Citicoline (CDP-Choline): Benefits, Uses, and Side Effects

A stellar brain-health nutrient that will give you an edge in cognitive performance.

Citicoline (CDP-Choline): Benefits, Uses, and Side Effects

Citicoline is a compound that the human body produces naturally and promises to improve overall mental performance.

It is one of the most common ingredients used in supplements for cognitive support, but does it meet all the hype it receives? That is what we are here to find out.

Contents

    What is Citicoline?

    Citicoline is the generic name for CDP-choline or cytidine diphosphocholine. It is a vital part of cell membranes and is integral to acetylcholine production in the brain.

    It also goes by other names like cytidine-5-diphosphocholine CDP, cytidine diphosphate choline, or even cytidine 5 diphosphocholine CDP choline.

    As opposed to choline alone, citicoline is synthesized from choline and converted into phosphatidylcholine.

    As such, citicoline is a source of choline and provides all the health benefits of choline. It includes processes such as:

    • Maintaining cell structure
    • Cell messaging
    • Fat metabolism
    • DNA synthesis
    • Preserving nervous system health

    Besides, citicoline is also a source of cytidine, which yields additional effects in synthesizing nucleic acids in the body.

    Studies have investigated the benefits of citicoline extensively in both human and animal studies.

    The effects of citicoline can best be seen when dietary supplements take care of the following two compounds:

    Acetylcholine (Ach)

    Acetylcholine is an essential and one of the most abundant neurotransmitters in the body. It is present in both the central nervous system and the peripheral nervous system and facilitates communication between neurons.

    Acetylcholine also helps transform short-term memories into long-term ones. In this manner, acetylcholine levels play a vital role in many mental processes like memory, attention, brain development, and overall cognitive function.

    Phosphatidylcholine (PC)

    Phosphatidylcholine is an essential vital component of human cells and helps maintain cellular structure and cell membrane integrity.

    Both these essential compounds perform multiple functions to improve cognitive help functions along with muscular performance.

    What’s The Difference Between Choline Sources?

    Choline supplements for nootropic purposes come in different forms with the following three being the most prominent:

    • Choline Bitartrate
    • Alpha-GPC
    • Citicoline

    However, the efficacy of any choline supplements depends on their ability to cross the blood-brain barrier successfully. And since not all choline types are created equal, we will investigate which one works best as a nootropic for brain development.

    Choline Bitartrate

    A common component of choline supplements, choline bitartrate, is the most basic, least expensive, and most readily available form of choline. Choline bitartrate combines choline with one tartaric acid salt to increase its bioavailability.

    Interestingly, studies show this choline form to present a better absorption rate as compared to free choline. It also works well for choline benefits associated with the liver.

    That said, its cognition-boosting benefits are somewhat limited. Since choline bitartrate is quite inept in crossing the brain’s blood flow barrier, evidence suggests that it isn’t very good at yielding nootropic effects.

    By weight, choline bitartrate contains 41% choline. Compared to other choline forms, this is relatively high.

    However, its ineffectiveness at crossing the blood flow to the brain barrier does not qualify it for cognitive enhancement or other similar brain health benefits. As such, choline supplements using choline bitartrate should not be the first choice for improving cognitive function.

    Alpha Glycerylphosphorylcholine (Alpha-GPC)

    Alpha-GPC contains 40% choline and is quite close in density to choline bitartrate. However, it also comes with the benefit of superior bioavailability as it is more adept at crossing the brain’s blood flow barrier.

    This choline form is present as a by-product of phosphatidylcholine. Whenever choline’s requirement increases, it breaks down the phosphatidylcholine content from brain cell membranes converting it into Alpha-GPC.

    Function-wise, studies show Alpha-GPC to be associated with improving memory and learning, enhancing overall cognitive function while preventing cognitive decline.

    It has also been studied for boosting thinking skills in patients having Alzheimer’s disease and Parkinson’s disease, improving symptoms of mild to moderate dementia such as mood, behavior, and thinking skills, and even as a treatment for stroke survivors (1).

    When looking for Alpha-GPC food sources, it is present naturally in red meats and organs. However, to fulfill the requirement for its cognition-boosting effects, you would need to eat a lot of red meat.

    So, when comparing Alpha-GPC and choline bitrate, Alpha-GPC stands out as the definitive choline source for enhancing cognitive performance.

    Citicoline (CDP-Choline)

    Citicoline is considered an excellent choline source as it serves a double whammy of cognitive effects. First, it contains 18% choline, and second, it also yields cytidine (2).

    When ingested, the cytidine content of citicoline converts to uridine. Uridine, by itself, is a very handy nootropic with several cognitive benefits to offer.

    At first glance, 18% choline may seem like a small percentage compared to the two other choline forms. But when it gets paired up with cytidine, the effect of citicoline easily dwarfs both choline bitartrate and alpha GPC.

    For nootropic potential, evidence shows citicoline (CDP Choline) supplements to provide promising neuroprotective properties, increase mental energy, raise neurotransmitter levels, and prevent cognitive decline.

    But if Alpha-GPC is the densest choline source with the ability to cross the brain-blood barrier, what is a better source when comparing CDP-Choline and Alpha-GPC?

    Simply put, citicoline tops alpha-GPC as a choline source because it yields a very potent nootropic duo containing both choline and cytidine. By doing so, it adds something extra to what alpha-GPC already offers.

    This makes citicoline one of the best components of premium nootropic supplements.

    Additionally, given its high potency and reliability, citicoline may also work as a standalone supplement.

    How Does CDP-Choline Work In The Brain?

    When CDP-choline is administered, it releases its two components, cytidine, and choline. Of these, the former is required for the biosynthesis of cell membranes while the latter speeds up acetylcholine release.

    Also, citicoline triggers the production of the brains’ several phospholipids.

    A phospholipid, in other words, is a selectively permeable fat molecule that allows only specific substances to enter or leave the cells. As such, phospholipids regulate and insulate the cell’s interior from its neighboring environment. This mechanism helps the stability and efficiency of the brain cells.

    Once in the brain, phospholipids play an essential role in synthesizing neurotransmitters and regulating cell membranes’ proper functioning. Both these are important factors that contribute to healthy brain function.

    With CDP choline supplementation, phospholipid production gets boosted, which results in improved brain cell performance. So, anyone looking to enhance cognitive functioning, mood, and memory can benefit from using citicoline supplementation.

    What Are The Benefits of Citicoline?

    Citicoline, in its supplemental form, gets broken down into smaller components that are easily absorbed. These components then cross the blood-brain barrier, where they form into citicoline once again.

    When this happens, the user can experience the full range of nootropic effects.

    Enhance Cognitive Function

    The brain is a complex network of neurons whose health is crucial to preserving and enhancing cognition. Levels of phosphatidylcholine decline and changes occur in acetylcholine metabolism with age which can be corrected by supplementing with citicoline.

    This nootropic shows promising results for improving different aspects of cognitive health. This includes verbal memory, learning ability, attention, and impulsivity in healthy teens and adults.

    Improve Memory

    Studies show citicoline to support memory function in people suffering from age-related memory issues. Experts recommend it to people in need of supporting the health and performance of aging or damaged brain cells after injury.

    Most of this comes from research done on older adults, with findings showing it to be most effective for preventing memory loss in individuals between the ages of 50 to 85. This includes people suffering from Alzheimer’s disease as well.

    Patients with Alzheimer’s disease have been administered cholinesterase inhibitors to increase nerve cell communication to improve symptoms.

    Improve Circulation In The Brain

    The brain requires a continuous energy supply, much of which cannot be stored. Most of this energy is sourced from glucose in the blood. Study findings show that use of citicoline helps improve glucose metabolism while also enhancing cerebral circulation (3).

    Any issues with blood flow to the brain can cause memory loss, fatigue, vertigo, and even acute stroke. But because citicoline effectively improves circulation in the brain, it is used as a prescription drug for treating mental health conditions like Alzheimer’s disease and Parkinson’s disease by doctors in many European countries.

    Prevents Brain Damage

    Alongside improving specific aspects of brain performance, also CDP choline is an essential neuroprotective. Because it can regulate and restrict movement across cell membranes and prevent harmful substances from entering the cells.

    There is a complex mechanism behind allowing oxygen, water, and nutrients into the cells and keeping toxins out. Sometimes, membranes can become compromised, which allows heavy metals, metabolic waste, and pathogens to find their way in.

    A study shows that use of citicoline prevents this from happening and works as a cell membrane stabilizer that preserves the cells’ health, integrity, and stability.

    It also counters inflammation and free radical damage, which are two fundamental causes of cellular damage.

    Helps With Depression and Drug Addiction

    Research shows CDP choline to be involved in increasing key neurotransmitter levels in the brain. These include acetylcholine, norepinephrine, dopamine, and serotonin. All of them are integral to regulating mood, improving memory, and overall human health.

    Because it acts as a precursor to choline and dopamine, dietary choline intake can help you experience an increase in energy levels, a boost in mood, and some heightened motivation.

    One randomized, double-blind, placebo-controlled study with bipolar disorder participants indicated that citicoline might have an antidepressant potential for such people.

    Also, because citicoline provides the additional boost you may need to improve your mood, any reliance on addictive foods will also decrease. This includes substances like sugar, caffeine, or other such ingredients.

    A study shows severe addictions like cocaine have also been investigated regarding citicoline (4).

    Citicoline has a counter addictive effect and works as a safe and natural compound to increase dopamine levels. It is considered a possible safe therapy for people living with addiction or substance abuse issues.

    Supports Stroke Recovery

    One research area has also looked at citicoline’s effects on cognitive impairment resulting from a head injury, acute stroke, or other causes. It has been used as supportive therapy for people with traumatic brain injury and shows positive effects in post-stroke patients with mild to severe consequences.

    Such cases are most noticeable in areas of improving temporal orientation, attention, and executive functions.

    A meta-analysis investigating choline for acute ischemic stroke supported its effectiveness in treating the condition (5).

    On the other hand, a Cochrane Database Syst Rev assessed that there might be little to no difference in acute ischemic stroke individuals. As such, the evidence regarding stroke recovery is somewhat mixed.

    Protects Heart Health

    A significant concern for heart disease is elevated homocysteine levels.

    Choline and folate help regulate homocysteine levels by converting them to methionine.

    Some other studies show that choline may keep the heart and blood vessels healthy by keeping blood pressure low. In this case, acetylcholine helps regulate heartbeat and may assist heart health (6).

    Treats Vision Problem

    Citicoline also shows potential for slowing visual acuity loss caused by glaucoma. Glaucoma patients have an eye condition that inflicts damage on the optic nerve. As a result, it can cause progressive vision problems and even blindness.

    Another vision-related area where citicoline seems promising is amblyopia or lazy eye. One research team used intramuscular citicoline dosed at 1000 mg per day. The study results showing an improvement in visual acuity with no side effects observed.

    As a treatment to improve vision, clinical studies have administered citicoline between the range of 250-1600 mg per day. The available forms for vision therapy include gels, soft gels, and tablets. Other options include eye drops and intramuscular injections.

    Maintains Liver Health

    Treatment with citicoline shows promise in improving liver health. A choline deficiency and liver disease are linked, increasing NAFLD’s chance, which can then progress to cirrhosis, liver failure, or cancer.

    A study explored the effects of citicoline administration on participants with fatty liver disease.

    The study used an intravenous dose of 2 grams per day, which showed citicoline to reverse the condition completely.

    Prevents Neural Tube Birth Defects

    Pregnant women expecting a child should consume sufficient choline to lower the risk of neural tube congenital disabilities.

    One 2013 study involving pregnant women in their third trimester received daily doses of either 480 or 930 mg of citicoline. Women who took higher doses of choline intake showed reduced preeclampsia markers, including lower blood pressure and fewer headaches.

    Another study with pregnant women showed that choline protects infant brain health development when used as a prenatal supplement.

    What Are Dietary Sources of Choline?

    Choline is available from several foods, including meat, fish, poultry, eggs, and dairy.

    Among these, the best sources of choline include:

    • Beef
    • Liver
    • Chicken breast
    • Shitake mushrooms
    • Milk
    • Yogurt

    People who follow a vegan diet can choose some vegetables as a good source of choline. Thee include:

    • Potatoes
    • Cauliflower
    • Cabbage
    • Brussel sprouts
    • Legumes

    However, to get the full therapeutic effects of citicoline, experts recommend taking a supplement that gets broken down into choline and cytidine for maximal benefits.

    How To Take Citicoline?

    Citicoline can be taken as a single supplement on its own or as an ingredient in nootropic stacks.

    As a supplement, it is consumed orally. But as a medicine, doctors may administer it as an injection or via IV.

    Dosage

    The typical citicoline intake dosage is between 250 and 1,000 mg per day when used as a dietary supplement.

    Healthy adults who want to try oral citicoline can start at the lower end of the recommended dose of 250 mg per day. However, if you already have memory issues, then the recommended dose goes up to 500 mg of citicoline.

    At the same time, citicoline supplementation should be complementary to other dietary and lifestyle treatments.

    Experts recommend taking 250-1,000 mg per day of citicoline divided into two doses a day. There should be a gap of about 8 to 12 hours between the two doses.

    For more severe conditions, dosages as high as 2,000 mg per day of choline intake have been shown beneficial in individuals with addictive disorders.

    Citicoline doses will vary depending on different factors, so you should always start choline supplementation after consulting with your healthcare provider before going to the dosage up to 2,000 mg daily.

    Experts also recommend taking citicoline on a cycle instead of taking it long-term. The most often cited cycling period is two weeks on and two weeks off of choline intake.

    You should stack it up with other nootropics like acetyl-L-carnitine or piracetam to optimize its positive effects for maximum cognitive benefits.

    Does Citicoline Have Side Effects?

    A gradual decline in brain function is not uncommon. And natural nootropics like citicoline are considered safe to use in boosting cognitive functions.

    Clinical trials with citicoline show it to be well-tolerated by most people. Some side effects that have been associated with its uses include:

    • Gastrointestinal trouble
    • Headaches
    • Hypotension
    • Tachycardia
    • Bradycardia
    • Restlessness

    Is Citicoline Safe To Take?

    Citicoline taken in the recommended dosage is tolerated well. But certain groups need to be careful when using any dietary supplements.

    Typically, this includes lactating and pregnant women. Other than this, some people may have some difficulty sleeping, experience headaches or gastric distress like diarrhea or nausea.

    One concern is for anyone using L-dopa. Citicoline should not be used alongside L-dopa as it can interact with it.

    Conclusion

    Given citicoline’s tolerance levels, evidence suggests it to be safe for most healthy adults to consume, considering that they stay within the recommended dosage. This nootropic has the scientific research to back it up as effective for enhancing cognitive performance.

    Citicoline benefits are well-documented and include improving cognitive function in the aging brain cells. Its safety and efficacy is also well-tolerated, so we recommend using this supplement if you want to see results in boosting brain performance.

    FAQs

    Can you take choline every day?

    You can take choline every day, staying within the daily recommended limit. Webmd states the daily adequate choline intake for adult men to be at 550 mg and for women at 425 mg.

    Pregnant women can take 450 mg of choline and lactating mothers 550 mg.

    Too much dietary choline may otherwise present unpleasant symptoms like fishy body odor, gastric trouble, or even a drop in blood pressure.

    Does choline give you energy?

    Choline is an essential part in fat metabolism, breaking it down as an energy source for the body.

    However, fat stores are not easy to access, so they can’t be relied on for a quick burst or release of energy. Instead, fat stores are used when carbohydrate supplies are limited.

    Citicoline also improves energy levels by powering brain cell mitochondria. Studies show mitochondrial energy production to increase in the frontal cortex. This is the brain region associated with thinking, language, planning, and decision making.

    Which form of choline is best?

    Alpha GPC and CDP choline both qualify as effective nootropics because of their brain-boosting benefits that serve very similar purposes. Yet, both are different in their ways.

    Alpha GPC contains more choline than citicoline, so it makes for a better choice for choline supplementation. Alpha GPC also has a shorter half-life as opposed to CDP choline.

    Whereas alpha GPC lasts 4-6 hours in the body, CDP choline does so for 60-70 hours. It allows choline to collect in the system.

    CDP choline breaks down into uridine, which may have less choline by weight, still functions as a 2-in-1 supplement. Paired together, both choline and uridine deliver a double dose of brain support and overall health benefits.

    CDP choline also boasts a cytidine content that is missing from other choline forms.

    In the end, it may all come down to personal preference which choline supplement you opt for. The one consideration is to never use the two together since too much acetylcholine can cause brain fog.

    What is Cognizin Citicoline?

    Cognizin is a clinically tested and patented type of citicoline that provides the brain all that it needs for optimal functioning. Cognizin is a vegetarian and allergen-free option used extensively in brain supplements.

    Unlike other sources of choline, Cognizin has been clinically tested in humans.

    What are the symptoms of choline deficiency?

    A choline deficiency can present concerning symptoms like feeling anxious or restless. Choline deficient individuals may also experience muscle or liver damage.

    A condition called non-alcoholic fatty liver disease can also result where fat starts to deposit in the liver.