Home Ingredients Choline Bitartrate
CognitiveLiver Health

Choline Bitartrate

Evidence Level
Moderate
4 Clinical Trials
4 Documented Benefits
3/5 Evidence Score

Choline bitartrate is choline bound to tartaric acid, one of the forms used in supplements alongside phosphatidylcholine and lecithin. Choline is an essential nutrient: the body uses it to build cell membranes, make the neurotransmitter acetylcholine, move fat out of the liver and process homocysteine. The body makes some choline but not enough, and in a controlled study most men and postmenopausal women fed a very low choline diet developed fatty liver or muscle damage that reversed when choline was restored. Adequate intakes are 550 mg a day for men and 425 mg for women, and a US survey found only about 8% of adults reach them. EU regulators accept that choline contributes to normal liver function, fat metabolism and homocysteine metabolism. Taking extra choline bitartrate has not been shown to sharpen memory in healthy adults, and evidence that higher intake in pregnancy helps the child's brain is still uncertain.

Studied Dose Adult adequate intake 425 mg (women) or 550 mg (men) of choline; 450 mg in pregnancy and 550 mg when breastfeeding; upper limit 3,500 mg. Choline bitartrate is about 41% choline by weight, so 1,000 mg gives about 410 mg choline. Memory trials used 2 to 2.5 g of bitartrate.
Active Compound Choline (as bitartrate salt; ~41% free choline by weight).

Benefits

Supports Acetylcholine Synthesis

Choline is needed to make acetylcholine, a neurotransmitter for memory, mood and muscle control. Getting enough choline supports this, but extra choline bitartrate showed no significant memory benefit in healthy young adults: in three placebo-controlled experiments, 2 to 2.5 g taken an hour before testing did not improve working or picture memory.

Supported by Trial 3

Methyl Donor via Betaine

Choline is converted to betaine, which donates methyl groups to recycle homocysteine, working alongside folate and vitamin B12. EU regulators accept that choline contributes to normal homocysteine metabolism.

Supported by Trial 3, Trial 4

Supports Liver Fat Metabolism

The liver needs choline to package and export fat. In a controlled study, 77% of men and 80% of postmenopausal women fed a very low choline diet developed fatty liver or muscle damage, which reversed when choline was added back. EU regulators accept that choline contributes to normal liver function and fat metabolism. This shows the need for enough choline, not a benefit of taking more than you need.

Supported by Trial 4

Pregnancy and Infant Development

The adequate intake rises to 450 mg a day in pregnancy. In a controlled feeding trial of 26 women, 930 mg versus 480 mg a day in the third trimester gave infants faster information processing. A systematic review of 4 trials and 5 observational studies found most outcomes showed no benefit and called the evidence insufficient either way.

Supported by Trial 1, Trial 2

Mechanism of action

1

Acetylcholine Precursor

Choline crosses the blood-brain barrier and is acetylated by choline acetyltransferase to produce acetylcholine in cholinergic neurons, supporting cortical, hippocampal, and neuromuscular signaling.

2

Phosphatidylcholine Synthesis

Choline enters the CDP-choline (Kennedy) pathway to form phosphatidylcholine, the dominant phospholipid in cell membranes and a structural component of lipoproteins and bile.

3

One-Carbon Metabolism

Oxidation to betaine provides methyl groups for converting homocysteine back to methionine, linking choline with the folate and vitamin B12 pathways.

4

Hepatic Lipid Export

Without enough phosphatidylcholine the liver cannot package fat into VLDL particles, and fat builds up. In human depletion studies, adding choline back restored normal liver function.

Clinical trials

1
Maternal Choline Supplementation and Infant Information Processing
PubMed

Randomized double-blind controlled feeding study comparing 480 versus 930 mg choline a day from the start of the third trimester until delivery; infants tested at 4, 7, 10 and 13 months. Funded in part by the Egg Nutrition Center and the Beef Checkoff. (Caudill et al. 2018, FASEB J)

26 pregnant women (13 per group); 24 infants tested.

Mean reaction time across the four ages was significantly faster in infants whose mothers had 930 mg a day. This is one small trial; a later systematic review judged the overall prenatal evidence insufficient.

2
Choline During Pregnancy and Child Neurodevelopment: Systematic Review
PubMed

Systematic review of randomized trials and observational studies of prenatal choline and child brain development, covering 20 publications. (Gould et al. 2025, Nutrients)

4 randomized trials of choline supplementation in pregnancy and 5 observational studies.

Most neurodevelopmental outcomes did not support a benefit of higher prenatal choline; some trials found better scores on single measures, but most of each trial's outcomes were null. The authors concluded the evidence is insufficient to support or refute a benefit.

3
Choline Bitartrate and Memory in Healthy Young Adults
PubMed

Three double-blind placebo-controlled crossover experiments: 2.0 to 2.5 g of choline bitartrate or placebo about 60 minutes before memory testing. (Lippelt et al. 2016, PLoS One)

Healthy young students (28, 26 and 40 participants).

Choline did not significantly improve visuospatial working memory, verbal working memory or picture memory in any experiment, and Bayesian analysis strongly supported no effect.

4
Choline Depletion and Liver Function in Adults
PubMed

Controlled feeding study: 550 mg choline per 70 kg a day for 10 days, then under 50 mg for up to 42 days with or without folic acid, followed by choline repletion in those who developed organ dysfunction. (Fischer et al. 2007, Am J Clin Nutr)

57 healthy adults (26 men, 16 premenopausal and 15 postmenopausal women).

On the low choline diet, 77% of men and 80% of postmenopausal women developed fatty liver or muscle damage, versus 44% of premenopausal women; organ function returned to normal when choline was added back. Six men showed these signs even at the adequate intake.

Side effects and drug interactions

Common Potential side effects

Fishy body odor at high doses due to trimethylamine production by gut bacteria.
Gastrointestinal upset, nausea, or diarrhea at gram-level doses.
Excessive sweating and salivation at very high intakes.
Possible low blood pressure with chronic large doses.
Generally well-tolerated within the 3,500 mg/day upper limit.

Important Drug interactions

Choline is not known to have clinically relevant interactions with medications, according to the NIH Office of Dietary Supplements.
High choline intakes raise production of TMAO, a compound linked to heart disease risk, in a dose-dependent way; whether this matters for supplement users is not settled.

More Cognitive Ingredients

Cognitive
Ashwagandha
Ashwagandha (Withania somnifera) is an herb from Ayurvedic tradition whose root extracts a…
Cognitive
KSM-66®
KSM-66 is a widely studied branded ashwagandha (Withania somnifera) extract, made by Ixore…
Cognitive
Phosphatidylcholine
Phosphatidylcholine (PC) is one of the two most abundant phospholipids in cell membranes a…
Cognitive
Phosphatidylserine
Phosphatidylserine (PS) is a phospholipid found in cell membranes and especially abundant…

Explore Other Ingredients

Antioxidant
Milk Thistle
Milk thistle (Silybum marianum) supplies silymarin, a mix of plant compounds called flavon…
Antioxidant
NAC (N-Acetylcysteine)
N-acetylcysteine (NAC) is a modified form of the amino acid cysteine. The body uses cystei…
Muscle & Recovery
L-Glutamine
L-glutamine is the most abundant amino acid in the body and the primary metabolic fuel for…

Related articles from our blog

📝 Article
Choline: The Underrated Nutrient for Brain, Liver, and Pregnancy
Choline rarely makes the headlines that vitamin D or magnesium do, which is strange, because it is an essential nutrient…
June 25, 2026

Frequently asked questions about Choline Bitartrate

What is choline bitartrate?

Choline bitartrate is choline bound to tartaric acid, one of the common choline supplement forms along with phosphatidylcholine and lecithin. It is about 41% choline by weight. No studies have compared how well the different forms are absorbed.

Is choline bitartrate good for the brain?

Choline is needed to make acetylcholine, a brain messenger, so getting enough matters. But in three placebo-controlled experiments in healthy young adults, a single 2 to 2.5 g dose of choline bitartrate taken about an hour before testing did not improve memory. Longer-term trials of this form in healthy adults are lacking.

How much choline bitartrate should I take?

Adequate choline intake is 425 mg a day for women and 550 mg for men, more in pregnancy and breastfeeding, counting food. Because the bitartrate is about 41% choline, check the label for the choline amount. The upper limit is 3,500 mg of choline a day.

Does choline bitartrate have side effects?

At high intakes choline can cause a fishy body odor, vomiting, heavy sweating and salivation, and low blood pressure. Staying near the adequate intake avoids these.

What is Choline Bitartrate used for?

Choline Bitartrate is researched primarily for Cognitive and Liver Health. Choline is needed to make acetylcholine, a neurotransmitter for memory, mood and muscle control. Getting enough choline supports this, but extra choline bitartrate showed no significant memory benefit in healthy young adults: in three place…

What is the recommended dosage of Choline Bitartrate?

The clinically studied dose is Adult adequate intake 425 mg (women) or 550 mg (men) of choline; 450 mg in pregnancy and 550 mg when breastfeeding; upper limit 3,500 mg. Choline bitartrate is about 41% choline by weight, so 1,000 mg gives about 410 mg choline. Memory trials used 2 to 2. Always follow the product label and check with a healthcare provider for personal advice.

Is Choline Bitartrate safe, and does it have side effects?

For most healthy adults, Choline Bitartrate is well tolerated at studied doses. Reported effects can include: Fishy body odor at high doses due to trimethylamine production by gut bacteria. Gastrointestinal upset, nausea, or diarrhea at gram-level doses. It may also interact with some medications. Choline Bitartrate is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Choline Bitartrate interact with any medications?

Possible interactions include: Choline is not known to have clinically relevant interactions with medications, according to the NIH Office of Dietary Supplements. High choline intakes raise production of TMAO, a compound linked to heart disease risk, in a dose-dependent way; whether this matters for supplement… If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Choline Bitartrate?

NutraSmarts rates the evidence for Choline Bitartrate as Moderate (3 out of 5). It is backed by 4 clinical trials and 7 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(7 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. 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;32(4):2172-2180. doi: 10.1096/fj.201700692RR.PubMedUsed to support: Controlled feeding RCT in 26 women: 930 versus 480 mg choline a day in the third trimester; infants of the higher-intake group had significantly faster mean reaction times on information-processing tests across 4 to 13 months. Partly funded by the Egg Nutrition Center and the Beef Checkoff.
  2. Gould JF, Hines S, Best KP, Grzeskowiak LE, Jansen O, Green TJ. Choline During Pregnancy and Child Neurodevelopment: A Systematic Review of Randomized Controlled Trials and Observational Studies. Nutrients. 2025;17(5). doi: 10.3390/nu17050886.PubMedUsed to support: Systematic review of 4 randomized trials and 5 observational studies (20 publications): most neurodevelopmental outcomes did not support a benefit of higher prenatal choline, and the evidence was judged insufficient to support or refute one.
  3. Wallace TC, Fulgoni VL. Usual Choline Intakes Are Associated with Egg and Protein Food Consumption in the United States. Nutrients. 2017;9(8). doi: 10.3390/nu9080839.PubMedUsed to support: NHANES 2009 to 2014 analysis: only about 8% of US adults and 8.5% of pregnant women met the choline adequate intake; egg eaters had almost double the usual choline intake of non-eaters. One author reported consulting for Balchem and the Egg Nutrition Center.
  4. Lippelt DP, van der Kint S, van Herk K, Naber M. No Acute Effects of Choline Bitartrate Food Supplements on Memory in Healthy, Young, Human Adults. PLoS One. 2016;11(6):e0157714. doi: 10.1371/journal.pone.0157714.PubMedUsed to support: Three double-blind placebo-controlled crossover experiments in healthy students: 2.0 to 2.5 g choline bitartrate did not significantly improve working memory or declarative memory 1 to 2 hours after intake.
  5. Fischer LM, daCosta KA, Kwock L, Stewart PW, Lu TS, Stabler SP, Allen RH, Zeisel SH. Sex and menopausal status influence human dietary requirements for the nutrient choline. Am J Clin Nutr. 2007;85(5):1275-85. doi: 10.1093/ajcn/85.5.1275.PubMedUsed to support: Controlled depletion study in 57 adults: on a very low choline diet, 77% of men and 80% of postmenopausal women (44% of premenopausal women) developed fatty liver or muscle damage, which reversed with choline repletion.
  6. Office of Dietary Supplements, National Institutes of Health Choline: Fact Sheet for Health Professionals NIH Office of Dietary Supplements. 2022;Online fact sheet, updated June 2, 2022..SourceUsed to support: Not PubMed-indexed. Gives the adequate intakes and upper limits, lists choline bitartrate among supplement forms, states that no studies have compared bioavailability between forms, notes no known clinically relevant drug interactions, and lists high-intake effects (fishy body odor, sweating, low blood pressure).
  7. European Commission Commission Regulation (EU) No 432/2012 of 16 May 2012 establishing a list of permitted health claims made on foods, other than those referring to the reduction of disease risk and to children's development and health Official Journal of the European Union. 2012;OJ L 136, 25.5.2012, p. 1. Based on EFSA Journal 2011;9(4):2056 and 2011;9(6):2203..SourceUsed to support: Not PubMed-indexed. Lists the authorised claims that choline contributes to normal homocysteine metabolism, normal lipid metabolism and the maintenance of normal liver function, for foods with at least 82.5 mg choline per 100 g or per portion.