CDP-Choline (Citicoline)

Safety and Pitfalls

• Can be stimulating in sensitive users[164,168,391, etc.]
• Potential side effect: headache[164,168,391, etc.]
• Potential side effect: insomnia[164,168,391, etc.]
• Interaction check: levodopa (dose interactions possible)[164,168,391, etc.]
• ODS safety note: Humans can produce choline endogenously in the liver, mostly as phosphatidylcholine, but the amount that the body naturally synthesizes is not sufficient to meet human needs [ 4 ].[164,168,391, etc.]
• ODS safety note: Free choline, phosphocholine, and glycerophosphocholine are absorbed in the small intestine, enter the portal circulation, and are stored in the liver, where they are subsequently phosphorylated and distributed throughout the body to make cell membranes [ 1-3 ].[164,168,391, etc.]
• ODS safety note: Choline Deficiency Choline deficiency can cause muscle damage, liver damage, and nonalcoholic fatty liver disease (NAFLD or hepatosteatosis) [ 1 , 2 , 4 , 15 ].[164,168,391, etc.]
• ODS safety note: Groups at Risk of Choline Inadequacy The following groups are among those most likely to have inadequate choline status.[164,168,391, etc.]
• ODS safety note: The risk of inadequate choline status might be greater in pregnant and lactating women who do not take folic acid supplements, those with low vitamin B12 status, and those with a common variant in methylenetetrahydrofolate dehydrogenase (an enzyme that can affect folate status), all of which reduce the body’s pool of methyl groups needed for metabolism [ 17-20 ].[164,168,391, etc.]
• ODS safety note: Some evidence indicates that lower plasma or serum choline levels (e.g., serum concentration of 2.77 mmol/L in midpregnancy) are associated with an increased risk of neural tube defects [ 21 , 22 ].[164,168,391, etc.]
• ODS safety note: In a study of 100 African, Asian, Caucasian, and Mexican Americans, individuals of European ancestry had a higher prevalence of four SNPs that increased the risk of organ dysfunction when these individuals consumed a low-choline diet [ 27 ].[164,168,391, etc.]
• ODS safety note: Other research suggests that higher dietary choline might increase cardiovascular disease risk because some choline and other dietary ingredients, such as carnitine, are converted to trimethylamine (TMA) by intestinal bacteria.[164,168,391, etc.]
• ODS interaction note: Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet.[164,168,391, etc.]
• ODS interaction note: Interactions with Medications Choline is not known to have any clinically relevant interactions with medications.[164,168,391, etc.]
• Legacy caution group: Generally very safe; few contraindications[164,168,391, etc.]