Last updated October 9, 2023.
Edited and medically reviewed by Patrick Alban, DC. Written by Deane Alban.
Memory slipping? Thinking slower? An acetylcholine deficiency may be why. We review the best choline-based, herbal, and nutrient supplements.
Acetylcholine was the first neurotransmitter to be discovered and is one the most prevalent in the human nervous system.
It’s known mainly as the “memory molecule” because it helps us remember, learn, focus, and stay mentally alert.
But it plays many other roles as well.
Acetylcholine also promotes a positive mood, while modulating negative emotions like fear and anger.
And it enhances brain plasticity, a trait that allows the brain to stay mentally flexible for a lifetime.
If you’re having problems in any of these areas, you may have an acetylcholine deficiency.
There are ways to help remedy that.
Why You May Need an Acetylcholine Supplement
There are several excellent reasons to consider taking an acetylcholine supplement.
You may be trying to improve your memory or want to proactively preserve your memory for the future.
Maybe you are trying to overcome typical signs of acetylcholine deficiency, such as constantly misplacing items, an inability to follow movie plots and conversations, or ADHD.
Acetylcholine deficiency is linked to serious neurological disorders such as Alzheimer’s, Parkinson’s, myasthenia gravis, and multiple sclerosis.
The brains of Alzheimer’s patients contain low levels of both acetylcholine and acetylcholine receptors, which is how Alzheimer’s drugs like Aricept work (by blocking acetylcholine breakdown).
Acetylcholine supplements are especially important if you don’t normally consume foods that provide the building blocks of acetylcholine.
This includes anyone who follows a low-fat diet or doesn’t eat eggs or meat.
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Dietary fat and the choline found in animal foods are needed to synthesize acetylcholine.
World-renowned Harvard researcher Datis Kharrazian, PhD, DHSc explains in his book, Why Isn’t My Brain Working?, that the brain will literally consume itself to get the raw materials it needs to make acetylcholine.
Anticholinergic Medications That Block Acetylcholine
The need for acetylcholine supplementation is especially critical if you take any anticholinergic medications.
Anticholinergics are substances that block the action of acetylcholine in the nervous system.
A good rule of thumb is that any medication that starts with “anti” is likely to lower your acetylcholine level.
This includes antidepressants, antipsychotics, antibiotics, antispasmodics, antihypertensives, and even over-the-counter antihistamines.
Three Kinds of Supplements That Increase Acetylcholine
You can’t take acetylcholine directly, but you can take supplements that:
- increase its release by the body
- slow its breakdown
- encourage its reuptake
- stimulate its receptors
- provide the raw materials to create it
Substances, either drugs or supplements, that enhance or mimic the action of acetylcholine are described as cholinergic.
The best cholinergic supplements fall into three main categories — choline-based, herbs, and nutrients.
A few of these are so powerful that they are sometimes prescribed as drugs.
Next, we’ll provide a brief summary of the best supplements for increasing acetylcholine and we’ll also warn you about a few popular cholinergic supplements that are best avoided.
Choline-Based Acetylcholine Supplements
Choline is a nutrient related to the vitamin B complex that is a precursor of acetylcholine.
It is found mainly in animal products with the best sources being beef liver and eggs.
An estimated 90% of us do not get enough choline from our diets.
" The brain will literally consume itself to get the raw materials it needs to make acetylcholine.
So choline supplementation is a great idea, at least in theory.
But, in fact, not all choline-based supplements increase choline in the brain or raise acetylcholine levels.
Here’s a look at those that do.
Alpha-GPC
Alpha-GPC (L-alpha-glycerylphosphorylcholine) is a highly bioavailable form of choline that readily enters the brain.
It’s considered one of the best forms of choline for raising acetylcholine levels.
Alpha-GPC enhances memory and cognition and slows the rate of cognitive decline in the elderly.
It shows promise as a potential Alzheimer’s treatment.
In Europe, it is prescribed to increase acetylcholine levels in Alzheimer’s patients.
In the United States, it’s available as an over-the-counter memory supplement.
The ideal standard dose is yet to be determined, but 400 mg, three times a day, is a typical amount used in studies on mental decline.
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Citicoline
Citicoline is a naturally occurring compound found in every cell in the body and in particularly high concentrations in the brain.
It is a choline precursor that increases acetylcholine.
Citicoline was first developed to treat strokes, then later was prescribed for age-related cognitive decline, dementia, and Alzheimer’s.
Now it’s available as a supplement that offers impressive brain benefits.
Citicoline improves blood flow to the brain and encourages the growth of new brain cells.
It can significantly improve memory, focus, and attention.
Citicoline goes by a few other names, most commonly CDP-choline.
We recommend looking for a supplement that contains the brand name Cognizin®.
Cognizin is a patented, highly bioavailable form of citicoline that’s been clinically tested in humans.
A typical daily dose of citicoline for cognitive enhancement is 1,000 to 2,000 mg.
Choline Supplements to Avoid
Choline Bitartrate
If you buy a supplement that simply states “choline” on the label, it will almost certainly be choline bitartrate.
However, there is no evidence that this inexpensive form of choline reliably enters the brain or enhances cognitive functions.
DMAE
DMAE (dimethylaminoethanol) is another precursor to choline that’s found in some brain supplements.
It’s also a popular active ingredient in skin care products.
While it does increase acetylcholine levels, studies have failed to show that it improves cognition.
And since it’s been linked to birth defects, it’s not advised for use by women during their childbearing years.
Herbal Acetylcholine-Boosting Supplements
There are a surprising number of herbal supplements that work, in part, by increasing acetylcholine.
Most of them have long histories as proven boosters of brain health and performance.
Some of these are so safe that they’ve historically been consumed as food.
But a few of them act more like drugs than supplements and should be taken with extreme caution.
Bacopa
Bacopa (Bacopa monnieri) has been used for thousands of years as a brain tonic in Chinese and Indian medicine traditions.
Bacopa is considered an adaptogen.
Adaptogens are herbs that neither sedate nor stimulate, but help bring the body into a state of balance known as homeostasis.
One of the ways bacopa does this is by balancing the levels of neurotransmitters, including acetylcholine, dopamine, and serotonin.
Bacopa may offset the memory loss caused by anticholinergic drugs.
When tested against the popular smart drug Modafinil, bacopa worked better at improving memory, accuracy, and processing speed.
Bacopa is an excellent choice if you are under a lot of stress or experience insomnia or anxiety.
It is considered very safe and can even be given to children.
A typical dose of bacopa is 300 mg per day.
For maximum absorption, take it with meals.
Be patient when taking bacopa.
It can take a few months to experience maximum benefits.
American Ginseng
American ginseng (Panax quinquefolius) is not as universally popular as its Asian cousin (Panax ginseng), but that may be changing.
American ginseng is highly regarded for its superior quality and proven effectiveness as a cognitive enhancer.
For maximum brain benefits, look for supplements containing Cereboost®, a patented American ginseng extract that increases acetylcholine levels.
In clinical trials, a single dose of Cereboost quickly improved memory, mental clarity, and sharpness within hours after ingestion.
A typical dose of American ginseng is 200 to 400 mg daily.
You can also take American ginseng as a tea or add dried slices to cooked foods.
Gotu Kola
Gotu kola (Centella asiatica) is in the same plant family as parsley and carrots and has been consumed as a food and tea in Asia for thousands of years.
It is used traditionally to treat disorders of the mind, including memory loss, mental fatigue, anxiety, and depression.
Its Chinese name means “fountain of youth” because it’s believed to promote longevity.
Gotu kola is also a highly regarded brain supplement.
In human studies, gotu kola increased alertness, decreased anger, and significantly reduced anxiety and depression.
What makes gotu kola unique are compounds called triterpenes.
These steroid precursors work much like the Alzheimer’s drug Aricept to inhibit the breakdown of acetylcholine.
They also prevent the formation of amyloid plaques that accumulate in the brains of Alzheimer’s patients.
The word “kola” has many Westerners assuming that gotu kola contains caffeine.
But, in fact, it contains no caffeine and is a relaxant, not a stimulant.
A typical gotu kola dosage is 30 to 60 mg, 2 to 3 times per day.
Huperzine A
Huperzine A is an isolated extract of Chinese club moss (Huperzia serrata), a traditional Chinese remedy for memory improvement.
According to Dr. Kharrazian (see above), it’s one of the most potent supplements for increasing acetylcholine and one of the first to consider for memory loss.
Huperzine A works by blocking the enzyme acetylcholinesterase which breaks down acetylcholine.
It is sold as a single-ingredient supplement and is also included in many nootropic and memory supplement formulas.
Huperzine A is powerful enough that it’s used as an approved drug for treating Alzheimer’s in China.
The generally recommended dosage is 50 to 200 mcg taken twice daily.
Unlike the herbs mentioned previously which are considered very safe, huperzine A is more likely to cause side effects.
Potential side effects include digestive upset, anxiety, muscle cramps and twitching, and changes in blood pressure and heart rate.
Huperzine A should not be taken with anticholinergic drugs, including antihistamines, antidepressants, and the Alzheimer’s drug Aricept.
Galantamine
Galantamine (Galanthus caucasicus) is another acetylcholine-promoting herbal supplement that should be taken with caution.
In the US, it’s available as both a prescription drug and an over-the-counter remedy.
It’s considered a first-line medication for mild to moderate Alzheimer’s and is used to improve memory, reduce mental confusion, and slow the progression of this disease.
Galantamine’s list of side effects is very similar to those of huperzine A.
And there are literally hundreds of medications it reacts with badly as well.
Note: Before you give galantamine a try, discuss it with your doctor first.
More Herbal Acetylcholine Supplements
While the above supplements are the most potent cholinergics, there are several other herbs that exhibit some ability to increase acetylcholine:
- Arctic root (Rhodiola rosea)
- ashwagandha (Withania somnifera)
- cinnamon (Cinnamomum cassia)
- ginger (Zingiber officinale)
- ginkgo (Ginkgo biloba)
- holy basil (Ocimum sanctum)
- saffron (Crocus sativus)
- turmeric (Curcuma longa)
Nutrients That Increase Acetylcholine
In this last group, you’ll learn about two important nutrients that support acetylcholine synthesis — one vitamin and one amino acid.
Vitamin B5
Vitamin B5 (pantothenic acid) is one of the B complex vitamins.
Pantothenic means “from everywhere” because pantothenic acid is found in so many food sources.
While all B vitamins are essential for healthy brain function, vitamin B5 is an essential cofactor required to turn choline into acetylcholine.
That’s one reason that B5 is sometimes added to alpha-GPC, citicoline, and other brain supplements.
Unlike most other vitamins, there is no RDA (Recommended Dietary Allowance) for vitamin B5, but the generally recommended daily dosage is 5 mg.
If you take a good multivitamin, it very likely will meet or exceed this amount for vitamin B5.
Acetyl-l-Carnitine
Acetyl-l-carnitine (ALC or ALCAR) is an amino acid that is well-documented for its ability to improve alertness, focus, mental clarity, and mood.
This amino acid is a precursor to acetylcholine and has a similar structure, so it binds with and activates acetylcholine receptors in the brain.
Acetyl-l-carnitine has fast-acting antidepressant properties, making it a good choice if you have memory loss and depression.
When shopping for an ALCAR supplement, avoid the less expensive version, l-carnitine, which does not readily enter the brain.
The standard daily dose ranges from 500 to 2,000 mg.
Acetyl-l-carnitine is generally safe, but should not be taken with blood-thinning medications.
Acetylcholine Supplement Side Effects
As with all neurotransmitters, too much can be as harmful as not enough.
It’s possible to raise acetylcholine levels too high.
A common symptom of overdoing acetylcholine-boosting is feeling depressed.
Anecdotally, some people report headaches.
Dr. Kharrazian finds in his practice that patients can experience muscle tightness and cramps, nausea, and intense fatigue if they are too aggressive with acetylcholine supplementation.
He recommends that if you are suffering from taking too much too soon, simply scale back until your body adjusts.
Be particularly careful with the more potent supplements like huperzine A and galantamine.
And keep in mind that any supplement strong enough to be prescribed as a drug is also strong enough to cause side effects or have negative interactions with other substances.
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