Choline (Choline bitartrate)
Choline bitartrate is a form of the nutrient choline, which is one of the B-complex vitamins naturally produced in the liver. Choline is present in various food groups including liver meat, muscle meat, wheat germ, fish, beans, nuts, spinach, peas, and eggs. Choline bitartrate is the combination of choline and a salt of tartaric acid. It has better absorption rate and is more potent than pure choline.
Overall Health Benefits
- Boosts cognitive function [1-9]
- Detoxifies the liver and prevents liver disease [10-11]
- Helps lose weight 
- Maintains a healthy pregnancy [13-18]
- Helps stabilize mood [19-20]
- Fights inflammation [21-24]
- Prevents cancer [25-27]
Proven Health Benefits
Boosts Cognitive Function
Studies suggest that choline is an essential brain nutrient:
- A study showed that chronic choline supplementation can improve behavioral, oxidative, and neurochemical outcomes. 
- In adults, dietary intake of choline positively influenced cognitive function. 
- In men, choline supplementation lowered the risk of dementia. 
- In older people, higher intake of choline resulted in better cognitive performance. 
- In mice models, choline supplementation reduced the progression of Alzheimer’s disease (AD). 
- A study showed that choline can help improve cognitive impairment. 
- In a study assessing the effects of choline on brain function, choline supplementation was found to improve cognitive performance. 
- A review of multiple studies showed that choline supplementation ameliorated specific behavioral, neurological, and cognitive deficits caused by fetal alcohol exposure. 
- In patients with AD, choline supplementation treated the cognitive symptoms of dementia disorder. [9
Prevents Liver Disease
Choline has also been found to be essential for liver health:
- A study showed that intake of dietary choline can help prevent liver dysfunction. 
- A study reported that higher intake of choline was associated with a lower risk of liver cancer. 
- A study also found that dietary choline supplementation attenuated high-fat diet-induced liver inflammation. 
- A mice study also found that dietary choline supplementation attenuated high-fat diet-induced liver cancer. 
Helps Lose Weight
Studies suggest that choline can help prevent obesity:
- In adults, high intakes of dietary choline produced favorable body composition. 
- In female athletes, choline supplementation rapidly reduced body mass without any side effects. 
- In rats, choline supplementation decreased body fat and food intake. 
Maintains a Healthy Pregnancy
Evidence shows that choline is an essential nutrient in pregnancy:
- In pregnant women, sufficient intake of dietary choline resulted in optimal fetal outcomes. 
- In pregnant women entering their third trimester, choline supplementation improved infant’s information processing speed. 
- A study showed that higher choline supplementation can help improve the infant’s early behavioral development. 
- A study showed that choline and DHA deficiency could harm maternal and infant health. 
- A study showed that prenatal dietary supplementation of choline decreased the risk of mental illness. 
- In mid-pregnancy women, high dose of choline was associated with better infant health. 
Helps Stabilize Mood
Choline has also been found to possess mood-stabilizing properties:
- In adult female rats, dietary choline supplementation protected against stress and depression. 
- A study showed that small portion of dietary choline is metabolized to form acetycholine which is responsible for memory and mood. 
Fights Pain and Inflammation
Studies also show that choline has pain-relieving and anti-inflammatory properties:
- In a mouse model of postoperative pain, choline supplementation decreased pain. 
- In patients with asthma, choline therapy improved symptoms by suppressing oxidative stress. 
- A study showed that choline reduced the regular dose of aspirin in an animal model of inflammatory pain. 
- In diabetic patients, choline supplementation reduced the levels of inflammatory substances. 
Evidence also suggests that choline has anti-cancer properties:
- In an analysis of multiple studies, choline supplementation lowered cancer incidence. 
- A study showed that choline can help lower the incidence of breast cancer. 
- High intake of choline has been found to lower the risk of colorectal cancer. 
- Tabassum S, Haider S, Ahmad S, Madiha S, Parveen T. Chronic choline supplementation improves cognitive and motor performance via modulating oxidative and neurochemical status in rats. Pharmacol Biochem Behav. 2017 Aug;159:90-99. doi: 10.1016/j.pbb.2017.05.011. Epub 2017 Jun 19. PMID: 28642069.
- Blusztajn JK, Slack BE, Mellott TJ. Neuroprotective Actions of Dietary Choline. Nutrients. 2017;9(8):815. Published 2017 Jul 28. doi:10.3390/nu9080815.
- Maija P T Ylilauri, Sari Voutilainen, Eija Lönnroos, Heli E K Virtanen, Tomi-Pekka Tuomainen, Jukka T Salonen, Jyrki K Virtanen, Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study, The American Journal of Clinical Nutrition, Volume 110, Issue 6, December 2019, Pages 1416–1423, https://doi.org/10.1093/ajcn/nqz148.
- Poly C, Massaro JM, Seshadri S, Wolf PA, Cho E, Krall E, Jacques PF, Au R. The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort. Am J Clin Nutr. 2011 Dec;94(6):1584-91. doi: 10.3945/ajcn.110.008938. Epub 2011 Nov 9. PMID: 22071706; PMCID: PMC3252552.
- Velazquez R, Ferreira E, Knowles S, Fux C, Rodin A, Winslow W, Oddo S. Lifelong choline supplementation ameliorates Alzheimer’s disease pathology and associated cognitive deficits by attenuating microglia activation. Aging Cell. 2019 Dec;18(6):e13037. doi: 10.1111/acel.13037. Epub 2019 Sep 27. PMID: 31560162; PMCID: PMC6826123.
- Gareri P, Castagna A, Cotroneo AM, Putignano S, De Sarro G, Bruni AC. The role of citicoline in cognitive impairment: pharmacological characteristics, possible advantages, and doubts for an old drug with new perspectives [published correction appears in Clin Interv Aging. 2015;10:1625]. Clin Interv Aging. 2015;10:1421-1429. Published 2015 Sep 3. doi:10.2147/CIA.S87886.
- Synoradzki K, Grieb P. Citicoline: A Superior Form of Choline?. Nutrients. 2019;11(7):1569. Published 2019 Jul 12. doi:10.3390/nu11071569.
- Akison LK, Kuo J, Reid N, Boyd RN, Moritz KM. Effect of Choline Supplementation on Neurological, Cognitive, and Behavioral Outcomes in Offspring Arising from Alcohol Exposure During Development: A Quantitative Systematic Review of Clinical and Preclinical Studies. Alcohol Clin Exp Res. 2018 Sep;42(9):1591-1611. doi: 10.1111/acer.13817. Epub 2018 Jul 13. PMID: 29928762.
- 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. 2003 Jan;25(1):178-93. doi: 10.1016/s0149-2918(03)90023-3. PMID: 12637119.
- Mehedint MG, Zeisel SH. Choline’s role in maintaining liver function: new evidence for epigenetic mechanisms. Curr Opin Clin Nutr Metab Care. 2013;16(3):339-345. doi:10.1097/MCO.0b013e3283600d46.
- Zhou, Rf., Chen, XL., Zhou, Zg. et al. Higher dietary intakes of choline and betaine are associated with a lower risk of primary liver cancer: a case-control study. Sci Rep 7, 679 (2017). https://doi.org/10.1038/s41598-017-00773-w.
- Jin M, Pan T, Tocher DR, et al. Dietary choline supplementation attenuated high-fat diet-induced inflammation through regulation of lipid metabolism and suppression of NFκB activation in juvenile black seabream (Acanthopagrus schlegelii). J Nutr Sci. 2019;8:e38. Published 2019 Nov 22. doi:10.1017/jns.2019.34.
- Brown AL, Conrad K, Allende DS, Gromovsky AD, Zhang R, Neumann CK, Owens AP, Tranter M, Helsley RN. Dietary Choline Supplementation Attenuates High-Fat-Diet-Induced Hepatocellular Carcinoma in Mice. J Nutr. 2020 Apr 1;150(4):775-783. doi: 10.1093/jn/nxz315. PMID: 31851339.
- Gao X, Wang Y, Randell E, et al. Higher Dietary Choline and Betaine Intakes Are Associated with Better Body Composition in the Adult Population of Newfoundland, Canada. PLoS One. 2016;11(5):e0155403. Published 2016 May 11. doi:10.1371/journal.pone.0155403.
- Elsawy G, Abdelrahman O, Hamza A. Effect of choline supplementation on rapid weight loss and biochemical variables among female taekwondo and judo athletes. J Hum Kinet. 2014;40:77-82. Published 2014 Apr 9. doi:10.2478/hukin-2014-0009.
- Hongu N, Sachan DS. Caffeine, carnitine and choline supplementation of rats decreases body fat and serum leptin concentration as does exercise. J Nutr. 2000 Feb;130(2):152-7. doi: 10.1093/jn/130.2.152. PMID: 10720162.
- Zeisel SH. Nutrition in pregnancy: the argument for including a source of choline. Int J Womens Health. 2013;5:193-199. Published 2013 Apr 22. doi:10.2147/IJWH.S36610.
- Caudill MA, Strupp BJ, Muscalu L, Nevins JEH, Canfield RL. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. FASEB J. 2018 Apr;32(4):2172-2180. doi: 10.1096/fj.201700692RR. Epub 2018 Jan 5. PMID: 29217669; PMCID: PMC6988845.
- Freedman R, Hunter SK, Law AJ, et al. Maternal choline and respiratory coronavirus effects on fetal brain development. J Psychiatr Res. 2020;128:1-4. doi:10.1016/j.jpsychires.2020.05.019.
- Mun JG, Legette LL, Ikonte CJ, Mitmesser SH. Choline and DHA in Maternal and Infant Nutrition: Synergistic Implications in Brain and Eye Health. Nutrients. 2019;11(5):1125. Published 2019 May 21. doi:10.3390/nu11051125.
- Freedman R, Ross RG. Prenatal choline and the development of schizophrenia. Shanghai Arch Psychiatry. 2015;27(2):90-102. doi:10.11919/j.issn.1002-0829.215006.
- Jacobson SW, Carter RC, Molteno CD, Stanton ME, Herbert JS, Lindinger NM, Lewis CE, Dodge NC, Hoyme HE, Zeisel SH, Meintjes EM, Duggan CP, Jacobson JL. Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Alcohol Clin Exp Res. 2018 Jul;42(7):1327-1341. doi: 10.1111/acer.13769. Epub 2018 Jun 15. PMID: 29750367; PMCID: PMC6028282.
- Glenn MJ, Adams RS, McClurg L. Supplemental dietary choline during development exerts antidepressant-like effects in adult female rats. Brain Res. 2012;1443:52-63. doi:10.1016/j.brainres.2012.01.018.
- Sanders LM, Zeisel SH. Choline: Dietary Requirements and Role in Brain Development. Nutr Today. 2007;42(4):181-186. doi:10.1097/01.NT.0000286155.55343.fa.
- Rowley TJ, McKinstry A, Greenidge E, Smith W, Flood P. Antinociceptive and anti-inflammatory effects of choline in a mouse model of postoperative pain. Br J Anaesth. 2010 Aug;105(2):201-7. doi: 10.1093/bja/aeq113. Epub 2010 May 28. PMID: 20511332; PMCID: PMC2903311.
- Mehta AK, Singh BP, Arora N, Gaur SN. Choline attenuates immune inflammation and suppresses oxidative stress in patients with asthma. Immunobiology. 2010 Jul;215(7):527-34. doi: 10.1016/j.imbio.2009.09.004. Epub 2009 Nov 7. PMID: 19897276.
- Wang Y, Su DM, Wang RH, Liu Y, Wang H. Antinociceptive effects of choline against acute and inflammatory pain. Neuroscience. 2005;132(1):49-56. doi: 10.1016/j.neuroscience.2004.12.026. PMID: 15780465.
- Samaneh Rashvand, Majid Mobasseri & Ali Tarighat-Esfanjani (2019) The Effects of Choline and Magnesium Co-Supplementation on Metabolic Parameters, Inflammation, and Endothelial Dysfunction in Patients With Type 2 Diabetes Mellitus: A Randomized, Double-Blind, Placebo-Controlled Trial, Journal of the American College of Nutrition, 38:8, 714-721, DOI: 10.1080/07315724.2019.1599745.
- Sun S, Li X, Ren A, et al. Choline and betaine consumption lowers cancer risk: a meta-analysis of epidemiologic studies. Sci Rep. 2016;6:35547. Published 2016 Oct 19. doi:10.1038/srep35547.
- Xu X, Gammon MD, Zeisel SH, et al. Choline metabolism and risk of breast cancer in a population-based study. FASEB J. 2008;22(6):2045-2052. doi:10.1096/fj.07-101279.
- Available from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0118661.