A highly absorbable choline compound the body uses to make a key brain-signaling chemical for memory and focus. Its best evidence is in older adults with memory loss after stroke or early dementia, showing modest gains; benefits in healthy people are unproven. Generally well tolerated, but a possible stroke-risk question remains unresolved. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Blood pressure | <120/80 mmHg | Central to the main stroke-risk concern |
| Fasting homocysteine | <7–8 µmol/L | Methylation and vascular risk tied to choline metabolism |
| TMAO | As low as feasible (~<6 µmol/L) | Reflects the choline→TMAO pathway underlying the vascular concern |
| ApoB | <80 mg/dL (lower if high-risk) | Best single marker of atherosclerotic particle burden and stroke risk |
| Fasting glucose / HbA1c | HbA1c <5.4% | Vascular risk factor relevant to the stroke concern |
| Cognitive assessment (MoCA) | ≥26 / 30 | Tracks the cognitive endpoint the intervention targets |
Cadence: Baseline, then ~3 months, then every 6–12 months; more frequent blood-pressure checks in those with cardiovascular risk