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If hepatotoxicity is suspected, these agents should be discontinued in favor of alternative therapies

Mechanisms of Action Nootropics do not act directly by releasing neurotransmitters or as receptor ligands [16], but improve the brains supply of glucose and oxygen, have antihypoxic effects, and protect brain tissue from neurotoxicity [9,17]

Dietary Intakes of Choline: What We Eat in America, NHANES 2007-2008

Healthcare providers should maintain a low threshold for testing given the potential for irreversible neurological damage if deficiency remains undetected and untreated