs, whole grains, and broccoli. It can also be found as a nutritional supplement. Choline supplements can be helpful for people with low dietary intake, pregnant people, and those at risk forliver damage. Pregnant people should consult a healthcare provider before starting choline to ensure they take the right amount.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
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What Is a Choline Supplement?
A choline supplement is a dietary supplement that contains choline. Typically, choline supplements are taken when you can’t get enough choline from your diet.
Choline supplements are widely available. They can be found as an individual nutrient supplement, combined with B vitamins, or combined into a multivitamin or multimineral product.
Choline supplements typically come in the form of choline bitartrate,phosphatidylcholine, andlecithin. There is no research available to suggest that one form is better than another.
Typical dosages in supplements range from 10 milligrams (mg) to 250 mg.
What’s the difference between choline and a CDP-choline supplements?CDP-choline supplements contain both choline and a natural compound called cytidine diphosphocholine (also called citicoline). It is thought that CDP-choline may be more effective than choline for improving cognition.However, more research is needed.
What’s the difference between choline and a CDP-choline supplements?
CDP-choline supplements contain both choline and a natural compound called cytidine diphosphocholine (also called citicoline). It is thought that CDP-choline may be more effective than choline for improving cognition.However, more research is needed.
What Is Choline?
Choline is an essential nutrient. It has many functions in the human body, including the following:
What Foods Have Choline?
According to theDietary Guidelines for Americans,most choline should be consumed through diet.Foods that contain choline include:
Most people don’t consume enough choline in their diet. However, deficiency is rare because your body can make choline.
When it occurs, choline deficiency can eventually lead to the following:
What Causes a Choline Deficiency?
Choline deficiency can happen when you don’t get enough from the food you eat.
How Do I Know if I Have a Choline Deficiency?
Choline status is not routinely measured in healthy people. If measured, normal plasma choline levels range from 7 to 20 micromoles/liter (mcmol/L).
Groups at Risk of Choline Deficiency
The following groups are at higher risk of developing a choline deficiency:
Pregnant women are at risk of choline deficiency because their requirements are higher and they don’t get enough choline in their diet.Historically, many prenatal vitamin formulations did not contain choline. Check the supplement facts label for choline content in prenatal vitamins.
The amount of choline you need daily depends on a few factors. The average daily recommended amounts of choline you need are:
Choline plays a role in cardiovascular health, liver disease prevention, and brain function improvement. However, further research is needed to confirm whether supplemental choline helps.
Below are some of the areas where choline supplementation has been studied.
Metabolic Dysfunction-associated Steatotic Liver Disease
Most choline converts to phosphatidylcholine, a major phospholipid that helps build fat-carrying proteins. Phosphatidylcholine helps carry fat away from the liver. Fat can accumulate in the liver without enough choline. This can increase the risk of developingmetabolic dysfunction-associated steatotic liver disease (MASLD).
However, limited research exists about whether supplementation can treat the condition once it has developed.One clinical trial evaluating a supplement containing choline and other natural substances found little benefit in people with MASLD.
11 Proven Vitamins and Supplements for a Healthier Liver
Heart Health
Choline plays a role in reducinghomocysteinelevels. High homocysteine levels are a risk factor forheart disease. This has led researchers to consider whether choline might help reduce the risk of heart disease.
However, the results have been mixed:
Further research is needed to determine choline’s role in heart health.
Cognitive Function
Choline is needed to make acetylcholine, which has a role in memory and thinking. Higher intakes of choline have been associated with higher levels of cognitive function. However, that does not necessarily mean that choline supplementation can directly improve cognition.
For example, a systematic review published in 2015 found that choline supplementation did not result in improved cognition in healthy people.Additionally, a Cochrane review concluded that lecithin (a source of choline) supplementation resulted in no clear benefits.
There is also interest in choline’s possible role in Alzheimer’s disease. In a study of older adults, 300 mg of daily egg yolk choline for six weeks increased verbal memory.
Further research is needed.
Long-Term Parenteral Nutrition (PN)
There is not enough evidence to support many uses of choline supplementation. An exception would be people requiring long-term parenteral nutrition (PN) or tube or intravenous (IV) feeding. PN does not routinely contain choline.
Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known as nonalcoholic fatty liver disease or NAFLD) has been reported in people who need PN as their sole source of nutrition.The American Society for Parenteral and Enteral Nutrition recommends the routine addition of choline to parenteral nutrition formulations.
If you use PN long-term talk with your healthcare provider to determine whether you need a choline supplement.
Should I Take a Choline Supplement?
Whether you need to use a choline supplement can depend on several factors, including the following:
Speak with your healthcare provider or registered dietitian nutritionist about whether you are getting enough choline and what to do.
What Are the Side Effects of Choline?
Supplementing excessive amounts of choline is more likely to result in side effects. Adults should not take more than 3.5 g (3,500 mg) daily.Side effects of choline supplementation may include:
In severe cases, hypotension (low blood pressure) or liver toxicity could occur. Side effects involving the gastrointestinal (GI) tract often resolve after discontinuing the supplement.
Though supplementing with choline is likely safe for most people in doses less than 3.5 grams (g) daily, adequate intake (AI) is actually much lower.
For pregnant women, choline supplementation appears to be safe in amounts up to 3 g daily if under 18 or 3.5 g daily if over 19 years of age.
Choline supplementation is likely safe in children in appropriate amounts.
Dosage: How Much Choline Should I Take?
Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.
Not enough evidence is available to provide a recommended dietary allowance (RDA) for choline, but an adequate intake has been established.
Choline supplementation is likely safe for most adults in doses less than 3.5 g daily.
Jessica Olah / Verywell
Summary
Choline is an essential nutrient. It is made in the body but not in adequate amounts, so you must mostly get it from the foods you eat. It is best to get choline from food sources.
Foods rich in choline include the following:
Some people may need to supplement their diet with choline if they can’t get enough. However, research does not support some of the claims about choline supplements.
Talk with a registered dietitian nutritionist or healthcare provider if you have concerns about your choline level and how it may affect your health. If you are pregnant, review your risk of deficiency with your prenatal care provider.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health: Office of Dietary Supplements.Choline.Jaiswal A, Dewani D, Reddy L, Patel A.Choline supplementation in pregnancy: Current evidence and implications.Cureus. 2023 Nov;15(11):e48538. doi:10.7759/cureus.48538Synoradzki K, Grieb P.Citicoline: A Superior Form of Choline?Nutrients. 2019 Jul 12;11(7):1569. doi: 10.3390/nu11071569Sheffler ZM, Reddy V, Pillarisetty LS.Physiology, neurotransmitters. StatPearls [Internet].U.S. Department of Agriculture and U.S. Department of Health and Human Services.Dietary guidelines for Americans, 2020-2025. 9th ed.Heras-Sola J, Gallo-Vallejo JL.Importancia de la colina durante el embarazo y lactancia. Una revisión sistemática [Importance of choline during pregnancy and lactation: A systematic review]. Semergen. 2024 Jan-Feb;50(1):102089. Spanish. doi: 10.1016/j.semerg.2023.102089Cerletti C, Colucci M, Storto M, et al.Randomised trial of chronic supplementation with a nutraceutical mixture in subjects with non-alcoholic fatty liver disease.Br J Nutr. 2020;123(2):190-197. doi: 10.1017/S0007114519002484Millard HR, Musani SK, Dibaba DT, et al.Dietary choline and betaine; associations with subclinical markers of cardiovascular disease risk and incidence of CVD, coronary heart disease and stroke: the Jackson Heart Study.Eur J Nutr. 2018;57(1):51-60. doi:10.1007/s00394-016-1296-8Bertoia ML, Pai JK, Cooke JP, et al.Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease.Atherosclerosis. 2014;235(1):94-101. doi:10.1016/j.atherosclerosis.2014.04.010Zheng Y, Li Y, Rimm EB, et al.Dietary phosphatidylcholine and risk of all-cause and cardiovascular-specific mortality among US women and men.The American Journal of Clinical Nutrition. 2016;104(1):173-180. doi: 10.3945/ajcn.116.131771Leermakers ETM, Moreira EM, Kiefte-de Jong JC, et al.Effects of choline on health across the life course: a systematic review.Nutr Rev. 2015;73(8):500-522. doi:10.1093/nutrit/nuv010Higgins JP, Flicker L.Lecithin for dementia and cognitive impairment. Cochrane Dementia and Cognitive Improvement Group. Cochrane Database of Systematic Reviews. 2000;(4):CD001015. doi:10.1002/14651858.CD001015Yamashita S, Kawada N, Wang W, et al.Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study. Lipids Health Dis. 2023 Jun 20;22(1):75. doi: 10.1186/s12944-023-01844-wVanek VW, Borum P, Buchman A, Fessler TA, et al.A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012 Aug;27(4):440-91. doi: 10.1177/0884533612446706Zeisel SH, Klatt KC, Caudill MA.Choline.Advances in Nutrition. 2018;9(1):58-60. doi: 10.1093/advances/nmx004
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health: Office of Dietary Supplements.Choline.Jaiswal A, Dewani D, Reddy L, Patel A.Choline supplementation in pregnancy: Current evidence and implications.Cureus. 2023 Nov;15(11):e48538. doi:10.7759/cureus.48538Synoradzki K, Grieb P.Citicoline: A Superior Form of Choline?Nutrients. 2019 Jul 12;11(7):1569. doi: 10.3390/nu11071569Sheffler ZM, Reddy V, Pillarisetty LS.Physiology, neurotransmitters. StatPearls [Internet].U.S. Department of Agriculture and U.S. Department of Health and Human Services.Dietary guidelines for Americans, 2020-2025. 9th ed.Heras-Sola J, Gallo-Vallejo JL.Importancia de la colina durante el embarazo y lactancia. Una revisión sistemática [Importance of choline during pregnancy and lactation: A systematic review]. Semergen. 2024 Jan-Feb;50(1):102089. Spanish. doi: 10.1016/j.semerg.2023.102089Cerletti C, Colucci M, Storto M, et al.Randomised trial of chronic supplementation with a nutraceutical mixture in subjects with non-alcoholic fatty liver disease.Br J Nutr. 2020;123(2):190-197. doi: 10.1017/S0007114519002484Millard HR, Musani SK, Dibaba DT, et al.Dietary choline and betaine; associations with subclinical markers of cardiovascular disease risk and incidence of CVD, coronary heart disease and stroke: the Jackson Heart Study.Eur J Nutr. 2018;57(1):51-60. doi:10.1007/s00394-016-1296-8Bertoia ML, Pai JK, Cooke JP, et al.Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease.Atherosclerosis. 2014;235(1):94-101. doi:10.1016/j.atherosclerosis.2014.04.010Zheng Y, Li Y, Rimm EB, et al.Dietary phosphatidylcholine and risk of all-cause and cardiovascular-specific mortality among US women and men.The American Journal of Clinical Nutrition. 2016;104(1):173-180. doi: 10.3945/ajcn.116.131771Leermakers ETM, Moreira EM, Kiefte-de Jong JC, et al.Effects of choline on health across the life course: a systematic review.Nutr Rev. 2015;73(8):500-522. doi:10.1093/nutrit/nuv010Higgins JP, Flicker L.Lecithin for dementia and cognitive impairment. Cochrane Dementia and Cognitive Improvement Group. Cochrane Database of Systematic Reviews. 2000;(4):CD001015. doi:10.1002/14651858.CD001015Yamashita S, Kawada N, Wang W, et al.Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study. Lipids Health Dis. 2023 Jun 20;22(1):75. doi: 10.1186/s12944-023-01844-wVanek VW, Borum P, Buchman A, Fessler TA, et al.A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012 Aug;27(4):440-91. doi: 10.1177/0884533612446706Zeisel SH, Klatt KC, Caudill MA.Choline.Advances in Nutrition. 2018;9(1):58-60. doi: 10.1093/advances/nmx004
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institutes of Health: Office of Dietary Supplements.Choline.Jaiswal A, Dewani D, Reddy L, Patel A.Choline supplementation in pregnancy: Current evidence and implications.Cureus. 2023 Nov;15(11):e48538. doi:10.7759/cureus.48538Synoradzki K, Grieb P.Citicoline: A Superior Form of Choline?Nutrients. 2019 Jul 12;11(7):1569. doi: 10.3390/nu11071569Sheffler ZM, Reddy V, Pillarisetty LS.Physiology, neurotransmitters. StatPearls [Internet].U.S. Department of Agriculture and U.S. Department of Health and Human Services.Dietary guidelines for Americans, 2020-2025. 9th ed.Heras-Sola J, Gallo-Vallejo JL.Importancia de la colina durante el embarazo y lactancia. Una revisión sistemática [Importance of choline during pregnancy and lactation: A systematic review]. Semergen. 2024 Jan-Feb;50(1):102089. Spanish. doi: 10.1016/j.semerg.2023.102089Cerletti C, Colucci M, Storto M, et al.Randomised trial of chronic supplementation with a nutraceutical mixture in subjects with non-alcoholic fatty liver disease.Br J Nutr. 2020;123(2):190-197. doi: 10.1017/S0007114519002484Millard HR, Musani SK, Dibaba DT, et al.Dietary choline and betaine; associations with subclinical markers of cardiovascular disease risk and incidence of CVD, coronary heart disease and stroke: the Jackson Heart Study.Eur J Nutr. 2018;57(1):51-60. doi:10.1007/s00394-016-1296-8Bertoia ML, Pai JK, Cooke JP, et al.Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease.Atherosclerosis. 2014;235(1):94-101. doi:10.1016/j.atherosclerosis.2014.04.010Zheng Y, Li Y, Rimm EB, et al.Dietary phosphatidylcholine and risk of all-cause and cardiovascular-specific mortality among US women and men.The American Journal of Clinical Nutrition. 2016;104(1):173-180. doi: 10.3945/ajcn.116.131771Leermakers ETM, Moreira EM, Kiefte-de Jong JC, et al.Effects of choline on health across the life course: a systematic review.Nutr Rev. 2015;73(8):500-522. doi:10.1093/nutrit/nuv010Higgins JP, Flicker L.Lecithin for dementia and cognitive impairment. Cochrane Dementia and Cognitive Improvement Group. Cochrane Database of Systematic Reviews. 2000;(4):CD001015. doi:10.1002/14651858.CD001015Yamashita S, Kawada N, Wang W, et al.Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study. Lipids Health Dis. 2023 Jun 20;22(1):75. doi: 10.1186/s12944-023-01844-wVanek VW, Borum P, Buchman A, Fessler TA, et al.A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012 Aug;27(4):440-91. doi: 10.1177/0884533612446706Zeisel SH, Klatt KC, Caudill MA.Choline.Advances in Nutrition. 2018;9(1):58-60. doi: 10.1093/advances/nmx004
National Institutes of Health: Office of Dietary Supplements.Choline.
Jaiswal A, Dewani D, Reddy L, Patel A.Choline supplementation in pregnancy: Current evidence and implications.Cureus. 2023 Nov;15(11):e48538. doi:10.7759/cureus.48538
Synoradzki K, Grieb P.Citicoline: A Superior Form of Choline?Nutrients. 2019 Jul 12;11(7):1569. doi: 10.3390/nu11071569
Sheffler ZM, Reddy V, Pillarisetty LS.Physiology, neurotransmitters. StatPearls [Internet].
U.S. Department of Agriculture and U.S. Department of Health and Human Services.Dietary guidelines for Americans, 2020-2025. 9th ed.
Heras-Sola J, Gallo-Vallejo JL.Importancia de la colina durante el embarazo y lactancia. Una revisión sistemática [Importance of choline during pregnancy and lactation: A systematic review]. Semergen. 2024 Jan-Feb;50(1):102089. Spanish. doi: 10.1016/j.semerg.2023.102089
Cerletti C, Colucci M, Storto M, et al.Randomised trial of chronic supplementation with a nutraceutical mixture in subjects with non-alcoholic fatty liver disease.Br J Nutr. 2020;123(2):190-197. doi: 10.1017/S0007114519002484
Millard HR, Musani SK, Dibaba DT, et al.Dietary choline and betaine; associations with subclinical markers of cardiovascular disease risk and incidence of CVD, coronary heart disease and stroke: the Jackson Heart Study.Eur J Nutr. 2018;57(1):51-60. doi:10.1007/s00394-016-1296-8
Bertoia ML, Pai JK, Cooke JP, et al.Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease.Atherosclerosis. 2014;235(1):94-101. doi:10.1016/j.atherosclerosis.2014.04.010
Zheng Y, Li Y, Rimm EB, et al.Dietary phosphatidylcholine and risk of all-cause and cardiovascular-specific mortality among US women and men.The American Journal of Clinical Nutrition. 2016;104(1):173-180. doi: 10.3945/ajcn.116.131771
Leermakers ETM, Moreira EM, Kiefte-de Jong JC, et al.Effects of choline on health across the life course: a systematic review.Nutr Rev. 2015;73(8):500-522. doi:10.1093/nutrit/nuv010
Higgins JP, Flicker L.Lecithin for dementia and cognitive impairment. Cochrane Dementia and Cognitive Improvement Group. Cochrane Database of Systematic Reviews. 2000;(4):CD001015. doi:10.1002/14651858.CD001015
Yamashita S, Kawada N, Wang W, et al.Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study. Lipids Health Dis. 2023 Jun 20;22(1):75. doi: 10.1186/s12944-023-01844-w
Vanek VW, Borum P, Buchman A, Fessler TA, et al.A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012 Aug;27(4):440-91. doi: 10.1177/0884533612446706
Zeisel SH, Klatt KC, Caudill MA.Choline.Advances in Nutrition. 2018;9(1):58-60. doi: 10.1093/advances/nmx004
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