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Anxiety In the Hordaland Health Study (5,900 adults), people with the lowest plasma choline had 33% higher odds of significant anxiety symptoms compared to those with higher levels, even after adjusting for diet and lifestyle.52 Researchers suggest this may be because acetylcholine helps regulate the parasympathetic calming response, so low choline could impair stress resilience.53 Bipolar disorder A small trial found that patients with mania receiving high-dose phosphatidylcholine (approximately 2,000-3,000mg/day) alongside standard treatment showed faster symptom improvement than those on standard treatment alone.54 The authors suggested that increased choline availability may modulate overactive brain signaling, potentially aiding recovery, though evidence is limited by the small sample size and lack of recent replication.55 Depression Some population studies have found that people with higher choline intake are less likely to report depressive symptoms, suggesting diet quality and choline status may play a role in mood regulation

doi: 10.1177/0004563214557678 Summary Keywords carnitine, breast cancer, women, metabolites, risk assessment Citation Zhang J, Wu G, Zhu H, Yang F, Yang S, Vuong AM, Li J, Zhu D, Sun Y and Tao W (2022) Circulating Carnitine Levels and Breast Cancer: A Matched Retrospective Case-Control Study

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