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Choline, BHMT, and Your Health: What Your Genotype Means

Choline is an essential nutrient that supports brain function, liver health, nerve signaling, muscle movement, fat metabolism, and the body’s methylation processes. The BHMT gene makes an enzyme that helps convert choline into betaine. Betaine donates methyl groups used to process homocysteine, an amino acid that can pose health risks when elevated. Variations in BHMT can change how efficiently choline is converted into betaine and how well the BHMT pathway supports methylation.

How to Read This Report

The variant discussed here is rs3733890 in the BHMT gene. Below you will find plain-language interpretations for each possible genotype and practical, consumer-focused recommendations for diet, supplements, lifestyle, and testing to support healthy methylation and overall metabolic function.

Two effect alleles — AA (reduced BHMT activity)

What this means

If your genotype is AA, you carry two copies of the effect allele. This is associated with reduced BHMT enzyme activity. Less choline may be converted into betaine, so the BHMT route for processing homocysteine may be less efficient.

Practical implications

  • Your body may channel more choline toward CDP-choline (phosphatidylcholine) for cell membrane building and repair.
  • Folate supplementation alone may be less effective at lowering homocysteine for people with this genotype because the BHMT pathway is less active.
  • Supporting multiple methylation pathways is especially important.

Diet recommendations

  • Focus on choline-rich foods: egg yolks, liver (beef or chicken), salmon, shrimp, chicken, and soy products.
  • Include cruciferous vegetables: broccoli, Brussels sprouts, kale, and cauliflower.
  • Eat a balanced diet with quality protein, healthy fats, and whole grains to support overall methylation and liver health.

Supplement considerations

  • Consider a choline supplement if dietary intake is low. Options include choline bitartrate, phosphatidylcholine, or CDP-choline. Work with your provider on dose.
  • Support methylation with a B-complex that provides active forms: folate (5-MTHF), vitamin B12 (methylcobalamin), B6 (pyridoxal-5-phosphate), and riboflavin (B2).
  • Betaine (trimethylglycine) supplements may help boost methyl donor availability if diet alone is insufficient.

Lifestyle and monitoring

  • Limit excessive alcohol intake, which stresses the liver and methylation systems.
  • Maintain a healthy weight and regular physical activity to support liver function and metabolism.
  • Consider testing fasting homocysteine and liver function (ALT, AST) with your provider to monitor response to dietary and supplement changes.
One effect allele — AG (moderate influence)

What this means

If your genotype is AG, you carry one copy of the effect allele. This may moderately reduce BHMT enzyme efficiency. Your body might convert somewhat less choline into betaine compared to people with the GG genotype.

Practical implications

  • A moderate shift in choline use toward membrane-building pathways like CDP-choline may occur.
  • Folate alone may be somewhat less effective at lowering homocysteine, so multi-nutrient strategies are useful.

Diet recommendations

  • Include regular sources of choline: eggs, poultry, fish, soy, and cruciferous vegetables.
  • Eat a variety of fruits, vegetables, whole grains, and lean proteins to support overall methylation and antioxidant status.

Supplement considerations

  • A B-complex with active forms of folate and B12 can help cover key methylation cofactors.
  • If dietary choline is low, a choline supplement such as phosphatidylcholine or CDP-choline may be beneficial.

Lifestyle and monitoring

  • Exercise regularly and maintain healthy sleep patterns to support metabolic health.
  • Discuss with your provider whether homocysteine testing is appropriate for you, especially if you have other risk factors.
No effect alleles — GG (typical BHMT function)

What this means

If your genotype is GG, your BHMT enzyme function is expected to be typical. Your body efficiently converts choline into betaine and uses that pathway to help process homocysteine.

Practical implications

  • Your BHMT-mediated methylation capacity is likely functioning as expected.
  • Standard dietary and lifestyle measures to support methylation and liver health are appropriate.

Diet recommendations

  • Continue regular intake of choline-rich foods: egg yolks, liver, fish, chicken, and soy.
  • Include plenty of vegetables, particularly cruciferous types, to supply antioxidants and dietary fiber.

Supplement considerations

  • Most people with a balanced diet do not require targeted BHMT support, but a B-complex can be helpful during periods of high demand or limited nutrition.

Lifestyle and monitoring

  • Maintain healthy lifestyle habits: avoid excessive alcohol, stay active, manage stress, and aim for restorative sleep.
  • Routine provider-led bloodwork including lipid panel and metabolic markers is useful for overall health monitoring.

General Tips to Support Choline, Betaine, and Methylation

  • Eat a variety of whole foods: prioritize eggs, fish, lean meats, legumes, nuts, seeds, and cruciferous vegetables.
  • Balance your B vitamins: ensure adequate folate, B12, B6, and riboflavin through diet or a B-complex when needed.
  • Consider omega-3 rich foods like salmon and walnuts for brain and liver support.
  • Manage alcohol intake and avoid smoking to reduce stress on liver methylation pathways.
  • Stay hydrated, maintain a healthy weight, and engage in regular physical activity.

When to Talk to Your Healthcare Provider

  • If you have elevated homocysteine, liver disease, or a family history of cardiovascular or cognitive concerns, discuss targeted testing and personalized nutrient strategies.
  • If you are pregnant, breastfeeding, or planning pregnancy, discuss choline needs with your provider because choline is important for fetal brain development.
  • Before starting any supplements, especially high-dose B vitamins, betaine, or choline supplements, consult your healthcare provider to ensure safety and appropriate dosing.

PlexusDx does not provide medical advice. This information is educational and intended to help you understand genetic predispositions related to BHMT and choline metabolism. Always consult your healthcare provider before making changes to your diet, supplement routine, or medical care.