encyclopedia

Choline (Vitamin B-complex)

Natural Sources:    

Bottle gourd fruit (1.6% choline); Fenugreek leaves; shepherd's purse herb; Brazil nuts; dandelion flowers; poppy seeds; Soybeans; mung bean and other beans; eggs, liver; dairy products, and meats.    
     

Forms:    

Standardized Choline capsules and tablets; soybean oil; Multivitamin and Mineral tablets containing choline.    
     

Therapeutic Uses:    

– ADD (Attention Deficit Disorder)
– Aging Disorders
– Alzheimer's Disease
– Attention Deficit Disorder (ADD/ADHD)
– Brain Functioning
– Child Development
– Depression
– Digestive Disorders
– Fatty Liver
– Fetal Development
– Infertility
– Jaundice
– Liver Health Maintenance
– Male Health Maintenance
– Male Infertility
– Memory Loss
– Physical Performance
– Reproductive System Health
– Vascular Disorders     
     
    
Overview:    

Choline, a B-complex vitamin, is a phospholipid concentrated in high cholesterol foods including eggs, liver, peanuts and milk and in herbs including the bottle gourd (1.6% choline), fenugreek leaves and other herbs. Choline is also a major building block of lecithin. Choline is converted within the brain to an important brain-cell transmitter called acetylcholine. Studies show that lecithin increases concentrations of acetylcholine in the brain and improves memory in laboratory mice. Research has also shown that the consumption of lecithin by humans elevates serum-free choline levels more effectively than an equivalent amount of choline salts (choline chloride). Low levels of choline in the diet have been linked to poor memory, reduced ability to concentrate and Alzheimer's disease. Restricting high cholesterol foods in the diet that are the natural sources of choline can lead to the development of a choline deficiency, which causes liver damage according to research by Steven Zeisel at the University of North Carolina. Dr. Zeisel showed in a clinical trial with health men that removing choline from the diet for only three weeks led to signs of liver dysfunction. Choline deficiency promotes lipid (fat) accumulation in the liver. Prolonged deficiency of choline can produce severe liver damage. Research shows that lecithin and its primary component, choline, are important for the maintenance of a healthy liver, a healthy heart and circulatory system, increasing physical performance, successful pregnancy and proper child development. Lecithin and choline are essential components of VLDL (very low-density lipoproteins), the principal form of triglycerides exported from the liver to the blood. Dr. James Duke, in The Green Pharmacy, also recommends choline for treating infertility. Dr. Duke notes that studies done on male rats at the University of North Carolina School of Medicine have shown that a dietary deficiency of choline is associated with male infertility.
    
  
Chemistry:    

Choline is a natural phospholipid found within the human body, particularly concentrated in brain tissues and also in bile. A French chemist, Gobley, isolated a phosphorus-containing lipid from egg-yolk and brain tissues and named it lecithin (from the Greek lecithos, egg-yolk) (now phosphatidylcholine). He showed in 1850 that glycero-phosphoric acid could be prepared from lecithin while another chemist named Strecker demonstrated the presence of choline in bile.    
     
    
Suggested Amount:    

The Recommended Daily Intake (RDI) or Adequate Intake levels of choline for adults as published by The Food and Nutrition Board of the National Academy of Sciences are:
 
– Infants, birth to six months old – 125mg/day
– Infants, six months to one year old – 150mg/day
– Children, one to three years old – 200mg/day
– Children, four to eight years old – 250mg/day
– Children, nine to thirteen years old – 375mg/day
– Men, ages fourteen and older – 550mg/day
– Women, fourteen to eighteen – 400mg/day
– Women, nineteen and older – 425mg/day
– Women, pregnant – 450 mg/day
– Women, lactating – 550 mg/day

The upper level intake considered to be safe is 3500mg daily. It is interesting to note that lecithin supplements provide a more bioavailable, timed-release form of choline than supplements made from choline salts like choline chloride. Lecithin supplements also raise choline levels in the blood higher for a longer time. Lecithin is found concentrated in Brazil nuts (up to 10 percent lecithin on a dry weight basis), dandelion flowers, poppy seeds, soybeans, mung beans and other beans and legumes. Note: The best way to get choline in the diet is from foods. Some researchers report that intestinal bacteria within the gut frequently break down choline salts (i.e.. choline bitartrate, choline chloride, and choline citrate). The bloodstream also does not readily take up choline salts and reputedly choline from these sources has a poor ability to cross the blood-brain barrier. The blood-brain barrier is a two-part barrier which prevents toxins from entering the brain and also prevents disruptions of brain function due to surges in the blood of various nutrients, even those essential for optimum brain function. And while another acetylcholine precursor, phosphatidylcholine, is more effective than simple choline salts, studies have found large (and expensive) doses – 10 to 60 grams – are often needed to elevate brain acetylcholine levels. The Food and Nutrition Board also notes in the RDI table that some stages of growth may not require choline supplements. Further studies are required.
    
     
Drug Interactions:    

None known.    
     
    
Contraindications:    

There are no contraindications known for choline taken at normal dosages. However, dosages at the upper limit (UL) intake levels are contraindicated for persons suffering from trimethylaminuria, kidney (renal) disease, liver disease, depression and Parkinson's disease as they may be at risk of adverse effects.    
     
    
Side Effects:    

Excessive choline (above 3,500 mg daily) can cause an offensive, fishy body odor, sweating, salivation, hypotension (low blood pressure) and liver toxicity.    
   
     
References:    

Buchman AL, Ament ME, Sohel M, Dubin M, Jenden DJ, Roch M, Pownall H, Farley W, Awal M, Ahn C. 2001. Choline deficiency causes reversible hepatic abnormalities in patients receiving parenteral nutrition: proof of a human choline requirement: a placebo-controlled trial.  JPEN J Parenter Enteral Nutr 2001 Sep-Oct; 25(5): 260-8.
 
Carper, J. 1993. Food Your Miracle Medicine. HarperCollins Publishers, 10 East 53rd Street, New York, New York 10022-5299. Pp. 64.
 
Duke, J. 1997: The Green Pharmacy, The Ultimate Compendium of Natural Remedies from the World's Foremost Authority on Healing and Herbs. Pp. 47-49; 50; 342. Rodale Press.
 
Food and Nutrition Information Center – Food and Nutrition Board – National Academy of Sciences http://www.nal.usda.gov/fnic/etext/000105.html; Dietary Reference Intakes: Vitamins (Current)
 
Hirch M.J., Gowden J.H., Wurtman R.J. 1978. Relations between dietary choline or lecithin intake, serum choline levels, and various metabolic indices. Metabolism. 1978; 27: 953-960.
    
    
Additional Information:    

Positive Results for Choline for Treating Liver Damage caused by Deficiency:
Buchman AL, Ament ME, Sohel M, Dubin M, Jenden DJ, Roch M, Pownall H, Farley W, Awal M, Ahn C. 2001. Choline deficiency causes reversible hepatic abnormalities in patients receiving parenteral nutrition: proof of a human choline requirement: a placebo-controlled trial.  JPEN J Parenter Enteral Nutr 2001 Sep-Oct; 25(5): 260-8.
 
Division of Gastroenterology, Northwestern University Medical School, Chicago, IL 60611, USA. a-buchman@northwestern.edu

Abstract from Medline:

BACKGROUND: Previous studies have shown that plasma free choline concentrations are significantly decreased in many long-term home total parenteral nutrition (TPN) patients. Furthermore, low choline status has been associated with both hepatic morphologic and hepatic aminotransferase abnormalities. A preliminary pilot study suggested choline-supplemented TPN might be useful in reversal of these hepatic abnormalities.
METHODS: Fifteen patients (10 M, 5 F) who had required TPN for > or =80% of their nutritional needs were randomized to receive their usual TPN (n = 8), or TPN to which 2 g choline chloride had been added (n = 7) for 24 weeks. Baseline demographic data were similar between groups. Patients had CT scans of the liver and spleen, and blood for plasma free and phospholipid-bound choline, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, gamma glutamyl transferase (GGT), bilirubin, serum lipids, complete blood count (CBC), and chemistry profile obtained at baseline, and weeks 2, 4, 6, 12, 16, 20, 24, and 34. CT scans were analyzed for Hounsfield unit (HU) densities.
RESULTS: There were no significant differences in any measured parameters after 2 weeks. However, at 4 weeks, a significant difference in liver HU between groups was observed (13.3+/-5.0 HU [choline] vs 5.8+/-5.2 HU [placebo], p = .04). This significant trend continued through week 24. Recurrent hepatic steatosis and decreased HU were observed at week 34, 10 weeks after choline supplementation had been discontinued. A significant increase in the liver-spleen differential HU was also observed in the choline group (10.6+/-6.2 HU [choline] vs 1.3+/-3.3 HU [placebo], p = .01). Serum ALT decreased significantly (p = .01 to .05) in the choline group vs placebo at weeks 6,12, 20, and 24. Serum AST was significantly decreased in the choline group by week 24 (p = .02). The serum alkaline phosphatase was significantly reduced in the choline group at weeks 2, 12, 20, 24, and 34 (p = .02 to 0.07). Total bilirubin was normal in these patients and remained unchanged during the study. Serum GGT tended to decrease more in the choline group, but the greater decrease was not statistically significant.
CONCLUSIONS: Choline deficiency is a significant contributor to the development of TPN-associated liver disease. The data suggest choline is a required nutrient for long-term home TPN patients.

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