Low Energy, Memory Loss, Muscle Aches, and Insulin Resistance Might be a Choline Deficiency

the importance of choline in the diet

Choline is found in all body cells

Choline is an essential nutrient that the liver can produce in small amounts, but we must get most of it from the foods we eat each day.

Choline and its byproducts (metabolites) support key body functions, including fat and bile metabolism, brain, liver, and muscle function, energy production, and cell membrane function (1).

• Each cell that makes up the human body must have a healthy cell membrane for proper function.  Choline provides structural integrity to each cell through components such as phosphatidylcholine, the primary structural component of cellular membranes, which is necessary for maintaining cell structure, fluidity, and function (5).  Proper cell structure allows nutrients to enter cells, enables the elimination of waste products, and supports proper cell signaling for cellular communication (6).

• One subcellular role of choline, through phosphatidylcholine, is the production and secretion of lipoproteins (fat and protein) such as VLDLs and chylomicrons, which are important for triglyceride transport to tissues for energy or storage and dietary lipid transport from the intestines throughout the body (6). 

• When liver phosphatidylcholine concentrations are altered, as can be the case in choline deficiency, conditions like non-alcoholic fatty liver disease and insulin resistance can occur as the insulin signaling pathway becomes impaired (6).

• As part of the mucus layer in the intestine, phosphatidylcholine helps protect intestinal cells from bacteria in the gut, and when this barrier is reduced, as can be the case in choline deficiency, chronic conditions like ulcerative colitis can occur (6).

• Choline is a precursor for acetylcholine, a vital neurotransmitter involved in muscle control, memory, circadian rhythm, and other functions like sleep, heart rate, and blood pressure control (7).  Deficits of acetylcholine have been linked to conditions like Alzheimer’s and can worsen symptoms of conditions like myasthenia gravis (8).

So, choline deficiency can lead to conditions like muscle damage, impaired cognition, neural tube defects in pregnancy, as well as liver damage and disease (1) (2).

Choline can be deficient if it is not consumed regularly, as in those who avoid animal products (vegans), or when demand exceeds daily intake, as may occur during pregnancy or lactation (3).

The current Recommended Dietary Allowance (RDA) for choline recommends daily intakes of 425 mg for women 19 years of age and older; 550 mg for men 19 years of age and older; 450 mg for pregnant women; and 550 mg for breastfeeding women (10).

Choline insufficiency or deficiency symptoms (9)

In addition to insufficient intake, choline deficiency can occur when the small intestine is unable to properly absorb essential nutrients from food, as in malabsorption syndromes, and in individuals receiving essential nutrients intravenously (total parenteral nutrition) due to digestive system complications (4).

·       Lower blood pressure (hypotension)

·       Memory loss and difficulty concentrating

·       Anxious or restless

·       Headaches

·       Liver problems

·       Constipation

·       Sluggish, low energy

·       Muscle aches

·       Nerve pain or tingling

·       Insulin resistance

·       Non-alcoholic fatty liver disease

Foods containing choline (2) (9)

·       Organ meats like beef or chicken liver

·       Eggs (yolk)

·       Cod and Salmon

·       Beef

·       Chicken and Turkey

·       Shiitake mushrooms

·       Kidney beans

·       Lentils

·       Cauliflower

·       Quinoa

·       Yogurt

·       Brussels sprouts

·       Broccoli