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In patients with primary biliary cirrhosis, one author concluded that vitamin E supplementation should be considered not only in individuals with overt vitamin E deficiency, but also in individuals who meet certain additional criteria, such as total serum bilirubin over 3 mg/dL, serum cholylglycine (a crystalline bile acid involved in emulsification of fat) over 600 mcg/dL, or serum alkaline phosphatase over 1000 IU/L (Sokol 1989)

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Yet, common polymorphisms in genes involved in choline or folate metabolism alter ones susceptibility to choline deficiency and thus may affect dietary requirements for choline (see Deficiency) (18, 20, 33, 34)