This Dr. Axe content is medically reviewed or fact checked to ensure factually accurate information.
With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Note that the numbers in parentheses (1, 2, etc.) are clickable links to these studies.
The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.
This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Note that the numbers in parentheses (1, 2, etc.) are clickable links to medically peer-reviewed studies.
Our team includes licensed nutritionists and dietitians, certified health education specialists, as well as certified strength and conditioning specialists, personal trainers and corrective exercise specialists. Our team aims to be not only thorough with its research, but also objective and unbiased.
The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.
What Is Choline? Benefits, Sources & Signs of Choline Deficiency
May 11, 2018
Choline is a macronutrient that’s important for liver function, normal brain development, nerve function, muscle movement, supporting energy levels and maintaining a healthy metabolism. Choline is present in the form of phosphatidycholine, a compound that makes up the structural component of fat, and thus can be found in different types of foods that naturally contain certain fats. Choline plays a part in several important processes within the body that are carried out hundreds of times, every single day.
Choline is a water soluble nutrient that is related to other vitamins, such as folate and those in the B vitamin complex family. Just like B vitamins, choline plays a similar role in terms of supporting energy and brain function, as well as keeping the metabolism active.
What is choline most beneficial for? Choline helps in the process of methylation, which is used to create DNA, for nerve signaling, and for detoxification. It’s also important for the functioning of a key neurotransmitter called acetylcholine, which similarly helps nerves to communicate and muscles to move, acts as an anti-aging neurotransmitter, and performs other basic processes.
Choline is not actually considered a mineral or a vitamin, but is known to be an essential micronutrient needed for many functions of the body, especially for brain function. So while at this time there isn’t an official Daily Value Recommendation for Choline established by the USDA, it’s important to avoid a choline deficiency to help support various systems throughout the body, including the nervous, endocrine, digestive and reproductive systems.
Daily Recommended Amount of Choline
Our bodies are able to make a small amount of choline on their own, but the rest we must obtain from food sources.
What is choline found in? Choline can be found naturally in foods including eggs, liver, beef, salmon, cauliflower, Brussel sprouts and breast milk. In fact, eggs are sometimes called “brain food” because they are known for supplying high amounts of choline.
Choline was actually only added to the Nation Academy of Science’s (NAS) required nutrients list in 1998, making it one of the most recent additions of all nutrients. (1) Choline is still being studied in order to learn more about its potential benefits and uses, but at this time, most experts agree that the amounts listed below are sufficient for producing optimal benefits without causing any harm:
- Infants and babies: 125–150 mg
- Children ages 1-8: 150–250 mg
- Teens ages 8-13: 250–375 mg
- Women above age 14: 425–550 mg
- Men above age 14: 550 mg
- Pregnant women: 450–550 mg
- Women who are breastfeeding: 550 mg
Some experts recommend getting even higher levels of choline in order to boost brain function and to retain memory. Some reports have shown that a percentage of the choline found in food sources isn’t actually absorbed by the body, and that this may be one reason why certain people can experience a choline deficiency, especially those with liver damage since choline is processed partially in the liver.
If you choose to take choline supplements, it’s best to purchase one that is made from whole food sources and is of very high quality. There are several choices available for different types of choline supplements, some which will be more readily absorbed and used by the body, while others don’t fully have the same effects.
This has to do with how your body converts choline into the molecule acetylcholine, which is responsible for many of choline’s health benefits. Different types of choline also differ in their ability to cross the blood-brain barrier once ingested.
Some experts have pointed to the fact that the types of choline that is best used by the body are CDP choline, also called Citicoline, or Alpha GPC choline. These are potent types of choline that produce the most benefits in the body, according to some sources, because they closely mimic the way that choline is found naturally in food sources. (2)
Related: Giloy: The Ayurvedic Herb that Aids Digestion, Detoxification & More
Choline Deficiency Symptoms & Signs
There is some evidence that most people don’t acquire enough choline in their diets, despite eating choline-rich food sources, because some choline is not actually absorbed. Therefore, even though most people regularly eat foods that provide high enough levels of choline, certain factors make choline hard to absorb and studies show that the average person doesn’t have levels of choline present within their body that meet the daily recommendation. (3)
This is most likely due to genetic factors in certain people that create a higher need for choline. For example, according to researchers, 50 perent of the population may have genes that increase dietary methyl requirements, and since choline is a major source of methyl processes, this can result in a choline deficiency.
Researchers are still debating how much choline should be recommended to the public to consume each day, but the topic remains difficult to agree upon because there seems to be a wide range of needs when it comes to choline, with some people needing much more than others. Therefore, an average amount is hard to establish.
Symptoms of a choline deficiency may possibly include:
- low energy levels of fatigue
- memory loss
- cognitive decline
- learning disabilities
- muscle aches
- nerve damage
- mood changes or disorders
People with a condition of the liver called “fatty liver” are at a higher risk for having choline deficiency and experiencing negative symptoms. Fatty liver, also known as fatty liver disease (FLD), is a reversible condition where triglyceride fat accumulates in liver cells. It commonly develops with people who have an excessive alcohol intake, are obese, suffer with diabetes or a form of insulin resistance, and have other diseases that influence fat metabolism.
A choline deficiency may also play a part in age-related cognitive decline, including memory loss and Alzheimer’s disease. This is because choline helps with neurotransmitter maintenance and, as someone ages, nerve signaling can decrease and signs of dementia can be experienced. (3)
Eating a varied diet is the best way to ensure you acquire enough choline. Choline is especially present in animal products, so vegetarians and vegans are more prone to experiencing a deficiency in choline.
It’s also important to point out that folate plays a part in the body’s ability to create and use choline — as the two nutrients have a strong relationship and rely on one another to do their jobs. Researchers used to believe that we could make enough choline on our own but are finding out otherwise in recent years, hence the addition of choline to the list of required nutrients.
According to recent research, the amount of folate you consume may dictate how much choline your body makes and needs from food sources, so someone who obtains more folate from things like leafy green vegetables and certain grains will need less choline from food. (4)
Related: What Is the Boiled Egg Diet? Benefits, How to Follow, Risks & More
12 Foods High in Choline
The following 12 foods provide high levels of choline naturally, in addition to many other nutrients. All percentages below are based on the recommended amount of 550 milligrams daily.
1. Beef Liver
3 ounces: 283 mg (51% DV)
1 filet: 242 mg (44% DV)
1 cup uncooked: 198 mg (36% DV)
4. Split Peas
1 cup uncooked: 188 mg (34% DV)
5. Navy Beans
1 cup raw: 181 mg (32% DV)
1 large egg: 147 mg (27% DV)
7. Grass-Fed Beef
3 ounces: 78 mg (14% DV)
3 ounces: 57 mg (10% DV)
9. Chicken Breast
3 ounces: 50 mg (9% DV)
1 cup raw: 47 mg (8% DV)
11. Goat Milk
1 cup: 39 mg (7% DV)
12. Brussel Sprouts
1 cup raw: 17 mg (3% DV)
Choline & Soy Lecithin
It’s also worth noting that choline can be found in soy products, especially soy lecithin. Choline is a key component of lecithin (phosphatidylcholine), which is a fat-like substance found in our cells. Soy lecithin is a controversial substance that is used in food products as an emulsifier and sold as supplements.
Soy lecithin contains choline and other molecules, including fatty acids, glycerol and phosolipids. It was originally extracted from egg yolks, but today is derived from cottonseeds, marine sources, milk, sunflowers or most commonly, soy beans. Lecithin itself has important roles in the body, including to help maintain cell membranes, transmit nerve impulses, process fat and cholesterol, and perform other tasks.
Soy lecithin is added to many processed, packaged foods because it helps to bind foods and acts like an emulsifier, preserving the texture of foods and making them more shelf-stable. Although soy lecithin is considered safe by the FDA, at times it can result in negative reactions including nausea, bloating, constipation, rashes on the skin, abdominal pain and other digestive problems.
I have some other issues with soy lecithin in general, including that it contains isoflavones that have estrogenic effects on the body and that the majority of soy on the market today is genetically modified. There’s really no way to detect the source of soy lecithin, so we should assume that it’s extracted from GM soy, unless it’s labeled as organic. (5)
On the other hand, there are potential health benefits of soy lecithin, including its ability to help lower cholesterol, improve cognitive function, relieve menopause symptoms and help the body deal with stress. (6)
When it comes to getting choline from soy products, I’d advise you to only consume organic fermented soy products (tempeh, natto, miso) in moderation and to avoid unfermented soy, especially the kinds that are not organic and are processed. As you can see, there are plenty of other sources of choline that offer many more health benefits without the risks, including wild salmon, cage-free eggs and even certain vegetables, so why not obtain most of your choline from these foods?
Health Benefits of Choline
1. Forms DNA and Cell Structures
Choline helps the body to absorb fat, and fats are then used to create cell membranes and structures. Without enough choline in the body, our cells cannot properly withhold their structure and signal messages to other parts of the body. (7)
What is choline’s role in gene expression and DNA? Choline is needed to create DNA that is responsible for building out entire body structure. Choline and folate are known to be key nutrients involved in the methyl group processes, which the body uses to form genetic material that helps build every system within the body.
2. Supports Central Nervous System
One of the main benefits of choline is that it is used by the body in a variety of ways that are crucial for nerve functioning, including aiding in nerve signaling and maintaining the membranes of brain cells.
Choline also helps form tissue within the nervous system that plays a part in brain development and growth. It’s believed that choline can improve signaling capacity of nerves, support their structural integrity, and protect vital neuronal membranes. (8)
Choline acts like a precursor to certain important neurotransmitters, including acetylcholine, which is used in healthy nerve and muscle function. Neurotransmitters are chemical symptoms of communication used throughout the body constantly to relay information from system to system.
The neurotransmitter acetylcholine specifically plays a part in memory and learning, so a choline deficiency can result in poor concentration, poor memory, mood changes and other cognitive impairments, especially as someone ages. Acetylcholine is formed when an acetate molecule combines with a choline molecule, so without enough choline present in the body, this molecule cannot be properly produced and brain function can suffer. (9)
3. Maintains Healthy Liver Function
Choline is needed to properly transport fat from the liver to cells throughout the body. A benefit of choline is cleansing the liver because choline is partially responsible for keeping the liver clear from fat build-up that can accumulate and cause harm. Choline plays a part in transporting both cholesterol and triglycerides, two forms of important fats, from the liver to other parts of the body where they are needed.
In people who have low levels of choline present within their body, some studies have found that they are more at risk for experiencing liver damage and even liver failure. (10) Choline also helps form LDL cholesterol within the liver, and even though LDL is considered the “bad” kind of cholesterol, a certain level is still needed for healthy functioning — without enough, the body will suffer by storing fat in the liver.
4. Helps Protect Memory and Loss of Brain Function
Another one of the benefits of choline is its ability to keep your mind mentally sharp as you age. Because it’s a component of cell membranes and neurotransmitters that are used in nerve signaling, choline also plays a role in preserving memory and preventing dementia, memory loss and other signs of cognitive decline as someone becomes older.
As we age, our brain becomes less elastic. Choline does an important job of maintaining brain elasticity by working to maintain levels of acetylcholine, which naturally declines into old age.
Some studies point to the fact that low levels of acetylcholine may lead to cognitive decline, including Alzheimer’s disease and senile dementia. (11) Patients who develop Alzheimer’s at times show very low levels of acetylcholine, and some medications used to treat Alzheimer’s actually mimic choline’s effect of increasing this neurotransmitter’s effects.
5. Can Help with Exercise Performance and Muscle Function
Choline helps to improve mental energy, focus and concentration, which are all important for physical activity and athletic performance. It’s believed that choline’s effect on your metabolism and neurotransmitters in the brain can produce quicker reaction times and cut down on the amount of time needed for mental processing. (12)
Choline may also be helpful in improving energy levels, your mood, sleep cycles and recovery time following strenuous activity. Additionally, choline is used in muscle nerve functioning and may be useful in preventing fatigue and muscle aches or pains following exercise. Every time a muscle moves within the body, choline is needed to activate the neurotransmitter acetylcholine, which sends chemical signals to muscles and makes them mobile.
6. May Help Maintain Heart Health
Choline and folate assist in the conversion of homocysteine, which prevents the body from accumulating too much fat and may be beneficial in cutting down on the risk of having a heart attack or stroke. (13) Homocysteine is an amino acid that enters the body from protein sources, normally meat, and high levels of homocysteine have been correlated with development of heart and blood vessel diseases.
Some studies have shown that choline and lecithin can help to reduce blood cholesterol and risk for heart disease, but different studies have yielded inconsistent results, so more research is still needed before doctors will begin to prescribe choline for its ability to lower LDL (“bad”) cholesterol and trigylcerides. (14)
7. Supports a Healthy Pregnancy
Choline belongs in a pregnancy diet. Why? Pregnant women need even more choline than anyone else because choline is rapidly used by fetuses while their brains, cell structures and nerve channels are forming. Some studies even show that when a fetus obtains more choline, they have a better chance of later having healthy, sharp brain functioning and a lower risk of brain abnormalities. (15) Other studies show that pregnant women with a low blood level of choline have been shown to be at a higher risk for having children with neural tube defects and developmental problems.
Choline is also naturally found in breast milk since it’s important for a newborn’s growth and proper development. This is the reason it’s added to most infant formulas. Neuron synapses are being formed in the brain of fetuses and infants at a very rapid rate, so choline plays a major part in helping to build the foundation of the brain’s structure. (16)
Choline is also important during pregnancy because of its relationship with folate. Choline, folate and B vitamins all work together to keep levels of one another in check. Choline is one of the methyl donors in the body — which means that when folate, a vital nutrient needed for fetal development, is low, that choline is able to help fill in and carry out body functions where folate is needed but is missing.
8. Important for Children’s Growth and Development
Neuron plasticity refers to the brain’s ability to build new neuron connections, and choline is thought to be very important for supporting brain elasticity and plasticity. (17)
As children grow older, choline is needed to help develop brain function since it plays a role in learning, remembering, logical thinking and concentration abilities. Children need to acquire choline to form neurotransmitters channels in their brain that will help with information retention, verbal abilities, creative thinking, mathematical skills, social cues, and more. (18)
In fact, choline is needed for forming new brain connections between neurons called synapses, which is the chemical reaction needed for memories to actually form in the brain. Some reports even show that choline can help prevent learning disabilities, including ADHD, and can improve concentration in children and teens.
Choline is considered to be a safe nutrient and rarely causes negative side effects. However, like all nutrients, when too much is taken, it can become toxic.
If you vastly exceed the recommended amount of choline, you can possibly experience symptoms, including diarrhea, nausea, fatigue, higher blood pressure, excessive perspiration and a fishy odor of the skin. Always be sure to carefully read the recommended amount of any supplement you take and stick to the recommendation, unless you speak with your doctor first about doing otherwise.
How to Add More Choline to Your Diet
Choline can be found naturally in these recipes which contain choline-rich foods such as salmon, eggs and cauliflower.
- Breakfast Salmon Egg Bake
- Grilled Honey Glazed Salmon or Pecan Pesto Salmon
- Cauliflower with Chili Lime Butter
- Brussel Sprouts with Turkey Bacon
- Chicken Vegetable Soup
Read Next: What is Betaine? Benefits, Signs of Deficiency and Food Sources