Who should use Healthmatters?

Individuals who want to track and understand their health over time, health professionals, such as doctors, nutritionists, and wellness coaches, need to manage and interpret lab data for their clients.

What can I do with a Healthmatters account?

With a Healthmatters account, you can: Upload lab reports from any lab, View your data in interactive graphs, tables, and timelines, Track trends and monitor changes over time, Customize your reference ranges, Export and share your full lab history, Access your results anytime, from any device. Professionals can also analyze client data more efficiently and save time managing lab reports.

What test results do you interpret?

Healthmatters.io personal account provides in-depth research on 10000+ biomarkers, including information and suggestions for test panels such as, but not limited to: The GI Effects® Comprehensive Stool Profile, GI-MAP, The NutrEval FMV®, The ION Profile, Amino Acids Profile, Dried Urine Test for Comprehensive Hormones (DUTCH), Organic Acids Test, Organix Comprehensive Profile, Toxic Metals, Complete Blood Count (CBC), Metabolic panel, Thyroid panel, Lipid Panel, Urinalysis, And many, many more.

Do you only accept reports from specific labs listed here?

While we work with many popular labs, we welcome reports from lots of other places too. It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.

How do I get reports into my Healthmatters account?

There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our 'Data entry service.' Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values. For those who prefer assistance, we offer a 'Data entry service' to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.

What is the Data Entry Service, and why does it cost $15 per report?

Our Data Entry Service is for when you don't want to manually type in your lab results yourself. You simply upload your report (PDF, image, or screenshot), and our trained team enters the information into your Healthmatters account for you — accurately and neatly organized, ready to view in graphs, tables, and timelines. The $15 per report covers the time and care it takes for a real person to review your file, make sure each result is entered correctly, and double-check for accuracy. This ensures your health data is precise and easy to work with — without you having to spend the time doing it yourself. Prefer to do it yourself? You can always use our free self-entry tool to add results manually — it just takes a bit more time and attention.

Does a personal account come with a data entry service?

For users on the Advanced Plan, the first 5 reports are included free of charge, and each additional report incurs a $15 fee. Unlimited Plan holders enjoy the entry of 10 reports at no charge. Subsequent reports are subject to a $15 fee per report. Additionally, users on the Advanced Plan can upgrade to the Unlimited Plan from their account settings.

How much does a professional account cost?

All professional accounts allow you to import and onboard an unlimited number of clients and their lab results. The distinction between professional plans lies solely in the data entry service. The Pro Monthly Plus plan is priced at $75 per month and includes a data entry service for five reports each month. Additional reports can be self-entered at no extra cost or, if preferred, you can use our data entry service for an additional fee of $15 per report. The Pro Monthly plan is priced at $45 per month and does not include a data entry service. Self-entry is free for an unlimited number of reports, and you can opt for the data entry service at a fee of $15 per report. You also have the option to upgrade to higher monthly or to annual plans, which come with substantial discounts. All upgrades can be done directly from your account.

How do I terminate my account?

Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.

Can I download my information from my account?

Yes, you can download your information anytime. We offer two easy ways to export your lab data: 1. Download a CSV file: Go to Account Settings and scroll to the bottom of the page. There, you'll find a link to download all your labs as a CSV file. 2. Download an Excel file: To export your data in Excel format, go to either the Graph or Table view and click “Export Excel File.”

Can I print my report?

Yes, you can print your report. To do so, navigate to 'All tests' and open the report you wish to print. You'll find a print button in the right corner of the report. Click on it, and your browser's print window will open. If you prefer to print in a bigger typeface, adjust the scale using the print window settings.

Can I secure my account with Two-Factor Authentication (2FA)?

Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the 'Profile and Security' section of your account, where you will find instructions for activating 2FA.

Can I use a custom range for biomarkers?

Yes, you can. When entering values for the biomarker, you will see an 'Edit Range' button. Click this button, and you'll have the option to enter a custom range.

What’s the difference between personal and professional accounts?

A personal account is all about keeping your own lab test results in check. It's just for you and your personal use. The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.

Where can I learn more about professional accounts?

To learn more about Healthmatters Pro, please refer to the professional page.

Can I share my results in the HealthMatters dashboard with my doctor?

Yes, you can! Simply go to the 'Invite Doctor' section, enter your doctor’s email address, and send the invitation. Your doctor will receive an email with secure access to view your results. You can revoke this access at any time. All shared information is securely encrypted and protected for your privacy.

Can I export my information to an Excel file?

Yes, you can! Go to the Graph view or Spreadsheet view. In the top-right corner, click 'Export to Excel,' and the file will be downloaded to your device.

Choline

Urine

Optimal Result: 13 - 30 µmol/g Crea.

Neurotransmitter XL getTested

Choline is an essential nutrient that plays a foundational role in brain health, liver function, methylation, and neurotransmitter synthesis. It serves as both a structural building block for cell membranes and a biochemical precursor for several key molecules, including acetylcholine (a neurotransmitter critical for memory, focus, and muscle control) and betaine (trimethylglycine), a major methyl donor in the body.

On the Neurotransmitter XL panel, choline reflects the body’s capacity to maintain membrane integrity, neurotransmitter balance, and methylation efficiency. Adequate choline ensures optimal communication between neurons, healthy liver metabolism, and efficient detoxification through the methionine cycle, which depends on methyl donors for proper function.

Because the brain and liver are among the most metabolically active organs, choline status is often a key indicator of both cognitive performance and cellular energy balance.

Biochemical Role and Function

1. Precursor to Acetylcholine

Choline is converted into acetylcholine, one of the brain’s most important neurotransmitters, by the enzyme choline acetyltransferase. Acetylcholine governs attention, learning, memory, and muscle contraction. Low choline availability can directly limit acetylcholine synthesis, affecting mental sharpness, memory retention, and focus.

2. Structural Component of Cell Membranes

Choline contributes to the formation of phosphatidylcholine (PC) and sphingomyelin, key phospholipids that maintain cell membrane integrity and support neuronal communication. Phosphatidylcholine also plays a central role in lipid transport, helping prevent fat accumulation in the liver and promoting proper cell signaling and repair.

3. Methylation and Homocysteine Regulation

Through its oxidation into betaine, choline participates in methyl group donation—a vital process for DNA methylation, gene regulation, and neurotransmitter metabolism. Betaine donates methyl groups via the betaine-homocysteine methyltransferase (BHMT) pathway, which converts homocysteine into methionine, sustaining S-adenosylmethionine (SAM) production.
This connection makes choline essential for maintaining balanced homocysteine levels and efficient methylation alongside folate, vitamin B12, and vitamin B6.

4. Liver Function and Fat Metabolism

Choline is indispensable for liver health, as it supports the synthesis of phosphatidylcholine required for VLDL (very-low-density lipoprotein) export. Without enough choline, fat accumulates in the liver, leading to non-alcoholic fatty liver disease (NAFLD) and impaired detoxification.

5. Cellular Energy and Mitochondrial Protection

By promoting membrane fluidity and supporting methylation-dependent ATP synthesis, choline indirectly maintains mitochondrial efficiency and protects against oxidative stress.

Choline and the Nervous System

Within the nervous system, choline serves as a link between neurochemical communication and metabolic stability:

Acetylcholine production: Crucial for cognitive function, learning, and REM sleep regulation.
Methylation of neurotransmitters: Through betaine and SAM support, choline assists in dopamine, serotonin, and adrenaline metabolism.
Membrane composition: Phosphatidylcholine and sphingomyelin ensure optimal receptor sensitivity and signal transmission between neurons.

Deficiency in choline can manifest as mental fatigue, brain fog, irritability, or low focus, reflecting both neurotransmitter and membrane instability.

Causes of Low Choline Levels

1. Insufficient Dietary Intake

Choline is found primarily in animal-based foods such as eggs, fish, chicken, and liver. Plant-based diets, especially vegan or low-protein diets, may provide inadequate amounts. The body can synthesize small amounts of choline via the PEMT enzyme (phosphatidylethanolamine N-methyltransferase), but this pathway alone is insufficient to meet full metabolic demands.

2. Increased Methylation Demand

Chronic stress, toxin exposure, or inflammation increases the need for methyl donors, depleting choline stores faster than they can be replenished. This can occur even with normal dietary intake.

3. Genetic Variants (PEMT, BHMT, MTHFR)

PEMT polymorphisms reduce endogenous phosphatidylcholine synthesis.
BHMT and MTHFR variants can impair methylation efficiency, causing over-reliance on choline as a methyl donor.
These genetic factors increase susceptibility to low choline levels, especially when dietary intake or B-vitamin status is suboptimal.

4. B-Vitamin Deficiency

Because choline works closely with B12, folate, and B6 in the methylation cycle, deficiencies in these vitamins can reduce the efficiency of both homocysteine recycling and SAM regeneration, indirectly depleting choline reserves.

5. Liver or Gut Dysfunction

Poor liver function or bile flow impairs both choline synthesis and absorption. Gut inflammation or dysbiosis may further limit uptake and increase degradation, reducing systemic availability.

Symptoms of Low Choline Levels

Low choline levels can affect multiple systems, particularly the brain, liver, and methylation pathways. Common symptoms include:

Cognitive and Neurological Signs:

Brain fog, memory loss, or poor focus
Fatigue or lack of mental clarity
Difficulty concentrating or learning
Low mood or irritability
Muscle tension or weakness (due to low acetylcholine)

Metabolic and Systemic Signs:

Elevated homocysteine levels
Fatty liver or impaired fat metabolism
Digestive sluggishness or bloating
Poor detoxification (sensitivity to caffeine, alcohol, or medications)
Hormonal imbalance, particularly estrogen dominance in women

Choline deficiency may also worsen oxidative stress and mitochondrial strain, leading to symptoms of chronic fatigue or “wired-but-tired” energy patterns.

Interpretation Context on Neurotransmitter XL

Related Marker	Interpretation Insight
Betaine	Low betaine with low choline suggests poor conversion and reduced methylation support.
SAM / SAH Ratio	Low ratio indicates slowed methylation due to insufficient methyl donors.
Homocysteine	Elevated levels confirm reduced choline- and betaine-dependent methylation efficiency.
Methionine	Low methionine suggests impaired homocysteine-to-methionine conversion.
Methylmalonic Acid (B12 Status)	Elevated values reflect B12 deficiency, worsening methylation inefficiency.
Liver Markers (e.g., Suberic Acid, Citrate)	May indicate mitochondrial stress or fatty liver related to low choline.

This integrative view helps determine whether low choline results from dietary insufficiency, poor liver function, or increased methylation demand.

Clinical Implications of Low Choline

Persistently low choline levels can have widespread metabolic and neurological effects:

Cognitive decline and poor memory (low acetylcholine availability)
Fatty liver disease (NAFLD) due to reduced VLDL formation
Elevated homocysteine and cardiovascular risk
Low SAM and sluggish methylation
Hormonal imbalances and poor detoxification
Mitochondrial and redox dysfunction, contributing to fatigue

In pregnancy, low choline intake can impact fetal brain development, making adequate choline particularly important for maternal health.

Supportive Strategies to Discuss with Your Clinician

1. Increase Dietary Choline Intake

Include choline-rich foods such as:

Eggs (especially yolks)
Liver and fish (salmon, cod)
Chicken, turkey, and beef
Soybeans, legumes, quinoa, and cruciferous vegetables (for plant-based sources)

2. Optimize B-Vitamin Status

Ensure sufficient intake of:

Folate (5-MTHF)
Vitamin B12 (methylcobalamin)
Vitamin B6 (P5P)
Riboflavin (B2) and magnesium

These cofactors support choline’s methylation and homocysteine-lowering functions.

3. Support Liver Function and Detoxification

Include antioxidants (vitamin C, NAC, glutathione, alpha-lipoic acid) to protect against oxidative damage.
Avoid excessive alcohol or refined fats that tax hepatic methylation.
Consider liver-supportive botanicals like milk thistle, dandelion root, or artichoke extract under supervision.

4. Consider Choline Supplementation

If dietary intake is low or metabolic demand is high, choline supplementation may be beneficial.
Common forms include:

Alpha-GPC or Citicoline (CDP-Choline) — enhance brain acetylcholine and cognition
Phosphatidylcholine (lecithin form) — supports liver and cell membranes
Choline bitartrate — supports general methylation and liver function

Typical doses range from 250–1,000 mg/day, adjusted for dietary intake and clinical need.

5. Manage Inflammation and Oxidative Stress

Reduce lifestyle and environmental stressors that increase methylation demand, and ensure adequate antioxidant support to preserve choline-dependent pathways.

Key Takeaway

Choline is essential for healthy brain function, liver metabolism, and methylation balance. Low levels indicate reduced acetylcholine synthesis, weakened liver detoxification, and slowed methylation, often tied to poor diet, B-vitamin deficiency, or genetic inefficiency in methylation pathways.

On the Neurotransmitter XL panel, choline levels help reveal the body’s capacity to regulate neurotransmitter activity, lipid metabolism, and energy production.

All Your Lab Results.
One Simple Dashboard.

Import, Track, and Share Your Lab Results Easily

Import, Track, and Share Your Lab Results

Import lab results from multiple providers, track changes over time, customize your reference ranges, and get clear explanations for each result. Everything is stored securely, exportable in one organized file, and shareable with your doctor—or anyone you choose.

Cancel or upgrade anytime

What does it mean if your Choline result is too low?

Low choline levels on the Neurotransmitter XL panel indicate a deficiency in one of the body’s most essential nutrients for neurotransmitter synthesis, liver function, and methylation balance. Choline serves as a building block for acetylcholine, the neurotransmitter responsible for memory, learning, attention, and muscle control, and is a critical precursor to phosphatidylcholine and betaine (trimethylglycine)—molecules central to cell membrane health, detoxification, and methyl group donation.

When choline is insufficient, the body’s ability to synthesize acetylcholine, maintain membrane integrity, and support the methionine cycle is compromised. This can manifest as fatigue, poor focus, low mood, and liver dysfunction, often accompanied by biochemical evidence of methylation slowdown, elevated homocysteine, or fat accumulation in the liver.

Low choline is particularly important to address early, as it often represents a foundational metabolic deficiency that disrupts both neurological performance and systemic detoxification.

Biochemical and Functional Implications

1. Reduced Acetylcholine Synthesis

Choline is converted into acetylcholine by the enzyme choline acetyltransferase, a reaction that underlies learning, memory retention, and neuromuscular coordination. When choline levels fall, acetylcholine production drops, leading to symptoms such as brain fog, memory lapses, poor focus, and low motivation.

2. Impaired Methylation and Homocysteine Recycling

Choline oxidation produces betaine, which donates methyl groups via the betaine-homocysteine methyltransferase (BHMT) pathway to regenerate methionine and sustain S-adenosylmethionine (SAM) production.
Low choline therefore weakens methylation efficiency, resulting in:

Elevated homocysteine levels (a marker of impaired methyl group recycling)
Reduced SAM, limiting neurotransmitter synthesis and detoxification
Sluggish catecholamine metabolism, causing stress intolerance or mood swings

3. Liver Fat Accumulation and Detoxification Impairment

Phosphatidylcholine, synthesized from choline, is essential for packaging and exporting fats from the liver as VLDL particles. Inadequate choline causes lipid buildup in hepatocytes, leading to fatty liver (hepatic steatosis) and reduced toxin elimination. This can result in sluggish digestion, poor fat tolerance, and hormonal imbalance due to decreased estrogen clearance.

4. Structural and Cellular Consequences

Choline is a major component of cell membranes. When levels are low, phospholipid synthesis is disrupted, compromising cell signaling, membrane fluidity, and mitochondrial protection. Over time, this can contribute to fatigue, oxidative stress, and reduced cellular repair capacity.

Causes of Low Choline

1. Inadequate Dietary Intake

The body’s choline requirement is high, and synthesis alone cannot meet demand. Diets low in eggs, fish, meat, and dairy—or strict vegan and vegetarian diets—often lead to choline insufficiency.