The American Institute of Medicine (IoM) established an intake of 7.5 g of choline/day as the lowest evaluated intake level that produced an adverse effect (LOAEL), and on this basis, as well as taking into account a safety factor and rounding, established a so-called Tolerable Upper Intake Level (UL). This UL reflects the safe maximum amount of choline that does not cause any adverse effects when consumed daily.
The European food safety authority (EFSA) adopted the contents of this publication and supplemented them with the results of the Wang et al. study.
| The maximum safe daily intake for choline for adults is 3.5 g.The maximum safe daily intake for choline is 8.75 times the adequate intake level of choline (EFSA), which can be considered as European guideline values. |
This value applies to adult women, pregnant women, lactating women, and men (> 19 years).For adolescents and young adults (14-18 years), a UL of 3 g/day applies.
According to IoM, the possible side effects of choline overdose are body odor, sweating and salivation as well as hypotensive effects. In addition, in individual studies, high doses of choline magnesium trisalicylate have been associated with the side effects of mild hepatotoxicity (liver toxicity) as well as tinnitus (ringing in the ears) and pruritus (itching).
Based on their study, Wang et al. suggested an association of “elevated” choline intake, presumably exceeding intestinal absorption capacity, with increased risk of cardiovascular disease. They investigated this issue by looking at the relationship between plasma choline and trimethylamine N-oxide (TMAO) concentrations and cardiovascular heart disease risk.
It is likely that unabsorbed choline is available for degradation by microorganisms, to trimethylamine. Trimethylamine is metabolized in the liver to trimethylamine N-oxide. Trimethylamine has been found to promote atherosclerosis (arteriosclerosis) in animals. In addition, trimethylamine is thought to be associated with depression, neurological symptoms, teratogenic effects as well as the formation of the carcinogen N-nitrosodimethylamine in humans.
Special caution should also be exercised in persons suffering from trimethylaminuria, renal or hepatic disease, depression, or Parkinson’s disease, as they may react with side effects even at amounts of choline equal to the safe daily maximum.