How Acetylcholine Deficiency Impacts Memory

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Last updated August 30, 2023.
Edited and medically reviewed by Patrick Alban, DC. Written by Deane Alban.

An acetylcholine deficiency can have a negative effect on learning and memory. Learn the specific ways to increase your acetylcholine level.

You misplaced your car keys. Again.

Those “tip of the tongue” moments happen more often.

You can no longer do the simplest math problem in your head.

If these things are happening to you, you may think that your bad memory is due to stress or your age.

Or that being a scatterbrain is just the way you are.

But it’s possible that you have an acetylcholine deficiency.

Acetylcholine is a brain chemical that plays a significant role in the ability to learn and remember.

An adequate acetylcholine level is critical for good memory and mental sharpness, both now and later in life.

Acetylcholine Deficiency Symptoms

Acetylcholine is one of the most abundant neurotransmitters in the nervous system.

It’s needed to turn short-term memories into long-term ones.

If you experience symptoms like these, you may be deficient in acetylcholine:

  • You frequently struggle to find the right word.
  • You lose your train of thought during conversations.
  • You can’t follow plots in movies and books.
  • You can’t recall something you just read.
  • You often misplace everyday items like keys, phone, and glasses.
  • You find yourself driving under the speed limit.
  • Your overall reaction time is slow.
  • You know or suspect that you’ve got ADHD.
  • Your sense of direction is poor and you frequently get lost.
  • You have poor muscle tone and find it hard to exercise.
  • You crave fatty foods.

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Many of the symptoms of acetylcholine deficiency are typical of what we refer to as “senior moments.”

And, in fact, they are very similar to those of the early stages of Alzheimer’s.

And that is no coincidence.

Chronic acetylcholine deficiencies are associated with numerous serious neurological disorders, including: 

The acetylcholine levels of Alzheimer’s patients are often far below normal. 

Alzheimer’s drugs work on this premise and aim to keep levels of acetylcholine up by blocking its breakdown.

How to Increase Acetylcholine With Food

One of the signs of a low acetylcholine level is a craving for fatty foods.

You may consider this a problem, especially if you are trying to lose weight, but, in fact, it’s a good thing.

It’s your brain’s way of telling you what it needs.

Low-fat diets have been a massive failure

Not only have they not made us thinner, but they’ve also been a disaster for our brains.

One of the many ways low-fat diets wreak havoc on overall brain and mental health is by contributing to acetylcholine deficiency.

Here are the best ways to increase acetylcholine levels with food.

1. Eat Foods That Contain Choline

The precursor to acetylcholine is choline, a vitamin B complex-related nutrient found mainly in fatty animal foods.

Choline crosses the blood-brain barrier into the brain where it gets converted into acetylcholine.

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The best source of choline by far is egg yolks. 

Your brain will thank you if you skip the egg white omelet and eat whole eggs instead.

Other excellent sources are beef liver, shrimp, and scallops.

Virtually all animal foods not artificially turned into low-fat versions are good sources of choline — full-fat dairy products, fish, meat, and poultry.

Consequently, getting adequate choline is a challenge for anyone following a low-fat or vegan diet.

" The brain will literally eat itself if it doesn’t get the healthy fat it needs to make acetylcholine.

There are some plant foods that are reasonable sources of choline: almonds, avocados, blueberries, brewer’s yeast, brown rice, cruciferous and green leafy vegetables, fava beans, peanut butter, tofu, and wheat germ.

But these foods are not as densely packed with choline as animal foods.

For example, one egg contains 150 mg of choline, about the same amount as 1½ cups of soybeans, the top vegetable source. 

The daily Adequate Intake (AI) of choline is 425 mg for women and 550 mg for men. 

2. Eat Plenty of Healthy Fat

Datis Kharrazian, PhD, DHSc, is an award-winning Harvard research fellow.

In his book, Why Isn’t My Brain Working?, Kharrazian writes:

“If the brain needs acetylcholine and is not getting it from adequate dietary fat, then it will break down brain tissue … from which acetylcholine can be synthesized.”

In layman’s terms, your brain will literally eat itself if you don’t provide it with the healthy fat it needs to make acetylcholine.

Healthy dietary fat is that important.

The two best brain-healthy fats are olive oil and coconut oilnot seed-based vegetable oils like canola, safflower, and sunflower.

Eating fat will help you be mentally sharper and happier, but don’t worry that it will make you fat.

Healthy dietary fat helps to keep hunger away and there’s evidence that it helps burn more calories.

3. Increase Acetylcholine With Tea

Tea is the most widely consumed beverage in the world.

Black tea, green tea, white tea, and oolong tea all come from the same plant (Camellia sinensis) and are good sources of brain-protecting antioxidants.

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And now there’s another good reason to drink tea — it inhibits enzymes that break down acetylcholine

Coffee does not have the same effect.

So, consider having tea, rather than coffee, with your choline-rich breakfast eggs.

4. Manage Blood Sugar to Balance Acetylcholine

One last dietary tip for maintaining your acetylcholine level is to keep your blood sugar level balanced.

Hypoglycemia, insulin resistance, and diabetes can all interfere with acetylcholine synthesis

The Best Supplements to Correct Acetylcholine Deficiency

While you can’t ingest acetylcholine directly, you can take supplements that provide its building blocks or slow its breakdown.

Since the choline found in food is a precursor of acetylcholine, it seems that taking a choline supplement would be helpful.

However, basic choline supplements do little to increase choline in the brain or acetylcholine levels. 

There’s quite an array of choline-based supplements available — phosphatidylcholine, choline bitartrate, CDP-choline, and choline chloride, to name a few.

But not all are equally bioavailable.

For example, one of the most popular forms, choline bitartrate, does not cross the blood-brain barrier and does not help with mental performance

Here’s a look at the best acetylcholine-boosting supplements — those that have been proven to be able to access the brain and raise acetylcholine levels.

Alpha-GPC

Of all the choline-based supplements available, alpha-GPC (L-alpha-glycerylphosphorylcholine) is considered one of the best forms for raising acetylcholine levels.

It’s well absorbed and can readily enter the brain.

It shows promise as a potential Alzheimer’s treatment and is used to enhance memory and cognition

Choline is critical for brain development in utero and during infancy — it’s no coincidence that human breast milk contains the alpha-GPC form.

Alpha-GPC supplements are usually derived from eggs or soy.

Citicoline

Another form of choline proven to increase acetylcholine is citicoline, also known as CDP-choline.

Citicoline is an impressive but underutilized memory supplement.

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It originally was developed to prevent strokes and is used therapeutically to treat a wide variety of serious brain disorders, including age-related cognitive decline, dementia, and Alzheimer’s. 

Besides raising acetylcholine levels, citicoline improves blood flow to the brain, thereby helping protect the brain from damage, and increasing both brain plasticity and the capacity to grow new brain cells.

Bacopa

Bacopa (Bacopa monnieri) is a brain-boosting herb that’s been used for thousands of years in traditional Ayurvedic medicine.

One of the ways it works is by bringing levels of several neurotransmitters, including acetylcholine, into balance

Compounds found in bacopa called bacopasides encourage the growth of new dendrites, nerve endings that brain cells use to communicate with each other. 

Bacopa has been found to be even better at improving cognition than the popular smart drug Modafinil

Huperzine A

Huperzia serrata, commonly called Chinese club moss, is a plant that’s been used in traditional Chinese medicine for hundreds of years to improve memory.

Scientists have isolated the main active component of Chinese club moss, huperzine A.

In China, huperzine A has been an approved drug for treating Alzheimer’s since the 1990s.

Here in the US, huperzine A is available as a supplement.

It’s sometimes sold as a single-ingredient supplement, but more commonly it’s included as an active ingredient in brain and memory supplements.

It works by blocking an enzyme in the brain that breaks down acetylcholine. 

This is the same mechanism used by the popular Alzheimer’s drug Aricept. 

Galantamine (Proceed With Caution!)

Galantamine is another plant-based supplement that works by blocking the breakdown of acetylcholine.

It’s derived from the snowdrop (Galanthus caucasicus), a plant with dainty white flowers that’s a harbinger of spring.

We’ve included it here because you may come across it when looking for an acetylcholine supplement.

You can readily buy galantamine over the counter.

It’s marketed as a nootropic that enhances brain function and promotes lucid dreaming.

But galantamine’s mechanism of action is drug-like and it should not be your first choice for mild memory loss.

It can have some serious side effects and reacts badly with many medications.

Galantamine is used to improve memory and reduce mental confusion in dementia and Alzheimer’s patients. 

In the US, it’s been approved for treating Alzheimer’s and is available as both a prescription and over-the-counter remedy.

It’s not a cure, but it can slow down the progression of the disease.

If you are in need of serious help and want to give galantamine a try, talk to your doctor first.

In the meantime, you can learn more about its safety at the US National Library of Medicine’s website.

Anticholinergic Drugs: A Major Cause of Acetylcholine Deficiency

Drugs that block the action of acetylcholine are known as anticholinergics.

Anticholinergic drugs are a common cause of acetylcholine deficiency.

A surprising number of drugs fall into this category, both prescription and over-the-counter.

A good rule of thumb is that any medication that starts with “anti”  is likely to affect your acetylcholine level.

This includes antihistamines, antidepressants, antipsychotics, antibiotics, antispasmodics, and antihypertensives.

The symptoms caused by these drugs — brain fog, mental confusion, and memory loss — can be so severe that they resemble the symptoms of dementia.

Over-the-Counter Remedies That Affect Acetylcholine Levels

It’s not just prescription medications that cause acetylcholine deficiency.

Some of the most popular over-the-counter (OTC) remedies for allergies, insomnia, pain, and acid reflux that affect acetylcholine levels include: 

  • Advil PM (pain and sleep)
  • Benadryl (allergies)
  • Claritin (allergies)
  • Dramamine (motion sickness)
  • Excedrin PM (pain and insomnia)
  • Nytol (insomnia)
  • Pepcid AC (acid reflux)
  • Sominex (insomnia)
  • Tagamet (acid reflux)
  • Tylenol PM (pain and insomnia)
  • Unisom (insomnia)
  • Zantac (acid reflux)

OTC remedies can have long-term consequences, even when taken for only a short while.

OTC medications like Benadryl significantly increase the risk of developing dementia and Alzheimer’s after only 60 days of use. 

Seniors who use these drugs for only two to three months double their risk of mild cognitive impairment and dementia. 

Taking acetylcholine supplements and adjusting your diet while taking anticholinergic medications is like driving a car with one foot on the brake.

If you take any prescription medications that you suspect are causing memory loss, brain fog, or mental confusion, talk to your doctor about reducing or switching medications.

If you are taking over-the-counter anticholinergics, make the necessary lifestyle changes to reduce your usage and look for drug-free remedies instead.

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