Best Choline Supplements for Pregnancy

By: Cara Everett, MS, RDN, LDN

Published: May 28, 2024

Estimated Reading Time: 6-7 minutes

Choline is just as essential as folate for a growing baby’s brain—but it’s hard to get enough from food, and most prenatal vitamins don’t include choline. Read on to find out why choline is a critical nutrient, when it’s most important in pregnancy, and how to find the best choline supplements.

Key Takeaways

  • Choline is a critical nutrient for neural tube and brain development . The body can make small amounts, but not enough to meet the demands of pregnancy.
  • Research shows that over 90% of women in the U.S. aren’t getting enough choline in their diet.
  • Up to 70% of women have genetic variants that limit the amount of choline their body can make.
  • Choline supplementation is essential for these women and can greatly impact their baby’s brain development and their own health.
  • Most prenatal vitamins include only 10% of the recommended intake of choline during pregnancy.

Choline is a water-soluble one-carbon nutrient that plays key roles in the development of a baby’s brain and nervous system, DNA, and cell membranes. But it’s not just for babies: choline also works in mom’s body to influence mood, fat metabolism, liver health, and pregnancy outcomes.[1]

Choline can be made by the body in small amounts and obtained from foods like beef liver and other cuts of beef, salmon, chicken, eggs, and some plant foods. Most people need choline supplements to meet their body’s requirements—especially in pregnancy when choline needs are high.

Choline supplements come in different forms, so how can you tell which one is right for you and your baby? When is choline most important in pregnancy? And do you even need a choline supplement, or can your diet meet your choline needs? 

The team at Genate is here to help. Read on to learn about when to take choline in pregnancy, see our recommendations for the best prenatal vitamins with choline, and find out how to choose the best choline supplement.

What Is Choline?

Choline is a nutrient that works in the body to support many processes, including:[1]

  • Brain development and function
  • Methylation of DNA, RNA, and proteins
  • Cell membrane formation
  • Neurotransmitter synthesis
  • Homocysteine regulation 
  • Liver health

Choline can be made by the body and obtained through diet and supplements. Estrogen helps boost the body’s production of choline. Because men and postmenopausal women lack estrogen, they’re at risk of liver and muscle damage from choline deficiency if they don’t get enough choline from food or supplements.

Studies show that over 90% of women in the United States do not get enough choline in their diet.[2] And while your body can make small amounts of choline, genetic researchers have found that up to 70% of women have gene variants that reduce the amount of choline produced. 

Do I Need a Choline Supplement?

If you’re trying to conceive, pregnant, or nursing, it’s essential to get enough choline. For most people, this will require a choline supplement.[3] The only way to know for sure whether you need one is to look closely at choline intake from your diet and find out if you have genetic variants that interfere with choline production or metabolism. 

The Genate Test offers an all-in-one solution with an at-home genetic screening test and an online nutrition survey designed to help you evaluate your current choline intake.

Choline requirements vary across the lifespan. The Dietary Guidelines for Americans include an adequate intake (AI) of choline for each age and gender group.[4]


Age/Life Stage

Recommended Choline Intake

Infants

6-11 months

150 mg/day

Children

1-3 years

200 mg/day

Children

4-8 years

250 mg/day

Children

9-13 years

375 mg/day

Men

14-18 years

550 mg/day

Men

19 years and older

550 mg/day

Women

14-18 years

400 mg/day

Women

19 years and older

425 mg/day

Women

Pregnant

450 mg/day

Women

Breastfeeding

550 mg/day

As mentioned above, choline is available from certain foods such as beef liver, other cuts of red meat, eggs, salmon, caviar, soy, chicken, and several plant foods like potatoes and beans. But the vast majority of Americans don’t eat enough of these foods on a regular basis to supply all of their choline needs. The good news is that you can find choline in supplement form as well, such as in the Genate Essential Prenatal and Genate Advanced Phosphatidylcholine (a nutrient made from choline).

The following people may benefit from choline supplementation:

  • Pregnant or breastfeeding women
  • Men
  • Postmenopausal women
  • People with genetic variants in choline production pathways
  • People with low dietary intake of choline

When Is Choline Most Important in Pregnancy?

Like folate, choline plays key roles in neural tube development, which occurs in the first 4-6 weeks after conception. But research shows that the second trimester is the most important time for adequate choline intake due to its involvement in brain development.

Choline deficiency can impact your health at all life stages, but when you’re pregnant it’s a huge deal. Low choline levels have been linked to poor pregnancy outcomes and may lead to lifelong consequences for your baby due to impaired brain development and DNA methylation.

The first 1,000 days after conception (pregnancy through the end of the second year of life) are the most critical period for optimal nutrition, especially when it comes to cognitive development. The American Academy of Pediatrics states that negative health effects due to poor nutrition during this time cannot be made up for later in life. Children born to mothers whose diets lack important nutrients struggle with issues affecting their education, mental health, earning potential, and overall quality of life.[5]

Genetic nutrition testing such as that offered by Genate is a powerful tool to identify gene variants that affect your ability to make choline and other nutrients. You and your healthcare provider can use that information to make sure you’re getting the right levels and forms of nutrients for a healthy pregnancy.

Best Form of Choline for Pregnancy

Choline comes in many forms, including:

  • Choline bitartrate
  • Citicholine (CDP choline)
  • Phosphatidylcholine
  • Lecithin

All of the above forms contain choline, and no studies have conclusively shown that absorption or bioavailability of one form is better than another. Genate uses choline bitartrate in its prenatal vitamins due to its purity and high absorption rate.

Before you begin taking any supplement, discuss the pros and cons with your doctor or other healthcare provider.

How to Find a Prenatal Vitamin With Choline

Not all prenatal vitamins are created equal. In fact, most of the vitamins you’ll find in stores include small amounts of choline or none at all. The Genate Essential Prenatal vitamin is a high-quality option that provides 450 mg of choline, 100% of the daily recommended intake. It also contains 19 other vitamins and minerals, including the one-carbon nutrients betaine, methylfolate, riboflavin, and vitamins B6 and B12 needed for fetal cognitive development. The Genate Essential also has a probiotic and a whole foods antioxidant blend, two things you won’t find in any other prenatal vitamin.

Why Genate Is the Best Choline Supplement for Pregnancy

The Genate Essential Prenatal has been formulated from genetic research into the nutrients that many women have trouble metabolizing, such as folate, choline, and betaine. Genate also offers single-ingredient products for women with gene variants that raise their need for certain nutrients. The Genate Test and Genate nutrition products allow you to create a nutrition plan tailored to your genetics, rather than relying on national guidelines that may or may not meet your needs.

As one of the leading developers of research-based prenatal supplements, Genate also provides an Advanced Phosphatidylcholine supplement in the form of polyenylphosphatidylcholine (PPC), which has an absorption rate of over 90%. Phosphatidylcholine (PC) includes a phospholipid attached to choline, and is vital for fat metabolism, brain development and function, and liver health. Keep in mind that PC is only about 14% choline, so a PC supplement will not include as much choline as a pure choline supplement. There are advantages to PC, though: It’s absorbed well regardless of a person’s gut bacterial profile, and it doesn’t cause a strong body odor like higher doses of choline can. As a reference, one serving of Genate Advanced Phosphatidylcholine (two capsules) provides 1800 mg PC, and about 250 mg of that is choline. Talk to your healthcare provider about whether a PC or choline supplement is the right choice for you.

Choline Safety & Side Effects

Choline is not only safe to take during pregnancy, it’s recommended because of its benefits for maternal and fetal health. Experts at the Cleveland Clinic note that when choline supplements are taken in doses below the Tolerable Upper Limit (TUL), there are no known side effects.[3]

See below for choline intake levels not to exceed.[6]


Age/Life Stage

Tolerable Upper Limit (TUL)

Children

1-8 years

1,000 mg/day

Children

9-13 years

2,000 mg/day

Men

14-18 years

3,000 mg/day

Men

19 years and older

3,500 mg/day

Women

14-18 years

3,000 mg/day

Women

19 years and older

3,500 mg/day

Women

Pregnant

3,500 mg/day

Women

Breastfeeding

3,500 mg/day

Bottom Line

Choline is one of the most important nutrients in pregnancy due to its roles in brain and nervous system development, cell membranes, and DNA methylation. Your body can make it, but most people need supplementation to meet their needs, especially during pregnancy.

Choline and phosphatidylcholine supplements are two excellent ways to meet you choline needs, and it’s critical to make sure you’re taking a high-quality supplement with enough choline to meet your needs while you’re pregnant and nursing. Your baby’s brain has a high need for choline during these life stages, and it’s impossible to achieve the cognitive benefits that could have been achieved if choline had been provided during that window.

Genate provides the only prenatal vitamin on the market with 100% of the recommended daily intake for choline along with other one-carbon nutrients for your baby’s brain development and your health. To find out more about how much choline your body needs, take the Genate Test.

This article is not intended as medical advice to treat or diagnose any health condition but rather as educational health information for the general public. It should not be used as a substitute for individualized medical care from your healthcare provider. 


This article is not intended as medical advice to treat or diagnose any health condition but rather as educational health information for the general public. It should not be used as a substitute for individualized medical care from your healthcare provider.

Sources

  1. Harvard Health. Choline. https://www.hsph.harvard.edu/nutritionsource/choline/ Published March 2023. Accessed May 9, 2024.
  2. Korsmo HW, Jiang X, Caudill MA. Choline: exploring the growing science on its benefits for moms and babies. Nutrients. 2019;11(8):1823. https://doi.org/10.3390/nu11081823
  3. Cleveland Clinic. Choline supplements. https://my.clevelandclinic.org/health/drugs/22202-choline-supplement Updated December 14, 2021. Accessed May 9, 2024.
  4. Dietary Guidelines for Americans, 2020-2025. 9th Edition. U.S. Department of Agriculture and U.S. Department of Health and Human Services. DietaryGuidelines.gov Published December 2020. Accessed May 5, 2024. 
  5. Schwarzenberg SJ, Georgieff MK, Daniels F, Corkins M, Golden NH, Kim JH, et al. Advocacy for improving nutrition in the first 1000 days to support childhood development and adult health. Pediatrics. 2018;141(2): e20173716. https://doi.org/10.1542/peds.2017-3716
  6. National Institutes of Health. Choline. https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/ Updated June 2, 2022. Accessed May 9, 2024.

Author Bio

Cara Everett, MS, RDN, LDN is a registered dietitian nutritionist with a passion for helping people optimize their health with sustainable diet and lifestyle changes. She provides nutrition counseling to clients of all ages, with specialties in nutrigenetics, women's health, and chronic medical conditions.

Cara is also a health writer and editor with over 20 years of experience creating content for print and digital media outlets, nutrition and wellness blogs, and medical white papers. Her work has been featured on websites such as the National Council on Aging, Everyday Health, HelpGuide, MarketWatch, and Verywell. Cara's current writing covers women's nutrition and nutrigenetics in pregnancy and lactation.

As lead dietitian for SNP Therapeutics, Cara shapes content strategy, medically reviews and edits articles, and provides gene-focused medical nutrition therapy for clients. She holds Bachelor of Science and Master of Science degrees in Nutrition from Texas A&M University and completed her dietetic internship at the University of Kentucky Hospital.

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