For a while, lecithin/phosphatidylcholine was one of the most commonly recommended natural treatments for high cholesterol. However, this idea appears to rest entirely on studies of unacceptably low quality.2,25 The best designed studies have failed to find any evidence of benefit.3,25-28 In Europe, phosphatidylcholine is also used to treat liver diseases, such as alcoholic fatty liver, alcoholic hepatitis, liver cirrhosis, and viral hepatitis. However, research into these potential uses remains preliminary and has yielded contradictory results.4-14
Researchers have recently become interested in the use of phosphadylcholine as a supportive treatment in severe ulcerative colitis. There may be an insufficient quantity of phosphatidylcholine in the mucus lining the colon in patients with ulcerative colitis. Taking phosphatidylcholine may correct this deficiency. A small double-blind, placebo controlled study of 60 patients whose ulcerative colitis was poorly responsive to corticosteroids were randomized to receive either phosphadylcholine (2 g per day) or placebo for 12 weeks.31 Half of the participants taking phosphadylcholine showed a significant improvement in symptoms versus only 10% taking placebo. Moreover, 80% taking phosphadylcholine were able to completely discontinue their corticosteroids without disease flare-up compared to 10% taking placebo.
Some evidence hints that phosphatidylcholine may reduce Homocysteine levels, which in turn was for a time thought likely to reduce heart disease risk.29
Because phosphatidylcholine plays a role in nerve function, it has also been suggested as a treatment for various psychological and neurological disorders, such as Alzheimers, Tourette's syndrome, and tardive dyskinesia (a late-developing side effect of drugs used for psychosis). However, the evidence that it works is limited to small studies with conflicting results.15-24,30
1. Brook JG, Linn S, Aviram M. Dietary soya lecithin decreases plasma triglyceride levels and inhibits collagen- and ADP-induced platelet aggregation. Biochem Med Metab Biol. 1986;35:31-39.
2. Wojcicki J, Pawlik A, Samochowiec L, et al. Clinical evaluation of lecithin as a lipid-lowering agent. Phytother Res. 1995;9:597-599.
3. Oosthuizen W, Vorster HH, Vermaak, WJ, et al. Lecithin has no effect on serum lipoprotein, plasma fibrinogen and macro molecular protein complex levels in hyperlipidaemic men in a double-blind controlled study. Eur J Clin Nutr. 1998;52:419-424.
4. Buchman AL, Dubin M, Jenden D, et al. Lecithin increases plasma free choline and decreases hepatic steatosis in long-term total parenteral nutrition patients. Gastroenterology. 1992;102:1363-1370.
5. Guan R, Ho KY, Kang JY, et al. The effect of polyunsaturated phosphatidyl choline in the treatment of acute viral hepatitis. Ailment Pharmacol Ther. 1995;9:699-703.
6. Lieber CS, Robins SJ, Li J, et al. Phosphatidylcholine protects against fibrosis and cirrhosis in the baboon. Gastroenterology. 1994;106:152-159.
7. Lieber CS, DeCarli LM, Mak KM, et al. Attenuation of alcohol-induced hepatic fibrosis by polyunsaturated lecithin. Hepatology. 1990;12:1390-1398.
8. Lieber CS, Leo MA, Mak KM, et al. Choline fails to prevent liver fibrosis in ethanol-fed baboons but causes toxicity. Hepatology. 1985;5:561-572.
9. Lieber CS, Rubin E. Alcoholic fatty liver. N Engl J Med. 1969;280:705-708.
10. Schuller-Perez A, Gonzalez San Martin F. A controlled study with polyunsaturated phosphatidylcholine compared to placebo in alcoholic steatosis of the liver [translated from German]. Med Welt. 1985;36:517-521.
11. Knuchel F. Double-blind study in patients with alcoholic toxic fatty liver. Effect of essential phospholipids on enzyme behavior and lipid composition of the serum [translated from German]. Med Welt. 1979;30:411-416.
12. Jenkins PJ, Portmann BP, Eddleston AL, et al. Use of polyunsaturated phosphatidylcholine in HBsAg negative chronic active hepatitis: results of prospective double-blind controlled trial. Liver. 1982;2:77-81.
13. Niederau C, Strohmeyer G, Heintges T, et al. Polyunsaturated phosphatidyl-choline and interferon alpha for treatment of chronic hepatitis B and C: a multi-center, randomized, double-blind, placebo-controlled trial. Hepatogastroenterology. 1998;45:797-804.
14. Singh NK, Prasad RC. A pilot study of polyunsaturated phosphatidyl choline in fulminant and subacute hepatic failure. J Assoc Physicians India. 1998;46:530-532.
15. Stoll AL, Sachs GS, Cohen BM, et al. Choline in the treatment of rapid-cycling bipolar disorder: clinical and neurochemical findings in lithium-treated patients. Biol Psychiatry. 1996;40:382-388.
16. Cohen BM, Lipinski JF, Altesman RI. Lecithin in the treatment of mania: Double-blind, placebo-controlled trials. Am J Psychiatry. 1982;139:1162-1164.
17. Polinsky RJ, Ebert MH, Caine ED, et al. Cholinergic treatment in the Tourette syndrome. N Engl J Med. 1980;302:1310.
18. Gelenberg AJ, Dorer DJ, Wojcik JD, et al. A crossover study of lecithin treatment of tardive dyskinesia. J Clin Psychiatry. 1990;51:149-153.
19. Domino EF, May WW, Demetriou S, et al. Lack of clinically significant improvement of patients with tardive dyskinesia following phosphatidylcholine therapy. Biol Psychiatry. 1985;20:1189-1196.
20. Weintraub S, Mesulan MM, Auty R, et al. Lecithin in the treatment of Alzheimer's disease. Arch Neurol. 1983;40:527-528.
21. Cohen BM, Miller AL, Lipinski JF, et al. Lecithin in mania: a preliminary report. Am J Psychiatry. 1980;137:242-243.
22. Cohen BM, Lipinski JF, Altesman RI. Lecithin in the treatment of mania: Double-blind, placebo-controlled trials. Am J Psychiatry. 1982;139:1162-1164.
23. Harris CM, Dysken MW, Fovall P, et al. Effect of lecithin on memory in normal adults. Am J Psychiatry. 1983;140:1010-1012.
24. Joe SH. Effect of lecithin on tardive dyskinesia. Korea Univ Med J. 1985;22:197-206.
25. Knuiman JT, Beynen AC, Katan MB. Lecithin intake and serum cholesterol. Am J Clin Nutr. 1989;49:266-268.
26. Greten H, et al. The effect of polyunsaturated phosphatidylcholine on plasma lipids and fecal sterol excretion. Atherosclerosis. 1980;36:81-88.
27. Childs MT, et al. The contrasting effects of a dietary soya lecithin product and corn oil on lipoprotein lipids in normolipidemic and familial hypercholesterolemic subjects. Atherosclerosis. 198;38:217-228.
28. Kesaniemi YA, et al. Effects of dietary polyenylphosphatidylcholine on metabolism of cholesterol and triglycerides in hypertriglyceridemic patients. Am J Clin Nutr. 1986;43:98-107.
29. Olthof MR, Brink EJ, KatanMB, et al. Choline supplemented as phosphatidylcholine decreases fasting and postmethionine-loading plasma homocysteine concentrations in healthy men. Am J Clin Nutr. 2005;82:111-117.
30. Higgins JPT, Flicker L. Lecithin for dementia and cognitive impairment. Cochrane Database Syst Rev. 2003;(3):CD001015.
31. Stremmel W, Ehehalt R, Autschbach F, et al. Phosphatidylcholine for steroid-refractory chronic ulcerative colitis: a randomized trial. Ann Intern Med. 2007;147:603-610.
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