In recent times, there has been increasing interest in smart drugs called nootropics that are believed to boost mental performance and cognitive function. Acetylcholine is one of those supplements. Please continue reading to learn more about the potential benefits and risks of taking acetylcholine supplements.

What is acetylcholine?

Acetylcholine is a key neurotransmitter (a naturally occurring chemical messenger in the central nervous system). Along with other important neurotransmitters like serotonin and dopamine, it relays messages at the neuromuscular junctions and between nerve cells. Acetylcholine plays a vital role in cognitive functioning, including learning, thinking, and memory as well as muscle contractions. The body makes acetylcholine by combining acetic acid and choline (acetyl coenzyme A) with the help of an enzyme called choline acetyltransferase. 

There are no acetylcholine supplements available for direct consumption. However, there are dietary supplements (natural or synthetic substances) that can indirectly raise acetylcholine levels in the brain. People take these supplements, which are called nootropics, in an attempt to enhance brain function and cognitive performance. 

Some supplements increase choline levels in the brain (choline is the raw material needed for acetylcholine production in the body). Other supplements, such as ginkgo biloba, huperzine A, and bacopa monnieri boost acetylcholine levels by blocking the breakdown of acetylcholine. In general, choline supplements are believed to be more effective than supplements that interrupt the breakdown of acetylcholine.

What is acetylcholine good for?

Acetylcholine plays a role in many important brain functions such as thinking, verbal memory, working memory, and learning, as well as muscle movements. 

Low levels of acetylcholine have been linked to memory and learning impairments and brain disorders associated with cognitive decline, such as Alzheimer’s disease and dementia. Substances like nerve gases and pesticides are believed to interrupt acetylcholine function. 

Some of the potential health benefits of acetylcholine are described below.

Cognitive Functions

Acetylcholine has a role in cognitive performance. A medicine used in Alzheimer’s disease patients, donepezil, works by increasing acetylcholine levels in the brain. Research has shown that a higher intake of choline may enhance cognition. Studies in mice have found that choline supplementation can significantly reduce Alzheimer’s plaques. However, this research is fairly new and the effect of choline supplementation on cognitive processes needs to be studied further.

Improved Memory and Learning

Acetylcholine is believed to play a critical role in learning and memory. Scientific evidence suggests that choline supplementation can boost memory in people with memory issues. Indeed, in people with memory impairments due to dementia and Alzheimer’s disease, symptoms may be linked to reduced acetylcholine levels in the hippocampus, a part of the brain involved in memory.

Attention, Alertness, and Focus

While the role of the cholinergic system in learning and short-term memory has been studied extensively, more recently, studies have shown that acetylcholine activity may play a role in attention, alertness, and focus. Research in animals has found that acetylcholine levels are significantly higher in the brain when an animal is in an environment requiring sustained attention. Increasing the difficulty of tasks leads to a further increase in acetylcholine levels. In humans, small studies have found that CDP-choline supplementation can enhance attention. 

Mental Health

Choline is a precursor for ACH synthesis and can help to boost acetylcholine function. Research suggests that low blood levels of choline are linked to a higher risk of anxiety. It would appear that supplements that contain choline may help to reduce behavioral symptoms and mental health conditions like anxiety. Choline supplements taken along with antidepressant medications were found to be more effective than antidepressants alone. 

Sleep-Wake Cycle

Besides brain health, acetylcholine also regulates the body’s natural sleep-wake cycle and has wakefulness-promoting effects. Some studies have demonstrated that nerve cells with nicotinic acetylcholine receptors are more active during wakefulness and REM sleep and less active during slow wave sleep. 

Inflammation

Acetylcholine is believed to play a role in protecting the body against tissue damage from inflammation in major organs like the liver, kidneys, and lungs. It is postulated that cholinergic activity acts as a braking system for the inflammatory response mediated through pro-inflammatory molecules like cytokines. 

Protection Against Infections

There is some evidence from animal studies that acetylcholine interacts with the immune system and plays a role in its response to infections.

Gut Movement

Acetylcholine is believed to facilitate peristalsis (muscle contractions of the gastrointestinal tract that aid the movement of food). This acetylcholine function is mediated through the parasympathetic nervous system (a part of the autonomic nervous system) which controls functions like digestion. 

Pain Reduction

Besides the central nervous system and brain function, studies suggest that acetylcholine may also be involved in mediating pain perception through the peripheral nervous system. Donepezil, a medication used to treat Alzheimer’s disease, has pain-relieving effects and is used for migraine prophylaxis (prevention).

Improved Blood Flow

Research shows that acetylcholine may be involved in regulating blood circulation by increasing the production of nitric oxide, a compound that causes vasodilation (widening of blood vessels) and increased blood flow. 

Hormone Balance

Studies suggest that acetylcholine plays a role in hormone production throughout the body. The exact mechanism is not well understood but it is believed to influence the secretion of hormones like prolactin and growth hormone from the pituitary gland in the brain.

Healthy Pregnancy

The vast majority of pregnant women consume less than the recommended amount of choline every day. There is some evidence that taking an essential nutrient like choline during pregnancy can support healthy growth and brain development and reduce the risk of neural tube defects in the baby. Choline may also reduce the effects of alcohol consumption by a pregnant woman on her baby’s brain function.

Other Health Conditions

There is some evidence that low levels of acetylcholine or a choline deficiency increase the risk of liver disease. Sufficient choline intake has been linked to a lower risk of heart disease. Choline bitartrate has been studied in patients with myasthenia gravis, a neuromuscular disease associated with muscle weakness in the skeletal muscles, for its role in muscle movements. 

Should I take choline dietary supplements?

In general, choline supplements like citicoline and alpha-GPC are safe and rarely cause severe side effects. However, as with all dietary and herbal supplements, it is important to consult a healthcare provider before taking choline supplements or any supplements that can increase acetylcholine levels. Your doctor can also guide you on the best choline supplements for you.

You should not take more than 3,500 mg of choline in a day. Consuming too much choline can cause side effects such as sweating, increased body secretions, a fishy body odor, low blood pressure, nausea, vomiting, diarrhea, stomach ache, headache, and liver damage. Keep in mind that most people can get adequate choline from a healthy diet (eggs, beef liver, organ meats, mushrooms, and soybeans are good sources). 
 

References:

https://www.ncbi.nlm.nih.gov/books/NBK11143/

https://nba.uth.tmc.edu/neuroscience/m/s1/chapter11.html

https://www.sciencedirect.com/topics/neuroscience/acetylcholine