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Choline and Liver Health : Benefits, Sources, and Supplements

Choline is an indispensable component for human health as it facilitates numerous physiological processes. Acting as a water-soluble nutrient structurally akin to the B vitamins, choline plays a pivotal role akin to that of a vitamin itself. The neurotransmitter acetylcholine, crucial for memory, emotion, and muscle regulation, relies on the presence of choline for its synthesis. Without adequate choline levels, the body’s ability to produce acetylcholine is compromised. Furthermore, choline is vital for the normal functioning of the liver, a vital organ engaged in a multitude of metabolic activities. The liver performs critical functions such as detoxification, bile production, and blood sugar regulation, which are essential for maintaining overall health. Choline has been shown to offer significant benefits to various aspects of liver function, including fat metabolism, reduction of inflammation, and prevention of liver diseases.

The Role of Choline in Liver Health

The movement of lipids from the liver relies on phosphatidylcholine, a crucial component of cell membranes. Phosphatidylcholine cannot be made without choline. Choline insufficiency has been linked to the development of NAFLD and other conditions related with fat buildup in the liver. Increasing choline intake has been shown in a number of studies to have beneficial effects on liver health and function, including a reduction in the development of fat in the liver.(1)

Choline and Liver Inflammation

Damage to the liver, including fibrosis and cirrhosis, may result from inflammation. Choline has been shown to suppress the production of inflammatory cytokines, which might explain why it is effective in reducing liver inflammation. Taking choline supplements has been linked in many studies to decreased liver inflammation in people with liver disease.(2)

Choline and Its Role In Preventing and Treating Liver Damage

A deficiency in choline has been linked to an increase in the incidence of alcoholic liver disease, non-alcoholic fatty liver disease, and liver cancer. Several studies have shown that reducing fat and inflammation in the liver by increasing one’s choline intake may prevent and treat liver disease.(3)

Scientific Evidence Supporting The Potential Benefits Of Choline In Liver Health

In a study researchers found that giving patients with non-alcoholic fatty liver disease (NAFLD) choline supplements reduced the amount of fat that had built up in their livers. This was a randomized, double-blind, placebo-controlled research in which people with NAFLD were given choline supplements or a placebo for six months. In addition to enhancing liver function, the use of choline supplements was shown to reduce liver fat in the study participants.(4)

Another study found that those with non-alcoholic steatohepatitis (NASH), a more severe form of NAFLD, had improvements in liver function after taking choline supplements. In this study, people with NASH were given choline supplements (or a placebo) for a total of six months. The results showed that those who took choline supplements had improved liver function and less liver inflammation.(5)

Examining the Connection Between Choline and Liver Inflammation

Research demonstrates that supplementing with choline reduces liver inflammation in rats fed a high-fat diet. In this study, rats were fed a high-fat diet for six weeks while others got choline supplements to see what would happen. The results of this study show that supplementing these rats with choline reduced inflammation in their livers and improved liver function.(6)

Examining Choline’s Role In Reducing The Risk Of Liver Disease

Research suggests that high choline intake is associated with a reduced risk of developing liver cancer. Nearly 200,000 participants were followed over many years in this major prospective cohort study, and their choline intake was assessed at regular intervals. The results of this study suggest that increasing your choline intake may lower your risk of acquiring liver cancer.(7)

Choline intake was linked to protection against nonalcoholic fatty liver disease in another study published in the American Journal of Clinical Nutrition. (NAFLD). In this study, over 2,000 people’s choline intake was analyzed, and their liver fat content was measured using magnetic resonance imaging (MRI). The study’s results related lower liver fat to higher choline intake, and vice versa, suggesting a protective effect against NAFLD.(8)

Other Potential Benefits of Choline

In addition to its role in liver functioning, choline has been linked to a number of other potential health benefits.

Acetylcholine, a neurotransmitter involved in learning, emotion, and muscle control, cannot be produced without choline. Choline helps the brain work better. Pregnant women and persons with Alzheimer’s disease are two categories of people who may benefit from taking choline supplements to improve their cognitive function.

Choline is a building block for phosphatidylcholine, a lipid found in cell membranes that is crucial for muscle contraction and relaxation. Choline is important for the proper execution of exercise as well. Results from a number of research suggest that choline supplements may help certain athletes perform better in the gym.(9)

Choline is a building block for the molecule trimethylamine N-oxide (TMAO), which has been linked to good digestive health. When choline is metabolized, TMAO is released. Multiple studies have shown that reducing TMAO levels in the stomach is associated with increasing choline intake.(10)

Food Sources of Choline

The following foods are good sources of choline in the diet:

  • About 147 mg of choline may be found in a single large egg. Choline levels in egg yolks are much greater than in the whites.
  • About 355 milligrams of choline may be found in three ounces of beef liver. One of the finest dietary sources of choline is cow liver due to its high concentration of choline.
  • Choline is abundant in fish, especially oily fish like salmon and cod. In a three-ounce plate of salmon, there are around 250 milligrams of choline.
  • Soybeans and other soy foods, such as tofu and tempeh, are rich in the nutrient choline. Choline may also be found in high concentrations in soybeans. After being cooked, one cup of soybeans has around 160 milligrams of choline.
  • The bioavailability of choline from dietary sources may be lower than that of choline from supplements, and it is important to be aware that the amount of choline present in different meals varies.

Choline Supplementation and Dosages

Supplemental choline is available in several forms, such as choline bitartrate, phosphatidylcholine, and citicoline. The most popular supplement is choline bitartrate, which is either as a powder or in capsule form.

The recommended daily allowance of choline varies with age and gender. The National Academy of Medicine recommends the following daily allowances of choline intake:

  • 125 milligrams each day for infants up to 6 months old
  • Infants between 7 and 12 months old: 150 mg per day
  • Children ages 1 to 3 should take 200 mg per day.
  • Children ages 4 to 8 years old, 250 mg each day
  • Boys 9-13 years: 375 mg/day
  • Boys 14-18 years: 550 mg/day
  • Girls 9-13 years: 375 mg/day
  • Girls 14-18 years: 400 mg/day
  • Men above the age of 18: 550 mg per day
  • 425 milligrams per day for women over the age of 18
  • Pregnant women: 450 mg/day
  • Breastfeeding women: 550 mg/day

Most individuals may safely use choline supplements in the dosages recommended by experts. However, taking in too much choline from supplements may cause stomach upset, diarrhea, and an unpleasant fishy odor. Extremely rare situations need for caution while using choline supplements since high doses might be harmful to the liver.

If you are on any other medications or have a medical condition that affects your liver, it is very important to see your doctor before starting to use choline supplements. Taken with blood-thinning medication, choline supplements may increase the risk of bleeding. Anticholinergic medicines may also interact poorly with choline supplements.

Potential Side Effects and Interactions

Choline supplements may have unpleasant side effects including nausea, diarrhea, and a fishy body odor if used in large enough quantities. Extremely rare situations need for caution while using choline supplements since high doses might be harmful to the liver. It’s important to remember that ingesting choline in one’s diet is associated with a decreased likelihood of having these unpleasant responses, but taking choline supplements is typically the source of them.

Anticholinergic medications, for example, have the potential to reduce the effectiveness of choline supplements. Interactions between different choline supplements are possible as well. Those on blood-thinning medications, such as warfarin, should be cautious while taking choline supplements as well.

If you are on any other medications or have a liver ailment, it is very important to see your doctor before starting choline supplements. The correct dosage, as well as information regarding potential interactions with other medications, may be provided by your healthcare provider.


Choline is a vital nutrient that aids in liver health and function. Potential benefits for liver function, inflammation reduction, and disease prevention have been linked to increasing dietary or supplemental choline intake. Consult your doctor before using choline supplements, especially if you have a liver condition or are on medication for another condition. When used at the recommended dosage, choline supplements are generally well tolerated.

Choline is essential for good liver function, and the best way to ensure that you’re getting enough of it is to eat foods like eggs, beef liver, salmon, and soybeans. Those who are unable to get enough choline through their diet, or who have increased needs for choline due to liver disease, may benefit from taking a choline supplement.

More research is needed to determine the benefits of choline for overall health and the role it plays in sustaining liver health. However, choline seems to be an essential component for liver function, and getting enough of it via food and supplements may have significant health benefits. This conclusion is supported by current scientific evidence.

In conclusion, improving your liver function and overall health may be as simple as eating more choline-rich foods and talking to your doctor about taking choline supplements if necessary.


  1. Lee HA, Chang Y, Sung PS, et al. Therapeutic mechanisms and beneficial effects of non-antidiabetic drugs in chronic liver diseases. Clin Mol Hepatol. 2022;28(3):425-472. doi:10.3350/cmh.2022.0186https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293616/?report=classic
  2. Vallianou N, Christodoulatos GS, Karampela I, et al. Understanding the Role of the Gut Microbiome and Microbial Metabolites in Non-Alcoholic Fatty Liver Disease: Current Evidence and Perspectives. Biomolecules. 2021;12(1):56. Published 2021 Dec 31. doi:10.3390/biom12010056https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8774162/?report=classic
  3. Fan G, Li F, Wang P, Jin X, Liu R. Natural-Product-Mediated Autophagy in the Treatment of Various Liver Diseases. Int J Mol Sci. 2022;23(23):15109. Published 2022 Dec 1. doi:10.3390/ijms232315109https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739742/?report=classic
  4. Vancells Lujan P, Viñas Esmel E, Sacanella Meseguer E. Overview of Non-Alcoholic Fatty Liver Disease (NAFLD) and the Role of Sugary Food Consumption and Other Dietary Components in Its Development. Nutrients. 2021;13(5):1442. Published 2021 Apr 24. doi:10.3390/nu13051442https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145877/?report=classic
  5. El-Mowafy M, Elgaml A, El-Mesery M, et al. Changes of Gut-Microbiota-Liver Axis in Hepatitis C Virus Infection. Biology (Basel). 2021;10(1):55. Published 2021 Jan 13. doi:10.3390/biology10010055https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828638/?report=classic
  6. Qu W, Ma T, Cai J, et al. Liver Fibrosis and MAFLD: From Molecular Aspects to Novel Pharmacological Strategies. Front Med (Lausanne). 2021;8:761538. Published 2021 Oct 22. doi:10.3389/fmed.2021.761538https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9921401/?report=classic
  7. Suárez M, Boqué N, Del Bas JM, Mayneris-Perxachs J, Arola L, Caimari A. Mediterranean Diet and Multi-Ingredient-Based Interventions for the Management of Non-Alcoholic Fatty Liver Disease. Nutrients. 2017;9(10):1052. Published 2017 Sep 22. doi:10.3390/nu9101052https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5691669/?report=classic
  8. Zhou Y, Wang J, Zhang D, et al. Mechanism of drug-induced liver injury and hepatoprotective effects of natural drugs. Chin Med. 2021;16(1):135. Published 2021 Dec 11. doi:10.1186/s13020-021-00543-xhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8665608/?report=classic
  9. Naber M, Hommel B, Colzato LS. Improved human visuomotor performance and pupil constriction after choline supplementation in a placebo-controlled double-blind study. Sci Rep. 2015;5:13188. Published 2015 Aug 14. doi:10.1038/srep13188https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536529/?report=classic
  10. López-Ortiz S, Pinto-Fraga J, Valenzuela PL, et al. Physical Exercise and Alzheimer’s Disease: Effects on Pathophysiological Molecular Pathways of the Disease. Int J Mol Sci. 2021;22(6):2897. Published 2021 Mar 12. doi:10.3390/ijms22062897https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999827/?report=classic
Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 15, 2023

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