What Is Acetylcholine?

Acetylcholine is a neurotransmitter in the central nervous system (CNS). It can also be found in the peripheral nervous system (PNS). Neurotransmitters are chemical signals made by neurons to send information to associated receptors, where information is received or blocked and processed into necessary action. Acetylcholine can do both: It can stimulate or block responses (excite or inhibit) for desired physiological effects.

neurotransmitters in the synaptic gap

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Acetylcholine has many functions in the body. It is released from cholinergic nerve synapses and acts on presynaptic (transmitter) and postsynaptic (receiver) acetylcholine receptors.

Dilates Blood Vessels

Acetylcholine plays a role in regulating blood pressure. When blood flows, it creates friction that can be seen on image signaling technology focusing on the endothelium, the cell barrier between your blood and blood vessel wall.

One ex vivo (outside of a living body) animal study on rats' main arteries found that this friction triggers the release of acetylcholine, which triggers calcium release from your endothelial cells, nitric oxide production (a known vasodilator, which relaxes or dilates blood vessels), and artery relaxation.

Human clinical trials are still needed before science can fully explain how acetylcholine works to dilate blood cells in the human body.

Contracts Smooth Muscles

Smooth muscles are those lining the walls of organs and tubular structures, including the intestine, bladder, airway, uterus, blood vessels, and stomach. Acetylcholine in the neuromuscular junction (located between the motor nerve and skeletal muscle) acts on nerve fibers, sending messages from the brain to targeted muscles, signaling them to respond with movement.

Here’s how it works, according to studies conducted on mice:

  • Acetylcholine released from nerve endings will bind to acetylcholine receptors on your smooth muscle’s surface, causing sodium channels to open. This allows action potential to travel along cells, which triggers a process that opens the L-type calcium channel. 
  • Calcium is released and binds to calmodulin, which regulates motor proteins with roles in muscle contraction.
  • Calmodulin then binds to kinase myosin light-chain kinase, stimulating phosphorylation (molecule attachment) of myosin light chain, which leads to muscle contraction.  

Acetylcholine plays an important role in muscle actions, so any drugs that influence this neurotransmitter can cause movement disruption and even paralysis.

Causes Erections

The penis is made of smooth muscle that is actually contracted in its flaccid state. As stimuli increase blood flow to the area, the cholinergic receptors on the endothelial cells inside the penis are activated by acetylcholine. This offers a relaxing effect, allowing for erection to occur.

Slows Heart Rate

Acetylcholine is the predominant neurotransmitter in the parasympathetic nervous system. When your heart rate increases beyond what's normal, acetylcholine is released to slow your heart rate and contractions until it goes back to baseline.

Stimulates Secretions

Acetylcholine also works on cholinergic muscarinic receptors in organ systems to stimulate secretions by all glands receptive to parasympathetic nerve impulses. 

Examples include:

  • Digestive glands
  • Salivary glands
  • Exocrine sweat glands


Acetylcholine sends messages along nerve cells through the nervous systems. All of your body’s movements depend on this communication. This means any disruption to acetylcholine functioning compromises this process and can result in illness.

Acetylcholine in the brain also plays crucial roles in memory and cognitive functioning. As such, it is associated with higher brain functions and some neurodegenerative brain diseases like Alzheimer’s.

On the flip side, the acetylcholine receptors can be targeted and manipulated with medications to adjust how your body functions in a disease state.

Abnormal Muscle Function

Cholinergic nerve receptors are those that receive and bind with acetylcholine. They can be found all over the body, including in muscle tissue. If there is any issue with these receptors or the appropriate release and uptake of acetylcholine, abnormal muscle function may result. In such cases, anticholinergic drugs may be necessary.

Anticholinergics are available by prescription to help treat conditions like:

  • Urinary incontinence or overactive bladder: They work on the abnormal uterine contraction that causes the sensation of needing to urinate.
  • Asthma or other obstructive respiratory disorders: They may have a protective effect on airway inflammation and airway changes due to pathology.
  • Symptoms of Parkinson’s disease: They work on involuntary movements like jerks.  
  • Gastrointestinal issues like diarrhea: They can inhibit gastrointestinal contractions. 
  • Poisoning by toxins such as organophosphates, a class of man-made chemicals that are poisonous to insects and mammals: Certain poisons can work on the same receptors as acetylcholine and cause choline toxicity. Anticholinergics work to restore the normal process.

These drugs block acetylcholine’s binding action and thereby interfere with parasympathetic nerve impulses. Anticholinergics have shown cognitive slowing effects and should be avoided in people over 70 due to the risk of confusion or hallucination.


Naturally occurring acetylcholine was first identified in 1914 by British physiologist Sir Henry Dale from London. It was named after its structure. Acetylcholine is made of acetic acid (ethanoic acid) and choline (a nutrient similar to B vitamins). Over two decades later, Dale and Otto Loewi from Graz shared the Nobel Prize in Physiology or Medicine for their work on chemical neurotransmission.

Frequently Asked Questions

What does acetylcholine do to the heart?

Acetylcholine is critical in the healthy functioning of your heart. It helps to regulate your heartbeat, blood pressure, and heart muscle contractions. 

What enzyme breaks down acetylcholine?

Acetylcholinesterase is a cholinergic enzyme that breaks down acetylcholine into acetic acid and choline. This enzyme is found at postsynaptic neuromuscular junctions, especially in muscles and nerves.

How do you lower acetylcholine?

You can lower levels of acetylcholine with prescription anticholinergic drugs, but the appropriate drug depends on the body system. For example, acetylcholine imbalance associated with brain conditions may be treated differently than that of asthmatic conditions. Your doctor can help determine what, if any, medication is necessary.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Michelle Pugle
Michelle Pugle, BA, MA, is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. Her work focuses on lifestyle management, chronic illness, and mental health. Michelle is the author of Ana, Mia & Me: A Memoir From an Anorexic Teen Mind.