Choline

Recommended Daily Intake

According to the Institute Of Medicine in the US, the Adequate Intake (AI) for choline for adult men is 550 mg/day and for women 425 mg/day ^[1].

Foods High in Choline

Most foods contain some choline but the richest sources are:

• PLANT FOODS: wheat germ, shiitake mushrooms, corn, beans (soy, mung), lentils, chickpeas, collards, beet greens, Brussel’s sprouts, broccoli, cauliflower
• ANIMAL FOODS: organ meats (liver, kidney, brain, heart), beef, veal, pork, fish (salmon, cod, mackerel) and other seafood (shrimps, oysters, crabs, clams), eggs (yolks), chicken, turkey
• Human breast milk contains 160 mg choline per liter, which is enough to meet the needs of infants 0-12 months of age.
• References: ^[1,2]

In foods, choline is in the form of  phosphatidylcholine (lecithin).

Choline Deficiency: Causes, Symptoms

Choline deficiency is rare ^[1].

Who may be at risk to develop choline deficiency?

• Strict vegetarians (vegans)
• Patients with cancer or rheumatoid arthritis receiving methotrexate ^[1]

In choline deficiency, fats from the liver cannot be incorporated into VLDL lipoproteins, so they may accumulate in the liver and cause fatty liver and increased blood levels of the liver enzyme alanine aminotransferase (ALT). It is not yet clear, if choline deficiency is related to heart disease, cancer, birth defects, memory or Alzheimer disease ^[1].

Choline Supplements

Without prescription (over-the-counter):

• Choline chloride, bitartrate and alfoscerate, and phosphatidylcholine (lecithin)

By prescription:

• Choline magnesium trisalicylate, which is a nonsteroidal anti-inflammatory drug (NSAID) for treatment of rheumatoid arthritis.

Possible Choline Supplements Benefits

There is CONVINCING EVIDENCE about choline effectiveness in prevention or treatment of choline deficiency ^[1].

There is SOME EVIDENCE about choline effectiveness in prevention or treatment of asthma ^[4].

There is INSUFFICIENT EVIDENCE about choline effectiveness in the prevention or treatment of allergies (hay fever), bipolar disorder, cancer, coronary heart disease, dementia, depression, high cholesterol, Huntington’s chorea, liver disease including hepatitis, mental disorders, neural tube defects, poor memory, seizures and Tourette’s syndrome ^[1,3,4,6].

Choline is POSSIBLY INEFFECTIVE in the prevention or treatment of Alzheimer’s disease, cerebellar ataxia and schizophrenia or in increasing of athletic performance ^[4].

Choline Safety: Side Effects, Toxicity

The Tolerable Upper Level Intake (UL)–the amount that should not cause side effects–for choline for adults is 3.5 g/day ^[1].

Side effects reported after taking 10 grams or more of choline per day included vomiting, excessive salivation, sweating, fainting (due to low blood pressure) and fishy body odor ^[1].

Choline is likely safe for most adults, children and pregnant women when taken in recommended amounts ^[4].