Choline is an essential nutrient that helps with cognitive function, muscle health, liver function, and especially prenatal development.
Its found in many prenatal vitamins.
Pregnant women should be especially conscious of their choline intake, as a raft of scientific evidence has shown that it plays a critical role in fetal development.
Choline is found in small amounts in foods like eggs, cheese, seafood, and peanuts, and is available in supplemental form as well, but its importance wasn’t recognized until recently.
Technically, it isn’t classified as a vitamin, because the realization that choline was as important as the rest of the essential nutrients came so late. For people who need to bolster their choline intake, our research team has reviewed and ranked the ten best choline supplements on the market right now—read on for more.
1. Nested Naturals Choline
Nested Naturals has a very pure choline supplement with a solid, middle of the road dosage. Each vegan-friendly capsule delivers 225 mg of choline, and contains only rice flour as an extra ingredient.
With purity this good, it’s no surprise why its users love it: people praise its purity and its efficacy. With these strengths and no real faults, it’s our number one pick.
2. Standard Process Choline
Standard Process makes a 175 mg choline supplement that uses only natural ingredients in its tablet. The purity and simplicity of this tablet puts many other manufacturers to shame.
With only choline bitartrate, honey, and calcium stearate, these tablets achieve what other companies need half a dozen ingredients or more to do. If you are looking for a lower dose of choline, this is an excellent choice.
3. Doctor Recommended Supplements Choline
Doctor Recommended Supplements makes one of the better high-dose choline supplements out there, with 500 mg per capsule. The capsules are vegetable-based, and the only other ingredient is rice flour.
While 500mg might be overkill for some people, especially if you already get a lot of choline in your diet, it should be your go-to if you need a high dose choline supplement.
4. Flamingo Supplements Choline
This choline supplement is gummy-based, making it a good choice for people who can’t or don’t like to swallow solid tablets or capsules.
Four gummies deliver 100 mg of choline, so it’s not the best choice if you need regular high-dose choline. Still, as far as gummies go, these are cleaner and better-designed than most.
They use tapioca syrup to give the gummies their texture, and they are colored and sweetened using only natural compounds. Many gummy supplements contain a lot of artificial flavors and colors, so it’s good to see their absence here.
5. Now Choline & Inositol
Now Choline & Inositol delivers a 50/50 mix of these two essential nutrients, at 250 mg of each per capsule.
The capsules are made of gelatin, meaning they aren’t suited for strict vegetarians, but on the bright side, the only other ingredient is magnesium stearate to help hold the powder together. If you want inositol as well as choline, it’s a good choice.
6. Twinlabs Choline Caps
Twinlabs is known for making basic and simple supplements, and that’s certainly the case with their choline caps. Each capsule contains 300 mg of choline from choline bitartrate.
The choline is delivered in a gelatin capsule, and while there are a couple of extra additives that you might prefer be left out, it’s still a decent supplement.
7. Bulksupplements Pure Choline Bitartrate
As always, bulksupplements caters to the do it yourselfer with its bulk-sized loose powder forms of popular supplements, and choline is no exception.
If you are cooking up your own meal replacement, protein shake, or nootropic smoothie, it’s a must-have, but most people will want to opt for a product that’s already been measured and proportioned out into tablets or capsules.
Since the necessary intake of choline is measured in milligrams, you’ll need a very accurate scale to be able to accurately parse out the powder on your own.
8. GNC Choline
GNC Choline has a fairly respectable 250 mg dose of choline, but it also comes with a few extra additives, like food glaze, that you won’t find in top choline supplements.
It’s a fine choice if all you want is something with 250 mg of choline per serving, and it is vegan-friendly thanks to its cellulose capsule, but fans of cleaner supplement design may want to look elsewhere.
9. Best Naturals Choline
Best Naturals has a choline supplement that delivers 265 mg of choline, which is a bit subpar, especially considering that it’s advertised as a high-dose supplement.
Further, the tablets have a lot of binders, glazes, and other additives that make it pretty heavily laden with extras. It gets beat out on a number of fronts by other choline supplements that are on the market.
10. KRK Supplements Choline-900
Despite the name, KRK Supplements only delivers 450 mg of choline per tablet—the recommended serving size is two capsules.
It’s got a bit too many extras, like silica, to recommend as a top-tier choline supplement, though the dosage is still higher than some of the competition. Even so, there’s a better option out there for pretty much everybody.
Choline benefits and side effects
Choline is an essential nutrient found in some foods and is taken as a supplement for memory, mood, muscle control and other brain and nervous system functions (1).
Choline bitartrate is related to the B-vitamins and serves several vital biological functions throughout the body. One of its roles is to increase choline in the body. The body needs choline to synthesize phosphatidylcholine and sphingomyelin, two major phospholipids vital for cell membranes.
Phosphatidylcholine accounts for about 95 percent of total choline in tissues. Sphingomyelin is found in cell membranes and in the fatty sheath that wraps myelinated nerve fibers (2).
Choline is also needed to produce acetylcholine, a significant neurotransmitter involved in memory, mood, muscle control, circadian rhythm and other neuronal functions.
Choline also plays important roles in modulating gene expression, cell membrane signaling, lipid transport and metabolism, and early brain development (3).
According to the authors of the November 2009 issue of Nutrition Reviews, “choline-deficiency is now thought to have an impact on diseases such as liver disease, atherosclerosis and possibly neurological disorders because of its wide-ranging roles in human metabolism, from cell structure to neurotransmitter synthesis.” (4)
According to one study of healthy adult subjects lacking dietary choline, 77 percent of the men and 80 percent of the postmenopausal women developed signs of fatty liver or muscle damage (5).
Foods rich in choline include eggs (especially yolks), liver (beef and chicken), fish, wheat germ, cruciferous vegetables (Brussel sprouts, cauliflower and broccoli), meat, peanuts and dairy products (6).
One of the reasons why many people are deficient in this important nutrient is that it is found in high cholesterol and high fat foods (such as egg yolks, liver and meat) which are what people tend to avoid for better health.
Choline shows memory-enhancing possibilities. Approximately 5.7 million Americans are living with Alzheimer’s disease and it is the sixth leading cause of death in the U.S. (7). While there are some medications available to help temporarily reduce symptoms, there is currently no cure for the disease. In their ongoing search for effective treatment options and a cure, researchers have long been focusing their attention on the role of choline in treating memory loss.
Loss of cholinergic neurons is associated with impaired cognitive function, particularly memory loss and Alzheimer disease. Brain atrophy and white-matter hyperintensity are also associated with impaired cognitive function and Alzheimer’s.
The long-term effects of dietary choline availability on the rodent’s brain and memory have been investigated extensively. For example, studies have shown that the brain’s acetylcholine concentrations increase after an enriched choline diet and memorization of food locations improve after rats are administered with choline either prenatally, around birth or later in life.
In addition, in cognitively-impaired mice, prenatal choline supplementation also enhances performance in typical attention and memory-related tasks (8).
Building on the promising results in animal studies, researchers theorized that by increasing the amount of choline in the diets of older patients with impaired memory, their memory functioning would improve. However, results of studies in humans have come back with mixed results.
Lecithin and choline chloride (substances containing the chemical structure of choline), did not successfully improve memory performance. However, cytidine diphosphate choline (citicoline) and choline alphoscerate, two alternative compounds that contain choline, seem to be effective in the treatment of progressively declining memory functioning in dementia patients (9,10).
In a study evaluating the effects of citicoline supplementation on the verbal memory of older volunteers, a higher dosage of the supplement was associated with improved immediate and delayed logical memory (11).
Researchers are left with understanding why and which choline-containing substances improve memory. More studies are needed to understand the actual mechanism behind choline supplementation and memory improvement.
Researchers are also interested in studying the potential interactions of other food supplements in memory. They have found that antioxidant, flavonoid, glucose and fatty acid ingestion improve memory functions. Evaluating the administration of a blend of these supplements together with choline may be an important design for future studies.
Choline helps fetal brain development. The brain is at its most vulnerable during critical periods of development, including the last trimester of pregnancy and the first two years of childhood (12). High choline concentrations in the brain and spinal cord are important for neural tube closure and brain development. There is a high rate of transfer of choline across the placenta and it is known that in pregnancy and breastfeeding maternal reserves of choline are depleted.
In a paper published in the Journal of the American College of Nutrition, researchers noted that in studies where rat pups received choline supplements (in utero or during the second week of life), their brain function was changed, resulting in lifelong memory enhancement.
This change in memory function appears to be due to changes in the development of the memory center (hippocampus) in brain.
Another study showed that depriving neonatal rats of maternal contact resulted in altered memory, and that these effects of deprivation could be reversed by choline. Animals treated with supplemental choline during this period exhibited significantly higher memory capacity in adulthood than animals who received choline later (embryonic day 15 to 28) (13).
Choline may be able to improve cognitive deficits associated with fetal alcohol syndrome. Fetal alcohol syndrome causes brain damage and growth problems (motor coordination deficits, hyperactivity and learning deficits) in children as a result of alcohol exposure during the mother’s pregnancy (14).
In a 2000 study, researchers evaluated whether early choline supplementation had the ability to counter the effects of prenatal alcohol treatment in pregnant rats. A visuospatial discrimination task was used for assessment. Group one received a liquid diet containing 35 percent ethanol-derived calories from gestational day 6-20; group two served as a pair-fed control group and the third group served as an ad lib lab chow control.
On postnatal day two, pups were assigned to one of three postnatal treatments: choline, saline vehicle or no treatment.
Ethanol-exposed subjects who were not treated neonatally with choline committed a significantly greater number of errors. Whereas, neonatal choline treatment significantly improved performance on the discrimination task in all groups; however, the beneficial effects of choline were significantly larger in ethanol-exposed subjects.
It is believed that these effects were due to long-term changes in brain and behavioral development (15).
Authors of the study concluded that future studies should try to answer the following: Does the form and amount of choline ingested contribute to variations in memory observed between humans? Does choline supplementation of pregnant women result in babies with enhanced memory? Are the women who are eating low-choline diets and have an increased risk of having babies with a neural defect also at risk of having babies with diminished memory function?
Choline may reduce the risk of neural tube defects in babies when taken during pregnancy. Neural tube defects are birth defects of the brain and spinal cord (16). To help prevent these defects, women frequently take a vitamin supplement that has folic acid. Researchers have also been placing their focus on choline supplementation as a preventive candidate.
In a 2004 study, researchers investigated whether dietary intakes of choline and betaine (a choline metabolite) before conception to early pregnancy influenced neural tube defect risk.
It was found that dietary intakes of choline were associated with reduced neural tube defect risks and risk estimates were lowest for women whose diets were rich in choline, betaine and methionine (17).
A prospective study performed in 2009 including data from more than 180,000 pregnant women in California from 2003 through 2005, revealed that elevated neural tube defect risks were associated with lower levels of total choline, and reduced risks with higher levels of choline (18).
Choline may play a role in treating bipolar disorder. According to the American Psychiatry Association, bipolar disorder cause changes in a person’s mood, energy and ability to function. People diagnosed with this disorder experience extreme and intense emotional mood episodes categorized as manic, hypomanic or depressive (19).
In some small studies choline has been shown to be effective in helping improve symptoms of mania.
A small, open-label study of six patients with treatment-resistant rapid cycling bipolar disorder and stabilized on lithium found that the addition of free choline 2000–7200 mg daily resulted in improvement of manic symptoms (20).
The results of a 2003 randomized controlled trial of oral choline in rapid cycling bipolar patients treated with lithium revealed significantly decreased purine levels in the brain over a 12-week period (21). The body produces uric acid when it breaks down purines, organic chemical compounds. Elevated levels of uric acid are observed in people with mania. Decreasing uric acid, therefore, may help symptoms (22).
While larger studies are needed before recommending use of oral choline as an adjuvant therapy for the treatment of mania in bipolar disorder, early results are promising.
Choline may help prevent and treat liver damage. In the last few years there have been significant advances in the understanding of choline’s effects on liver function. Liver is a central organ responsible for choline metabolism and humans consuming a diet low in choline may develop fatty liver and liver damage.
The goal of many studies has been to better understand the factors that influence the progression of fatty liver disease to steatosis, fibrosis, cirrhosis and liver cancer.
Researchers have learned that choline deficiency in humans is associated with liver dysfunction and susceptibility is dependent on factors, including genetics, gender and the gut microbiome, which influence choline requirements (23).
Choline may help recovery after a stroke. Folates (B-vitamins) play an important role in brain function and deficiencies are linked to increased risk of developing a stroke. Researchers taking part in a 2017 study attempted to understand the role of B-vitamins in stroke pathology using mice models.
Mice were maintained on a folic acid deficient diet for four weeks prior to ischemic damage to increased levels of plasma homocysteine — a risk factor for stroke. Post-operatively, mice were placed on a B-vitamin and choline supplemented diet for four weeks.
In supplemented diet mice, an improvement in motor function after ischemic damage was evident compared to mice fed a control diet after ischemic damage.
In addition, there was enhanced proliferation, anti-oxidant activity and neuroplasticity in mice fed the supplemented diet (24). Neuroplasticity is defined as the capacity of neurons and neural networks in the brain to change their connections and behavior in response to new information, sensory stimulation, development, damage or dysfunction (25).
Excessive consumption of choline (greater than 7,500 mg) has been associated with low blood pressure, sweating, fishy body odor and gastrointestinal side effects such as nausea, vomiting and diarrhea (26).
According to the National Institutes of Health, adequate intake for adults is 550mg daily for men and breastfeeding women; 425mg daily for women; and 450mg daily for pregnant women (27).
The daily maximum safety limit for adults is believed to be 3,500 mg per day. For children age 1 to 8, the maximum is 1,000mg; the maximum for 9 to 13 years is 2,000mg; and the maximum for 14 to 18 years is 3,000mg.
Choline bitartrate is an essential nutrient that serves several vital biological functions throughout the body. The body needs choline to synthesize phosphatidylcholine and sphingomyelin, two major phospholipids vital for cell membranes.
Choline is related to the B-vitamins and is also a precursor to acetylcholine, a significant neurotransmitter involved in neuronal functions. This nutrient is naturally found in several foods (mainly egg yolks, liver, meats and wheat germ) and is taken as a supplement for memory, mood, muscle control and other brain and nervous system functions.
Several clinical studies performed have shown its potential in treating and preventing various conditions. Early dietary interventions may reduce the severity of fetal alcohol effects, and high choline concentrations in the brain and spinal cord are important for neural tube closure and brain development in babies.
Choline has been shown in small studies to be effective in improving manic symptoms in bipolar patients. Although larger studies are needed, researchers are optimistic that use of oral choline may be a potential future adjuvant therapy for treating symptoms of this mental disorder.
In addition, there is believed to be a link between humans consuming a diet low in choline and the development of nonalcoholic fatty liver disease and liver damage.
Excess consumption of choline is linked to adverse reactions.