Choline is important for liver health

Professor Steven Zeisel is probably the leading figure in knowledge of and research into choline. He was mainly responsible for the choline datasheet on the USA government agency website (USDA choline database)

Whilst those who feel Trimethylaminuria (TMAU) fully explains their odor condition are obviously going to greatly reduce choline as the central theme of their 'anti-TMAU protocol', unfortunately it seems that choline may be quite important for liver health and it seems a choline deficiency can potentially cause 'reversible fatty liver' and in some cases do more damage. It seems from Dr Zeisel's papers that damage may also be partly due to those genetically predisposed to small common DNA 'polymorphisms' that may reduce efficient metabolism of choline, and that not everyone is 'susceptible' to problems.

It is a'spanner' in the works of the 'TMAU protocol', and so is worthy of mention. How relevant or likely it is an issue to each person, we do not know. It would probably seem best not to limit choline completely, and instead go for a 'low choline' diet rather than 'no choline'.

There has also been some suggestion that phoshatidylcholine is poorly metabolized into trimethylamine by gut bacteria and so may even be a good source of choline for those with TMAU. However, we do not know how well phosphatidylocholine is absorbed by humans.

Some Papers by Prof Zeisel on the need for choline

Dietary choline deficiency causes DNA strand breaks...
Nutritional genomics: defining the dietary requirement and effects of choline
...human gastrointestinal microbiome and development of fatty liver...
Dietary choline requirements of women...
Metabolomic profiling can predict which humans will develop liver dysfunction when deprived of dietary choline