Choline: benefits, dosage, contraindications
Scientific name(s)
Trimethylethanolamine
Family or group:
Pseudovitamins
Indications
Scoring methodology
EFSA approval.
Fatty liver ✪✪✪✪✪
Intravenous administration of choline is useful for treating hepatic steatosis secondary to choline deficiency in patients receiving exclusive parenteral nutrition. A dose of 1 to 4 grams per day of choline chloride for 24 weeks has been used.
Posologie
Oral
1 - 4 g
24 - weeks
Choline deficiency causes reversible hepatic abnormalities in patients receiving parenteral nutrition: proof of a human choline requirement: a placebo-controlled trial
Choline deficiency: a cause of hepatic steatosis during parenteral nutrition that can be reversed with intravenous choline supplementation
Liver disorders ✪✪✪✪✪
A dietary choline deficiency leads to an accumulation of hepatic fatty acids (triglycerides). Indeed, decreased choline leads to decreased synthesis of phosphatidylcholine (PC), a lipid molecule composed of a choline residue, a phosphate, and a glycerol residue. PC promotes the synthesis of VLDL (a lipoprotein) which transfers triglycerides from the liver to the plasma. Choline deficiency is rare, and occurs, for example, in people receiving long-term total parenteral nutrition, which suggests that dietary choline is required in addition to the choline normally synthesized by the body. Furthermore, in animal models, long-term consumption of a choline-deficient diet can cause hepatocellular carcinoma (a primary liver cancer).
Posologie
Oral
250 - 500 mg
Choline deficiency causes reversible hepatic abnormalities in patients receiving parenteral nutrition: proof of a human choline requirement: a placebo-controlled trial
Choline deficiency: a cause of hepatic steatosis during parenteral nutrition that can be reversed with intravenous choline supplementation
Asthma ✪✪✪✪✪
Oral choline supplementation appears to reduce the severity and duration of asthma symptoms, and the need to use bronchodilators in patients with asthma. There is evidence that high doses of 3 grams per day may be more effective than lower doses of 1.5 grams per day.
Posologie
Oral
1.5 - 3 g
4 months
Pregnancy ✪✪✪✪✪
Epidemiological data suggest that women who have a high dietary intake of choline during pregnancy have a lower risk of having a neural tube defect in the fetus compared with women with a low intake. The adequate daily intake of choline for pregnant women, as defined by EFSA, is 480 mg.
Posologie
Oral
480 mg
Fetal development ✪✪✪✪✪
When used during pregnancy, choline appears to increase cell proliferation and decrease apoptosis in the fetal hippocampus. During lactation, choline appears to improve hippocampal growth in the infant. Epidemiological studies suggest that women who consume high amounts of dietary choline at the time of conception are at lower risk of having a child with a neural tube defect than women who consume less.
Posologie
Orally
480 mg
Properties
Cardiovascular
Choline can be oxidized to betaine, which serves as a methyl donor to convert homocysteine into methionine, and then into S-adenosylmethionine. Thus, dietary choline intake could lower homocysteine levels, which is known as one of the risk factors for cardiovascular disease.
Hepatoprotective
A dietary choline deficiency leads to an accumulation of hepatic fatty acids (triglycerides). Indeed, decreased choline leads to decreased synthesis of phosphatidylcholine (PC), a lipid whose molecule is composed of a choline residue, a phosphate, and a glycerol residue. PC promotes the synthesis of VLDL (a lipoprotein) which transfers triglycerides from the liver to the plasma. Choline deficiency is rare, and occurs, for example, in people receiving long-term total parenteral nutrition, which suggests that dietary choline is required in addition to the choline normally synthesized by the body. Furthermore, in animal models, long-term consumption of a choline-deficient diet can induce hepatocellular carcinoma (a primary liver cancer).
Usages associés
Anti-inflammatory
Choline selectively activates alpha-7 nicotinic acetylcholine receptors, which are present on immune cells. Their activation leads to a decrease in the production of inflammatory cytokines, including tumor necrosis factor (TNF).
Usages associés
Neurological
In nervous tissue, choline is a component of cell membranes. It is necessary for the synthesis of phospholipids and is involved in brain development, neurotransmission, and signaling. Some evidence suggests that patients with schizophrenia have decreased expression of alpha-7 nicotinic acetylcholine receptors, which play a role in normal cognitive processes including attention and memory. There is evidence that choline supplementation can increase the density of alpha-7 nicotinic acetylcholine receptors.
Safe dosage
Adults 18 years and older: 400 mg
Infants 7 to 11 months: 160 mg
Children 1 to 3 years: 140 mg
Children 4 to 6 years: 170 mg
Children 7 to 10 years: 250 mg
Children 11 to 14 years: 340 mg
Children 15 to 17 years: 400 mg
Pregnant women 18 years and older: 480 mg
The adequate daily intake of choline for pregnant women, as defined by EFSA, is 480 mg.
Breastfeeding women 18 years and older: 520 mg
Interactions
Médicaments
Atropine: weak interaction
Animal studies have shown that administering choline one hour before atropine can inhibit the atropine-induced decrease in brain acetylcholine. Theoretically, concomitant use of choline and atropine may reduce atropine's effects.
Precautions
Urinary disorders: use with caution
When taken orally, high doses of choline (9 grams per day) may worsen urinary incontinence.
Depression: avoid
Choline intake is not recommended for people with depression, to avoid a possible worsening of symptoms.
Parkinson's disease: avoid
It has been suggested that higher levels of acetylcholine cause dyskinesia — uncontrolled involuntary movements — observed in people with Parkinson's disease undergoing long-term dopamine treatment. Choline supplementation (which is a precursor of acetylcholine) should therefore be avoided in people with Parkinson's disease.
