Common Name: Choline
Synonyms: bilineurine, 2-Hydroxy-N-N-trimethylethanaminium

Overview:

Although not a vitamin, Choline has only recently been designated as an essential nutrient by the United States Department of Agriculture. In fact, the FDA requires choline to be added to all infant formula made from cow’s milk, A small amount of Choline is synthesized in the body but not in the amounts that are needed to maintain good health. Most of the body’s supply of choline is found in specialized fat molecules called phospholipids (lecithin or phosphatidylcholine is the most common).

Choline functions as:

1. A precursor for phosphatidylcholine, acetylcholine and the phospholipid, sphingomyelin. The phospholipids, phosphatidylcholine and sphingomyelin, are essential structural components in all human cell membranes.
2. A precursor for acetylcholine, an important neurotransmitter that is involved in muscle control, memory and many other neurological functions.
3. A precursor for the intercellular messengers, diacylglycerol and ceramide as well as a precursor for platelet activating factor (PAF) and sphingophosphorylcholine, two more cellular signaling molecules.
4. A lipid transporter. As phosphatidylcholine it is packaged with the fats and cholesterol by the liver to form very low density lipoproteins (VLDL). With out this fat transporter, fat and cholesterol accumulate in the liver. This eventually leads to fatty degeneration of the liver. Studies done at the University of North Carolina put healthy men on a choline deficient diet. Within in three weeks, the men showed signs of liver dysfunction. In fact, a diet that is chronically choline deficient can produce severe liver damage.
5. A precursor for betaine, another metabolite made from choline, is used to convert homocysteine (a substance that in increased amounts is associated with increased risk of cardiovascular diseases) to methionine
6. Part of the cell membrane matrix. In cell culture, liver cells initiated what is called apoptosis or cell death when deprived of choline.

Benefits

Increase choline intake maybe helpful in the treatment of:

1. Alzheimer’s disease, as Alzheimer’s has been associated with a deficit of acetylcholine (a neurotransmitter).
2. Cognitive disorders. The Food and Nutrition Board of the National Academy of Science has recommended that pregnant and nursing mothers ensure that they are getting enough choline. Studies have shown that adequate intake of choline is essential for developing brains.
3. Manic conditions
4. Liver disease
5. Cardiovascular disease, as Betaine (derived from choline) combines with homocysteine to form methionine. In a small study, doses of Betaine were found to lower the blood levels of homocysteine in patients with cardiovascular disease

Dietary Sources

The foods that are high in cholesterol are also high in choline. These include:

	Beef Liver		Wheat Germ
	Eggs		Brussels' Sprout
	Cod		Shrimp
	Salmon		Peanut Butter
Milk Chocolate

Recommended Dosage:

Choline supplements come in

1. capsules of 348m & 648mg
2. Tablets of 250mg, 500mg, 648mg & 650mg
3. Powder for

Pediatric

6-11 months 150mg/day or 17mg per kilo of weight
1-3 years 200mg/day
4-8 years 250mg/day
9-13 years 375mg/day

Adult

Men
14-18 years 550mg/day
19 & older 550mg/day

Women
14-18years450/day
19 & older 550/day
Pregnant450mg/day
Lactating any age 550mg/day

Contra-indications

High doses of choline (10-16gm/day) have been associated with a fishy body odor, vomiting, salivation, and increased sweating. The strong fishy odor is caused by the excretion of a metabolite of choline. This does not happen when lecithin is the source of choline.

Dosages of 7.5gms can cause a drop in blood pressure and cause dizziness or fainting.

The Food and Nutrition Board has established 3.5gm/day as the upper intake level of choline. This was based on minimizing the drop in blood pressure and the fishy body odor.

People with liver and kidney disease, Parkinson’s disease, and depression should avoid choline supplements.

People who have a genetic disorder called trimethylaminuria might be at increased risk of suffering the adverse effects of choline supplementation at levels near 3gm/day level,

Drug interactions

Methotrexate (a medication used in the treatment of cancer, psoriasis and rheumatoid arthritis) has been shown to lower the levels of choline available to the body. Those taking this drug may an increased need for choline supplementation.

Note

Choline works with folate and vitamin B12. If the diet is low in either of these nutrients, it will affect the body’s ability to use choline.

Web References

1. http://lpi.oregonstate.edu/infocenter/othernuts/choline/
2. http://en.wikipedia.org/wiki/Choline
3. http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/cho_0283.shtml

Printed Reference Material

1. Albright CD, Liu R, Berthea TC, et al. Choline deficiency induces apoptosis in SV 40-immortalized CW SV-1 rat hepatocytes in culture. FASEB J. 1996; 10:510-516.
2. Blusztajn JK. Choline, a vital amine. Science. 1998; 281:794-795.
3. Canty DJ, Zeisel SH. Lecithin and choline in human health and disease. Nutr Rev. 1994; 52:327-339.
4. Cohen BM, Renshaw PF, Stoll, AL. Decreased brain choline uptake in older adults. An in vivo magnetic resonance spectroscopy study. J Amer Med Ass. 1995; 274:902-907.
5. Food and Nutrition Board. Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (National Academy Press, Washington, DC, 1998).
6. Pyapili GK, Turner DA, Williams, CL. Prenatal dietary choline supplementation decreases the threshold for induction of long-term potentiation in young adult rats. J Neurophysiol. 1998; 79:1790-1796.
7. Schocke Z, J, Kohlmueller D, Quak E, et al. Mild trimethylaminuria caused by common variants in FMO3 gene. Lancet. 1997; 354:834-835.
8. Shelly EP, Shelley WB. The fish odor syndrome. Trimethyluria. J Amer Med Ass. 1984; 251:253-255.
9. Wurtman RJ, Hefti F, Melamed E. Precursor control of neurotransmitter synthesis. Pharmacol Rev. 1981; 32:315-335.
10. Yen C-L, E Mar, M-H, Zeisel SH. Choline deficiency-induced apoptosis in PC 12 cells is associated with diminished membrane phosphatidylcholine and sphingomyelin, accumulation of ceramide and ciccylglycerol, and activation of a caspace. FASEB J. 1999; 13:135-142.