Choline Dosing and Safety

safety

Allergies

Avoid with known allergy or sensitivity to choline, lecithin, phosphatidylcholine, or products containing these components.

Side Effects and Warnings

In general, choline is regarded as safe, and it appears to be well tolerated. However, when taken in high amounts, it may cause agitation, anorexia, constipation (blocked bowel movements), delusions, diarrhea, epilepsy (repeated seizures), fecal incontinence (uncontrolled bowel movements), feelings of hopelessness, fishy odor, gastroenteritis (inflammation of the lining of the stomach), headache, increased saliva flow, insomnia (lack of sleep), movement disorders, nausea, paranoia, respiratory depression (inadequate breathing), severe depression, skin rashes, steatorrhea (excess fat in stools), stomach discomfort, stunted growth, sweating, thoughts of suicide, urinary incontinence (leakage of urine), vertigo (dizziness), and vomiting.
Choline may cause low blood pressure. Caution is advised in people taking drugs, herbs, or supplements that lower blood pressure.
Choline may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Use cautiously in people taking drugs to lower cholesterol levels.
Use cautiously in people with depression, fish odor syndrome, high cholesterol levels, kidney disease, liver disease, or Parkinson's disease.
Use cautiously in children and in women who are pregnant or breastfeeding.
Avoid using doses of choline at the upper level (UL) intake levels in people with fish odor syndrome, kidney disease, liver disease, or Parkinson's disease.
Avoid in people with a known allergy or sensitivity to choline, lecithin, or phosphatidylcholine.

Pregnancy and Breastfeeding

Use cautiously in children and in women who are pregnant or breastfeeding. While these individuals may consume choline within the recommended adequate intake (AI) parameters, supplementation outside of dietary intake may not be necessary.
The Food and Nutrition Board of the Institute of Medicine of the National Academy of Science states that choline is necessary in prenatal supplementation. During pregnancy, choline taken by the mother may affect brain development in the growing infant.
The U.S. Food and Nutrition Board of the Institute of Medicine recommends that pregnant women take 450 milligrams of choline by mouth daily. Breastfeeding women are advised to take 550 milligrams of choline by mouth daily.
Taking choline by mouth before becoming pregnant and during early pregnancy may reduce the risk of cleft palate. Low levels of choline in the blood of pregnant women may increase the risk of neural tube defects such as anencephaly (absence of part of the brain) and spina bifida (incomplete closure of backbone and spinal canal).

dosing

Adults (18 years and older)

In general, adequate choline (400-900 milligrams) can be taken by mouth by eating an "average" diet. However, it is unclear whether a dietary supply of choline is needed at all ages.
The U.S. Food and Nutrition Board of the Institute of Medicine recommends that men over the age of 18 years consume 550-3,500 milligrams of choline daily; women aged 18 years old are advised to consume 400-3,000 milligrams of choline daily, while those who are older may consume 425-3,500 milligrams. Pregnant women are advised to consume 450 milligrams of choline daily, while breastfeeding women are advised to consume 550 milligrams daily. Higher doses are not recommended for people with the metabolic disorder trimethylaminuria, kidney disease, liver disease, depression, or Parkinson's disease.
For hay fever, 500 milligrams of tricholine citrate has been taken by mouth three times daily for eight weeks.
For asthma, 500-1,000 milligrams of choline has been taken by mouth three times daily. Also, 500 milligrams of choline citrate syrup has been taken by mouth three times daily for 18 weeks.
For brain injuries, one gram of choline alphoscerate has been injected into the vein daily for 14 days, and then 0.8 grams has been taken by mouth daily for an additional 28 days.
For cerebellar ataxia, a movement disorder caused by damage to a certain part of the brain, choline chloride has been taken by mouth for six weeks.
For heart disease, 12 grams of choline has been taken by mouth daily.
For preventing liver disorders in women, 425 milligrams of choline has been recommended, to be taken by mouth daily. Doses of two grams of choline chloride in combination with total parenteral nutrition (TPN) have been taken by mouth for 24 weeks. Doses of 15 milligrams of choline have been taken by mouth daily.
To improve memory, two grams of choline chloride in combination with TPN has been taken by mouth for 24 weeks. Doses of 50 milligrams of choline per kilogram of body weight have been taken my mouth before exercise.
For physical endurance, 50 milligrams of choline per milligram of body weight have been taken by mouth before exercise. Doses of 8.425 grams of choline citrate have been taken by mouth before and midway through exercise. Doses of 2.43 grams of a choline bitartrate-containing drink have been taken by mouth one hour after exercise.
For the mental disorder schizophrenia, 20 grams of choline chloride has been taken by mouth daily.
For dental pain, choline salicylate gel has been applied to the skin.
For airway inflammation (bronchitis), 3-5 milliliters of a 20% choline chloride solution has been inhaled once daily for 7-10 days.

Children (under 18 years old)

The Committee on Nutrition of the American Academy of Pediatrics recommends that infant formula be fortified with at least seven milligrams choline per 100 kilocalories. The committee advises that children aged 1-8 years avoid taking more than one gram of choline by mouth daily, that children aged 9-13 years avoid more than two grams of choline daily, and that children aged 14-18 years avoid more than three grams of choline by mouth daily.
The U.S. Food and Nutrition Board of the Institute of Medicine recommends that infants up to six months old take 125 milligrams of choline by mouth daily, that infants 6-12 months old take 150 milligrams of choline by mouth daily, that children 1-3 years old take 200-1,000 milligrams of choline by mouth daily, that children 4-8 years old take 250-1,000 milligrams of choline by mouth daily, and that children 9-13 years old take 375-2,000 milligrams of choline by mouth daily. Girls 14-18 years old are advised to take 400-3,000 milligrams of choline by mouth daily, while boys 14-18 years old are advised to take 550-3,500 milligrams daily.
For infants, choline is recommended to be taken by mouth only from formula, breast milk, and food.

interactions

Interactions with Drugs

Choline may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Choline may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.
Choline may interact with anticholinergics (agents that block the neurotransmitter acetylcholine), caffeine, drugs that lower cholesterol levels, drugs that stimulate the central nervous system, eritadenine, fluoxetine, isoniazid, lithium, methotrexate, methylphenidate, penicillamine, phenothiazine, scopolamine, and selective serotonin reuptake inhibitors (SSRIs).

Interactions with Herbs and Dietary Supplements

Choline may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Choline may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.
Choline may interact with anticholinergics, antioxidants, betaine, caffeine, carnitine, herbs and supplements that affect heart disease, herbs and supplements that lower cholesterol levels, herbs and supplements that stimulate the central nervous system, lecithin, vitamin A, and vitamin E.