when to take choline bitartrate

Advanced Guide to Choline in Nootropic Stacks

David Tomen
David Tomen
10 minute read

best form of choline supplement

Choline is often the center of a great nootropic stack. Because without adequate levels of choline in your brain, the rest of your stack is unlikely to work very well.

Choline is neither a vitamin or mineral.  It is a water-soluble “nutrient” related to the B-Vitamin group. Choline was recognized as an “essential” nutrient by the US Institute of Medicine in 1998.[i]  “Essential” because your body cannot make enough choline on its own. You need to get it from food, or a supplement.

Choline is found naturally in eggs, liver, beef, salmon, cauliflower, Brussels sprouts and breast milk. Eggs are often considered “brain food” because they supply high amounts of choline.

Choline is needed by your body for liver function, normal brain function and development, nerve function, muscle movement, cellular energy and metabolism.

Choline assists in methylation involved in genetic expression and the repair of DNA, nerve signaling, and detoxification.

Your brain has a huge appetite for choline. It is critical for the synthesis of the key neurotransmitter acetylcholine. Which your brain uses to maintain clear communication between its billions of neurons.

In fact, choline is so vital to cognition and nerve function that, without it, we couldn’t move, think, sleep or remember anything.

Choline and acetylcholine are needed for the basics of attention, focus, memory, mood, thinking, and sleep.

Not enough choline and you deal with poor recall, memory loss, fatigue, brain fog, inability to learn, feeling irritable or distracted, and difficulty walking or staying balanced.

Stacking Racetams with Choline

If you use any of the racetam-family of nootropics in your stack, you likely should add a choline supplement. Because the racetams all affect choline and/or acetylcholine use in your brain in some way.

  • Aniracetam – releases more acetylcholine (ACh)
  • Coluracetam – increases choline – ACh conversion through the High Affinity Choline Uptake (HACU) process
  • Noopept – modulates ACh transmission
  • Oxiracetam – enhances choline-acetyltransferase (ChAT) which is used to synthesize acetylcholine
  • Piracetam – potentiates the flow of, and increases the effect of ACh
  • Phenylpiracetam – increases the density of ACh receptors
  • Pramiracetam – increases choline – ACh conversion through the High Affinity Choline Uptake (HACU) process
  • Nefiracetam – potentiates nicotinic acetylcholine receptors

I’ll dive into more detail on how each of the racetams affect acetylcholine in your brain in the post on acetylcholine. For now, you should know that when a racetam affects ACh in some way, it usually means you need to make sure more ACh is available. Or the racetam will not be as effective.choline bitartrate vs phosphatidylcholine

The other primary issue facing neurohackers are racetam-headaches. These headaches are unique because they usually only happen in a part of your brain. You’ll get to recognize them for what they are with more experience.

Racetam-headaches are caused by using a racetam without enough supplemental choline. Your brain is telling you it’s starved for choline.

Who Needs Choline

Even if you’re not interested in nootropics or brain optimization, anyone over 45 years can benefit from a good choline supplement. You’ll experience more alertness, energy, faster recall and better memory.

We all need choline for clarity and mental energy. And we have several nootropic supplements to choose from to boost choline in the brain. And increase the synthesis of acetylcholine.

We’ll review the best nootropics for boosting choline in your brain next.

CDP Choline and Alpha GPC together

Best Forms of Choline Supplements

Alpha GPC

Alpha GPC (L-Alpha Glycerylphosphorylcholine) is a choline source derived from soy or sunflower lecithin. This highly bioavailable form of choline quickly enters your brain.

As a nootropic supplement, Alpha GPC is about 40% choline by weight.

Alpha GPC naturally occurs in your brain as a byproduct of phosphatidylcholine (PC). When your brain needs more choline, and choline floating around in your brain is running low, it breaks down PC from cell membranes. And turns it into Alpha GPC.

The combination of the omega-3 fatty acid DHAAlpha GPC, and phosphatidylserine (PS) is used to form brain cell membranes.[ii]

And like other choline supplements, Alpha GPC provides the choline needed to synthesize acetylcholine.

But Alpha GPC is unique from other forms of choline. It helps increase human growth hormone.[iii] It restores and boosts nerve growth factor receptors in the brain.[iv] And stimulates the release of dopamine.[v]

One study in particular demonstrated why Alpha GPC is a favorite among neurohackers. 32 healthy volunteers received either Alpha GPC or a placebo.  Ten days later they were injected with scopolamine to induce amnesia. The researchers found Alpha GPC was able to prevent the impairment of attention and memory normally caused by scopolamine.[vi]

The researchers showed that memory function in healthy young people could be boosted simply by taking Alpha GPC as a nootropic supplement.

Choline Bitartrate

Choline Bitartrate is choline combined with tartaric acid to increase bioavailability. One of the least expensive forms of choline, it’s about 40% choline by weight.

Like other choline supplements, Choline Bitartrate provides the choline needed for acetylcholine synthesis. But neurohackers have found this form is not nearly as effective as other forms of choline.

However, if Choline Bitartrate is the only choline supplement you have available, we do have the science to prove it works as a nootropic.

A research team in the Netherlands gave 28 volunteers 2 grams of Choline Bitartrate or a placebo. An hour and 10 minutes after taking the supplements, they had participants attempt to hit the center of a target.

The volunteers who used the choline supplement were not only more accurate at hitting the target center than the placebo group. The also did it faster.

The researchers concluded there was a “choline-induced bias” towards precision, speed and accuracy.[vii] Now logic tells us that you’d have this positive outcome with any choline supplement. So if all you have to take is Choline Bitartrate – you’ll be OK.

Choline Citrate

Choline Citrate is choline combined with citrate which is an ester of citric acid. Citrate is involved in the transport mechanism of acetyl units from its site of synthesis in mitochondria to the site of acetylcholine synthesis.[viii]

And citrate plays another important role in the brain. Citrate is an intermediate in the Krebs cycle (also known as the TCA cycle or Tricarboxylic Acid cycle, or Citric acid cycle).

Citrate synthase catalyzes the condensation of oxaloacetate with acetyl CoA to form citrate. Citrate then acts as the substrate for aconitase and is converted in aconitic acid. This cycle ends with the regeneration of oxaloacetate.

This series of chemical reactions is the source of 2/3’s of the energy we get from food. Most of the energy made available by these steps is transferred to form NADH. Which then drives adenosine triphosphate (ATP) synthesis that fuels mitochondria and provides the energy needed for brain cells.[ix]

One of the less expensive versions of choline, Choline Citrate is about 50% choline by weight. And like other sources of choline, provides the raw material needed to synthesize acetylcholine.

Acetylcholine is the neurotransmitter needed to signal muscle movement.[x] But Choline Citrate is unique because it helps prevent fatigue, muscle aches and pain following a workout.best choline source reddit

I have personal experience with the benefits of Choline Citrate. For years, I saw a rheumatologist who injected cortisone into my shoulder muscles to relieve excruciating pain. Once I began supplementing with 3 – 4 grams of Choline Citrate per day, the severe muscle pain in my shoulders was gone.

So Choline Citrate provides the double benefit of improving concentration, energy levels, focus and memory. Along with less muscle pain and faster recovery after a workout.

CDP-Choline (Citicoline)

CDP-Choline (Cytidine Diphosphate Choline or cytidine 5′-diphosphocholine) is also known as Citicoline. This naturally occurring choline source is present in every cell in your body.

The CDP-Choline supplement is unique as a choline source. Once it’s digested it separates into cytidine and choline. When it gets to your brain it converts back to CDP-Choline.

Choline is needed for the synthesis of acetylcholine. And cytidine is a component of Ribonucleic acid (RNA). This molecule is involved in coding, decoding, regulation and the expression of genes. And once it gets into the brain, it converts to uridine.

When choline is in short supply, neuronal signaling resorts to grabbing choline molecules from phosphatidylcholine (PC) in cell membranes. This is where uridine steps in. Uridine is used to synthesize phosphatidylcholine (PC). Supplemental CDP-Choline provides the uridine needed for this synthesis. Which means that CDP-Choline helps repair those same cell membranes. To maintain neuron integrity.[xi]

CDP-Choline is only about 18% choline by weight. But it packs a punch when it comes to brain optimization. And is a favorite nootropic stack addition with many experienced neurohackers.

CDP-Choline vs Alpha GPC

When it comes to choosing between CDP-Choline or Alpha GPC for your nootropic stack. There really is no contest. These two choline supplements work well together.

The synthesis of acetylcholine (ACh) is largely dependent on the choline provided by phosphatidylcholine (PC).

Alpha GPC is a byproduct of phosphatidylcholine (PC). And supplemental CDP-Choline provides the uridine needed for PC synthesis.

So taken together, you provide your brain with the type of choline it needs right down at the cellular level.

Combining CDP-Choline together with Alpha GPC
 is a winning combination for any nootropic stack.

when to take choline bitartrate

Side Effects of Choline

Choline is considered safe and non-toxic. Small amounts are made in your body. And it is an “essential” nutrient.

But too much choline, like all nutrients and supplements, can become toxic if too much is taken. Or your body does not need supplemental choline.

My wife is a classic example. This stunningly beautiful, charming, intelligent women turns into the Wicked Witch From the West if she takes a choline supplement.

Like any nootropic used for brain optimization, neurotransmitter balance is key. Excess acetylcholine will depress levels of dopamine, norepinephrine and serotonin.

Serotonin and acetylcholine have an inverse relationship in your brain. In other words, as one goes up, the other goes down. So taking too much of a choline supplement can boost ACh too much. And force serotonin levels to drop.

Symptoms of too much choline or acetylcholine can include:

  • Irritability or anger
  • Anxiety and/or depression
  • Fatigue or feeling overly sleepy
  • Trouble concentrating, brain fog, lack of focus
  • Mental confusion or fatigue
  • Decreased motivation
  • Negativity, pessimism, rumination
  • Poor memory
  • Problems understanding or performing tasks
  • Feelings of helplessness or hopelessness
  • Diarrhea, constipation, gas, bloating, nausea, vomiting, dizziness
  • Muscle weakness
  • Tingling or numbness in the arms or legs
  • Joint pain, discomfort or swelling[xii]

Nootropics Expert Recommendation

Every one of us needs choline to function. Choline is an essential nootropic supplement for anyone whose goal is brain optimization.

Choline is needed to synthesize acetylcholine (ACh). We need choline for cell-membrane signaling (phospholipids), lipid transport (lipoproteins), and methyl-group metabolism (homocysteine reduction).[xiii]

We need choline to provide the acetylcholine affected by any of the racetam-family of nootropics.

Your brain will start to literally consume itself to get the building blocks it needs to make acetylcholine. If you don’t provide it with enough choline.

My favorite choline supplements after years of trial and error are CDP-Choline (Citicoline) and Alpha GPC. If I’ve got muscle pain, I’ll take Choline Citrate for a few days. Until the pain goes away.

I use 500 mg of Cognizin™ (branded form of citicoline) per day in my nootropic stack. Cognizin is included in the double-dose of Mind Lab Pro I use every day.

Whenever I feel a racetam-headache coming on I’ll take 500 mg of Alpha GPC. And the headache is gone within 15 minutes.

Your Mileage May Vary. Each of us has a unique body and brain. So what works for me may not work as well for you. Listen to your body and give your brain the choline it needs.

As an Amazon Associate I earn from qualifying purchases. This post may also contain other affiliate links and I will be compensated if you make a purchase after clicking on my links.

[i] Zeisel S.H., da Costa K.A. “Choline: an essential nutrient for public health.” Nutrition Reviews. 2009 Nov;67(11):615-23. (source)

[ii] Kidd P.M. “Neurodegeneration from mitochondrial insufficiency: nutrients, stem cells, growth factors, and prospects for brain rebuilding using integrative management.” Alternative Medicine Revue. 2005 Dec;10(4):268-93. (source)

[iii] Ceda G.P., Ceresini G., Denti L., Magnani D., Marchini L, Valenti G., Hoffman A.R. “Effects of cytidine 5′-diphosphocholine administration on basal and growth hormone-releasing hormone-induced growth hormone secretion in elderly subjects.” Acta Endocrinologica (Copenhagen).1991;124(5):516-20. (source)

[iv] Vega J.A., Cavallotti C., del Valle M.E., Mancini M., Amenta F. “Nerve growth factor receptor immunoreactivity in the cerebellar cortex of aged rats: effect of choline alfoscerate treatment.” Mechanisms of Ageing and Development 1993 Jun;69(1-2):119-27. (source)

[v] Trabucchi M., Govoni S., Battaini F.  “Changes in the interaction between CNS cholinergic and dopaminergic neurons induced by L-alpha-glycerylphosphorylcholine, a cholinomimetic drug.” Farmaco Sci.1986 Apr;41(4):325-34. (source)

[vi] Canal N., Franceschi M., Alberoni M., Castiglioni C., De Moliner P., Longoni A. “Effect of L-alpha-glyceryl-phosphorylcholine on amnesia caused by scopolamine.” International Journal of Clinical Pharmacology, Therapy, Toxicology. 1991 Mar;29(3):103-7. (source)

[vii] Naber M., Hommel B., Colzato L.S. “Improved human visuomotor performance and pupil constriction after choline supplementation in a placebo-controlled double-blind study.” Scientific Reports 2015 Aug 14;5:13188. (source)

[viii] Sterling G.H., O’Neill J.J. “Citrate as the precursor of acetyl moiety of acetylcholine” Journal of Neurochemistry 31(2):525-30 · September 1978 (source)

[ix] Ebenhöh O., Heinrich R. “Evolutionary optimization of metabolic pathways. Theoretical reconstruction of the stoichiometry of ATP and NADH producing systems.” Bulletin of Mathematical Biology. 2001 Jan;63(1):21-55. (source)

[x] Sanders L.M., Zeisel S.H. Choline – Dietary Requirements and Role in Brain Development Nutrition Today 2007; 42(4): 181–186. (source)

[xi] Wang L., Pooler A.M., Albrecht M.A., Wurtman R.J. “Dietary uridine-5′-monophosphate supplementation increases potassium-evoked dopamine release and promotes neurite outgrowth in aged rats.” Journal of Molecular Neuroscience 2005;27(1):137-45. (source)

[xii] Overstreet D.H., Janowsky D.S. “The Role of Acetylcholine Mechanisms in Affective Disorders” American College of Neuropsychopharmacology (source)

[xiii] Penry J, Manore M. ‘Choline: an important micronutirent for maximal endurance-exercise performance?’  International Journal of Sports Nutrition, Exercise and Metabolism. 2008;18:191–203. (source)

Subscribe to the Nootropics Expert newsletter

Keep up to date with the latest developments in the nootropics space.

Head First 2nd Editon

The Award Winning Guide to Healing & Optimizing Your Brain with Nootropic Supplements.

Head First 2nd Edition

NEW! Eliminate Brain Fog, Low Energy, Moodiness, Difficulty Sleeping, Memory Loss or Anxiety. Available on Amazon, Barnes & Noble, Apple Books, Walmart and more...

Where to Buy Nootropics

Wondering where to buy the best nootropic supplements? Well, you’re in the right place. Because here you will find the nootropic supplements that I personally use and recommend. Each supplement has a link to the company store and product that I use. I also include a link to my full review for each supplement here […]

The Definitive Guide to Nootropics

Nootropics can help increase your memory, boost learning ability, improve your mood and assist overall brain function. If you’re new to nootropics, or wonder about the difference between a nootropic and a smart drug, then this page is for you. Here you’ll find the definition of a nootropic, how to pronounce the word “nootropic”, the […]

The Most Comprehensive Nootropics List

This is our big list of the most popular Nootropics in use today. Here you’ll learn what each nootropic is, what it does and suggested dosages. What is this List of Nootropics About? Nootropic supplements are cognitive enhancers aiming to improve brain function. Whether you are looking to treat mild cognitive impairment, improve mental focus, or biohack […]

Free Secrets of the Brain 3rd Edition

Get “Secrets of the Optimized Brain,” 92 nootropics to help you plan your Nootropic Stack when you sign up for my newsletter:

Join The Discussion - 80 comments

April 10, 2021

Hi David,

You really are the best resource om the web. I recently started using Pramiracetam plus Brain Support by 1 Body (on amazon), and although everyone is different, for me it cured my depression right away that was untreatable with SSRIs (probably due to your explanation that serotonin reduces acetylcholine & vice versa).

I’d read another commenter who’d thought that her problem was low choline due to exercise. I’d always had exceptional muscle recovery but when I began Pramiracetam I got muscle soreness that didn’t really heal from a mild 30 min jog/walk (I tried to do it daily but skipped a day, then two, etc), and I’m pretty sure I’ve gained weight although I didn’t measure it. After the jog I’d take hydrolyzed protein which is why the soreness is even stranger. I read on your nootropics list that Creatine is a nootropic and it’s good to stack with racetams because of the increased mitochondrial activity in the brain drains creatine from the muscles. I began taking 3 grams even when I wasn’t exercising and the muscle pain disappeared that day. I can’t find this info anywhere else on the web!

Because I like to work out & build muscle, what do you recommend for Creatine & Choline supplementation when taking 1200mg of Pramiracetam? The Brain Support has 500mg of Alpha GPC; would adding Cognizin and the Citrate you mentioned put me in an over cholinated state? Should I double my creatine if I exercise?

I recently purchased more supplements to add to my treatment since I had to restock on the Brain Support. Please let me know if anything stands out to you as *not recommended*:

Source of Life Energy Smoothie
Dr. Mercolas Quercetin + Pterostilbene

Artichoke Extract

Thank you! It’s wonderful that you offer advice because I became concerned when I read that racetams are stimulants and it’s hard to understand exactly how they work.

    David Tomen
    April 16, 2021

    Erin, using more Creatine when you exercise may help. But I’m not expert in that area.

    Try adding Cognizin (CDP-Choline) as well because while it also increases acetylcholine it works in a different way. And get familiar with the symptoms of excess acetylcholine so you know when to back off.

    The ONLY time I would suggest using Choline Bitartrate or Choline Citrate is to reduce muscle soreness. It cannot cross the blood-brain barrier so will not support your use of Pramiracetam. But it may alleviate muscle soreness.

Carrie Ballard
March 17, 2021

P.S. I too have been recently diagnosed with hypothyroidism within the last 6 months and have been taking meds for that. It helps with my energy and fog but I think my Dr. and I are still working out the kinks on dosages.

Carrie B.

    David Tomen
    March 18, 2021

    Carrie, this was my bible when I was first diagnosed hypothyroid: https://stopthethyroidmadness.com/. Please spend time on that site and learn how to read your own labs, support your adrenals, learn about iron levels, etc.

Carrie Ballard
March 17, 2021

Hello David,
I am so thankful for your website. The info and help you provided to us all is immeasurable. With that being said, I have been experimenting with supplements due to an increase in brain fog and poor memory recall. I started out wholesome enough. More B12 and Fish oils, iron. Then moved on to Ginko Biloba as well. Now Im on to Choline Bitrate and Citicholine. Ive also gotten a subscription for Formula where they put stackers together for you. Including APCGs and Racetams ( quite a few if I remember, 3-4 different ones) as well as Citicholine and a couple others. So far I haven’t felt like any of those formulas worked for me they were to strong or I felt to sick, too dissociative, too jittery, too staticky. I just want something that comes on smooth and has no weird crash that leaves me feeling like I don’t remember the little things everybody knows and takes days to feel somewhat normal when my normal isnt even optimal. Im searching for something to help with memory recall and recall speeds. As well as attention and concentration for RN school. Lately, I just cant find the focus and drive to sit down and get through several chapters or really commit and understand the information. I also, wanted a little boost in the fatigue area, as school and full time job we’re leaving me energy depleted and I was needing more sleep than I have time for.

I usually take:
Ginko Biloba and sometimes Ginseng
Fish Oil
Acetyl L- Cartinine , which I feel was a mild/moderate improvement but still I went searching for stronger or more. My plan was to just throw as much brain boost and energy I could find at it. But Im starting to feel like I could just end up with too much stuff that isint working together ver efficiently, and that just sounds unpleasant.

After researching for over 6 months and seeing all the posts here I guess my mix is pretty basic. I do sometimes get a tummy ache or some other annoying side effect, but nothing thats a deal breaker. I had high hopes while trying the racetams but the neg. effects outweighed the pos. for my first go around.

I picked up some Cogzinin and added that to the line up but couldn’t find Acetyl L- Cart. this time around.

I realize I am a novice and it could take forever to get this right but my question is can I take The Cognizin (Citicholine) and Brainstrong (Choline Bitrate) together or is that too much or do you suggest something else altogether?

I guess my ultimate question is what am I doing wrong? I feel like Ive tried it all with little improvements and slight adverse results. Am I not a normal human with normal physiology? I guess Im wierd…LoL

Lost in the Sauce in Louisiana,
Carrie B.

    David Tomen
    March 18, 2021

    Carrie, your plan “to just throw as much brain boost and energy I could find at it” is not a good idea. And how newbies get into trouble when first discovering nootropics.

    You are doing plenty to increase acetylcholine in your brain while ignoring things like dopamine, serotonin, and brain cell health for neuroplasticity. And then there is providing mitochondria with what they need to make ATP which is your most fundamental source of energy.

    I don’t normally reference this page which is a shame when I think about it. https://nootropicsexpert.com/best-nootropics/. Near the top of that page is a table with categories to boost. I suggest putting together a stack using Categories 1,2, 4, & 5 from that table based on what you said in your essay above. You’ll notice some supplements work in multiple categories. Which means fewer supplements and fewer capsules to make a well-rounded stack.

    And I highly recommend that you closely read my entire review for each individual supplement you are considering. Because if you did that before you’d know that choline bitartrate cannot cross the blood-brain barrier very well and is useless as a nootropic when compared to things like Alpha GPC and CDP-Choline (Cognizin).

    And forget about the racetams for now. Stay with the basics until get more experience. And have some success with getting closer to how you want to feel.

March 14, 2021

Hi David,

Your website is incredible and your research is so thorough. I want your opinion on my situation, if you’re willing: I get pretty bad brain fog that persists for weeks/months at a time. Experimenting with various nootropics, I’ve gotten the best results with ALCAR and CDP-Choline. I recently read that prolonged, intense exercise (a la endurance sport such as long distance running, cycling) can dramatically drop plasma choline levels. As it turns out, I’m a vegetarian cyclist who often goes too hard for a little too long when riding. So now I’m starting to put 2 and 2 together and suspect that my brain fog is caused by low choline levels, exasperated by endurance exercise and a vegetarian diet. I want to boost my choline levels specifically around my physically activity to see if that alleviates the issue, but as I’m reading up, it seems the free choline increases TMAO (a marker for cardiovascular disease). So, in your opinion, would it be safe to supplement with 2-4 grams of choline bitartrate or citrate (“free” choline) for this sports-specific purpose to alleviate the brain fog problems I’m getting with the physically activity I’m doing? For what it’s worth, I’m riding like 2 hrs 3 times per week with a decent amount of intensity, so I’m not trying to go from 20 hrs to 25 hrs of endurance exercise. I’m really just trying to ride a little bit more. I’m not even on the “moderate” end of volume as cycling goes and I keep hitting this wall, which I now believe is related to a choline deficiency. I can’t eat enough eggs or nuts to get the choline through food (both eggs and nuts bother my lower digestive tract at amounts to would significantly boost my dietary choline intake). A supplement would make things easier and more precise, but I’m trying to figure out which one is best for such high doses. phosphatidylcholine does not seem to affect TMAO levels, but the exercise research has been done with choline bitartrate and citrate, not phosphatidylcholine. Plus, I don’t know where’s a good source for high amounts of phosphatidylcholine supplement.

    David Tomen
    March 15, 2021

    Shelley, it sounds like you are overthinking this. You got great results with ALCAR and CDP-Choline. Why not continue using those and forget about TMAO levels.

      April 25, 2021

      There are studies showing that TMAO from choline, phosphatidylcholine, L-carnitine, and lecithin supplements increase your chance of colorectal cancer and heart disease. It also contributes to pushing you into diabetes?


      Is it possible to get some of these same benefits without those supplements?

        David Tomen
        April 26, 2021

        James, the main study they point to in that article used choline bitartrate. Which most experienced neurohackers do not use because Alpha GPC and CDP-Choline are far more effective choices. And no one that I know of has ever shown they increase TMAO.

        Next, scroll down and take a look at who funded that study. They include P&G, Pfizer Inc., Roche Diagnostics, Siemens, and Esperion. Do you really think any of those companies are champions of dietary supplement use? They either manufacturer and/or sell pharmaceutical drugs.

        I never, ever, ever believe a clinical study that was funded by Big Pharma. Talk about a conflict of interest.

        May 3, 2021

        I see. Thank you, I did find a study that says that Alpha GPC does not raise TMAO levels as much.

Danny Gonzalez
February 18, 2021

David, thanks for your contributions. I don’t have any questions but would like to say that I appreciate your time and effort. Especially when it comes to answering questions that are 5 paragraphs long. You people that have issues should do a phone consult with David. You’d probably get a lot more and save money in the long run.

    David Tomen
    February 19, 2021

    Thank you for that Danny. Ditto.

February 2, 2021

Dear David,
I would like to thank you for writing this article. The “Symptoms of too much choline or acetylcholine” list you provided has opened my eyes a bit to what might be going on with me.

I have been taking a daily stack consisting of:
1- A racetam or two (Alternating between racetams)
2- Choline source (CDP or AGPC)
3- Phenibut
4- Other nootropics such as theanine & ashwagandha at night – sulbutiamine & Nalt/Alcar in the morning.

I went through hell the past few months having almost all the acetylcholine symptoms you listed there, I didn’t know what was happening, blamed it all on the phenibut at first… then suspected maybe excess serotonin because taking L-tryptophan at night made my heart pound rapidly.

I noticed at first that sometimes when I take Centrophenoxine, things get better. However, other times it worsens my symptoms… Same with AGPC. It’s still confusing me to this day.

Any idea how I might be able to reverse this? Abstinence from cholinergics isn’t doing much.

Thank you.

    David Tomen
    February 2, 2021

    Fall, I think you’re onto something because of your reaction to Centrophenoxine. Contrary to what most think Centrophenoxine doesn’t ‘make’ more acetylcholine. It can’t. But it does force your cells to give up more choline for the production of acetylcholine.

    Alpha GPC and CDP-Choline both give up a choline molecule for the synthesis of acetylcholine. But they each have a different mechanism of action prior to that happening.

    One way to test if it’s excess acetylcholine is to take a double dose of whatever racetam you are using. But do NOT double your dose of the choline supplement. The double dose of the racetam will force your brain to use more acetylcholine. And if it’s in excess then this method should deplete your acetylcholine stores. Easiest way I know of to “reverse” this.

      February 3, 2021

      Thank you for taking the time to reply David, I thought the same at first, the issue would be either too little Acetylcholine readily available or the exact opposite.

      So I tried to supplement with extra choline some days, didn’t work, still had brain fog, muscle weakness/tingling, tremors & joint pain.

      The week after, I took Oxiracetam & Aniracetam together without a choline source in hopes of depleting the excess choline stores available (if any). I still got negative reactions.
      (The joint pain subsided but the tingling is still here for months now).

      I still try to figure out what’s wrong & believe the issue might be something a bit deeper than Choline levels. I was reading another post of yours the other day, where you replied to someone on how to reverse anhedonia, by looking at “NMDA Receptor Antagonists”, you listed Piracetam among the list.

      I took a good dose of Piracetam that day & felt something switched on, the brain fog, depression & joint pain instantly disappeared.

      Things still aren’t back to normal 100% yet, but it’s better… Could it be an “NMDA receptor” issue?
      I’m suspecting this because Phenylpiracetam has always been my personal racetam of choice & I’ve taken it for a prolonged period of time.

      What do you think I should try next?
      (Still feeling tingling in the feet & Muscle discomfort as we speak)

        David Tomen
        February 3, 2021

        It very well could be a NMDA receptor issue. I’m not going to suggest anything else because it sounds like you are on track to figuring this out.

        The only way that I know of to get to the bottom of what is causing your symptoms is experimenting with different supplements and research. And it sounds like you are doing exactly that.

        You’ll get this figured out if you stay with it.

January 19, 2021


I have been dealing with a host of issues (brain fog, depression, ADHD, OCD, panic disorder, etc.). Needless to say, my life has been derailed for 7 years. I have spent thousands of dollars on supps, ran OAT test, neuro test, gene tests, and have been through the medication merry go round. I take 5 mg (low dose) of memantine once a day for OCD/ADHD, and it has been the only med that I have tolerated. I take clonazepam 1/4 to 1/2 of a .5mg tab as needed, and it helps. My body does not tolerate high dosages of meds. I also have issues with multivitamins when used in past (brain fog and acne mostly). Blood tests show very high folate and b6 which is odd, as I don’t supplement or eat all that great, and low b12. My Natuopath thinks I have an overgrowth or conversion issue going on. I agree that gut health is essential and am going to do a parasite and candida cleanse shortly. I am going to try and isolate the anxiety issue using your step by step anxiety guide. But, I feel that my current stack is on to something.

My current stack is :

Neuro peak 1 x a day
2g salmon oil – 1 x a day
100mg panax ginseng 2x day
50 billion probiotic 1 x a day
l-theanine as needed when I consume caffeine

I believe that I am adhd with slight ocd tendancies. I have severe anxiety though, as I am always in doom mode. I feel depressed and I tire easily, likely due to all the worrying.

My questions are:

1. Does memantine use indicate anything to you that could point to an imbalance that could be fixed using nootropics. Also, is there any contraindications with my stack or things to stay away from in the future with this med?

2. I bought phosphatidyl choline by accident instead of alpha gpc. Can I still benefit from it? I do seem to get a slight headache with current stack. Is this from the serine?

3. I am low in L glutamine according to tests, but I am worried about supplementing with it, as I take memantine, and it is tricky to balance, as you have said in your post. Should I still give it a go?

4. ADHD meds work at very low doses for me, but they make me feel hot at night and increase heart rate. Any ideas?

5. My gene test indicate that I need to increase choline. Can nicotine lozenges help with this?

    David Tomen
    January 22, 2021

    Chey, memantine (https://en.wikipedia.org/wiki/Memantine#Pharmacology) works on NMDA receptors (glutamate), the 5-HT3 serotonin receptor (motion sickness, nausea), and nicotinic acetylcholine receptors (your main signaling neurotransmitter for muscle movement, brain cell signaling, etc.).

    As far as I can tell there are not a lot of supplements that are contraindicated with this drug particularly at such low doses.

    Phosphatidylcholine (PC) and Alpha GPC are two very different supplements. The first is a phospholipid that makes up your brain cell membranes. And Alpha GPC is a direct precursor to acetylcholine synthesis. PC can also throw off a choline molecule to make acetylcholine. But we use Alpha GPC so our brain does not need to cannibalize our brain cells just to make acetylcholine. You brain cells will like getting extra PC because it works with PS and DHA. But you’ll likely experience more benefit from Alpha GPC in the short term.

    There are no contraindications between using L-Glutamine and memantine. I think what you saw was my comment about Monosodium Glutamate (MSG) and not glutamine. It’s up to you but as far as I can tell should be safe. Just start with a 1/4 dose first (ie. a gram or less) and see how you feel.

    When do you take your ADHD meds and which one?

    Nicotine lozenges will activate nicotinic acetylcholine receptors but will not increase acetylcholine. For that you need Alpha GPC or CDP-Choline.

January 15, 2021

Hi David,

What is the ideal ratio of choline to a racetam?
Is it 1:1?

Every morning I take:
I take 150 mg of Alpha GPC
I take 250 mg of Cognizin
I take 150 mg of Choline Bitartrate (it is in my B complex)

Would that amount be enough for me to take any amount of a racetam I like? I usually take 1500-3000 mg of Aniracetam. Do I need to add more choline?

I don’t think it needs to be 1:1 but you are the nootropic expert so I wanted to make sure just so that I save money from taking more alpha-GPC later on in the afternoon.

As always, thank you for responding to me, your responses helped me a lot in the past!


    David Tomen
    January 16, 2021

    Rifat, I’ve found that 300 mg of Alpha GPC helps support a 750 mg dose of Aniracetam. Or you could use CDP-Choline instead. Or a combination of the two at a lower dose for each.

    But you need the choline dose each time you use Aniracetam. There is no specific “ratio”. It’s what your system needs to support using Aniracetam.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.