Phosphatidylcholine

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • EPL, essential phospholipids, Essentiale®, lecithin, Lipostabil®, phosphatidyl choline, phosphatidylcholine, polyenyl-phosphatidyl choline, polyunsaturated phosphatidyl choline, PPC, Sterpur P-30 Granulat.

Background

  • Phosphatidylcholine is the most abundant of the phospholipids, a class of specialized fat molecules, in plant and animal cells. Phosphatidylcholine is a key building block of cell membranes (the lining around each cell). It is also a precursor of acetylcholine, a compound required for normal brain activity.

  • Although phosphatidylcholine is present in almost all cells in the body, the highest concentrations may be found in the brain, heart, liver, and kidney. Liver, egg yolk, and peanuts are rich sources of dietary phosphatidylcholine.

  • For human health, phosphatidylcholine is most commonly used to treat liver conditions. There is some evidence of benefit in the treatment of ulcerative colitis and drug-induced high blood cholesterol and triglycerides. Injectable phosphatidylcholine has been used as an alternative to liposuction to break down localized fat deposits.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Body fat reducer (fat deposits)

Preliminary research suggests that phosphatidylcholine injections may aid in the reduction of localized fat deposits. Further research is required before conclusions can be made.

Hepatic disease (failure)

Preliminary research suggests that phosphatidylcholine may be useful in the treatment of hepatic (liver) failure. Additional research is needed before a conclusion can be made.

Hepatitis

Limited research suggests that phosphatidylcholine, in combination with interferon, may be useful in the treatment of some forms of chronic hepatitis. Further research is needed before a conclusion can be made.

Hyperlipoproteinemia (drug-induced)

Preliminary research suggests that phosphatidylcholine may reduce clofibrate-induced increases in low-density lipoprotein (LDL, or “bad”) cholesterol. Additional research is needed before a conclusion can be made.

Ulcerative colitis

Phosphatidylcholine is found on the inner lining of the gastrointestinal (GI) tract and plays a key role in defense. Research suggests that increasing the level of phosphatidylcholine in the GI tract may improve the defense system and decrease inflammatory activity in ulcerative colitis. Additional research is required before conclusions can be made.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Acne, atherosclerosis (hardening of the arteries), bipolar disorder, cardiac ischemia (insufficient oxygen supply to the heart), dementia, depression, Friedreich’s ataxia, gallbladder disease, headache, high blood pressure, high cholesterol, Huntington’s chorea/disease, mania, memory loss, multiple sclerosis, neurological disorders, peripheral vascular disease, psoriasis, steatohepatitis (fatty liver), tardive dyskinesia (involuntary movement).

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • For body fat reduction (removal of localized fat deposits), 0.4 milliliters of phosphatidylcholine (50 milligrams per milliliter, American Lecithin Company, Oxford, CT) has been injected into the fat deposit every two weeks, for 3-5 total injections; and 0.4 milliliters of phosphatidylcholine (50 milligrams per milliliter) has been injected every 15 days for a total of 1-5 injections. For localized fat deposits, 0.2 milliliters of phosphatidylcholine (250 milligrams per milliliter) has been injected under the skin at each deposit, with up to 10 milliliters per session, for 1-5 treatment sessions, with an average of 15 days between sessions.

  • For chronic hepatitis, 1.8 grams of polyunsaturated phosphatidylcholine has been taken by mouth in three divided doses daily (in addition to subcutaneous interferon) for 24 months. Six grams of polyunsaturated phosphatidylcholine has been taken by mouth daily for 24 months. For acute viral hepatitis, 300 milligrams (Essentiale®, Natterman International GmbH, Germany) has been taken by mouth three times daily for 12 weeks. For HBsAG-negative chronic active hepatitis, three grams of polyunsaturated phosphatidylcholine (brand not specified) has been taken by mouth daily for one year.

  • For drug-induced hyperlipoproteinemia (clofibrate-induced increase in low density lipoprotein (LDL, “bad”) cholesterol), 1.8 grams of polyenyl phosphatidylcholine has been taken by mouth daily for 28 days.

  • For liver disease or failure, 350 milligrams of polyunsaturated phosphatidylcholine (brand not specified) has been taken by mouth three times daily for 6-8 weeks.

  • For chronic active ulcerative colitis, 1.5 grams of phosphatidylcholine-rich phospholipids (Sterpur P-30 Granulat; Stern Lecithin and Soja GmbH, Germany) have been taken by mouth four times daily, after meals and before bed, for three months.

Children (under 18 years old)

  • There is no proven safe or effective dose for phosphatidylcholine in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid with known allergy or sensitivity to phosphatidylcholine.

Side Effects and Warnings

  • Phosphatidylcholine may cause burning at the injection site, fatigue, fever, flu-like symptoms, headache, itching, limb pain, rash, skin redness, or swelling.

  • Injectable phosphatidylcholine should only be administered by a qualified healthcare provider.

  • Use cautiously in patients with gastrointestinal disorders, due to the potential for bloating, nausea, and vomiting.

  • Avoid with known allergy or sensitivity to phosphatidylcholine.

  • Avoid in pregnant and or breastfeeding women, due to a lack of safety data.

Pregnancy and Breastfeeding

  • Avoid in pregnant and or breastfeeding women, due to a lack of safety data.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Phosphatidylcholine may interact with agents that affect the immune system, agents that affect the liver, cholesterol- and lipid-lowering agents, or gastrointestinal agents.

Interactions with Herbs and Dietary Supplements

  • Phosphatidylcholine may interact with cholesterol- and lipid-lowering herbs and supplements, gastrointestinal herbs and supplements, herbs and supplements that affect the immune system, or herbs and supplements that affect the liver.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Ablon G, Rotunda AM. Treatment of lower eyelid fat pads using phosphatidylcholine: clinical trial and review. Dermatol Surg 2004;30(3):422-427. View Abstract
  2. Guan R, Ho KY, Kang JY, et al. The effect of polyunsaturated phosphatidyl choline in the treatment of acute viral hepatitis. Aliment Pharmacol Ther 1995;9(6):699-703. View Abstract
  3. Hexsel D, Serra M, Mazzuco R, et al. Phosphatidylcholine in the treatment of localized fat. J Drugs Dermatol 2003;2(5):511-518. View Abstract
  4. Holecek M, Mraz J, Koldova P, et al. Effect of polyunsaturated phosphatidylcholine on liver regeneration onset after hepatectomy in the rat. Arzneimittelforschung 1992;42(3):337-339. View Abstract
  5. Jenkins PJ, Portmann BP, Eddleston AL, et al. Use of polyunsaturated phosphatidyl choline in HBsAg negative chronic active hepatitis: results of prospective double-blind controlled trial. Liver 1982;2(2):77-81. View Abstract
  6. Jenness R. The composition of human milk. Semin Perinatol 1979;3(3):225-239. View Abstract
  7. Li Z, Vance DE. Phosphatidylcholine and choline homeostasis. J Lipid Res 2008;49(6):1187-1194. View Abstract
  8. Neuberger J, Hegarty JE, Eddleston AL, et al. Effect of polyunsaturated phosphatidylcholine on immune mediated hepatocyte damage. Gut 1983;24(8):751-755. View Abstract
  9. 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. Leich Study Group. Hepatogastroenterology 1998;45(21):797-804. View Abstract
  10. Panos JM, Palson R, Johnson R, et al. Polyunsaturated phosphatidylcholine for acute alcoholic hepatitis: a double blind randomized placebo controlled trial. Eur J Gastroenterol 1990;2:351-355.
  11. Rittes PG. The use of phosphatidylcholine for correction of lower lid bulging due to prominent fat pads. Dermatol Surg 2001;27(4):391-392. View Abstract
  12. Rotunda AM. Injectable treatments for adipose tissue: terminology, mechanism, and tissue interaction. Lasers Surg Med 2009;41(10):714-20. View Abstract
  13. Schneider J, Muller R, Buberl W, et al. Effect of polyenyl phosphatidyl choline on clofibrate-induced increase in LDL cholesterol. Eur J Clin Pharmacol 1979;15(1):15-19. View Abstract
  14. Singh NK, Prasad RC. A pilot study of polyunsaturated phosphatidyl choline in fulminant and subacute hepatic failure. J Assoc Physicians India 1998;46(6):530-532. View Abstract
  15. Stremmel W, Merle U, Zahn A, et al. Retarded release phosphatidylcholine benefits patients with chronic active ulcerative colitis. Gut 2005;54(7):966-971. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.