Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
This supplement has been used in connection with the following health conditions:
500 mg choline per day
In a preliminary study of California mothers, those who had higher intakes of choline during the three months prior to conception were significantly less likely to give birth to a child with an NTD, compared with women with lower choline intakes.1 The possibility that choline may protect against NTDs is plausible, as choline has similar biochemical effects as folic acid, which is known to reduce NTD risk.
2 grams daily choline or 34 grams daily lecithin
Betaine (trimethylglycine) (6 grams per day) and choline (2 grams per day) have each been shown to lower homocysteine levels.2, 3 Choline in the amount of 2.6 grams per day (provided as 34 grams per day of soy lecithin) has also been shown to lower homocysteine levels in a double-blind trial.4 More recently, 1.5 grams of betaine per day, an amount similar to that in a typical diet, also has been found to lower homocysteine levels.5 Doctors usually consider supplementation with these nutrients only when supplementation with folic acid, vitamin B6, and vitamin B12 do not reduce homocysteine levels sufficiently. The results of this study, however, point to the potential benefit of increasing one’s intake of foods rich in betaine (such as whole wheat, spinach, beets, and other plant foods).
25 grams lecithin twice a day, providing 35 grams of phosphatidyl choline per day
Choline and lecithin have both been used for people with TD. While some studies have shown a beneficial effect,6, 7, 8 others have reported variable improvement9 or no improvement.10 In a small, two-week, double-blind trial, people with TD were given 25 grams of lecithin twice a day (providing 35 grams of phosphatidyl choline per day), or a matching placebo. All participants experienced significant improvement of symptoms.11
Refer to label instructions
A double-blind trial of 20 to 25 grams per day of lecithin failed to produce improvements in mental function in people with Alzheimer’s disease.12 However, there were improvements in a subgroup of people who did not fully comply with the program, suggesting that lower amounts of lecithin may possibly be helpful. Lecithin supplementation has also been studied in combination with a cholinesterase inhibitor drug called tacrine, with predominantly negative results.13, 14, 15, 16
Refer to label instructions
Phosphatidylcholine (PC)—a purified extract from lecithin—is one of the components of bile that helps protect against gallstone formation. Some preliminary studies suggest that 300–2,000 mg per day of PC may help dissolve gallstones.17, 18 Some doctors suggest PC supplements as part of gallstone treatment, though the supporting research is weak.19
Refer to label instructions
Taking 3 grams per day of phosphatidylcholine (found in lecithin) was found to be beneficial in one investigation of people with chronic hepatitis B.20 Signs of liver damage on biopsy were significantly reduced in this trial.
Refer to label instructions
Although lecithin has been reported to increase HDL cholesterol and lower LDL cholesterol,21 a review of the research found that the positive effect of lecithin was likely due to the polyunsaturated fat content of the lecithin.22 If this is so, it would make more sense to use inexpensive vegetable oil, rather than take lecithin supplements. However, an animal study found a cholesterol-lowering effect of lecithin independent of its polyunsaturate content.23 A double-blind trial found that 20 grams of soy lecithin per day for four weeks had no significant effect on total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides.24 Whether taking lecithin supplements is a useful way to lower cholesterol in people with elevated cholesterol levels remains unclear.
How It Works
How to Use It
Small amounts of choline are present in many B-complex and multivitamin supplements.
Where to Find It
Choline, the major constituent of PC, is found in soybeans, liver, oatmeal, cabbage, and cauliflower. Soybeans, egg yolks, meat, and some vegetables contain PC. Lecithin (containing 10–20% PC) is added to many processed foods in small amounts for the purpose of maintaining texture consistency.
Although choline deficiencies have been artificially induced in people, little is known about human deficiency in the real world.
Interactions with Supplements, Foods, & Other Compounds
As of the last update, we found no reported interactions between this supplement and medicines. It is possible that unknown interactions exist. If you take medication, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.
With several grams of choline per day, some people will experience abdominal discomfort, diarrhea, or nausea. Supplementing choline in large amounts (over 1,000 mg per day) can lead to a fishy body odor. PC does not have this effect. Depression has been reported as a side effect in people taking large amounts of choline, such as 9 grams per day.
1. Shaw GM, Carmichael SL, Yang W, et al. Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol 2004;160:102–9.
2. Wilcken DEL, Wilcken B, Dudman NP, Tyrrell PA. Homocystinuria—the effects of betaine in the treatment of patients not responsive to pyridoxine. N Engl J Med 1983;309:448–53.
3. Jancin B. Amino acid defect causes 20% of atherosclerosis in CHD. Fam Pract News 1994(Oct 15):7.
4. Olthof MR, Brink EJ, Katan MB, Verhoef P. Choline supplemented as phosphatidylcholine decreases fasting and postmethionine-loading plasma homocysteine concentrations in healthy men. Am J Clin Nutr 2005;82:111–7.
5. Olthof MR, van Vliet T, Boelsma E, Verhoef P. Low dose betaine supplementation leads to immediate and long term lowering of plasma homocysteine in healthy men and women. J Nutr 2003;133:4135–8.
6. Davis KL, Hollister LE, Barchas JD, Berger PA. Choline in tardive dyskinesia and Huntington’s disease: preliminary results from a pilot study. Life Sci 1976;19:1507–15.
7. Gelenberg AJ, Doller-Wojcik JC, Growdon JH. Choline and lecithin in the treatment of tardive dyskinesia: preliminary results from a pilot study. Am J Psychiatry 1979;136:772–6.
8. Growdon JH, Hirsch MJ, Wurtman RJ, Wiener W. Oral choline administration to patients with tardive dyskinesia. N Engl J Med 1977;297:524–7.
9. Nasrallah HA, Dunner FJ, Smith RE, et al. Variable clinical response to choline in tardive dyskinesia. Psychol Med 1984;14:697–700.
10. Anderson BG, Reker D, Ristich M, et al. Lecithin treatment of tardive dyskinesia—a progress report. Psychopharmacol Bull 1982;18:87–8.
11. Jackson IV, Nuttall EA, Perez-Cruet J. Treatment of tardive dyskinesia with lecithin. Am J Psychiatr 1979;136:1458–60.
12. Little A, Levy R, Chuaqui-Kidd P, Hand D. A double-blind, placebo controlled trial of high-dose lecithin in Alzheimer’s disease. J Neurol Neurosurg Psychiatry 1985;48:736–42.
13. Gauthier S, Bouchard R, Lamontagne A, et al. Tetrahydroaminoacridine-lecithin combination treatment in patients with intermediate-stage Alzheimer’s disease. Results of a Canadian double-blind, crossover, multicenter study. N Engl J Med 1990;322:1272–6.
14. Chatellier G, Lacomblez L. Tacrine (tetrahydroaminoacridine; THA) and lecithin in senile dementia of the Alzheimer type: a multicentre trial. Groupe Francais d’Etude de la Tetrahydroaminoacridine. BMJ 1990;300:495–9.
15. Fitten LJ, Perryman KM, Gross PL, et al. Treatment of Alzheimer’s disease with short- and long-term oral THA and lecithin: a double-blind study. Am J Psychiatry 1990;147:239–42.
16. Eagger SA, Levy R, Sahakian BJ. Tacrine in Alzheimer’s disease. Lancet 1991;338:50–1 [letter; comment].
17. Toouli J, Jablonski P, Watts JM. Gallstone dissolution in man using cholic acid and lecithin. Lancet 1975;ii:1124–6.
18. Tuzhilin SA, Dreiling D, Narodetskaja RV, Lukahs LK. The treatment of patients with gallstones by lecithin. Am J Gastroenterol 1976;165:231–5.
19. Holan KR, Holzbach T, Hsieh JYK, et al. Effect of oral administration of ‘essential’ phospholipid, 8-glycerophosphate, and linoleic acid on biliary lipids in patients with cholelithiasis. Digestion 1979;19:251–8.
20. Jenkins PJ, Portmann BP, Eddleston AL, Williams R. Use of polyunsaturated phosphatidylcholine in HBsAg negative chronic active hepatitis: Results of prospective double-blind controlled trial. Liver 1982;2:77–81.
21. Childs MT, Bowlin JA, Ogilvie JT, et al. The contrasting effects of a dietary soya lecithin product and corn oil on lipoprotein lipids in normolipidemic and familial hypercholesterolemic subjects. Atherosclerosis 1981;38:217–28.
22. Knuiman JT, Beynen AC, Katan MB. Lecithin intake and serum cholesterol. Am J Clin Nutr 1989;49:266–8.
23. Wilson TA, Meservey CM, Nicolosi RJ. Soy lecithin reduces plasma lipoprotein cholesterol and early atherogenesis in hypercholesterolemic monkeys and hamsters: beyond linoleate. Atherosclerosis 1998;140:147–53.
24. 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;52:419–24.
The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2014.
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