Essential nutrient, dietary supplement. The basic choline form used in supplements. Not registered as a medicine in the EU or USA; sold as a supplement in Russia
ATC code: N06BX-CHOLINE-BITARTRATE (Choline bitartrate)
Brand names – supplements
Now Choline & Inositol, Solgar Choline, Source Naturals Choline, Jarrow Choline
Supplements are not tested in clinical trials and are not registered as medications.
Choline bitartrate is a salt of choline and tartaric acid, a cheap basic form for food supplements. After oral intake, choline is absorbed in the small intestine (specific enterocyte transporters), enters portal circulation and distributes to the liver, skeletal muscle and brain. It is used to synthesise acetylcholine, membrane phosphatidylcholine and methyl donors (via betaine formation in the liver). CNS bioavailability is lower than for alpha-GPC and CDP-choline: the blood-brain barrier choline transporter is easily saturated. 2016 set the adequate choline intake for adults at 400 mg/day; NIH ODS 2024 lists 425-550 mg/day. Choline deficiency manifests as NAFLD and myopathy, confirmed in controlled depletion studies in healthy volunteers.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Choline bitartrate is a dietary form of choline, marketed as a supplement for attention and focus, including in ADHD. No convincing benefit for ADHD has been shown, and there is no solid evidence base for this use. ADHD responds to approaches with proven effect – behavioral therapy and medication (stimulants, atomoxetine) chosen by a clinician.
Not recommended
Choline bitartrate is a salt form of choline sold as a supplement and marketed for anti-aging and longevity. Studies have not shown a convincing benefit for this use: there is no evidence that taking it extends life or slows age-related changes. What actually affects lifespan is different – not smoking, keeping blood pressure and blood sugar in check, physical activity and sleep, rather than a single supplement
Not recommended
Choline bitartrate is sold as a «natural memory and concentration nootropic» for healthy adults, students and knowledge workers. No evidence base in cognitively healthy people: RCTs with choline bitartrate and memory, attention or processing-speed endpoints showed no clinically meaningful effects. 2011 did not approve any memory or learning health claim for choline above the adequate intake. NIH ODS 2024 lists adequate intake at 425-550 mg/day from all food sources (eggs, meat, fish, soy); most of the population meets the requirement without supplements. CNS bioavailability for choline bitartrate is lower than for alpha-GPC. If choline bitartrate was recommended for subjective memory decline without workup (rule out anaemia, TSH, depression, sleep apnoea, vitamin B12 and D deficiency), consider seeking a second opinion.
Not recommended
Choline bitartrate is a source of choline, sold in supplements and promoted for mood and brain function, including mild to moderate depression. Convincing benefit for this use has not been shown – there is no evidence base supporting an antidepressant effect. For a mild to moderate depressive episode, psychotherapy and, when a doctor decides it fits, antidepressants are the approaches that help, so it is worth seeing a specialist.
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In pregnancy choline is an essential nutrient with raised demand (NIH ODS 2024 – 450 mg/day). Intake within the adequate amount is safe and important for fetal neural development. High doses (above 3500 mg/day tolerable upper intake) are not recommended. AEMPS has not registered the product as a medicine.
In breastfeeding choline is an essential nutrient with 550 mg/day requirement. Intake within the adequate amount is safe. Avoid high doses.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Choline bitartrate is evaluated for the following indications with varying evidence strength: Memory and concentration enhancement (evidence tier D), Anti-aging and longevity (evidence tier D), ADHD (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Choline bitartrate (≥ 1 in 100): Fishy body and breath odour (at doses above 1000 mg/day), Nausea, sweating, Diarrhoea, Decreased blood pressure. See the Safety section for uncommon and serious reactions.
FDA category N. In pregnancy choline is an essential nutrient with raised demand (NIH ODS 2024 – 450 mg/day). Intake within the adequate amount is safe and important for fetal neural development. High doses (above 3500 mg/day tolerable upper intake) are not recommended. AEMPS has not registered the product as a medicine.
In breastfeeding choline is an essential nutrient with 550 mg/day requirement. Intake within the adequate amount is safe. Avoid high doses.
Choline bitartrate is contraindicated in: Individual intolerance; Trimethylaminuria (genetic «fish odour» syndrome – elevated TMAO); Anticholinergic medications (theoretical antagonism). Full list in the Safety section.