Editing Choline (section)

===Signs and symptoms===
Symptomatic choline deficiency is rare in humans. Most obtain sufficient amounts of it from the diet and are able to biosynthesize limited amounts of it via [[Phosphatidylethanolamine N-methyltransferase|PEMT]].<ref name=ze>{{Cite book|title=Handbook of vitamins |url=https://archive.org/details/handbookvitamins00jzem |url-access=limited |vauthors= Rucker RB, Zempleni J, Suttie JW, McCormick DB |publisher=Taylor & Francis |year=2007 |isbn=9780849340222 |edition=4th |pages=[https://archive.org/details/handbookvitamins00jzem/page/n471 459]–477 }}</ref> Symptomatic deficiency is often caused by certain diseases or by other indirect causes. Severe deficiency causes muscle damage and [[non-alcoholic fatty liver disease]],<ref name="Kenny2025"/> which may develop into [[cirrhosis]].<ref name="Corbin_2012">{{cite journal | vauthors = Corbin KD, Zeisel SH | title = Choline metabolism provides novel insights into nonalcoholic fatty liver disease and its progression | journal = Current Opinion in Gastroenterology | volume = 28 | issue = 2 | pages = 159–65 | date = March 2012 | pmid = 22134222 | pmc = 3601486 | doi = 10.1097/MOG.0b013e32834e7b4b }}</ref>

Besides humans, fatty liver is also a typical sign of choline deficiency in other animals. Bleeding in the kidneys can also occur in some species. This is suspected to be due to deficiency of choline derived trimethylglycine, which functions as an osmoregulator.<ref name=ze/>