Herb & supplement monograph

Choline Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Choline interacts with medications. The heart of this page is the interaction list — every drug Choline is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Choline is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Choline Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Choline drug interaction appears low for most people. None of the listed interactions are rated major or moderate, and every one falls into the minor category.

Interactions deserving the most attention

The interaction most worth knowing about involves atropine. Animal research suggests choline might blunt some of atropine's effects in the brain, since choline is a building block for acetylcholine, the same chemical messenger atropine works against. This remains theoretical, as it has not been confirmed in human studies, and even so it is graded minor. Beyond this, nothing in choline's profile stands out as a well-documented concern in people.

What the rest of the list means

Seeing more than a dozen medications tied to choline can look worrying, but the number tells only part of the story. These interactions are all minor, and the supporting evidence comes largely from animal or lab research rather than from meaningful problems seen in people. As an essential nutrient the body already uses every day, choline has so far not shown any serious conflicts with medications.

Check your medications against Choline

Based on HelloPharmacist’s Choline interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Choline

16 medications have a known interaction with Choline, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
AtropineSal-Tropine
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine interaction
Atropine SulfateAtropine Sulfate, Isopto Atropine
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine Sulfate interaction
Atropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, PhenylAtrosept
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, Phenyl interaction
Atropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, Phenyl SalicylateUrinary Antiseptic 2, Urised
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Benzoic Acid, Hyoscyamine, Methenamine, Methylene Blue, Phenyl Salicylate interaction
Atropine, Chlorpheniramine, Hyoscyamine, Phenylephrine, Phenylpropanolamine, ScopolamineAtrohist Plus, Pro Tuss, Ru-tuss, Stahist
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Chlorpheniramine, Hyoscyamine, Phenylephrine, Phenylpropanolamine, Scopolamine interaction
Atropine, DifenoxinMotofen
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Difenoxin interaction
Atropine, DiphenoxylateLofene, Lomotil
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Diphenoxylate interaction
Atropine, Hyoscyamine, PhenobarbitalHypnaldyne
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Hyoscyamine, Phenobarbital interaction
Atropine, Hyoscyamine, Phenobarbital, ScopolamineBarbidonna No. 2, Belladonna Phenobarbital
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Hyoscyamine, Phenobarbital, Scopolamine interaction
Atropine, Hyoscyamine, ScopolamineColytrol
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Hyoscyamine, Scopolamine interaction
Atropine, Hyoscyamine, Scopolamine, PhenobarbitalBarbeloid, Donnatal #2, Donphen
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Hyoscyamine, Scopolamine, Phenobarbital interaction
Atropine, PhenobarbitalAnthrocol
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Phenobarbital interaction
Atropine, MeperidineAtropine, Meperidine
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Meperidine interaction
Atropine, Morphine SulfateAtropine, Morphine Sulfate
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Atropine, Morphine Sulfate interaction
Belladonna Alkaloids, PhenobarbitalBarbidonna, Donnatal
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Belladonna Alkaloids, Phenobarbital interaction
Edrophonium, AtropineEnlon-Plus
Minor Atropine

Theoretically, choline might decrease the effects of atropine in the brain.

Read the full Choline + Edrophonium, Atropine interaction
"phentolamineOraVerse, Rogitine, Ryzumvi › 6-mercaptopurinePurinethol › Ado-trastuzumab EmtansineKadcyla › AbacavirZiagen › Abacavir Sulfate, Dolutegravir, LamivudineTriumeq › Abacavir, LamivudineEpzicom › AbaloparatideTymlos › AbametapirXeglyze › AbarelixPlenaxis › AbciximabReoPro › AbemaciclibVerzenio › Abiraterone › Abiraterone AcetateYonsa, Zytiga › AbrocitinibCibinqo ›
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Choline combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Choline affects

Every type of medication (drug category) Choline is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 1 drug category Choline interacts with
Atropine
Atropine

Theoretically, choline might decrease the effects of atropine in the brain.
Animal research shows that administering choline one hour before administering atropine can attenuate atropine-induced decreases in brain levels of acetylcholine. Theoretically, concomitant use of choline and atropine may decrease the effects of atropine.

Likelihood Possible Evidence D
Monograph

Choline: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Choline is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like eggs, meat, and fish. Supplements may help people who are deficient or who have higher needs (such as during pregnancy), but they are not proven cure-alls and very high doses can cause side effects. Check with your pharmacist or doctor before starting a supplement.

Choline
Part used
Not applicable (an essential nutrient found in foods and made in the body)
Common forms
Capsules, tablets, softgels, and powders; common forms include choline bitartrate, choline chloride, phosphatidylcholine, alpha-GPC, and CDP-choline (citicoline)
People commonly use it for
  • Liver health and fatty liver
  • Brain and memory support
  • Prenatal nutrition and fetal development
  • General nutritional supplementation
  • Sports performance

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Generally safe in food amounts, but high-dose supplements can cause side effects and have a daily upper limit.

PregnancyLikely Safe

When used orally and appropriately. Choline is safe when taken in doses below the tolerable upper intake level (UL), which is 3 grams daily during pre...

Read the full pregnancy detail
BreastfeedingLikely Safe

When used orally and appropriately. Choline is safe when taken in doses below the tolerable upper intake level (UL), which is 3 grams daily during pre...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Choline is an essential nutrient, which means your body needs it but cannot make enough on its own. Because of this, you must get most of your choline from food or supplements.

Choline is found naturally in many foods. Some of the richest sources are eggs, beef, chicken, fish, and certain beans and vegetables. Your liver also makes a small amount of choline.

People take choline supplements for many reasons, including liver health, brain and memory support, and prenatal nutrition. It comes in several forms, such as choline bitartrate, choline chloride, phosphatidylcholine, alpha-GPC, and CDP-choline (citicoline).

How it works

Choline plays several roles in the body. It is a building block for phosphatidylcholine, a fat that is part of every cell membrane. It also helps the liver package and move fats, which is why low choline is tied to fat buildup in the liver.

Choline is a precursor to acetylcholine, a neurotransmitter (a chemical messenger) that nerves use to communicate. Acetylcholine is involved in memory, mood, and muscle control.

The body can also convert choline into a compound called betaine, which helps with other important chemical reactions. Much of what we know about these pathways comes from laboratory and animal research, and the way it works in supplement form in healthy people is not fully proven.

Effectiveness

Does Choline work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 27 uses evaluated
1 Leans ineffective 26 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.
Possibly Ineffective Athletic performance
Rating & evidence shown verbatim from Natural Medicines

Taking oral choline before exercise does not improve athletic performance.

Also studied for 26 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Age-related cognitive decline
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial in patients with age-related cognitive decline.

Insufficient Reliable Evidence To Rate Allergic rhinitis (hay fever)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial in patients with allergic rhinitis.

Insufficient Reliable Evidence To Rate Alzheimer disease
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral choline for Alzheimer disease, there is insufficient reliable information about the clinical effects of choline for this purpose.

Insufficient Reliable Evidence To Rate Asthma
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral choline may modestly improve symptoms in patients with asthma.

Insufficient Reliable Evidence To Rate Autism spectrum disorder
Rating & evidence shown verbatim from Natural Medicines

Oral choline has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Breast Cancer
Rating & evidence shown verbatim from Natural Medicines

It is unclear if dietary intake of choline reduces the risk of breast cancer.

Insufficient Reliable Evidence To Rate Bronchitis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral and inhaled choline for bronchitis, there is insufficient reliable information about the clinical effects of choline for this purpose.

Insufficient Reliable Evidence To Rate Cancer
Rating & evidence shown verbatim from Natural Medicines

It is unclear if dietary choline intake reduces the risk for cancer.

Insufficient Reliable Evidence To Rate Cardiovascular disease (CVD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if dietary choline intake reduces the risk of CVD or improves outcomes in patients with CVD.

Insufficient Reliable Evidence To Rate Cerebellar ataxia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial in patients with cerebellar ataxia.

Insufficient Reliable Evidence To Rate Cognitive function
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial for improving cognitive function in healthy adults.

Insufficient Reliable Evidence To Rate Complex partial seizures
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral choline for complex partial seizures, there is insufficient reliable information about the clinical effects of choline for this purpose.

Insufficient Reliable Evidence To Rate Dementia
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral choline for dementia, there is insufficient reliable information about the clinical effects of choline for this purpose.

Insufficient Reliable Evidence To Rate Depression
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial for the treatment or prevention of depression.

Insufficient Reliable Evidence To Rate Diabetes
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial for the treatment or prevention of type 2 diabetes; the available research is conflicting.

Insufficient Reliable Evidence To Rate Fetal alcohol spectrum disorders (FASD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline improves cognition in children with fetal alcohol spectrum disorders (FASD).

Insufficient Reliable Evidence To Rate Hepatitis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral choline for hepatitis, there is insufficient reliable information about the clinical effects of choline for this purpose.

Insufficient Reliable Evidence To Rate Huntington disease
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral choline for Huntington disease, there is insufficient reliable information about the clinical effects of choline for this purpose.

Insufficient Reliable Evidence To Rate Hypertension
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial for the prevention or treatment of hypertension.

Insufficient Reliable Evidence To Rate Infant development
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline intake during pregnancy is beneficial for infant development; the available research is conflicting.

Insufficient Reliable Evidence To Rate Metabolic syndrome
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial in patients with metabolic syndrome.

Insufficient Reliable Evidence To Rate Neural tube birth defects
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline intake is beneficial for preventing neural tube defects.

Insufficient Reliable Evidence To Rate Nonalcoholic fatty liver disease (NAFLD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral choline is beneficial in patients with nonalcoholic fatty liver disease (NAFLD).

Insufficient Reliable Evidence To Rate Schizophrenia
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral choline for schizophrenia, there is insufficient reliable information about the clinical effects of choline for this purpose.

Insufficient Reliable Evidence To Rate Tourette syndrome
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral choline for Tourette syndrome, there is insufficient reliable information about the clinical effects of choline for this purpose.

Insufficient Reliable Evidence To Rate TPN-associated hepatic steatosis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if intravenous choline is beneficial in patients with TPN-associated hepatic steatosis.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Choline from a normal balanced diet is considered safe for most people. As a supplement, low to moderate doses are usually well tolerated, but very high doses can cause unpleasant effects and there is a recognized daily upper limit for adults.

People with liver or kidney conditions, or certain rare metabolic disorders, should talk to a healthcare provider before taking choline supplements. Anyone with a known body odor (fishy smell) reaction to choline should avoid high doses.

Pregnancy and breastfeeding: Choline is an important nutrient during pregnancy and while breastfeeding, and needs are higher during these times. Even so, you should not start a separate high-dose choline supplement on your own. Use a prenatal vitamin or supplement only at the dose your doctor or pharmacist recommends.

Because supplements are not tightly regulated, choose reputable brands and remember to tell your pharmacist about everything you take.

Side effects

At normal intakes, choline rarely causes problems. At higher supplement doses, possible side effects include:

  • A fishy body odor
  • Nausea, stomach upset, or diarrhea
  • Sweating
  • Drop in blood pressure or dizziness (mainly at very high doses)

These effects are more likely as the dose goes up. If you notice a strong fishy smell or other bothersome symptoms, stop the supplement and talk to your pharmacist or doctor.

Choline: Reported Adverse Effects

Documented safety reports on Choline from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, choline is well tolerated when used appropriately. Adverse effects have been reported with doses exceeding the tolerable upper intake level (UL) of 3.5 grams daily.

Most Common Adverse Effects:

Orally: Fishy body odor. At high doses of at least 9 grams daily, choline has been reported to cause diarrhea, nausea, salivation, sweating, and vomiting.

Reports by condition
Anorexia Gastrointestinal

Orally, large doses of choline can cause nausea, vomiting, salivation, and anorexia. Gastrointestinal discomfort has reportedly occurred with doses of 9 grams daily, while gastroenteritis has reportedly occurred with doses of 32 grams daily. Doses of lecithin 100 grams standardized to 3.5% choline have reportedly caused diarrhea and fecal incontinence.

  1. Wood, J. L. and Allison, R. G. Effects of consumption of choline and lecithin on neurological and cardiovascular systems. Fed.Proc. 1982;41(14):3015-3021.
  2. Sidhu N, Davies S, Nadarajah A, et al. Oral choline supplementation for postoperative pain. Br J Anaesth 2013;111(2):249-55.
  3. Smith, C. M., Swash, M., Exton-Smith, A. N., Phillips, M. J., Overstall, P. W., Piper, M. E., and Bailey, M. R. Choline therapy in Alzheimer's disease. Lancet 8-5-1978;2(8084):318.
  4. Morrison, L. M. and W. F. Gonzales. Choline in coronary atherosclerosis. Amer.Heart J. 1950;39:729.
  5. Christie, J. G. Blackburn 1. M. Glen A. I. M. Zeisel S. Shering A. & Yates C. M. Effects of choline and lecithin on CSF choline levels and on cognitive functioning in patients with presenile dementia of the Alzheimer type. Nutrition and the brain 1979;5
Body odor Other

Orally, choline intake may cause a fishy body odor due to intestinal metabolism of choline to trimethylamine.

  1. Growdon, J. H. and Gelenberg, A. J. Choline and lecithin administration to patients with tardive dyskinesia. Trans.Am.Neurol.Assoc. 1978;103:95-99.
  2. Wood, J. L. and Allison, R. G. Effects of consumption of choline and lecithin on neurological and cardiovascular systems. Fed.Proc. 1982;41(14):3015-3021.
  3. Morrison, L. M. and W. F. Gonzales. Choline in coronary atherosclerosis. Amer.Heart J. 1950;39:729.
  4. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability. Nutr Res. 2013;33(11):897-904.
  5. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol disorders: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2015;102(5): 1113-25.
Cancer Oncologic

In one population study, consuming large amounts of choline was associated with an increased risk of colorectal cancer in females, even after adjusting for red meat intake. However, more research is needed to confirm this finding.

  1. Cho E, Willett WC, Colditz GA, et al. Dietary choline and betaine and the risk of distal colorectal adenoma in women. J Natl Cancer Inst 2007;99:1224-31.
Depression Psychiatric

Orally, large doses of choline (9 grams daily) have been associated with onset of depression in patients taking neuroleptics. Further research is needed to clarify this finding.

  1. Tamminga, C., Smith, R. C., Chang, S., Haraszti, J. S., and Davis, J. M. Depression associated with oral choline. Lancet 10-23-1976;2(7991):905.
Hypotension Cardiovascular

Orally, doses of choline greater than 7.5 grams daily may cause low blood pressure.

  1. Food and Nutrition Board, Institute of Medicine. Choline. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B-6, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington D.C.: National Academy Press; 1998:390-422.
Urinary incontinence Genitourinary

Orally, large doses of choline greater than 9 grams daily have been reported to cause urinary incontinence.

  1. Smith, C. M., Swash, M., Exton-Smith, A. N., Phillips, M. J., Overstall, P. W., Piper, M. E., and Bailey, M. R. Choline therapy in Alzheimer's disease. Lancet 8-5-1978;2(8084):318.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no single "treatment" dose of choline that works for everyone, and the right amount depends on your age, sex, life stage, and diet. Health authorities have set recommended adequate intake levels for daily choline as well as a daily upper limit, but these are general nutrition guides rather than doses for treating any condition.

Supplements come in different strengths and forms, and the amount of actual choline varies by form. The safest approach is to follow the directions on the product label and not exceed the recommended amount.

Because needs and the best form differ from person to person, ask your pharmacist or doctor what dose, if any, is right for you before starting a choline supplement.

Pregnancy & Breastfeeding

Choline & Pregnancy

Likely Safe

When used orally and appropriately. Choline is safe when taken in doses below the tolerable upper intake level (UL), which is 3 grams daily during pregnancy and lactation in those up to 18 years of age and 3.5 grams daily for those 19 years and older. There is insufficient reliable information available about the safety of choline used in higher doses during pregnancy and lactation.

  1. Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706.
  2. Ross RG, Hunter SK, McCarthy L, et al. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013;170(3):290-8.

Choline & Breastfeeding

Likely Safe

When used orally and appropriately. Choline is safe when taken in doses below the tolerable upper intake level (UL), which is 3 grams daily during pregnancy and lactation in those up to 18 years of age and 3.5 grams daily for those 19 years and older. There is insufficient reliable information available about the safety of choline used in higher doses during pregnancy and lactation.

  1. Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706.
  2. Ross RG, Hunter SK, McCarthy L, et al. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013;170(3):290-8.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 14 references that drive our Choline monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
  2. Cho E, Willett WC, Colditz GA, et al. Dietary choline and betaine and the risk of distal colorectal adenoma in women. J Natl Cancer Inst 2007;99:1224-31. PubMed
  3. Schmidt, C., Abicht, A., Krampfl, K., Voss, W., Stucka, R., Mildner, G., Petrova, S., Schara, U., Mortier, W., Bufler, J., Huebner, A., and Lochmuller, H. Congenital myasthenic syndrome due to a novel missense mutation in the gene encoding choline acetyl
  4. Tamminga, C., Smith, R. C., Chang, S., Haraszti, J. S., and Davis, J. M. Depression associated with oral choline. Lancet 10-23-1976;2(7991):905. PubMed
  5. Wood, J. L. and Allison, R. G. Effects of consumption of choline and lecithin on neurological and cardiovascular systems. Fed.Proc. 1982;41(14):3015-3021.
  6. Growdon, J. H. and Gelenberg, A. J. Choline and lecithin administration to patients with tardive dyskinesia. Trans.Am.Neurol.Assoc. 1978;103:95-99.
  7. Smith, C. M., Swash, M., Exton-Smith, A. N., Phillips, M. J., Overstall, P. W., Piper, M. E., and Bailey, M. R. Choline therapy in Alzheimer's disease. Lancet 8-5-1978;2(8084):318. PubMed
  8. Morrison, L. M. and W. F. Gonzales. Choline in coronary atherosclerosis. Amer.Heart J. 1950;39:729.
  9. Christie, J. G. Blackburn 1. M. Glen A. I. M. Zeisel S. Shering A. & Yates C. M. Effects of choline and lecithin on CSF choline levels and on cognitive functioning in patients with presenile dementia of the Alzheimer type. Nutrition and the brain 1979;5
  10. Sidhu N, Davies S, Nadarajah A, et al. Oral choline supplementation for postoperative pain. Br J Anaesth 2013;111(2):249-55. PubMed
  11. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability. Nutr Res. 2013;33(11):897-904. PubMed
  12. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol disorders: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2015;102(5): 1113-25.
  13. Ross RG, Hunter SK, McCarthy L, et al. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013;170(3):290-8. PubMed
  14. Food and Nutrition Board, Institute of Medicine. Choline. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B-6, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington D.C.: National Academy Press; 1998:390-422.
Keep reading

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Brand directory

Brands that make products with Choline

1,221 brands in our database make a supplement containing Choline.

Product directory

Supplement products with Choline

11,399 products in our database contain Choline. Open any to see its full ingredient list and every drug interaction we check.

Alive! Adult Ultra Potency Complete Multivitamin by Nature's Way Tablet Or Pill 60 Tablet(s) View ingredients & interactions Alive! Children's Chewables Multi-Vitamin Orange + Berry Fruit Flavors by Nature's Way Tablet Or Pill 120 Chewable Tablet(s) View ingredients & interactions Alive! Complete Liquid Multivitamin Max Potency Citrus Flavored by Nature's Way Liquid 30.4 Fluid Ounce(s) · 1.9 PT · 900 Milliliter(s) View ingredients & interactions Alive! Complete Liquid Multivitamin Max Potency Citrus Flavored by Nature's Way Liquid 30.4 Fluid Ounce(s) · 1.9 Pint(s) · 900 mL View ingredients & interactions Alive! Complete Premium Prenatal Multivitamin by Nature's Way Softgel Capsule 60 Vegan Softgel(s) View ingredients & interactions Alive! Diabetic Multivitamin by Nature's Way Tablet Or Pill 60 Tablet(s) View ingredients & interactions Alive! Kids Chewable Multivitamin Orange & Berry by Nature's Way Tablet Or Pill 120 Chewable Tablet(s) View ingredients & interactions Alive! Kids Chewable Multivitamin Orange & Berry Fruit Flavored by Nature's Way Tablet Or Pill 120 Chewable Tablet(s) View ingredients & interactions Alive! Kids Chewable Multivitamin Orange & Berry Fruit Flavored by Nature's Way Tablet Or Pill 120 Chewable Tablet(s) View ingredients & interactions Alive! Kids Gummy Multivitamin by Nature's Way Gummy Or Jelly 60 Gummy(ies) View ingredients & interactions Alive! Kids Multivitamin Gummy by Nature's Way Gummy Or Jelly 60 Gummy(ies) View ingredients & interactions Alive! Kids Premium Gummy Multivitamin by Nature's Way Gummy Or Jelly 90 Gummy(ies) View ingredients & interactions Alive! Kids Premium Multivitamin Gummy by Nature's Way Gummy Or Jelly 90 Gummy(ies) View ingredients & interactions Alive! Kids Zero Sugar Multivitamin Gummy Berry-Citrus by Nature's Way Gummy Or Jelly 40 Gummy(ies) View ingredients & interactions Alive! Max 3 Daily Potency Multivitamin by Nature's Way Tablet Or Pill 30 Tablet(s) View ingredients & interactions Alive! Max 3 Potency Adult Complete Multivitamin with Iron by Nature's Way Tablet Or Pill 90 Tablet(s) View ingredients & interactions Alive! Max 3 Potency Multivitamin by Nature's Way Tablet Or Pill 90 Tablet(s) View ingredients & interactions Alive! Max 3 Potency Multivitamin by Nature's Way Tablet Or Pill 30 Tablet(s) View ingredients & interactions Alive! Max 6 Potency Adult Complete Multivitamin No Added Iron by Nature's Way Capsule 90 Capsule(s) View ingredients & interactions Alive! Max3 Daily by Nature's Way Tablet Or Pill 30 Tablet(s) View ingredients & interactions Alive! Max3 Potency Adult Complete Multivitamin Tablets by Nature's Way Tablet Or Pill 180 Tablet(s) View ingredients & interactions Alive! Max3 Potency Adult Complete Multivitamin Tablets with Iron by Nature's Way Tablet Or Pill 90 Tablet(s) View ingredients & interactions Alive! Max3 Potency Men's Multivitamin by Nature's Way Tablet Or Pill 90 Tablet(s) View ingredients & interactions Alive! Max3 Potency Multivitamin by Nature's Way Tablet Or Pill 60 Tablet(s) View ingredients & interactions
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Choline: Common Questions

What is Choline used for, and does it work?
People use Choline for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Choline interact with prescription medications?
Yes. We list 16 medications with a known interaction with Choline. Use the checker above to see how Choline interacts with a specific drug.
How are Choline interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Choline with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Choline interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Choline used for?
Choline is an essential nutrient that supports liver function, brain and nerve health, and cell structure. People often supplement it for liver health, brain or memory support, and prenatal nutrition, though strong proof of extra benefit in well-nourished people is limited.
Can I get enough Choline from food?
Many people can meet their needs through diet. Eggs, beef, chicken, fish, and some beans and vegetables are good sources, so a varied diet often provides plenty.
Is Choline safe during pregnancy?
Choline is important during pregnancy and needs are higher, but you should not start a high-dose supplement on your own. Use a prenatal vitamin or supplement only at the dose your doctor recommends.
Why do some people smell fishy after taking Choline?
High doses of Choline can lead to a fishy body odor in some people because of how the body breaks it down. Lowering the dose or stopping the supplement usually resolves it.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Products that contain Choline

A rotating sample of real supplements in our database that list Choline — open any to see its full ingredients and every drug interaction we check.

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