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What is it? Overview Usage Side Effects and Warnings

Choline Usage

Written by FoundHealth.


Effect of Choline on Bipolar Disorder

Only weak evidence suggests choline for the treatment of depression.6

Read more about Bipolar Disorder and Choline.

Therapeutic Uses

A form of choline called choline alfoscerate has shown promise for Alzheimer's disease . 1 A substance related to choline called CDP-choline (or citicoline) may be slightly helpful for enhancing recovery from strokes . 2 Slight evidence hints that lecithin or pure choline may be helpful for people with bipolar disorder . 3 Lecithin has failed to prove effective for tardive dyskinesia . 4 Lecithin has also failed to prove effective for improving cholesterol profile levels. 5 Some evidence suggests that individuals with HIV who are low in choline may experience more rapid disease progression. 6 However, there is no direct evidence that choline supplements offer any benefit for people with HIV.

Numerous studies have found that diets very low in choline lead to impaired liver function. 7 But these diets are contrived: One would have to work very hard to get so little choline in the diet! To what degree additional choline may benefit people with pre-existing liver damage is an area of ongoing research. In a double-blind study , use of phosphatidylcholine enhanced the effect of interferon in people with chronic hepatitis C, but not those with chronic hepatitis B. 8 Open studies have yielded mixed results. 9 Finally, there are theoretical reasons to believe that choline might have cancer-preventive properties. The notion stems from its function as a methyl donor. Methyl units are essential for RNA and DNA replication—a process ongoing in every cell of the body. The theory goes like this: Diets lacking sufficient methyl donors (such as choline) may cause an error in RNA or DNA synthesis, leading to a mutated gene and, hypothetically, to cancer initiation. 10 Indeed, in rats fed diets very low in choline and other methyl donors, cancer rates increased. 11 However, again it is a long step from the effects of an artificially low-choline diet to taking choline supplements.

Choline as phosphatidylcholine may reduce homocysteine levels. 12 This, in turn, might reduce heart disease risk, although the proposed homocysteine-heart disease connection remains far from proven. (See the High Homocysteine article for more information.)


  1. De Jesus Moreno Moreno M. Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial. Clin Ther. 25(1):178-93.
  2. Dávalos A, Castillo J, Alvarez-Sabín J, Secades JJ, Mercadal J, López S, Cobo E, Warach S, Sherman D, Clark WM, Lozano R. Oral citicoline in acute ischemic stroke: an individual patient data pooling analysis of clinical trials. Stroke. 33(12):2850-7.
  3. Cohen BM, Lipinski JF, Altesman RI. Lecithin in the treatment of mania: double-blind, placebo-controlled trials. Am J Psychiatry. 139(9):1162-4.
  4. Gelenberg AJ, Dorer DJ, Wojcik JD, Falk WE, Brotman AW, Leahy L. A crossover study of lecithin treatment of tardive dyskinesia. J Clin Psychiatry. 51(4):149-53.
  5. Zeisel SH, Da Costa KA, Franklin PD, Alexander EA, Lamont JT, Sheard NF, Beiser A. Choline, an essential nutrient for humans. FASEB J. 5(7):2093-8.
  6. Bogden JD, Kemp FW, Han S, Li W, Bruening K, Denny T, Oleske JM, Lloyd J, Baker H, Perez G, Kloser P, Skurnick J, Louria DB. Status of selected nutrients and progression of human immunodeficiency virus type 1 infection. Am J Clin Nutr. 72(3):809-15.
  7. Zeisel SH. Choline: an important nutrient in brain development, liver function and carcinogenesis. J Am Coll Nutr. 11(5):473-81.
  8. Niederau C, Strohmeyer G, Heintges T, et al. Polyunsaturated phosphatidyl-choline and interferon alpha for treatment of chronic hepatitis B and C: a multi-center, randomized, double-blind, placebo-controlled trial. Leich Study Group. Hepatogastroenterology. 1998;45:797-804.
  9. Guan R, Ho KY, Kang JY, Yap I, Gwee KA, Tan CC. The effect of polyunsaturated phosphatidyl choline in the treatment of acute viral hepatitis. Aliment Pharmacol Ther. 9(6):699-703.
  10. Zeisel SH. Choline: an important nutrient in brain development, liver function and carcinogenesis. J Am Coll Nutr. 11(5):473-81.
  11. Wainfan E, Poirier LA. Methyl groups in carcinogenesis: effects on DNA methylation and gene expression. Cancer Res. 52(7 Suppl):2071s-2077s.
  12. Olthof MR, Brink EJ, Katan MB, Verhoef P. Choline supplemented as phosphatidylcholine decreases fasting and postmethionine-loading plasma homocysteine concentrations in healthy men. Am J Clin Nutr. 82(1):111-7.


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