Choline

28 research sources Also known as: choline bitartrate choline chloride phosphatidylcholine citicoline
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125.0 mg Median Dose
🟢 99/100 Market Safety Score
28 Research Sources
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Evidence Summary

Choline is an essential nutrient critical for the maintenance of liver, brain, and muscle homeostasis. Research primarily focuses on its metabolic pathways, its role in neurodevelopment, and its potential utility in managing neurodegenerative and psychiatric conditions.

Evidence by Condition

Schizophrenia Moderate

Meta-analysis indicates differences in choline-containing compounds and myo-inostiol levels between treatment-resistant and responsive patients.

Nutritional interventions are studied for their potential to prevent nonprogressive congenital and perinatal brain injuries.

Clinical trials are exploring the use of citicoline in conjunction with brain-computer interface training for attention.

Effective Doses

The IOM/NAM recommends an Adequate Intake (AI) of 550 mg/day for males aged 19-50.

Key Findings

  • Greater choline-containing compounds and myo-inositol are observed in specific schizophrenia subgroups (PMID: 37925074).
  • Choline deficiency is linked to negative health consequences in the liver, brain, and muscles (PMID: 33668062).
  • Plasma concentrations of choline and betaine can be used to accurately assess dietary intake levels in healthy adults (PMID: 41687879).

Limitations

Much of the current research focuses on the pharmacokinetics and metabolic assessment of choline rather than large-scale clinical efficacy for specific diseases. There is a lack of standardized therapeutic dosing protocols in the available literature.

Safety & Interactions

Regulatory bodies like EFSA have established scientific opinions regarding health claims for choline; however, specific contraindications were not detailed in the provided studies.

AI-generated summary from 28 peer-reviewed studies. Not medical advice. Always consult a healthcare provider.

Dietary Reference Intakes

Source: IOM/NAM Dietary Reference Intakes · Dietary Reference Intakes: Choline

Claims vs. Evidence

100% Evidence-Backed
0% Unsupported
90% Structure/Function
Claim Type% of ProductsEvidence RequiredStatus
All Other 97% Tier D (Unclassified) ✅ Supported
Structure/Function 90% Tier C (DSHEA Structure/Function (no pre-approval)) ✅ Supported
Nutrient 42% Tier D (Unknown) ✅ Supported
No Claim 1% Tier D (No claim on label) ✅ Supported

🏛️ NIH ODS Factsheet

Research by Topic

⚠️ FDA Safety Data

Research Evidence (28)

Clinical Trial: 11 Rct: 8 Guideline: 2 Meta Analysis: 2 Regulatory Source: 2 Systematic Review: 1 Openfda Safety: 1
B Greater Choline-Containing Compounds and Myo-inositol in Treatment-Resistant Versus Responsive Schizophrenia: A 1H-Magnetic Resonance Spectroscopy Meta-analysis
Meta Analysis Biological psychiatry. Cognitive neuroscience and neuroimaging 2024 n=239

**Smucny et al., 2024** | Biol Psychiatry Cogn Neurosci Neuroimaging | Meta Analysis Smucny Jason, Carter Cameron S, Maddock Richard J. Greater Choline-Containing Compounds and Myo-inositol in Treatment-Resistant Versus Responsive Schizophrenia: A 1H...

B Integrating multi-structure covalent docking with machine-learning consensus scoring enhances potency ranking of human acetylcholinesterase inhibitors.
Guideline Briefings in bioinformatics 2026

Acetylcholinesterase (AChE) inhibition is a key mechanism in the treatment of neurodegenerative diseases and in counteracting toxic exposures to pesticides and nerve agents. However, accurately ranking the potency of covalently binding AChE inhibitor...

B Evidence-based clinical practice guidelines for functional dyspepsia 2021.
Guideline Journal of gastroenterology 2022

BACKGROUND: Functional dyspepsia (FD) is a disorder that presents with chronic dyspepsia, which is not only very common but also highly affects quality of life of the patients. In Japan, FD became a disease name for national insurance in 2013, and ha...

B Scientific Opinion on health claims related to choline
Regulatory Source EFSA Journal 2011

**Authority**: European Food Safety Authority (EFSA) **Claim Type**: art13.1 **Substance**: choline **DOI**: 10.2903/j.efsa.2011.2056 **URL**: https://doi.org/10.2903/j.efsa.2011.2056

C Effectiveness of nutritional interventions to prevent nonprogressive congenital and perinatal brain injuries: a systematic review and meta-analysis of randomized trials
Meta Analysis Nutrition reviews 2022 n=5

**Curioni et al., 2022** | Nutr Rev | Meta Analysis Curioni Cintia C, Mocellin Michel C, ... André Charles. Effectiveness of nutritional interventions to prevent nonprogressive congenital and perinatal brain injuries: a systematic review and meta-ana...

C Two methods for assessment of choline status in a randomized crossover study with varying dietary choline intake in people: isotope dilution MS of plasma and in vivo single-voxel magnetic resonance spectroscopy of liver.
Rct The American journal of clinical nutrition

BACKGROUND: Choline deficiency has numerous negative health consequences; although the preponderance of the US population consumes less than the recommended Adequate Intake (AI), clinical assessment of choline status is difficult. Further, several pa...

C Choline and betaine concentrations in plasma discriminate levels of dietary choline intake in healthy adults: analysis of a double-blind randomized crossover controlled feeding study.
Rct The American journal of clinical nutrition

BACKGROUND: Choline is an essential nutrient, and insufficient intake negatively affects the liver, brain, and muscles. In the United States, habitual choline intake remains below the adequate intake (AI). To date, no circulating metabolites have bee...

C Nutrient-based therapies for bipolar disorder: a systematic review
Systematic Review Psychotherapy and psychosomatics 2013

**Sylvia et al., 2013** | Psychother Psychosom | Systematic Review Sylvia Louisa G, Peters Amy T, ... Nierenberg Andrew A. Nutrient-based therapies for bipolar disorder: a systematic review. Psychother Psychosom. 2013;82(1):10-9. doi:10.1159/00034130...

C The association of betaine, homocysteine and related metabolites with cognitive function in Dutch elderly people
Rct The British journal of nutrition 2007

**Eussen et al., 2007** | Br J Nutr | Rct Eussen Simone J P M, Ueland Per M, ... de Groot Lisette C P G M. The association of betaine, homocysteine and related metabolites with cognitive function in Dutch elderly people. Br J Nutr. 2007-Nov;98(5):960...

C Differential metabolism of choline supplements in adult volunteers.
Rct European journal of nutrition

BACKGROUND: Adequate intake of choline is essential for growth and homeostasis, but its supply does often not meet requirements. Choline deficiency decreases phosphatidylcholine (PC) and betaine synthesis, resulting in organ pathology, especially of ...

C Choline supplementation for preterm infants: metabolism of four Deuterium-labeled choline compounds.
Rct European journal of nutrition

BACKGROUND: Supply of choline is not guaranteed in current preterm infant nutrition. Choline serves in parenchyma formation by membrane phosphatidylcholine (PC), plasma transport of poly-unsaturated fatty acids (PUFA) via PC, and methylation processe...

C Different choline supplement metabolism in adults using deuterium labelling.
Rct European journal of nutrition

BACKGROUND: Choline deficiency leads to pathologies particularly of the liver, brain and lung. Adequate supply is important for preterm infants and patients with cystic fibrosis. We analysed the assimilation of four different enterally administered d...

C A Brain-Computer Interface-Based Attention Training Program Compared With Methylphenidate and Citicoline
Clinical Trial ClinicalTrials.gov 2025

**NCT ID**: NCT07333339 **Phase**: **Status**: COMPLETED **Enrollment**: 174 **Completion**: 2025-11-10

C Dietary and supplementary betaine: effects on betaine and homocysteine concentrations in males
Rct Nutrition, metabolism, and cardiovascular diseases : NMCD 2009

**Atkinson et al., 2009** | Nutr Metab Cardiovasc Dis | Rct Atkinson W, Slow S, ... George P M. Dietary and supplementary betaine: effects on betaine and homocysteine concentrations in males. Nutr Metab Cardiovasc Dis. 2009-Dec;19(11):767-73. doi:10....

C Dietary Reference Intakes: Choline
Regulatory Source IOM/NAM Dietary Reference Intakes 2000

**Source**: IOM 1998 Dietary Reference Intakes for Choline **Unit**: mg/day | Population | AI | |---|---| | Male 19-50 | 550 mg/day |

C Choline and Cardiometabolic Health
Clinical Trial ClinicalTrials.gov 2021

**NCT ID**: NCT04764162 **Phase**: NA **Status**: COMPLETED **Enrollment**: 14 **Completion**: 2023-11-21

C Cognitive Effects of Citicoline on Attention in Healthy Mean and Women
Clinical Trial ClinicalTrials.gov 2021

**NCT ID**: NCT04967157 **Phase**: NA **Status**: COMPLETED **Enrollment**: 148 **Completion**: 2022-08-31

C Changes in Muscle Strength, Inflammatory Markers, and Body Composition in Response to Alternate Day Fasting Combined With Krill Oil Supplementation in Adults With Overweight and Obesity
Clinical Trial ClinicalTrials.gov 2022

**NCT ID**: NCT06001632 **Phase**: NA **Status**: COMPLETED **Enrollment**: 50 **Completion**: 2025-10-01

C Whole egg consumption increases plasma choline and betaine without affecting TMAO levels or gut microbiome in overweight postmenopausal women.
Rct Nutrition research (New York, N.Y.)

As a crucial part of the symbiotic system, the gut microbiome is metabolically connected to many diseases and conditions, including cardiovascular diseases (CVD). Trimethylamine (TMA) is produced by gut bacteria from dietary choline, betaine, or L-ca...

C Choline Supplementation as a Neurodevelopmental Intervention in Fetal Alcohol Spectrum Disorders
Clinical Trial ClinicalTrials.gov 2016

**NCT ID**: NCT02735473 **Phase**: PHASE2 **Status**: COMPLETED **Enrollment**: 46 **Completion**: 2021-09-10

C Citicoline Effect on Non-arteritic Anterior Ischemic Optic Neuropathy (NAION)
Clinical Trial ClinicalTrials.gov 2017

**NCT ID**: NCT03046693 **Phase**: PHASE4 **Status**: COMPLETED **Enrollment**: 38 **Completion**: 2017-05

C Assessment of TMAO Formation With Egg Intake Versus Choline Supplement in a Healthy Population
Clinical Trial ClinicalTrials.gov 2017

**NCT ID**: NCT03142763 **Phase**: NA **Status**: COMPLETED **Enrollment**: 30 **Completion**: 2018-12-31

C The Combination Effect of Citicoline and Omega-3
Clinical Trial ClinicalTrials.gov 2018

**NCT ID**: NCT03444662 **Phase**: NA **Status**: COMPLETED **Enrollment**: 70 **Completion**: 2019-09-03

C The Effects of 8-week Choline, Betaine, and Folic Acid Supplementation on Plasma Homocysteine Concentration During Guanidinoacetic Acid Loading in Young Healthy Volunteers
Clinical Trial ClinicalTrials.gov 2011

**NCT ID**: NCT01371357 **Phase**: PHASE3 **Status**: COMPLETED **Enrollment**: 40 **Completion**: 2011-12

C Parental One-carbon Folate and Choline Nutrition Modulates Risk of Off-spring Cancer Development: Human Cohort Study
Clinical Trial ClinicalTrials.gov 2014

**NCT ID**: NCT02266641 **Phase**: NA **Status**: COMPLETED **Enrollment**: 118 **Completion**: 2017-12

C Examination of the Lipid Metabolism of the Liver After Choline Substitution in Cystic Fibrosis
Clinical Trial ClinicalTrials.gov 2014

**NCT ID**: NCT03312140 **Phase**: NA **Status**: COMPLETED **Enrollment**: 10 **Completion**: 2017-02-08

D Choline

**Source:** [Office of Dietary Supplements, NIH](https://ods.od.nih.gov:443/factsheets/Choline-HealthProfessional/) **Reading Level:** Health Professional This fact sheet from the NIH Office of Dietary Supplements provides evidence-based information ...

D Adverse Event Profile: Choline
Openfda Safety FDA CAERS

**Source**: FDA Center for Food Safety and Applied Nutrition (CFSAN) Adverse Event Reporting System **Total Events**: 7 **Serious Events**: 1 **Date Range**: 20121205 to 20250925 - **GASTROINTESTINAL PAIN**: 1

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Frequently Asked Questions

What is choline and why is it important?

Choline is an essential nutrient that is critical for maintaining the health of your liver, brain, and muscles. It plays a vital role in supporting the proper functioning and homeostasis of these key body systems.

Can choline help with schizophrenia?

There is moderate evidence suggesting that levels of choline-containing compounds differ between patients who are responsive to treatment and those with treatment-resistant schizophrenia. Further research is needed to fully understand its role in managing the condition.

Does choline improve focus and attention?

There is currently weak evidence regarding the use of choline for cognitive function and attention. Some clinical trials are investigating whether citicoline can be used alongside brain-computer interface training to assist with focus.

Is choline effective for preventing brain injuries in infants?

There is currently insufficient evidence to confirm if nutritional interventions with choline can prevent nonprogressive brain injuries in preterm or developing infants. Research is still ongoing in this area of neurodevelopment.

How much choline should I take daily?

The recommended adequate intake for men aged 19 to 50 is 550 mg per day. Maintaining this level is important for preventing negative health consequences in the liver, brain, and muscles.

Are there any side effects or drug interactions with choline?

There are no documented drug interactions or specific contraindications found in the current research. However, you should always consult with a healthcare professional before adding new supplements to your routine.

What happens if I don't get enough choline?

A deficiency in choline is linked to negative health consequences for your brain, liver, and muscles. Ensuring adequate intake is necessary to maintain essential bodily functions.

Answers generated from research evidence. Not medical advice.