Citicoline
Citicoline, also known as CDP-choline, is an intermediate in the generation of phosphatidylcholine from the essential vitamin choline, a major component of brain cell membranes. It is a preferred form for supplementation, as it is less prone to degradation in the intestinal tract than phosphatidylcholine and other choline derivatives, which means better bioavailability to brain tissue and lower likelihood of conversion to harmful trimethylamine oxide (TMAO)1.
Citicoline has been known for many years as a nootropic and neuroprotective drug and recently pronounced food supplement2. Intake of citicoline has been shown to enhance memory in both animal models3 and humans4.
In animal models of MS, citicoline at a dose of 500 mg/kg was observed to reverse motor coordination problems5, and at a dose as low as 50 mg/kg to enhance myelin regeneration5,6.
Though citicoline is a form of choline – which is highly recommended during pregnancy and nursing – its own use in supplement form has been discouraged during these periods due to a lack of studies reflecting safety7. In animal studies, maternal citicoline intake has been associated with improved fetal response to episodes of oxygen deprivation in the womb8,9, but no such clinical evidence exists yet.
Food sources of pre-formed citicoline are scarce, so intake of choline sources is recommended to enable the body to generate the desired compound. Choline can be obtained from both animal and plant sources, including eggs, chicken, organ meats, tofu, soynuts, soymilk, cruciferous vegetables, shiitake mushrooms, cooked dried beans, quinoa, peanuts, and peanut butter10.
References
1.Synoradzki K, Grieb P. Citicoline: A Superior Form of Choline? Nutrients. Jul 12 2019;11(7)doi:10.3390/nu11071569
2.Grieb P, Swiatkiewicz M, Kaminska A, Junemann A, Rejdak R, Rejdak K. Citicoline: A Candidate for Adjunct Treatment of Multiple Sclerosis. Pharmaceuticals (Basel). Apr 2 2021;14(4)doi:10.3390/ph14040326
3.Teather LA, Wurtman RJ. Dietary CDP-choline supplementation prevents memory impairment caused by impoverished environmental conditions in rats. Learn Mem. Jan-Feb 2005;12(1):39-43. doi:10.1101/lm.83905
4.Cotroneo AM, Castagna A, Putignano S, et al. Effectiveness and safety of citicoline in mild vascular cognitive impairment: the IDEALE study. Clin Interv Aging. 2013;8:131-7. doi:10.2147/CIA.S38420
5.Skripuletz T, Manzel A, Gropengiesser K, et al. Pivotal role of choline metabolites in remyelination. Brain. Feb 2015;138(Pt 2):398-413. doi:10.1093/brain/awu358
6.Gudi V, Schafer N, Gingele S, Stangel M, Skripuletz T. Regenerative Effects of CDP-Choline: A Dose-Dependent Study in the Toxic Cuprizone Model of De- and Remyelination. Pharmaceuticals (Basel). Nov 12 2021;14(11)doi:10.3390/ph14111156
7.Citicoline. WebMD, LLC. Accessed September 25, 2024, https://www.webmd.com/vitamins-and-supplements/citicoline
8.Isac S, Panaitescu AM, Iesanu MI, et al. Maternal Citicoline-Supplemented Diet Improves the Response of the Immature Hippocampus to Perinatal Asphyxia in Rats. Neonatology. 2020;117(6):729-735. doi:10.1159/000512145
9.Koc C, Cakir A, Salman B, et al. Preventive effects of antenatal CDP-choline in a rat model of neonatal hyperoxia-induced lung injury. Can J Physiol Pharmacol. Feb 1 2023;101(2):65-73. doi:10.1139/cjpp-2022-0321
10.Choline. Office of Dietary Supplements Health Information https://ods.od.nih.gov/factsheets/Choline-Consumer/