Choline

Increased Choline intake has been recently recommended by the Food and Nutrition Board of the National Academy of Sciences for nursing mothers and women who are pregnant to help ensure normal fetal brain development. Choline may be useful in some cognitive disorders, liver diseases, manic conditions, tardive dyskinesia, and some cancers.

Trimethylaminuria is a rare genetic metabolic disorder occurring in oil to 0.1 to 1% of the population and is due to deficiency of the enzyme trimethylamine-N-oxide synthetase. Trimethylamine, which is produced from Choline, is excreted from the body by the urine, sweat, breath and other bodily secretions. It has a nauseating, rotten-fish-smelling odor. Trimethylamine-N-oxide is non-odorous. Individuals with primary genetic trimethyluria should restrict intake of Choline. Individuals with certain types of liver disease caused by any of the hepatitis viruses or from other etiologies might develop fishy body odor when taking supplemental Choline. Choline intake should be restricted in these cases. Choline doses of up to 3 grams daily are generally well tolerated although there are occasional reports of diarrhea, loose stools, and nausea. Higher doses have been associated with fishy body odor, particularly in individuals with trimethylaminuria. Trimethylaminuria might also occur in individuals with liver damage who are using high doses of Choline. High intakes of Choline have been linked with excessive sweating and hypotension. There are reports of depression or increased symptoms of depression in individuals using high doses of choline bitartrate. There are no adequate data demonstrating a no-observed-adverse-effect level for excess Choline intake. Based on two clinical studies in humans, a lowest-observed-adverse-effect level of 7.5 grams daily has been determined. At 7.5 grams of Choline daily, diarrhea, nausea, and a small decrease in blood pressure were reported in some patients. The upper limit for adults is 3.5 grams daily. Individuals that might be at increased risk of side effects with Choline intakes at the upper limit include those with depression, liver disease, renal disease, Parkinson's disease, and trimethylaminuria. Methotrexate might diminish pools of all Choline metabolites. Choline supplementation reverses fatty liver caused by methotrexate administration in rats. Choline works in concert with vitamins B6, B12, and folic acid in the metabolism of homocysteine. This website is intended to educate and inform, and should not replace discussions with your doctor.