Beth, may I ask which choline supplement you are using?
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I bought Life Extension Citicoline (CDP-Choline). I don’t 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 I’ve 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.
I’ve 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 don’t know much about alpha GPC. Would you consider half of each compound for me or just stick with what I’m 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 you’re 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
“This is the first meta-analysis to show a chemical pattern in the brain in anxiety disorders,” said Jason Smucny, co-author and an assistant professor in the Department of Psychiatry and Behavioral Sciences. “It suggests nutritional approaches — like appropriate choline supplementation — may help restore brain chemistry and improve outcomes for patients.”
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 don’t see some form of choline on more people’s supplement stacks
Last year I discovered I was deficient, so now I take life extension choline cdp
I’m vegan, so I guess it’s 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 — sometimes called “choline overload” or being “overmethylated.” 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 “lower ceiling” 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 — 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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For 500 mg of choline, ranked by fewest calories:
| Source | Amount needed | Calories |
|---|---|---|
| Whole eggs | 3.4 large eggs | ~265 kcal |
| Fenugreek seeds | 100 g | ~323 kcal* |
| Boiled Brussels sprouts | 7.8 cups | ~438 kcal |
| Edamame | 5.7 cups | ~1,068 kcal |
| Firm tofu | ~1.78 kg | ~1,388 kcal |
| Cooked mature soybeans | ~6.1 cups | ~1,805 kcal |
| Supplement | Approximate choline delivered | Sensible supplemental dose |
|---|---|---|
| CDP-choline / citicoline | about 21% choline | 250–500 mg/day, providing about 50–105 mg choline |
| Alpha-GPC | about 40% choline | 150–300 mg/day, providing about 60–120 mg choline |
| Choline bitartrate | about 41% choline | enough only to fill the dietary gap |
| Phosphatidylcholine | roughly 13% choline | often 600–1,200 mg, providing about 80–160 mg choline |
The fenugreek number is extremely uncertain
Multiple reviews repeat 0.5% choline, equivalent to 500 mg/100 g. But another recent review gives only 0.02–0.05%, equivalent to 20–50 mg/100 g.
Under that lower estimate, obtaining 300 mg would take:
- At 50 mg/100 g: about 600 g and 1,938 kcal
- At 20 mg/100 g: about 1.5 kg and 4,845 kcal
So the honest conclusion is:
Fenugreek could theoretically rival eggs at roughly 194 kcal per 300 mg, but the underlying choline value is too poorly validated to trust.
Food (prep) Choline (mg/100g) Calories (kcal/100g) Amount for 550mg choline Calories in that amount Egg, hard-boiled 294 156 ~185g (≈4 eggs) ~290 kcal Soybeans, cooked/boiled ~62 (estimated, see below) 173 ~880g ~1,520 kcal Soybeans, raw/dry 120 446 ~460g ~2,040 kcal Navy beans, cooked 45 140 ~1,230g ~1,720 kcal Kidney beans, canned 34 127 ~1,620g ~2,050 kcal Black beans, cooked 35 132 ~1,575g ~2,080 kcal Chickpeas, cooked 43 164 ~1,285g ~2,110 kcal Pinto beans, cooked 35 143 ~1,565g ~2,240 kcal
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https://www.sciencedirect.com/science/article/abs/pii/S1756464615001735
Conclusion
Our study suggests that antimicrobial phytochemicals such as allicin, probably dietary dosage derived from garlic, effectively neutralize the metabolic ability of TMAO production of gut microbiota induced by daily intake of L-carnitine. It may offer an opportunity for us to take advantage of plants’ delicately designed defense system against microorganisms, to protect ourselves by modulating gut microbiota to a healthier status. Our research also suggested that allicin and dietary fresh garlic…
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For the statin users.
Below is the full study.
Berberine also reduces TMAO production.
https://www.nature.com/articles/s41392-022-01027-6
TMA and TMAO in patients decreased by 38 and 29% in faeces (*P < 0.05; *P < 0.05), and 37 and 35% in plasma (***P < 0.001; *P < 0.05), after 4 months on BBR. BBR might treat atherosclerotic plaque at least partially through decreasing TMAO in a mode of action similar to that of vitamins.
TMAO may also be linked to Afib.
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