Health Benefits of Choline - Rejuvenation Therapeutics

Health Benefits of Choline

choline vitamin b4 health benefits

Choline is a nutrient that’s essential for maintaining the structural integrity of all plant and animal cells. You could say choline literally helps hold human beings together. So, it’s important to know where choline comes from and how it works to maintain good health.1

What is choline?

Choline is a source of different methyl groups that the body needs for a wide range of metabolic processes. For instance, choline helps to preserve the structural integrity of cell membranes by synthesizing two vital phospholipids: phosphatidylcholine and sphingomyelin.1

Choline is needed to produce acetylcholine, a neurotransmitter that is vital for brain and nervous system functions like memory, mood, and muscle control. Choline also plays a key role in lipid transport and metabolism, as well as early brain development.1

The most common food-based sources of choline are the fat-soluble phospholipids phosphatidylcholine and sphingomyelin and the water-soluble compounds phosphocholine, glycerolphosphocholine, and free choline. When ingested, free choline is released from half the fat-soluble phospholipids and some of the water-soluble forms by the body’s pancreatic and mucosal enzymes.2

Free choline, phosphocholine, and glycerolphosphocholine are absorbed in the small intestine. Then, they enter circulation and are stored in the liver, where they are synthesized and used in the making of cell membranes throughout the body.

So, what happens to the half of the fat-soluble phospholipids that do not release free choline? The body absorbs them intact, incorporates them into chylomicron lipoproteins, and secretes them into the lymphatic system, where they are circulated to tissues and organs like the brain and the placenta.1

Getting enough choline

The daily adequate intake (AI) of choline is 550 milligrams for men over the age of 19 and 425 milligrams for non-pregnant, non-lactating women over the age of 19. The body can naturally produce some choline in the liver, but not enough to meet all its needs.3 So, it is important to get choline from food and/or supplements.

Choline can be found in a wide variety of foods, including meat, poultry, fish, dairy products, eggs, cruciferous vegetables, beans, nuts, seeds, and whole grains. One source that provides a concentrated amount of choline is egg yolk, which contains 680 milligrams of choline in every 100 grams.4

If the body does not get enough choline, this deficiency can result in muscle damage; liver damage; and nonalcoholic fatty liver disease, a condition resulting from fat deposits in the liver.4 In one study, when healthy men and women consumed a diet low in choline, 77% of the men and 80% of the postmenopausal women showed signs of organ dysfunction, including fatty liver or muscle damage.5 It doesn’t take long to become choline-deficient; one study found the concentration of choline in the blood decreased about 30% in people fed a diet lacking in choline for three weeks.6

Some groups are at a higher risk of choline deficiency, including pregnant women, people with certain genetic variations, and patients requiring intravenous feeding. Approximately 90%-95% of pregnant women do not get the daily AI of 450 milligrams of choline.1 Supplementation is advisable given the connection between high intake of choline during pregnancy and early postnatal development and improved cognitive function in adulthood. Getting plenty of choline during pregnancy has also been associated with a reduced risk of neural tube defects.7

Choline has shown neuroprotective qualities in adults as well. In one study, a community-based population of nondemented individuals who received choline demonstrated better cognitive function.8 In a small clinical trial, there was some limited reduction in cognitive impairment in human vascular dementias in patients treated with some compounds containing choline.7

Healthy for the heart

Some research has indicated that choline could be beneficial in various cardiovascular applications, in part because of its potential to lower inflammation. Results from a study known as ATTICA showed that participants consuming a diet rich in choline and the methyl donor betaine had the lowest levels of several inflammatory markers, including C-reactive protein (CRP). Experts have recognized elevated levels of CRP as a marker for cardiovascular disease.4

But when considering good cardiovascular health, it’s also important not to get too much choline. Very high amounts of the nutrient have been associated with other markers indicating an elevated risk of cardiovascular disease.1 For optimum health, it is recommended to keep choline levels below 3,500 milligrams a day.3

In animal studies, choline was found to have cardioprotective effects that could make the nutrient a potential complementary therapeutic for hypertension, a major risk factor for cardiovascular disease. Some disorders that can result from hypertension include cardiac remodeling, stroke, and stiffening of the arteries, as well as kidney dysfunction.9 A separate study in mice shows choline provided some protective effects against cardiac hypertrophy, a thickening of the heart muscle caused by prolonged, increased stress on the heart.10

Among African American participants in the Jackson Heart Study, higher dietary intake of choline was correlated with reduced risk of incident ischemic stroke.11

Other benefits of choline

Choline is being investigated for several other applications in humans. In a small study of adult patients with cystic fibrosis (CF), supplementation with choline was connected with improved lung function and decreased liver fat, suggesting that correcting choline deficiency in CF patients could be clinically significant.12

Results of another human study found a positive association between choline and bone mineral density in middle-aged and elderly participants.13 And in a study of female patients, higher dietary intake of choline was correlated with a lower risk of breast cancer.14


  1. US National Institutes of Health, Office of Dietary Supplements, July 2019.
  2. Cent Nerv Syst Agents Med Chem. 2012 Jun;12(2):100-13.
  3. Institute of Medicine (US). Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998. 12, Choline.
  4. Nutr Rev. 2009 Nov; 67(11): 615–623.
  5. Am J Clin Nutr. 2007 May; 85(5): 1275–1285.
  6. FASEB J. 1991 Apr;5(7):2093-8.
  7. Nutrients. 2017 Aug; 9(8): 815.
  8. Am J Clin Nutr. 2011 Dec;94(6):1584-91.
  9. Sci Rep. 2017 Feb 22;7:42553.
  10. Int J Biol Sci. 2013;9(3):295-302.
  11. Eur J Nutr. 2018 Feb; 57(1):51–60.
  12. Nutrients. 2019 Mar; 11(3):656.
  13. J Nutr. 2017 Apr;147(4):572-578.
  14. FASEB J. 2008 Jun; 22(6):2045–2052.