Phosphatidylcholine supplement health benefit and medical uses by Ray Sahelian, M.D.
September 20 2016

Lecithin is known as phosphatidylcholine, although lecithin is also a term loosely applied to describe a combination of phosphatidylcholine with other phospholipids. Most people normally ingest 3 to 6 grams of lecithin a day through eggs, soy, and meats. Vegetables, fruits and grains contain very little lecithin.
   Phosphatidylcholine is the most abundant phospholipid component in all cells. Levels in brain cell membranes decline with age, perhaps contributing to memory loss.
   Several studies have been done with phosphatidylcholine to investigate its effects on memory. The results of the studies have not been consistent. Some have shown positive responses (Sorgatz 1987, Ladd, 1993), while others showed no difference in memory or learning after lecithin administration (Gillin 1980). Phosphatidylcholine
has even been evaluated in Parkinson’s disease (Tweedy 1982). In this nine-week long double-blind study, sixteen elderly patients took a daily dose of approximately 32 grams of a commercial lecithin preparation. Marked clinical improvement was not observed, but there was a slight improvement in memory, cognition, and motility. Phosphatidylcholine may be helpful in ulcerative colitis.

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Phosphatidylcholine (PC) is used as a nutritional supplement. This versatile phospholipid is now recognized for its advantages to liver function as well as a nutrient for brain function. Phosphatidylcholine my also maintain healthy cholesterol levels. Luca Meyer, Inc. produces Leci-PC, which has one of the highest levels of phosphatidylcholine available in a nutritional supplement. This Phosphatidylcholine is derived from soy, making it a completely natural substance.

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The herbs in this mental enhancer include: Ashwagandha, Bacopa, Fo-Ti, Ginkgo biloba, Ginseng, Gotu kola, Mucuna pruriens, Reishi, and Rhodiola.  The nutrients and vitamins in Mind Power Rx include Acetyl-l-carnitine, Carnitine nutrient, Carnosine, Choline, DMAE, Inositol, Methylcobalamin, Pantothenic acid, Trimethylglycine, Tyrosine, and Vinpocetine.

Phosphatidylcholine is sold in the form of liquid, capsules, or granules. The amount in each product varies between different brands. The lecithin you buy in a health food store will generally include about 10 to 70 percent phosphatidylcholine, along with other lipids. Different types of lecithin will differ in their lipid compositions depending on the source of the lecithin — soy or egg yolk — or the extraction process. One product contains 1,200 mg of phosphatidylcholine in each capsule along with small amounts of other phospholipids.

Additional mind and memory boosting supplements include:
Acetyl l-Carnitine 300 mg is quite popular since many people notice an effect within a few hours.
CDP-Choline may also have some sexual enhancing properties.
DMAE in high doses can cause tenseness of the neck muscles
Sam-e is a potent mood lifter and should be treated with respect. Use no more than 100 or 200 mg.

Phosphatidylcholine and homocysteine
A report in the July 2005 issue of the American Journal of Clinical Nutrition, indicates that a high daily dose of choline, supplemented as phosphatidylcholine, lowers fasting as well as postmethionine-loading plasma homocysteine concentrations in healthy men with mildly elevated homocysteine concentrations. If high homocysteine concentrations indeed cause cardiovascular disease, choline intake may reduce cardiovascular disease risk in humans.

Use in pregnancy
Phosphatidylcholine supplementation in pregnant women consuming moderate-choline diets does not enhance infant cognitive function: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 2012.

Ulcerative colitis
Z Gastroenterol. 2013. Mucosal protection by phosphatidylcholine as new therapeutic concept in ulcerative colitis. The colonic mucus serves a first barrier towards invasion of commensal bacteria in stool. One essential component of intestinal mucus is phosphatidylcholine (PC) which represents more than 90 % of the phospholipids in mucus indicative for a selective transport of PC into this compartment. It is arranged in lamellar structures as surfactant-like particles which provide a hydrophobic surface on top of the hydrated mucus gel to prevent invasion of bacteria from the intestinal lumen. In ulcerative colitis (UC) the mucus PC content is reduced by 70 % irrespective of the state of inflammation. Thus, it could represent an intrinsic primary pathogenetic condition predisposing to bacterial invasion and precipitation of inflammation. Since PC was shown to be mainly secreted by the ileal mucosa from where it is assumed to move distally to the colon, the PC content along the colonic wall towards the rectum gradually thins out with lowest PC content in the rectum. It explains the start of the clinical manifestation of UC in the rectum and expansion from there to the upper parts of the colon. When the lacking mucus PC in the UC was supplemented by an oral, delayed released PC preparation, it was shown in three clinical trials that the inflammation improved and even resolved. The data indicate the essential role of the mucus phosphatidylcholine content for protection against inflammation in colon. This can be the basis for the development of an innovative therapy for ulcerative colitis using orally available delayed released phosphatidylcholine.

Research findings regarding the role of phosphatidylcholine in cognition have not been consistent. My professional and personal experience does not indicate that this supplement has any dramatic effects on mental abilities. Based on the available evidence, it appears that the cognitive benefits of taking lecithin are likely to be minor. As a rule, individuals who consume a wide variety of foods are not likely to suffer from phosphatidylcholine deficiency. Whether lecithin supplements benefit a subgroup of seniors with age related memory decline has not yet been adequately determined. It is certainly possible that there are those who may have a biochemical difficulty in making adequate amounts of phosphatidylcholine and would benefit from additional supplementation. If you are planning to take it, keep your dosages low, such as three grams a day or less. At this point there does not seem to be a need to supplement with phosphatidylcholine for cognitive purposes unless someone has an unusual diet and is not ingesting enough of this nutrient. However, it could be of help to those with high homocysteine levels.

Dr. Sahelian's experience
I have interviewed many individuals who have taken lecithin in order to improve cognition. The reports have not been impressive. The majority of users do not notice any obvious benefits from lecithin. Lecithin does not provide me with cognitive effects. I have taken fifteen capsules a day of lecithin for a week without a noticeable effect on alertness, vision, or mood. Each capsule contained 1,200 mg of phosphatidylcholine. However, it is possible that long term use of smaller amounts my have benefits for certain individuals.

Research study
Cell Physiol Biochem. 2015. Plasma phosphatidylcholine alterations in cystic fibrosis patients: impaired metabolism and correlation with lung function and inflammation Liver impairment, ranging from steatosis to cirrhosis, is frequent in cystic fibrosis (CF) patients and is becoming increasingly significant due to their improved life expectancy. In CF patients, hepatic and plasma homeostasis of choline and PC correlate with lung function and inflammation. Impaired hepatic PC metabolism, exemplarily shown in three CF patients, provides an explanation for such correlations.

Therapeutic applications of citicoline for stroke and cognitive dysfunction in the elderly: a review of the literature.
American Institute for Biosocial and Medical Research, Puyallup, WA
Altern Med Rev. 2004.
Citicoline (CDP-choline; cytidine 5'-diphosphocholine), a form of the essential nutrient choline, shows promise of clinical efficacy in elderly patients with cognitive deficits, inefficient memory, and early-stage Alzheimer's disease. CDP-choline has also been investigated as a therapy in stroke patients, although the results of trials to date are inconclusive. Produced endogenously, CDP-choline serves as a choline donor in the metabolic pathways for biosynthesis of acetylcholine and neuronal membrane phospholipids, chiefly phosphatidylcholine. The principal components of CDP-choline, choline and cytidine, are readily absorbed in the GI tract and easily cross the blood-brain barrier. Exogenous CDP-choline, as the sodium salt, has been researched in animal experiments and human clinical trials that provide evidence of its cholinergic and neuroprotective actions. As a dietary supplement, CDP-choline appears useful for improving both the structural integrity and functionality of the neuronal membrane that may assist in membrane repair. This review, while not intended to be exhaustive, highlights the published, peer-reviewed research on CDP-choline with brief discussions on toxicology and safety, mechanisms of action, and pharmacokinetics.

"Brain-specific" nutrients: a memory cure?
Department of Psychology, University of New Mexico,
Nutrition. 2003.
We review the experimental evaluations of several widely marketed nonprescription compounds claimed to be memory enhancers and treatments for age-related memory decline. We generally limit our review to double-blind placebo-controlled studies. The compounds examined are phosphatidylcholine, citicoline (CDP-choline), vinpocetine, and acetyl-L-carnitine. The choline compounds phosphatidylcholine and CDP-choline are thought to promote synthesis and transmission of neurotransmitters important to memory. Phosphatidylcholine has not proven effective for improving memory in patients with probable Alzheimer's disease. The issue remains open for older adults without serious degenerative neural disease. Research on citicoline is practically nonexistent, but one study reported a robust improvement in story recall for a small sample of normally aging older adults who scored lower than their peers in baseline testing. Vinpocetine increases blood circulation and metabolism in the brain. Animal studies have shown that vinpocetine can reduce the loss of neurons due to decreased blood flow. In three studies of older adults with memory problems associated with poor brain circulation or dementia-related disease, vinpocetine produced significantly more improvement than a placebo in performance on global cognitive tests reflecting attention, concentration, and memory. Effects on episodic memory per se have been tested minimally, if at all. Acetyl-L-carnitine participates in cellular energy production, a process especially important in neurons, and in removal of toxic accumulation of fatty acids. Animal studies show that acetyl-L-carnitine reverses the age-related decline in the number of neuron membrane receptors. Studies of patients with probable Alzheimer's disease have reported nominal advantages over a range of memory tests for acetyl-L-carnitine-treated patients relative to placebo groups. Significant differences have been reported rarely, however. Whether acetyl-L-carnitine would have mnemonic benefits for aging adults without brain disease is untested as far as we know. In sum, for most of the "brain-specific" nutrients we review, some mildly suggestive effects have been found in preliminary controlled studies using standard psychometric memory assessments or more general tests designed to reveal cognitive impairment.

Lecithin for dementia and cognitive impairment.
Cochrane Database Syst Rev. 2003.
Alzheimer's disease sufferers have been found to have a lack of the enzyme responsible for converting choline into acetylcholine within the brain. Lecithin is a major dietary source of choline, so extra consumption may reduce the progression of dementia. To determine the efficacy of lecithin in the treatment of dementia or cognitive impairment, the Cochrane Dementia and Cognitive Improvement Group's Specialized Register was searched on 15 May 2002 using the terms lecithin and phosphatidylcholine. Twelve randomized trials have been identified involving patients with Alzheimer's disease (265 patients), Parkinsonian dementia (21 patients) and subjective memory problems (90 patients). No trials reported any clear clinical benefit of lecithin for Alzheimer's disease or Parkinsonian dementia. Few trials contributed data to meta-analyses. The only statistically significant result was in favur of placebo for adverse events, based on one trial, which appears likely to be a spurious result. A dramatic result in favour of lecithin was obtained in a trial of subjects with subjective memory problems. Evidence from randomized trials does not support the use of lecithin - phosphatidylcholine -  in the treatment of patients with dementia. A moderate effect cannot be ruled out, but results from the small trials to date do not indicate priority for a large randomized trial.

Q. Is alpha gpc similar to phosphatidylcholine?
   A. See the link above for more information.

Q.  I have been told that I am deficient in acetylcholine. After conducting some research, I have found that Phosphatidylcholine requires Vitamin B5 to assist in the synthesizing process that eventually boost Acetylcholine. Additionally, I would like to know if this is true, would it be better to take a Vitamin B complex? What kind of dosage would you suggest.
   A.  Each person has a different diet and different nutritional requirement, therefore no blanket statements can be made regarding how much or whether to supplement with B5. As a rule, though, one or two times the RDA for the B vitamins is fine for most people.

Is memory, particularly short-term, involved in speech? Therefore, if phosphatidylcholine contributes to memory, and makes up most of the brain, would it help speech? I've emailed you before about how I believe massive amounts of soymilk slowed my speech and caused me to sound choppy, not fluent, and generally, retarded. I drank almost a gallon of soy a day for a year and a half, and I've been off for seven months now. But my speech is not like it was in May 2008 and prior. One thing that's not in my diet is eggs and organ meats, like liver or brain, things rich in phosphatidylcholine.
    There are many, many substances in the brain that influence brain function and PC is only one of many. It is worth trying a variety of memory herbs and nutrients to see which one will work for you.

I read the blurb about Phosphatidylcholine versus alpha glycerylphosphocholine, but I still have a hard time distinguishing the two. Apparently the second one, alpha, crosses the blood brain barrier because it is water soluble. Does this mean it works better for increasing acetylcholine and therefore short term memory? The short Wikipedia blurb mentions a study that looks promising.
    As of 2016 there have not been any comparison studies in humans to know which is preferable. There are many supplements that are helpful for memory and have more studies backing up their benefits.

Natural Factors, Phosphatidyl Choline (PC), 420 mg, 90 Softgels
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Supplement Facts:
Lecithin 1200 mg
Phosphatidylcholine 35% - 420 mg
Suggested Usage: Take 1 phosphatidylcholine capsule, 3 times daily with meals or as directed by a health professional.

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Supplement Facts Natural Factors, Phosphatidyl Choline (PC), 420 mg, 90 Softgels
Serving Size 1 Softgel
  Amount Per Serving % Daily Value
Lecithin 1200 mg **
Phosphatidylcholine 420 mg **
** Daily Value not established.