The 7 Best Choline Supplements for Pregnancy of 2024

Choline is an essential nutrient that is particularly important during pregnancy. While folate gets most of the attention as a pregnancy nutrition concern, choline plays a critical role in the brain and spinal cord development of the growing baby. The benefits of choline extend beyond brain health—some research suggests it may help support a healthy placenta and may help lower the risk for preeclampsia.

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Bodies produce some choline, but pregnant people need more than the body makes—which is why pregnant people must get more, with food, supplements, or both. Choline is predominantly found in animal foods, including eggs, beef, fish, and chicken, and there are small amounts in some plant-based and dairy foods. However, data shows that only five to ten percent of pregnant people consume the Adequate Intake (AI) amount of dietary choline. On top of this, many prenatal vitamins have little to no choline. Adding a choline supplement may be beneficial to meet your increased needs during pregnancy, particularly if you don't eat a lot of choline-rich foods. 

To select our top choline supplements for pregnancy, we analyzed the research and reviewed several brands, prioritizing products that are third-party tested and contain research-backed forms of choline in appropriate dosages with quality ingredients. 

Always speak with a healthcare professional before adding a supplement to your routine to ensure that the supplement is appropriate for your individual needs and to find out what dosage to take.

Our Favorites

Best Overall: Ritual Natal Choline

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Why We Recommend It

Ritual’s Natal Choline is our top choline pick, with transparent sourcing, third-party testing, and optimal dosage and form. It contains 550 milligrams of choline chloride, a highly absorbable and well-studied form of choline. Recent studies show that this form of choline taken during pregnancy improves the brain development of the baby and improves cognition later in life.

We like that this product is third-party tested for purity and potency, including testing for heavy metals and microbes. Ritual also practices transparent sourcing, providing detailed information on each active ingredient, including form and where it was sourced. It’s also non-GMO, is project verified and clean label certified, is vegan and gluten-free, and has no artificial colorings or flavorings. Ritual recommends taking this with their prenatal supplement, which provides an additional 55 milligrams of choline, as well as other key nutrients to support a healthy pregnancy. 

But Take Note

One serving is two capsules, so it will add more bulk to your daily supplement routine. It is also a relatively higher dosage, meeting over 100% Daily Value (DV) of choline during pregnancy. If your prenatal is high in choline and you consume a diet rich in choline, you may not need this high of a dose. 

Product Details

• Form: Capsule
• Type: Choline chloride
• Dose: 550 mg
• Recommended Use: Take two capsules daily, with or without food.

Best Budget: GNC Choline

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Why We Recommend It

For a budget-friendly option, try GNC Choline, which contains 250 milligrams of choline bitartrate, a concentrated form that’s commonly used in choline supplements. We like that it is third-party tested for purity and potency, including heavy metal testing.

This dose provides about 45% DV of choline during pregnancy, so it’s a good option to boost your intake if you already consume some choline-rich foods or if your prenatal contains some choline. 

This supplement is certified gluten-free and does not contain any artificial colors, flavors, or preservatives. These capsules are vegetarian-friendly.

But Take Note

These capsules do contain a longer list of additives compared to other options on our list. While they are generally recognized as safe to consume, some may choose to avoid these extras.

Product Details

• Form: Capsule
• Type: Choline Bitartrate
• Dose: 250 mg
• Recommended Use: Take one or two capsules daily.

Best Liquid: Perque Choline Citrate

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Why We Recommend It

Perque Choline Citrate is a great choice for pregnant people who don’t want to swallow more pills, and who are looking for a relatively higher dosage. We like that it contains just choline citrate and vegetable glycerin (a liquid made from plant oils), and it is third-party tested for purity and potency.

One teaspoon provides 650 mg of choline in the form of choline citrate. This is a higher-dose choline supplement, as one teaspoon is equal to 118% DV choline. This may be a good choice for those with low choline intake in their diet, such as vegans and vegetarians. If you want a lower dose, the liquid form makes it easy to adjust how much you take.

This supplement is non-GMO and free of common allergens. Mix one teaspoon with water or other liquids like juice. 

But Take Note

Even when diluted in liquid, this product can have a sour and tart taste, which is something to consider if you’re having aversions to strong smells or tastes in your pregnancy. Similar to our top pick, this is a relatively higher dosage, so if your prenatal has choline and you consume a diet rich in choline, it may be more than you need. 

Product Details

• Form: Liquid
• Type: Choline citrate
• Dose: 650 mg
• Recommended Use: One teaspoon daily, diluted in water or juice

Best Subscription: Needed. Prenatal Choline 

Needed

Why We Recommend It

Needed Prenatal Choline provides 250 milligrams, or 45% of the Daily Value, of choline per capsule (in the form of Bitartrate VitaCholine). We like that this product is third-party tested for ingredient accuracy, heavy metals, microbes, pesticides and herbicides, allergens, and other potential contaminants. 

The capsules are vegetable-based, making them suitable for vegans and vegetarians. We also like that Needed offers monthly subscription options, which also bring down the cost of the supplements. Needed is a supplement company backed by Registered Dietitians focused on women’s reproductive health. They offer supplements designed for fertility, pregnancy, and postpartum, so you can get all the supplements you might need, including a prenatal multi and added choline, from one place. 

But Take Note

This supplement contains a lower dose per capsule, but you have the option to add up to four capsules (spread out throughout the day) to meet your needs.

Product Details

• Form: Capsule
• Type: Choline L(+) Bitartrate VitaCholine
• Dose: 250 mg
• Recommended Use: Take one capsule up to four times daily with food.

Best Low Dose: NOW Lecithin

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Why We Recommend It

If you’re looking to supplement in a lower dose with the naturally occurring form of choline found in food, we recommend NOW Lecithin. The three-capsule serving contains 3,600 milligrams of soy lecithin with 500 milligrams of phosphatidylcholine. Keep in mind this form is well absorbed, but only about 15% of this is actual choline—meaning you only get about 75 milligrams of choline per serving. This is a good option if you need a small boost in choline to meet the recommended intake of 450 milligrams during pregnancy and you would prefer a natural form found in food. Another benefit of taking lecithin is it also contains essential fatty acids and inositol.  

We also recommend this pick because NOW is a trusted brand with quality supplements produced in a Certified GMP facility. This supplement is third-party tested for purity and potency and is also non-GMO. 

But Take Note

These capsules are made from bovine gelatin, so they are not suitable for vegans and vegetarians, and they also contain soy. Note that it is a relatively bulky serving size of three capsules for a small amount of actual choline.

Product Details

• Form: Capsule
• Type: Lecithin (Phosphatidylcholine)
• Dose: 500 milligrams phosphatidylcholine (~75 milligrams choline)
• Recommended Use: 

Best Choline + DHA: MegaFood baby & Me 2 DHA & Choline

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Why We Recommend It

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Getting the recommended amount of omega-3 during pregnancy can be challenging, especially if you don't eat fish or have an aversion to it. Choline and omega-3 DHA are both critical nutrients for the neural development of the baby during pregnancy and are often left out of prenatal vitamins. If you want a supplement with both of these brain nutrients, we like MegaFood Baby & Me 2 Prenatal DHA and Choline. MegaFood products undergo rigorous testing for potency and purity, including testing for over 125 pesticides. They also work with third-party testing companies, and many of their products, including their prenatal, are also third-party tested and approved by ConsumerLab.com. 

The two-capsule serving provides 200 milligrams of choline (36% DV) and 250 milligrams of DHA. The DHA in this supplement is sourced from algae, and the capsule does not contain gelatin, making it a vegan and vegetarian-friendly option. This is a great add-on option to your prenatal if it does not include (or has low amounts of) these nutrients. 

But Take Note

Each serving contains less than half the amount of choline recommended during pregnancy, so this is a good option if you get some choline in your diet and/or through your prenatal multivitamin. 

Product Details

• Form: Capsule
• Type: Choline Bitartrate
• Dose: 200 mg
• Recommended Use: Take 2 liquid capsules any time with food and beverage.

Best Prental with Choline: Beli Women Prenatal

Beli  

Why We Recommend It

Many prenatal multivitamins have low levels of choline or none at all. However, Beli Women Prental has 400 milligrams of choline per serving (in the form of Choline Bitartrate), which is 73% of the recommended intake during pregnancy. This can be a great choice if you don't want to take an additional choline supplement and a prenatal. We like that this supplement is third-party tested for purity and potency, given a Clean Label Project Purity Award, and produced in a certified GMP facility. 

In addition to choline, this supplement provides 20 key nutrients to support a healthy pregnancy. We like that they use the methylated forms of B vitamins, including the methylated form of folate, for optimal absorption. It also includes 18 milligrams of iron, which some prenatal multis leave out. Additionally, it is gluten and allergen-free, non-GMO, and vegan and vegetarian-friendly.

But Take Note

This supplement is a three-capsule serving size, which may be a lot to take every day if you have trouble swallowing pills. It also does not include omega-3 DHA, another important nutrient for brain development, so depending on your diet, an additional omega-3 supplement may be recommended.  

Product Details

• Form: Capsule
• Type: Choline Bitartrate
• Dose: 400 mg of choline 
• Recommended Use: Take 3 capsules daily.

Forms of Choline

There are different forms of choline supplements that can vary in the amount of actual choline your body can absorb and utilize. Choline can be listed as a compound amount or the actual amount of choline. We list the actual choline amount in each of the supplements on our list. Here are the most common forms of choline you will find in supplements:

• Choline Bitartrate is one of the most common forms, and it has a high concentration of choline—about 40%—making it an effective choice for increasing choline levels. It is also typically the least expensive form. Some studies show very high intakes can cause a rise in trimethylamine N-oxide (TMAO), a byproduct of choline metabolism, which may be associated with an increase in inflammatory responses and cardiovascular disease risk. However, this connection is not conclusive, and the amount found in the supplements we recommend is unlikely to cause any health risks. 
• Choline Chloride is a concentrated form of choline that is very effective at raising choline levels in the body. Studies have shown that supplementing choline chloride during pregnancy can benefit the neural development and outcome of the baby.

• Choline Citrate is not as commonly found in supplements due to its sour and tart taste, but with about a 40% concentration of choline, it is effective in increasing choline levels in the body.
• Phosphatidylcholine is the form of choline found in lecithin, which is the form predominantly found in foods. While it is well absorbed, it only contains about 14% choline, so you may need to take more of this supplement form to meet your needs.
• Lecithin is a mixture of fats found in foods that contain phosphatidylcholine. Lecithin supplements are usually derived from soybean, sunflower, and rapeseed and can be found as food-based supplements or pills or capsules. The concentration of choline in lecithin supplements is low, at around 3%, so you may need to take more of this supplement form to meet your needs.
• CDP-choline and Alpha-GPC (Choline alfoscerate) are other forms of choline that you may find in supplements. These two forms can easily cross the blood-brain barrier and are often used in the context of brain health, as some studies show they may enhance memory and cognitive function. However, these forms are not generally found in prenatal supplements. 

Benefits of a Choline Supplement During Pregnancy

Getting adequate choline through either food or supplementation is important to support a healthy pregnancy. Choline supports the health of both mom and baby, as it has a role in fetal brain development and can help prevent certain birth complications.

Even if you take a prenatal, keep in mind the amount of choline in most prenatal multivitamins is often very low or not included at all. An additional choline supplement on top of taking a prenatal can be helpful, especially if eating choline-rich foods is challenging. Lauren Manaker, MS, RD, LD suggests there is little to no risk in taking a choline supplement during pregnancy, but it’s always recommended to talk to a healthcare professional before taking it.

Choline during pregnancy can have the following potential benefits:

• Baby brain development. Choline is an important component for the neurodevelopment of the baby.
  There is evidence that higher maternal intake of choline—at levels as high as 930 mg—is linked to faster processing speed and reaction time in infants 4 to 13 months of age and even up through age seven.

• Prevention of neural tube defects. Folate gets most of the press when it comes to preventing neural tube defects (NTDs) for babies, and while folic acid supplementation does help reduce the risk of NTDs, they can still occur. Studies are mixed, but some show a strong link between higher choline intakes and fewer NTDs; other studies are less conclusive.

• Supporting a healthy placenta. While the research has mostly been conducted in animals, there appears to be a link between choline supplementation and enhanced nutrient transport through the placenta, specifically improved transport of DHA, a fatty acid crucial for a baby’s brain and nervous system development.

• Lower risk for preeclampsia. One small study found that 930 mg of choline per day for 12 weeks improved placental vascular function and reduced preeclampsia risk.

Our Supplement Review Process

In reviewing and researching prenatal vitamins, we consult with experts and our own in-house Registered Dietitians. We support supplements that are evidence-based and rooted in science, and we value certain product attributes that we find to be associated with the highest-quality products. In order to find the best choline supplements for pregnancy, we closely consider several factors, including quality of ingredients, third-party testing certifications, and comparing different forms and dosages. For prenatal supplements especially, we prioritize products that are third-party tested for purity and potency, as the FDA does not review dietary supplements for safety and effectiveness before they go to market.

While we hope this serves as a guide, we recommend consulting with your healthcare provider before taking any supplements. 

Our Experts

• Lauren Manaker, MS, RD, LD, is a Registered Dietitian and Certified Lactation Educator, and author of Fueling Male Fertility. She was named an Emerging Leader in Women's Health by the National Academy of Nutrition and Dietetics.
• Holly Klamer, MS, RD is a registered dietitian and the Parents nutrition commerce editor who double-checks the product picks and research for choline supplements.
  

Choline Supplement Dosage & Safety

Dosage

The Adequate Intake (AI) for pregnancy is 450 milligrams per day and 550 milligrams during lactation. Recent studies have shown that even higher intakes (from either food or supplements) of 950 milligrams per day may be beneficial.

The Tolerable Upper Intake Level (UL), meaning the maximum amount that can be safely taken on a daily basis for choline, is 3500 milligrams for adults, including during pregnancy and lactation. If choline doses exceed the UL of 3500 milligrams, you might start to notice a fish body odor, excessive sweating and salivation, vomiting and gastrointestinal upset, or hypotension (low blood pressure). More serious side effects of excessive choline supplementation are liver toxicity and the concern over-production of TMAO, depending on the type of choline supplement taken. 

Ingredients and Potential Interactions 

It is essential to read the ingredient list and nutrition facts panel of a supplement carefully to know which ingredients are included (and how much of each), relative to the recommended daily value of that ingredient. Please take the supplement label to a healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking.

Choline is not known to have any interactions with medications, but always speak with a healthcare provider to ensure supplementation is safe for you.

TMAO, Choline, and Cardiovascular Disease Risk 

Trimethylamine N-oxide (TMAO) is a byproduct of choline metabolism that is produced by gut bacteria and the liver during digestion. Some studies have shown a link between elevated TMAO and increased inflammation and cardiovascular disease risk; however, more research is needed.

Choline bitartrate appears to have the most effect on rising TMAO levels compared to other supplemental forms and compared to naturally derived choline in food (called phosphatidylcholine). Studies that showed rises in TMAO from choline bitartrate where at levels of 1000 milligrams per day or more. Therefore, high doses of choline bitartrate should be consumed with caution until more research is done.

Your Questions Answered

When should I start taking prenatal choline?

Getting the recommended intake of 450 milligrams per day is important throughout the entire pregnancy. If your prenatal does not contain choline, and your diet is low in choline, it may be beneficial to start a choline supplement alongside a prenatal multi when trying to conceive. 

Which trimester is choline most important?

The formation of the spine and brain (neural tube) of the baby happens primarily during the first trimester, so given choline is critical for this process, adequate choline intake during the first trimester is likely most important. However, studies show that high intakes of choline in the third trimester can have beneficial outcomes on the baby’s brain and cognitive development. Bottom line—it’s probably best to consume at least 450 milligrams of choline per day throughout your pregnancy. 

Why do many prenatal vitamins not have choline?

Folate (or folic acid) traditionally got most of the attention for its role in preventing neural tube defects in the growing baby, which is why the CDC recommends all women of reproductive age consume 400 mcg of folic acid daily, and most prenatal multivitamins contain this amount. The importance of choline in supporting a healthy pregnancy and fetal neural development has only recently been emphasized. If you want a prenatal with a higher amount of choline, we recommend Beli Women Prenatal.

Who We Are

Casey Seiden is a registered dietitian nutritionist and certified diabetes care and education specialist based in New York City. Casey works at Maternal Fetal Medicine Associates, the premier maternal-fetal medicine practice in Manhattan, where she provides nutrition therapy and counseling to women with high-risk pregnancies. She is also the founder of Casey Seiden Nutrition, a virtual private practice specializing in a non-diet approach to diabetes care and women’s health.

Anne Cook Carroll, MS, RD, CDN is a Registered Dietitian who works with patients, including pre- and postnatal women, to meet their health goals. She educates patients on the appropriate usage of supplements to optimize their nutritional status and overall health and specializes in supplement research and analysis.

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