Beth, may I ask which choline supplement you are using?
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I bought Life Extension Citicoline (CDP-Choline). I donāt remember why I chose this one! I imagine I read about that form on here.
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Life Extension Citicoline is a great choice! CDP-Choline is metabolized differently than choline salts like bitartrate, which tend to raise TMAO the most. From what Iāve seen, studies on TMAO and choline supplementation almost always use choline bitartrate, so the risks might not translate directly to CDP-Choline.
Regardless, mitigating TMAO makes a lot of sense. Supporting a healthy gut microbiome with probiotics and prebiotics can help reduce TMAO production, and omega-3s like DHA and EPA may counteract some of its potential cardiovascular effects. A fiber-rich, plant-forward diet is another great strategy to keep TMAO in check.
Anecdotally, I have seen the bloodwork of someone who used significant amounts of Alpha GPC and there TMAO was undetectable.
Iāve been mindful of TMAO as well, but I feel good about CDP-Choline, especially considering its cognitive benefits and different metabolic pathway.
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CDP-Choline was found to mitigate COVID infection also.
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I really appreciate you sharing all of this.
I donāt know much about alpha GPC. Would you consider half of each compound for me or just stick with what Iām doing? THX!
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In my experience, CDP-Choline (Citicoline) and Alpha GPC have very similar effects, but there are key differences. Alpha GPC is faster-acting and provides a direct boost in choline availability, making it better for immediate cognitive enhancement or physical performance. On the other hand, CDP-Choline has a more sustained effect and provides both choline and cytidine, which converts to uridine. Uridine plays a role in synaptic plasticity, neurogenesis, and brain repair, so CDP-Choline might have additional long-term benefits. If youāre looking for a quick choline boost, Alpha GPC might be the better choice, whereas CDP-Choline may offer a more balanced approach with potential neuroprotective effects.
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From November 2025:
A new study finds the essential nutrient is 8% lower in the brains of people with generalized anxiety disorder, panic disorder and social anxiety disorder
āThis is the first meta-analysis to show a chemical pattern in the brain in anxiety disorders,ā said Jason Smucny, co-author and an assistant professor in the Department of Psychiatry and Behavioral Sciences. āIt suggests nutritional approaches ā like appropriate choline supplementation ā may help restore brain chemistry and improve outcomes for patients.ā
I take GNC Triple Lecithin + berberine to reduce TMAO.
In that recent study about meat-eating and APOE4, I wonder if the hidden benefits of meat is really mostly that it is a source of choline (and carnitine, though the body can use the methyl groups derived from choline to synthesize it).
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I am surprised I donāt see some form of choline on more peopleās supplement stacks
Last year I discovered I was deficient, so now I take life extension choline cdp
Iām vegan, so I guess itās not surprising
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I supplemented with CDP (citicoline) for several months and noticed no subjective difference in brain function, reduced morning brain fog, increased alertness, etc. So, thinking that I still needed some additional choline, I switched to choline bitartrate, which is cheaper. Oddly, I have noticed a subjective difference in brain function with the choline bitartrate. My early morning brain fog is definitely better with the choline bitartrate.
I asked Claude for an explanation.
Claude:
The CDP-Choline paradox: too much acetylcholine?
CDP-choline is highly bioavailable and efficiently raises acetylcholine levels in the brain. However, for some individuals, this can actually overshoot the optimal acetylcholine balance. Excess acetylcholine activity has been associated with symptoms like brain fog, lethargy, and mental sluggishness ā sometimes called ācholine overloadā or being āovermethylated.ā This is more common than most supplement literature acknowledges.
Choline bitartrate: a gentler, more peripheral effect
Choline bitartrate is generally considered to cross the blood-brain barrier less efficiently than CDP-choline. This means it raises plasma choline levels and supports peripheral choline functions (liver health, cell membrane integrity, etc.) without necessarily flooding brain acetylcholine receptors. For someone already sensitive to cholinergic activity, this ālower ceilingā effect in the brain might actually feel better subjectively.
Individual neurochemistry matters enormously
People vary significantly in their baseline cholinergic tone, the density of their acetylcholine receptors, and how efficiently they metabolize choline. Someone with naturally higher cholinergic activity might respond better to a milder choline source, while someone with a genuine deficiency might benefit more from CDP-choline. This is not widely discussed in the popular literature, which tends to rank supplements by bioavailability as if higher always means better.
Morning brain fog specifically
Morning brain fog can be linked to several mechanisms ā cortisol awakening response, adenosine clearance, blood sugar, and yes, neurotransmitter balance. If your fog is related to a mild cholinergic imbalance rather than a deficiency, the gentler action of choline bitartrate could plausibly smooth that out rather than exacerbate it.
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