Choline

General Info

Active Forms
Choline bitartrate, choline citrate, choline chloride, CDP-choline, and in phosphatidyl choline, which is also known as lecithin.

Absorption
Choline is readily absorbed throughout the small intestine. Most foods contain choline in the form of phosphatidylcholine. Both pancreatic secretions and cells in the intestinal mucosa contain enzymes that are capable of hydrolyzing phosphatidylcholine, which releases the choline for absorption.

Dietary Sources
The richest source of dietary choline is egg yolk. Other good sources include organ meats, wheat germ, soy beans, peanuts, and legumes.

Dosage Info

Dosage Range 150mg – 3500mg daily. Most Common Dosage 300mg, 3 times a day. Dosage Forms Tablets, capsules, liquid, and powder.		Adult RDI 550mg 425mg Adult ODA None established		RDA Infants < 6 months: 125mg (Adequate Intake, AI) Infants 7-12 months: 150mg (AI) Children 1-3 years: 200mg (AI) Children 4-8 years: 250mg (AI) Children 9-13 years: 375mg (AI) Males >14 years: 550mg (AI) Females 14-18 years: 400mg (AI) Females >19 years: 425mg (AI) Pregnancy: 450mg (AI) Lactation: 550mg (AI)

Overview

Choline is a member of the water-soluble B complex vitamin group. Classifying choline as a vitamin is questionable since humans synthesize it. However, because the rate of synthesis is normally insufficient to meet human metabolic needs, choline has been included as an essential vitamin nutrient. The primary dietary source of choline is in the form of the phospholipid known as phosphatidyl choline. Recently a new form of choline has become available called CDP-choline, which stands for cytidine 5-diphosphocholine. This unique form of choline crosses the blood-brain barrier and enters the brain much more efficiently than other forms of choline.

Toxicities & Precautions

Choline is readily absorbed throughout the small intestine. Most foods contain choline in the form of phosphatidylcholine. Both pancreatic secretions and cells in the intestinal mucosa contain enzymes that are capable of hydrolyzing phosphatidylcholine, which releases the choline for absorption.

General
The potential for serious toxicity with choline is very low.

Side Effects
Oral ingestion of large doses of choline salts such as choline chloride can produce nausea, diarrhea, and dizziness.

Oral doses of choline can also produce an unpleasant “fishy” odor.(1) This is due to gut bacteria metabolizing the choline and releasing the odorous substance trimethylamine.

Functions in the Body

Uses

Clinical Applications
	Alzheimer's Disease
	Manic Depression
	Memory Enhancement
	Parkinson's Disease
	Tardive Dyskinesia

Amino Acid and Protein Synthesis:
Converted to betaine and then functions in transmethylation reactions (methyl donor) in the synthesis of amino acids and proteins.

Biochemical Pathways:
Structurally contains three methyl groups which enable it to serve as a methyl donor in many important biochemical pathways.

Cells:
Part of phosphatidylcholine, a phospholipid that is a major structural component of cell walls and cellular membranes throughout the body.

Cerebrocortical Functions:
Plays a critical role in the higher level cerebrocortical functions of thoughts, memory and intellect.

Fat Emulsifying:
Is a lipotropic agent.

Fat Metabolism:
As part of phosphatidylcholine, functions in the metabolism of fat and in the transport of fat from the liver.

Memory and Cognitive Function:
Improvement with high dose phosphatidylcholine.

Neurological Activities:
Precursor to and a component of the neurotransmitter acetylcholine, which is involved in regulating a wide range of neurological activities, including the functions of movement, coordination, and the stimulation of muscle contraction.

Tremor Reduction:
Useful in reducing the tremors associated with tardive dyskinesia and other diseases of the nervous system.

Clinical Applications

Alzheimer's Disease
Treatment with CDP-choline slows the progression of Alzheimer's disease.(2) Alzheimer's disease patients treated with a combination of choline and piracetam acheived dramatic improvements in cognitive function, far greater than the improvements with either choline or piracetam.(3)

Manic Depression
Choline is an effective adjunctive treatment with lithium in the treatment of manic depression.(4, 5)

Memory Enhancement
Choline supplementation improves short term memory probably because it is the precursor to acetylcholine.(6)

Parkinson's Disease
Treatment with CDP-choline provides some symptomatic improvement.(7, 8)

Tardive Dyskinesia
Some patients with this nervous disorder respond to choline therapy.(9)

Symptoms & Causes of Deficiency

Clear cases of choline deficiency in humans have not been reported.

Footnotes

¹ Rehman HU. Fish odor syndrome [see comments]. Postgrad Med J. Aug1999;75(886):451-2.
View Abstract
NO footnote for fnID: 101742
NO footnote for fnID: 101745
⁴ Stoll AL, et al. Choline in the Treatment of Rapid-cycling Bipolar Disorder: Clinical and Neurochemical Findings in Lithium-treated Patients. Biol Psychiatry. Sep1996;40(5):382-88.
View Abstract
⁵ Lyoo IK, Demopulos CM, Hirashima F, Ahn KH, Renshaw PF. Oral choline decreases brain purine levels in lithium-treated subjects with rapid-cycling bipolar disorder: a double-blind trial using proton and lithium magnetic resonance spectroscopy. Bipolar Disord. Aug2003;5(4):300-6.
View Abstract
NO footnote for fnID: 101760
⁷ Agnoli A, et al. New Strategies in the Management of Parkinson's Disease: A Biological Approach using a Phospholipid Precursor (CDP-choline). Neuropsychobiology. 1982;8(6):289-96.
View Abstract
⁸ Secades JJ, et al. CDP-choline: pharmacological and clinical review. Methods Find Exp Clin Pharmacol. Oct1995;17(Suppl B):1-54.
View Abstract
⁹ Nasrallan HA. Variable Clinical Response to Choline in Tardive Dyskinesia. Psychol Med. Aug1984;14(3):697-700.