Facts 
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- Choline is widely found as a free form or as a part of lecithin (phosphalidylcholine).
- Choline is crucial for normal function of all cells and is synthesized in the body.
- It is a lipotropic B-vitamin like compound and is easily absorbed from the intestine. It is also able to cross the blood-brain barrier into the spinal fluid for direct involvement in brain metabolism.
- Choline is now considered an essential nutrient, classifying it as a vitamin.
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Functions 
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- Choline or its metabolites is important for the integrity of cell membranes, as a methyl donor, cholinergic neurotransmission, transmembrane signaling and lipid transport and metabolism.
- Choline is the precursor of phosphatidylcholine and sphingomyelin, structural components of cell membranes.
- Choline is also a precursor of acetylcholine, which plays a role in brain development and function.
- It is required for lipid transport and metabolism, and prevents fat accumulation in the liver.
- Choline helps the liver and gallbladder function properly.
- Choline is also the precursor of platelet-activating factor (PAF) and betaine.
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Requirements & Recommendations 
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Choline: Dietary Reference Intake 1
|
mg/day |
Tolerable Upper Intake Levels (UL) |
Infants 0 to 6 months 7 to 12
months |
125 150 |
ND ND |
Children 1 to 3 years 4 to 8 years |
200 450 |
1.0 1.0 |
|
Males 9 to 13 years 14 to 18 years 19 to 70+ years Females 9 to 13 years 14 to 18 years 19 to 70+
years |
375 550 550
375 400 425 |
2.0 3.0 3.5 3.0 3.5
|
Pregnancy <= 18 years 19 to 50 years |
450 450 |
3.0 3.5 |
Lactation <= 18 years 19 to 50 years |
550 550 |
3.0 3.5 |
* Value is Adequate Intakes (AI), others are RDA.
ND=Not determinable due to the lack of data of adverse effects in this age group
and concern with regard to lack of ability to handle excess amounts.
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Deficiency Signs and Symptoms 
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- There are no specific symptoms credited to a choline deficiency in humans. With choline depletion, fat metabolism and utilization may be decreased, possibly leading to fatty liver. Cell membrane and myelin sheath covering nerves may also be compromised.
- Choline is the only single nutrient for which dietary deficiency causes development of liver carcinomas without any known carcinogen
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Toxicity 
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- There are no known toxic effects from choline, though high doses could aggravate epileptic conditions because of its nerve stimulating effects.
- High oral doses may produce a 'fishy' body odor from the breakdown of choline to trimethylamine by bacteria in the lower digestive tract.
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Dietary Sources 
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The highest amount of choline is present in lecithin, usually obtained from soybeans. Other good sources include:
| Egg yolk |
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Brewer's yeast |
| Wheat germ |
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Fish |
| Peanuts |
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Liver |
| Cauliflower |
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Populations w/ Special Needs 
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Persons at higher risk for a choline deficiency include infants, pregnant or lactating women, cirrhotic patients, and patients
on TPN. Choline may also be helpful in some individuals with liver disease,
manic conditions, cognitive disorders, tardive dyskinesia and some cancers.
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Drug-Vitamin Interaction 
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2 3 4- No health hazards or side effects are known.
- Caution with pregnancy or nursing, consult physician before using.
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Research Summary 
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Reproduction and Development: Choline is an essential nutrient for humans. The availability of choline during pregnancy and lactation is critical for normal development of the brain. Choline appears to effect the hippocampus or memory center in the brain. The mother's dietary choline during a critical period in brain development of the infant influences the birth and death rate of hippocampus nerve cells. - Thomas and colleagues7 , using an animal model, suggest that early dietary interventions with choline may reduce the severity of fetal alcohol effects. Sprague-Dawley pregnant rats were fed a liquid diet containing 35% ethanol from gestational day 6-20. On postnatal day 2, pups were assigned choline, saline vehicle, or no treatment until day 21. Ethanol exposed subjects not treated with choline had significantly greater errors during visuospatial discrimination tasks. Choline treated groups showed significant improvement on the visuospatial discrimination task. Early postnatal choline supplementation significantly attenuated the effects of prenatal alcohol on learning skills.
- Yang and colleagues8 demonstrate that prenatal choline-supplementation can protect rats against memory deficits induced by status epilepticus. Pregnant rats received a control or choline supplemented diet during days 11 through 17 of gestation. Before the seizure was induced, offspring showed no differences in water maze performance. After status epilepticus, animals on the control diet had a severely impaired water maze performance, while the choline supplemented group's offspring showed no impairment.
Memory: Buchman and
colleagues9 tried to determine if choline-supplemented TPN would lead to
improvement in neuropsychological test scores in adult outpatients who are
choline deficient and receiving TPN. Eleven patients randomly received their
usual TPN or TPN plus 2 g of choline chloride for 24 weeks. The results
indicated both verbal and visual memory might be impaired in patients receiving
long term TPN and both may be improved by supplementing choline.
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