Choline, an essential nutrient found mainly in eggs, liver, meat, fish and soy and sold as a dietary supplement, helps build cell membranes, export fat from the liver and support memory. Most adults eat below the official target. Too little causes liver fat build-up, reversed by restoring it. Adequate intake tracks with better memory and lower dementia risk; heart concerns remain unresolved. Evidence supports adequacy far more than high-dose supplementation. (Full Review)
| Marker | Target | Why |
|---|---|---|
| ALT (alanine aminotransferase) | 29–33 IU/L or lower (men); 19–25 IU/L or lower (women) | Rises with choline deficiency, falls when intake is restored |
| Liver fat (FibroScan CAP) | No established target; track change from own baseline | Deficiency adds liver fat |
| Homocysteine | 5–15 µmol/L | Phosphatidylcholine lowers it |
| TMAO (fasting plasma) | No established target; track change from own baseline | Safety check: a marked rise prompts switching form or reducing dose |
| eGFR (kidney function) | 60 mL/min/1.73 m² or higher | Safety check: reduced kidney function changes form and dose choice |
Cadence: Baseline before starting; repeat at 3 months, then every 6–12 months while supplementing