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Lecithin

Scientific Name(s): 1,2-diacyl-sn-glycero-3-phosphatidylcholine.
Common Name(s): Granulestin, Kelecin, Lecithin, Lecithol, Vitellin

Clinical Overview

Use

Lecithin is used for its emulsifying properties in the food, pharmaceutical, and cosmetic industries. Proposed pharmacological use of lecithin includes treatment for hypercholesterolemia, neurologic disorders, manic disorders, and liver ailments. It has also been used to modify the immune system by activating specific and nonspecific defense systems. However, no quality clinical trials exist to support lecithin's use for these indications.

Dosing

Studies of lecithin in cognitive impairment have used a wide range of dosages, from 1 to 35 g daily. In a study of patients with bipolar disorder, 10 mg given 3 times daily was found to improve symptoms of mania.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Adverse effects are usually not associated with lecithin. However, there have been reports of anorexia, nausea, sweating, increased salivation, other GI effects, and hepatitis.

Toxicology

Information regarding toxicology with the use of this lecithin is limited.

Source

Lecithin is found in many animal and vegetable sources including beef liver, steak, eggs, peanuts, cauliflower, and oranges.1 Commercial sources for lecithin may come from soybeans, egg yolk, or brain tissue.2, 3 Some commercial lecithin and lecithin supplements contain between 10% and 35% phosphatidylcholine.1

History

The word "lecithin" originated from the Greek lekithos, referring to egg yolk.1, 4 Lecithin was discovered in 1805 by the French scientist Maurice Gobley5 and has been proposed for use in treating liver ailments, hypercholesterolemia, and neurologic diseases,1, 4 as well as in the food processing industry.2, 6 Lecithin is a common compound found in cells of all living organisms, as its presence is required for proper biological function.7

Chemistry

Lecithin is a phospholipid mixture of acetone insoluble phosphatides consisting mainly of phosphatidylcholine, phosphatidyl ethanolamine, phosphatidyl serine, and phosphatidyl inositol combined with various other substances, including fatty acids and carbohydrates.4 Lecithin is the common name for a series of related compounds, called phosphatidylcholines,6 and is defined chemically as a mixture of the diglycerides of stearic, palmitic, and oleic acids, linked to the choline ester of phosphoric acid (eg, soybean lecithin contains 4% stearic, 11.7% palmitic, 9.8% oleic acids, along with others). Lecithin also contains phosphorous and nitrogenous (eg, choline) compounds.6

Physical properties of lecithin can vary depending on acid value. It is a waxy mass at acid value 20 and a thick pourable fluid at acid value 30. The color is white when freshly made but turns yellow to brown in air. It is an edible and digestible surfactant and emulsifier.2

Uses and Pharmacology

Lecithin is used as an emulsifying and stabilizing agent in the food (eg, margarine, chocolate production), pharmaceutical, and cosmetic (eg, creams, lipsticks, conditioners) industries.2, 4, 6

Proposed pharmacological uses of lecithin primarily include treatment for hypercholesterolemia, neurologic disorders, and liver ailments.

Hypercholesterolemia

Lecithin may reduce cholesterol levels and control or prevent atherosclerosis. However, older studies conducted in the late 1970s to early 1980s provide insufficient clinical or epidemiologic evidence to definitively support a positive effect in atherosclerosis. Although other studies from this time appeared promising and found results such as "18% cholesterol reduction" or "lowered cholesterol levels along with changes in lipid metabolism," no study correlated such changes to atherosclerosis progression.6

Animal data

There are no animal data regarding the use of lecithin for hypercholesterolemia.

Clinical data

Four months of soybean lecithin administration was found to reduce total serum lipids, cholesterol, and triglycerides in 21 hyperlipidemic patients.7 The mechanism appears to be an enhancement of cholesterol metabolism in the digestive system. Similar results were seen with a commercially available combination product of 1.5% (5.025 mg) red yeast rice that also contained 30 mg coenzyme Q10, 20 mg procyanidins from grape seed, and 100 mg lecithin. Data from 52 participants with a total fasting cholesterol higher than 200 mg/dL and triglycerides less than 400 mg/dL revealed that 2 capsules taken twice daily for 8 weeks produced a 22% reduction in LDL cholesterol in 20% of the intervention group and a 15% reduction in total cholesterol (P < 0.001); magnitude of effect on LDL was high and ranged from −8% to 40.5%. No significant differences in creatine-kinase elevation or side effects were noted between treatment and placebo, although muscle aches tended to be more prevalent in the intervention group.25

Neurologic disorders

Variable results have been reported using lecithin supplementation for treatment of neurologic disorders. Evidence-based Canadian guidelines for pharmacotherapy of tic disorders (2012) determined that there was insufficient evidence to make a formal recommendation regarding lecithin for the treatment of tics. Although limited studies are available, group consensus agreed that further research is unwarranted.24

Lecithin is a good source of choline for treatment in dementias.4 Phosphatidylcholine is thought to be a precursor for acetylcholine (ACh) synthesis.6 Choline increases the accumulation of ACh within the brain. ACh is important for many brain functions, including memory; therefore, increasing concentration of this neurotransmitter can result in improved memory.1

Animal data

There are no animal data regarding the use of lecithin for neurological disorders.

Clinical data

Positive effects on long-term memory have been demonstrated after administration of lecithin 35 g for 4 to 6 weeks.6 However, another report showed no improvement with lecithin in memory disorders when taken in 30 mg/day dosages.8

Lecithin supplementation has also been studied in Alzheimer disease, starting with memory difficulties. Three of 7 patients with Alzheimer disease receiving lecithin 25 g showed improvement in learning ability coinciding with peak choline levels.9 Combination tacrine and lecithin therapy conducted in a 32-patient, double-blinded trial yielded poor results.10 In a multicenter study, this combination did not improve mental status in 67 Alzheimer patients.11

ACh deficiencies are associated with other neurological disorders, including tardive dyskinesia, Huntington chorea, Friedreich ataxia, myasthenia gravis, and other brain atrophies. In 2 patients with tardive dyskinesia, lecithin administration reduced abnormal movements. Ten cases of Friedreich ataxia were also improved by lecithin supplementation.12 But one study failed to show any beneficial response in 12 patients with Friedreich ataxia who were taking lecithin 25 g daily,13 and a meta-analysis from 2003 concluded that evidence does not support the use of lecithin for dementias.14

Liver disease

In Germany, the product Essentiale (phosphatidylcholine) is marketed for liver disorders, including acute and chronic hepatitis, cirrhosis, diabetic fatty liver, and toxic liver damage. Documentation supporting these claims has been authorized by the British-German Association, the German equivalent of the US Food Drug and Administration.

Animal data

One report described supplementation with phosphatidylcholine and protection against alcoholic cirrhosis in baboons.1 Another study in rats suggests that lecithin was able to counteract changes caused by alcohol in body weight and biochemical parameters. Specifically, enzyme markers, such as glutathione reductase and glutathione peroxidase levels, were improved with lecithin.15 Lecithin plus vitamin B complex was found to reduce AST, ALT, interleukin-10, interferon gamma, and thiobarbituric acid reactive substance level in mice exposed to long-term alcohol ingestion. The combination was also effective in increasing superoxide dismutase activity and glutathione levels.16

In a study of mice with mutations in the multidrug resistance 3 gene ABCB4, lecithin was found to decrease liver damage caused by dietary supplementation with cholic acid, which accelerates development of hepatic lesions. Bilirubin and gamma-glutamyltransferase (GGT) levels were higher in mice receiving a cholic acid supplemented diet. Lecithin administration to mice receiving a cholic acid supplemented diet was found to yield similar bilirubin and GGT levels compared with those mice receiving lecithin only. It was suggested that a possible role in patients with this mutated gene can lead to progressive familiar intrahepatic cholestasis type 3, which ultimately causes cirrhosis.17

In fresh rat hepatocytes and in vivo administration to rats with D-galactosamine hepatotoxicity, lecithin administration was found to exert hepatoprotective effects similar to those noted with silymarin.18

Clinical data

There are no clinical data regarding the use of lecithin for liver disease.

Gallstone treatment

Due to the high concentration of phospholipids, lecithin may decrease the lithogenicity of bile through increases in phospholipid concentrations.19

Animal data

There are no animal data regarding the use of lecithin for the treatment of gallstones.

Clinical data

Gallstone dissolution occurred in 2 of 7 patients treated with lecithin and oral cholic acid. One patient experienced stone size reduction.20

Mania

Animal data

There are no animal data regarding the use of lecithin for symptoms of mania.

Clinical data

In a small study of patients with bipolar disorder, lecithin 10 mg 3 times daily was found to improve hallucinations, delusions, and incoherent speech, as noted with changes in the Brief Psychiatric Rating Scale and the Global Assessment Scale.21

Other uses

Lecithin has also been used for immune modulation, activating specific and nonspecific defense systems in 20 patients receiving 1 tsp 3 times daily for 30 days.22 Another study in triathletes and adolescent runners found that lecithin supplementation could help prevent the reduction in plasma choline levels occurring under physical stress, suggesting a possible impact on athletic performance.23

Dosing

Studies of lecithin in cognitive impairment have used a wide range of dosages from 1 to 35 g daily. In a study of patients with bipolar disorder, 10 mg given 3 times daily was found to improve symptoms of mania.21

Pregnancy / Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Adverse effects generally have not been associated with lecithin as a nutritional supplement,6 with some studies also having no observable adverse reactions.2, 7, 12 Large intakes of lecithin (ie, more than 25 g/day) may cause short-term GI distress, sweating, increased salivation, or anorexia.5 GI adverse effects and hepatitis were reported in a study in Alzheimer patients taking both tacrine and lecithin. 11

Toxicology

One report in rats observed biochemical alterations and impaired sensorimotor development in offspring of rats fed a diet including 5% crude lecithin, suggesting its consumption is inadvisable during pregnancy.6

References

1. Murray M. Encyclopedia of Nutritional Supplements. Rocklin, CA: Prima Publishing; 1996.
2. Budavari S, ed. The Merck Index, 11th ed. Rahway, NJ: Merck and Co; 1989.
3. Venturella US. Natural Products. Gennaro AR, ed. Remington: The Science and Practice of Pharmacy, 19th ed. Easton, PA: Mack Publishing Co; 1995.
4. Reynolds J, ed. Martindale, The Extra Pharmacopoeia, 31st ed. London, Eng.: Royal Pharm. Society; 1996.
5. Potter M, Moses A, Wozniak J. Alternative treatments in pediatric bipolar disorder. Child Adolesc Psychiatric Clin N Am. 2009;18(2):483-514.19264275
6. DerMarderosian A, et al. Natural Product Medicine, Philadelphia, PA: George F. Stickley Co; 1988;121-22,140,313-315.
7. Saba P, et al. Curr Ther Res Clin Exp. 1978;24:299-306.
8. Caine ED. Cholinomimetic treatment fails to improve memory disorders. N Engl J Med. 1980;303(10):585-586.7402228
9. Etienne P, Gauthier S, Dastoor D, Collier B, Ratner J. Lecithin in Alzheimer's disease. Lancet. 1978;2(8101):1206.82173
10. Maltby N, Broe GA, Creasey H, Jorm AF, Christensen H, Brooks WS. Efficacy of tacrine and lecithin in mild to moderate Alzheimer's disease: double blind trial. BMJ. 1994;308(6933):879-883.8173365
11. Chatellier G, Lacomblez L. Tacrine (tetrahydroaminoacridine; THA) and lecithin in senile dementia of the Alzheimer type: a multicentre trial. Groupe Français d'Etude de la Tetrahydroaminoacridine. BMJ. 1990;300(6723):495-499.2107926
12. Barbeau A. Lecithin in neurologic disorders. N Engl J Med. 1978;299(4):200-201.149251
13. Pentland B, Martyn CN, Steer CR, Christie JE. Lecithin treatment in Friedreich's ataxia. Br Med J (Clin Res Ed). 1981;282(6271):1197-1198.6788133
14. Higgins JP, Flicker L. Lecithin for dementia and cognitive impairment. Cochrane Database Syst Rev. 2003;(3):CD001015.12917896
15. Das SK, Vasudevan DM. Effect of lecithin in the treatment of ethanol mediated free radical induced hepatotoxicity. Indian J Clin Biochem. 2006;21(1):62-69.23105571
16. Das SK, Gupta G, Rao DN, Vasudevan DM. Effect of lecithin with vitamin-B complex and tocopheryl acetate on long term effect of ethanol induced immunomodulatory activities. Indian J Exp Biol. 2007;45(8):683-688.17877144
17. Lamireau T, Bouchard G, Yousef IM, et al. Dietary lecithin protects against cholestatic liver disease in cholic acid-fed Abcb4-deficient mice. Pediatr Res. 2007;61(2):185-190.17237720
18. Raj PV, Nitesh K, Chandrashekhar HR, Mallikarjuna Rao C, Venkata Rao J, Udupa N. Effect of lecithin and silymarin on D-galactosamine induced toxicity in isolated hepatocytes and rats. Indian J Clin Biochem. 2010;25(2):169-174.23105905
19. Gaby AR. Nutritional approaches to prevention and treatment of gallstones. Altern Med Rev. 2009;14(3):258-267.19803550
20. Toouli J, Jablonski P, Watts JM. Gallstone dissolution in man using cholic acid and lecithin. Lancet. 1975;2(7945):1124-1126.
21. Cohen BM, Lipinski JF, Altesman RI. Lecithin in the treatment of mania: double-blind, placebo-controlled trials. Am J Psychiatry. 1982;139(9):1162-1164.7051871
22. Pawlik A, et al. Herba Polonica. 1996;42(1):42-46.
23. von Allworden HN, Horn S, Kahl J, Feldheim W. The influence of lecithin on plasma choline concentrations in triathletes and adolescent runners during exercise. Eur J Appl Physiol. 1993;67(1):87-91.8375373
24. Pringsheim T, Doja A, Gorman D, et al. Canadian guidelines for the evidence-based treatment of tic disorders: pharmacotherapy. Can J Psychiatry. 2012;57(3):133-143.22397999
25. Verhoeven V, Hartmann ML, Remmen R, Wens J, Apers S, Van Royen P. Red yeast rice lowers cholesterol in physicians-a double blind, placebo controlled randomized trial. BMC Complement Altern Med. 2013;13:178.23866314

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This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

Further information

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