People with anxiety disorders have lower levels of choline, an essential nutrient, in their brains, according to new research from the UC Davis School of Medicine.
The study found that individuals with anxiety had, on average, 8% lower levels of choline compared with those without anxiety. Choline plays a critical role in brain function, including mood regulation, memory, muscle control, and the maintenance of cell membranes. While the body produces small amounts of choline naturally, most must be obtained through diet.
“We observed a consistent reduction of soluble choline compounds in the cerebral cortex of people with anxiety disorders,” said Richard Maddock, senior author of the study and a psychiatrist at UC Davis, in an interview with Thervive.
Maddock explained that his interest in choline began after previous studies showed low levels of soluble choline in patients with panic disorder and hyperthyroidism—conditions linked by heightened metabolic arousal. He aimed to determine whether this pattern extended to the major anxiety disorders: panic disorder, generalized anxiety disorder, and social anxiety disorder. His findings confirmed that reduced choline levels appear across all three conditions, offering new insight into the biological basis of anxiety.
Published in the journal Molecular Psychiatry, the research analyzed data from 25 prior studies, including 370 participants with anxiety disorders and 342 without. The results highlighted reduced choline levels, particularly in the prefrontal cortex, the region of the brain responsible for thinking, behavior, and emotion.
The study suggests that nutrition could play a role in managing anxiety. Maddock noted that choline intake, through diet or supplementation, may influence brain chemistry and improve outcomes for patients with anxiety disorders.
“Among the metabolites measurable in the brain, choline is unique because it is an essential nutrient obtained from dietary intake,” he said. “This study encourages nutrition scientists and psychiatrists to explore whether increasing choline intake could benefit people with anxiety.”
In the U.S., most people—including children—do not consume enough choline. Foods rich in choline include eggs (especially yolks), soybeans, milk, fish, chicken, beef, and liver.
Maddock advises those with anxiety to ensure their diet contains adequate choline, though he cautions that the benefits of supplementation are not yet scientifically confirmed.
“It is not yet known if increasing dietary choline will help with anxiety disorders,” Maddock said. “However, consuming the recommended intake is safe and advisable for overall health. Future studies will clarify whether specific choline supplements can effectively raise brain levels and benefit those with anxiety.”
Maddock plans to conduct a randomized controlled trial to test the effects of choline supplementation in people with anxiety. Early evidence suggests that forms of choline bound to omega-3 fatty acids, such as those in fish oil, may be most effective at raising brain levels. Understanding which foods or supplements optimize choline uptake could mark a significant step forward in anxiety treatment.
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