All About Acetylcholine: Neurotransmitter for Memory and Focus

Edited and medically reviewed by Patrick Alban, DC | Written by Deane Alban

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A low level of acetylcholine has a uniquely negative impact on memory and focus. Learn the three most effective ways you can increase acetylcholine.

Acetylcholine is one of the most important and ubiquitous neurotransmitters.

It’s been called the “memory molecule” for the critical role it plays in memory, learning, and attention.

It was the first neurotransmitter discovered and is one of the most abundant in the nervous system.

A typical sign of insufficient acetylcholine is what’s referred to as “senior moments.”

But when your acetylcholine level is low, these memory lapses can occur at any age.

If your memory and ability to focus aren’t as good as you’d like, you should learn more about this unique brain chemical.

What Is Acetylcholine?

Acetylcholine was the first molecule to be identified as a neurotransmitter, a chemical that neurons use to communicate with each other.

Otto Loewi, the German scientist who first encountered acetylcholine, originally called it “vagusstoff” or “vagus substance” because it was released by the body’s longest nerve, the vagus nerve. (1)

He eventually won a Nobel Prize for this discovery.

Neurotransmitters are generally categorized as either excitatory or inhibitory, but acetylcholine is unique in that is doesn’t fall neatly into either camp.

It functions differently depending on its location and the type of receptors available. (2)

Acetylcholine doesn’t occur just in the brain and the nervous system, it’s distributed throughout the body.

In muscles, for example, it has an excitatory effect; but in the heart, it’s inhibitory.

Even though acetylcholine is critical for higher thought processes, it’s not unique to humans.

It’s found in other animals, plants, and even in bacteria and fungi.

There are two main kinds of acetylcholine receptors — nicotinic and muscarinic.

They get their unusual names from two substances that act upon acetylcholine receptors.

Nicotine binds to nicotinic receptors, while the mushroom toxin muscarine binds to muscarinic receptors.

What Does Acetylcholine Do?

Acetylcholine is found throughout the body, performing a wide array of functions.

In the brain, acetylcholine functions as both a neurotransmitter and as a neuromodulator, a substance that modulates the action of neurotransmitters, up or down, as needed. (3)

As a neurotransmitter, it helps you learn, focus, and stay mentally alert. (4)

It is also involved in functions as diverse as wakefulness, REM sleep, digestion, motor control, attentiveness, anger, aggression, sexuality, and thirst. (56, 7)

Acetylcholine enhances brain plasticity, your brain’s capacity to stay mentally flexible. (8)

Acetylcholine is the chief neurotransmitter of the parasympathetic nervous system which controls automatic functions such as digestion, respiration, and heart rate. (9, 10)

Any time your fight-or-flight response has been triggered, acetylcholine helps bring your body back into homeostasis by dilating blood vessels and slowing heart rate.

It also causes skeletal muscles and muscles in the intestines and lungs to contract.

It triggers the secretion of sweat, saliva, and tears in their corresponding glands.

Acetylcholine dysfunction is linked to numerous neurological and psychological disorders including: (111213, 1415)

  • addictions
  • Alzheimer’s
  • attention disorders
  • dementia
  • Huntington’s disease
  • multiple sclerosis
  • myasthenia gravis
  • Parkinson’s
  • schizophrenia
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Acetylcholine Function and Memory Loss

Of all acetylcholine’s functions, the most significant is the role it plays in memory.

Acetylcholine levels tend to decline as we age and the kind of memory loss we consider to be part of normal, age-related cognitive decline is often caused by this drop.

Acetylcholine is essential for the conversion of short-term memories into long-term ones.

This occurs in the hippocampus, the part of the brain that is considered the brain’s memory center.

The hippocampus is typically the first area of the brain to degenerate in dementia and Alzheimer’s.

The first signs of low acetylcholine are declines in visual memory, verbal memory, processing speed, and spatial orientation.

When visual memory starts to decline, you’ll find it harder to remember what you just read, to form images in your mind, to recall faces, or to remember where things are.

When verbal memory starts to go, you’ll more often forget words or lose your train of thought in the middle of a conversation.

If you find yourself driving under the speed limit or getting lost more easily, these may be more signs that your acetylcholine level is low.

While these changes are expected in older people, they should still not be ignored.

And when these symptoms occur in young adults, they are concerning and warrant immediate attention.

Acetylcholine Deficiency and Alzheimer’s

Alzheimer’s patients typically have significantly reduced levels and function of acetylcholine in their brains. (16)

This is why most drugs for treating Alzheimer’s, such as Aricept, Exelon, and Razadyne, work by blocking the breakdown of acetylcholine to help keep levels up. (17)

And, while these drugs can’t cure or stop the progression of Alzheimer’s, they can temporarily slow it down.

Causes of Acetylcholine Deficiency

There are a few medical reasons why you might have low levels of acetylcholine.

It is possible to have antibodies against acetylcholine receptors as in the case of myasthenia gravis. (18)

There’s evidence that similar autoimmunity to acetylcholine receptors may also occur in schizophrenia and chronic fatigue syndrome. (19, 20)

Insulin resistance and diabetes can interfere with acetylcholine synthesis. (21)

But the two most common causes of acetylcholine deficiency by far are diet and medications, factors that are largely under your control.

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How Low-Fat Diets Cause Acetylcholine Deficiency

Low-fat and vegetarian diets are so popular that they’re almost considered mainstream.

But these diets put your brain at risk and, in this scenario, acetylcholine is a pivotal player.

Here’s why …

Acetylcholine is synthesized mainly from choline, a nutrient related to the vitamin B complex. (22)

Acetylcholine production is limited by the amount of available choline, but 90% of us don’t get adequate choline from our diets. (23)

The best sources of choline by far are egg yolks and organ meats, but all fatty animal foods contain some of it. (24)

There are a few plant sources of choline, but it’s extremely hard to get enough from plants to meet the daily Adequate Intake (AI) requirement of choline — 425 mg for women and 550 mg for men. (25)

Whereas one egg contains roughly 150 mg of choline, to get that much from the best vegetable sources you’d have to eat 2 cups of tofu, 3 potatoes, 2-1/2 cups of broccoli, or 6 cups of brown rice! (26, 27)

So, following a diet that does not include fatty meats and/or eggs could lead to a deficit of both choline and acetylcholine.

And this can damage your brain in an unforeseen way.

Harvard Medical School researcher Datis Kharrazian, PhD, DHSc, explains this in his book Why Isn’t My Brain Working?:

“If the brain needs acetylcholine and is not getting it from adequate dietary fat, then it will break down brain tissue for phosphatidylserine and phosphatidylcholine, two fat-based components from neurons tissue from which acetylcholine can be synthesized.”

Put plainly, your brain literally digests itself if you don’t provide it with the raw materials it needs to make acetylcholine.

And that’s as detrimental to your brain health and function as it sounds.

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Drugs That Lower Acetylcholine Levels

The second major cause of acetylcholine deficiency is the use of drugs called anticholinergics which block the action of acetylcholine.

It’s easy to remember which drugs affect acetylcholine because their common names start with “ant” or “anti” such as antacids, antibiotics, antihistamines, antihypertensives, and antidepressants. (28)

While most anticholinergics are prescription drugs, there are also a number of common over-the-counter (OTC) remedies included in this group, such as Benadryl (antihistamine) and Pepcid AC (antacid).

Seniors’ brains are at particular risk from the use of anticholinergic drugs since they significantly increase the risk of dementia. (29)

Read more —
Learn more about which specific drugs and OTC remedies impact acetylcholine levels in our article Drugs That Cause Memory Loss (& what you can do).

How to Increase Acetylcholine Naturally

If you exhibit signs of low acetylcholine, it’s best to address it now since chronic acetylcholine deficiency can lead to dementia and Alzheimer’s later.

Two excellent places to start are to eat more choline-rich foods, especially eggs, and avoid taking anticholinergic drugs.

And please don’t worry about eating eggs because of heart health.

Numerous studies confirm that eating eggs does not increase your risk of heart disease, even if you eat up to 12 eggs per week. (30, 31, 32)

There’s even evidence that people who eat eggs have a lower risk of heart disease than those who don’t eat eggs. (33)

A huge long-term study conducted by Harvard T.H. Chan School of Public Health followed the dietary habits of over 200,000 people.

Researchers concluded that there is no link between moderate egg consumption and heart disease. (34)

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The Best Acetylcholine Supplements

The third main way to increase acetylcholine is with the appropriate supplements.

While you can’t take acetylcholine supplements directly, you can choose from one of the many supplements that increase acetylcholine by various mechanisms.

Alpha-GPC and citicoline provide the brain with choline that readily turns into acetylcholine.

Taking one of these supplements is critical if you don’t eat eggs, organ meats, or other fatty meats.

There are several herbal brain supplements that work, in part, by increasing acetylcholine, including bacopa (Bacopa monnieri), gotu kola (Centella asiatica), and American ginseng (Panax quinquefolius). (35, 36, 37)

Huperzine A, an extract derived from Chinese club moss (Huperzia serrata), is an acetylcholine booster so powerful that, in some parts of the world, it’s used as a medication for treating Alzheimer’s. (38)

And since vitamin B5 (pantothenic acid) is an essential cofactor required to turn choline into acetylcholine, this is one vitamin you may want to take along with other acetylcholine supplements. (39)

3 Surprising Benefits of Acetylcholine Supplements

Supplements that work on the acetylcholine system do more than just temporarily increase available levels of acetylcholine; they actually make acetylcholine receptors work better.

Acetylcholine receptors differ from the receptors of other neurotransmitters in that they are not subject to downregulation.

This means that they do not become less responsive to drugs or supplements over time, so you do not need to keep taking more to achieve the same effects.

In fact, the opposite occurs.

Stimulating acetylcholine receptors makes them more responsive so that, eventually, you may find that you need less acetylcholine supplementation to get the same benefits.

Another benefit of acetylcholine supplements is that you can take them on an as-needed basis, much like drinking coffee when you need a mental energy boost.

While working with patients and experimenting on himself, Dr. Datis Kharrazian discovered that you can safely add or increase acetylcholine supplements as needed during periods of intense focus and concentration, such as when taking exams or working on a mentally taxing project.

And finally, when you take supplements that increase acetylcholine activity, it’s not unusual to feel a boost in mental energy almost immediately, usually within a half hour!

Causes and Symptoms of Excess Acetylcholine

Most of the time, a neurotransmitter imbalance is a case of too little, rather than too much.

But it is possible to have an excess of acetylcholine, especially if you are taking active measures to increase your acetylcholine levels.

When you start taking any substance that is known to increase acetylcholine, begin with a low dosage and then work your way up gradually.

Too much acetylcholine can cause depression, headaches, jitteriness, tension, muscle cramps, nausea, and extreme fatigue. (4041)

These symptoms make sense when you consider that acetylcholine is in charge of skeletal muscle contractions and gastrointestinal muscles.

Substances to watch out for that increase acetylcholine include: (4243)

  • acetylcholine-boosting supplements
  • drugs for Alzheimer’s disease
  • the study drug piracetam
  • nicotine
  • nicotine replacement therapies

Acetylcholine: Take the Next Step

Acetylcholine has many functions, the most prominent being the role it plays in memory.

A low level of acetylcholine is linked to so-called “normal memory loss,” but it’s also strongly implicated in degenerative brain diseases.

The two biggest culprits in acetylcholine deficiency are a diet low in choline and drugs that block acetylcholine activity.

You can raise your acetylcholine level naturally by consuming choline-rich foods and taking supplements that increase acetylcholine.

And finally, if you take any prescription anticholinergic drugs, talk to your doctor about other available options.

READ NEXT: How Acetylcholine Deficiency Impacts Memory