Lecithin: The Dark Side of a Dietary Supplement

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There is no credible evidence to support the myriad claims of benefit of supplemental lecithin, but finding lecithin metabolites in the blood of heart attack and stroke patients raises a concern


Lecithin as a dietary supplement has been heavily promoted as a panacea for:

  • Cardiovascular health
  • Liver and cell function
  • Fat transport and fat metabolism
  • Reproduction and child development
  • Physical performance and muscle function
  • Cell communication
  • Improvement in memory, learning and reaction time
  • Relief of arthritis
  • Healthy hair and skin
  • Treatment for gallstones

If you believe any of that please let me know—I happen to have a bridge to sell you. I have always been suspect of promotions that promise to cure all human ailments. But recently, I came across a paper that prompted me to examine the evidence behind those claims. I’ll save you an excrutiatingly detailed account—none of the claims has any credible evidence to back it up.

 

What is lecithin?

Chemically, lecithin is called phosphtidyl choline. It is found in egg yolk, meats, soy and vegetables. Most commercial lecithin is made from soy. So, you’d assume that when you take lecithin (the supplement), you get phosphatidyl choline. In fact, commercial preparations contain between 20% and 90% of the stuff.

Why such variability? Because the suppliers of supplements were exempted by Congress from adhering to any standards of manufacture, purity, or claims of benefits. How this came about is emblematic of our broken political system, but don’t get me going on this.

Anyway, if only a small fraction of commercial lecithin is made up of the real thing—phosphatidyl choline—then what makes up the rest? The answer: fatty acids! Not exactly the stuff to help in weight reduction, or cardiovascular health, or liver function. In fact, it may work against all those wonderful benefits.

 

What’s the downside?

If it doesn’t cause any harm, why not give it the benefit of the doubt? A future study may prove its benefit.

In a paper in Nature, Wang et al. studied the metabolic fate of lecithin. But first, by way of explanation, let me introduce a new term. We are all familiar with the concept of genomics, meaning the study of the genome, or the total genetic content and its effect on health and disease.

Likewise, the total of chemicals, substrates, and metabolites is called the metabolome, and the study of those substances in health and disease is called metabolomics. The advantage of such an all-inclusive approach is that it is unbiased.

The classical approach was to study a specific gene or molecule, essentially ignoring everything else. This is akin to peeping through a keyhole; you see only what the hole allows you to see. Studying the whole genome or the whole metabolome gives a complete picture of everything involved in the process being studied.

For instance, for many years, type 2 diabetes was thought to involve only one or two genes. Why? Because these were the only genes that “made sense” as targets for study. The advent of whole-genome studies demonstrated the involvement of dozens of genes in the disease, which was a complete surprise.

Back to the paper. Wang and his collaborators used the metabolomic approach to look for circulating small molecules associated with coronary heart disease. They screened blood from patients who had experienced a heart attack or stroke and compared the results with those from blood of people who had not. They found major differences in choline, betaine and trimethylamine N-oxide (TMAO)—all metabolites of phosphatidyl choline.

Turns out that these metabolites are produced from lecithin by gut bacteria. We still don’t know if these lecithin metabolites are involved in some way as causative factors, or whether they are just markers of the disease; correlative studies can show only correlations, not cause and effect.

To find the source of these compounds, the researchers fed mice isotopically-labelled phosphtidyl choline, and demonstrated the appearance of the metabolites in the circulation. The implication was that the gut flora metabolized the lecithin.

Indeed, when the gut flora was wiped out with an antibiotic, none of the metabolites appeared in the blood. Could it be that the gut flora in people with cardiovascular disease is different in some way from that of healthy people? We don’t know; but we do know that the physiological state of a person can determine the gut flora. For instance, the gut flora of obese people is markedly different from that of the non-obese.

 

The bottom line

Here is the state of what we do know: phosphtidyl choline (lecithin) is metabolized by gut flora into three metabolites that show up at high concentrations in people who have had a heart attack or a stroke. We still don’t know if these compounds play a causative role in those events.

So how does one make a decision whether to take lecithin as a dietary supplement? Consider the fact that none of the myriad claims of benefits have any credible evidence to support it. On the other hand, careful science is showing a correlation of lecithin metabolites with heart attacks and strokes. You decide.

Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.

48 COMMENTS

  1. Sorry Doc, but I must disagree with your statements about lecithin. High quality lecithin (like a leading brand that is non-GMO and contains 95% phosphatides) is recommended by at least some leading cardiologists. My father was diagnosed with severe heart disease about 10 years ago. It was so bad that the doctors were shocked he had not had an MI already. They wanted to rush him into surgery, but he insisted on handling it in a more natural way.

    His cardiologist told him it would be an uphill battle, but my dad finally reversed his heart disease. Among the myriad supplements he was encouraged to take was 95% phosphatide lecithin – 2 Tbsp daily. He has been taking it for 10 years, and in conjunction with diet, exercise, and other supplements his blood work and disease markers regularly come back looking better than mine (38 years his junior!).

  2. One study doth not a conclusion make.

    It is not accurate to herald *one* primary study showing a correlation which, the writer himself, said doesn’t necessarily show cause and effect as, well, possibly showing cause and effect. Just like vitamin E being discared as a potentially harmful heart supplement, but only involving studies on d-alpha tocopherol and not the constellation of vitamin E – alpha, beta, gamma, etc.. Put another way, instead of looking through the keyhole….

    I’ll keep taking my lecithin as I have for 20 years – my last 2 stress tests being perfect- until a preponderance of evidence tells me otherwise. I decided.

    • Indeed. In looking at all the comments on this phony article, it’s clear that people are not stupid and are not blind. And the author is on the side of the big pharma. Afterall the website title is ‘the doctor…’. Exactly the type of nonsense a doctor would write. Same type of doctor who is against vitamin C, orthomolecular medicine and write “Surgery, drug treatment and radiation remain the major treatment modalities” when we have several different treatments and cures for cancers which don’t resort to the cut, burn and poison barbaric ways. Shame on you dear ‘doctor’.

  3. I was diagnosed with gallbladder sludge and gastritis in August of 2012. For months i was seeing different gastroenterologists who encouraged me to consider having my gallbladder removed. For months they had me on PPI and actigall. None of which worked. Within 2 days of taking soy lecithin right before bed, my gallbladder pains virtually disappeared. It’s been about 2 weeks now (June 2013) and i have not felt this relieved since i started having those pains and attacks on my right side.

    • Thanks for contributing, Jay. The millions of negligent homicides by the medical industry exposes their singular motive of money being their God, with the “care of patients” not being able to be found on the list by me.

      That’s not to say that some doctors are exceptions. I knew there are exceptions, but a good honest doctor being an exception is a tragic testimony of the industry that killed both my parents.

  4. OK, I’ll decide. With the wrongful deaths of the medical industry at 100,000 a year in the U.S. alone… well, I could go on, but your silence on that *FACT* sends sirens wailing about your lack of credibility(!) and the compounding factors in the medical industry’s DECEIT makes the other factors superfluous.

    Suffice it to say, trusting doctors is like trusting the government or trusting the mob. I’ll search the facts out myself and put the medical industry AT THE VERY BOTTOM of the list in CREDIBILITY.

  5. Many years ago a dear friend of mine noticed that her Mom was having memory problems. She would repeat herself and ask the same questions over and over. My friend put her Mom on 3 Triple lecithin (1200 mg) capsules with each meal. Within 2 weeks she no longer had issues with her memory.
    As an aside, I have studied in the field of functional nutrition/supplementation for over 40 years. Lecithin is a potent fat emulsifier, much more likely to positively impact the heart. There is too much to the process to go into here, but one thing the heart depends on to function normally is free fatty acids. Lecithin can help liberate these so that they can be used by the cells for fuel rather than stored as fat either in the organs or blood vessel system.

  6. My lifestyle is not too healthy, for nine years my wellman checkups showed my bad cholesterol as borderline high. Pretty stable set of results I’d say. A friend recommended Lecithin some time in 2013. I take two large softgels in the morning, each contain 1360mg of soya lecithin, according to the bottle. My last wellman checkup showed my cholesterol at a very healthy level. My doctor who sails and is skinny as a rake told me it is actually lower than hers, she was astonished. Nothing else in my diet or lifestyle has changed. That’s the only case study I need for now. I’ve been waiting for my next wellman to see if this is continued (in fact I just realized I should have had it this month).

  7. And adrenalin turns up in those who are scared -it gets you out of trouble. Surely a high amount in the gut is trying to counteract the heart attack bt too little too late

  8. Thanks for the interesting comments. Jay’s comment actually makes a lot of sense -lecithin is an emulsifier, and it could conceivably dissolve sludge or even a small size gallstone and thus relieve the symptoms. But so far, this is an experiment with N of 1 (sample of one). A proper trial would be very interesting. The other comments suffer from the same problem: they are testimonials that amount to N=1. None of them quoted a peer reviewed trial, the gold standard in clinical trials. Only such trials can demonstrate cause and effect.
    Gary Sellars comment is a bit over the top. To equate physicians to the mob is insulting. Yes, there are bad actors among physicians, just like in society at large. But there are thousands who put their lives at risk treating awful epidemics such as ebola, or the sick and injured in combat zones.

    • It’s difficult to decide whether to play it safe in light of the information you provided, or take a chance and move forward with the highest quality soy lecithin from a reputable lab. As a middle-aged man who is managing his diabetes, and given a choice of playing it safe or giving something a try based on anecdotal information from personal experiences, I tend to be risk adverse and play it safe.

      However, I’m asking after reading your article, were those with a correlation of lecithin metabolites with heart attacks and strokes, consumers of lecithin supplements? If not, then are the results an argument to avoid all foods containing lecithin, and if so, does that mean cutting out nutritious foods with benefits that may offset their lecithin content? Not knowing if those suffering heart attacks and strokes, whose conditions correlated to the presence of lecithin metabolites, were (a) consumers of foods containing lecithin; (b) consumers of lecithin supplements; or (c) personally not metabolizing lecithin properly due to perhaps lecithin intolerance or allergies, well, these factors appear unknown (or you would have mentioned them). Thus, I feel that I’m making a health decision based on weighing risk factors, similarly to choosing a mix of investments for my life savings (which could make or break my retirement). Just like I don’t dare just sit on my retirement money, too fearful of any risk, I must make a decision on choosing the highest quality supplements to physical survive retirement with hopefully a decent quality of life.

      I feel moved to try soy lecithin because in spite of eating a pristine, low-fat diet without sugar, and getting a reasonable amount of activity, my recent diabetic retinopathy showed, for the first time, slight evidence of retinopathy. I’m not getting any younger, I’m faithfully taking 1,000 mg of Metformin in the morning and again at night, and I’m trying to move rationally (but not panicked) to supplementation such as soy lecithin, salmon oil from wild sources, vitamins from reputable labs (vs. the drugstore variety), lots of organic salads with organic whole rye, lots of water, no meat (except wild fish on occasion), and keeping my fingers crossed.

      • Don’t use commercial/generic soy lecithin, if you think/decide a soy lecithin-based product is what you want then go for non-gmo organic soy product manufactured by a reputable health supplement company (Canadians or Europeans are best since they are regulated by third party agencies for purity, quality control/good manufacturing practices invested in their products).
        Personally i’m not a fan of any kind of soy product, I suggest you try sunflower lecithin.
        My humble recommendation comes from my last 10 yrs experience as a certified fitness trainer/nutritionist with emphasis towards sport medicine.
        I see that you are following an specific regime of food intake and exercise, that’s great regardless of your condition, the extend of the benefits you’ll get is definitely worth the effort.
        My advise, try a moderate fat intake rather than low, choose supplemental fats like fish oil and coconut oil (2 teaspoons a day and grill your food with it, just a dab) for dietary consumption.
        Make all your carbs be complex carbs from cruciferous vegetables, vegetables high on bioflavonoids/carotenoids (do not boil them but steam them, buy them whole and fresh nothing canned) and oatmeal only.
        Also buy supplemental nutritional fiber ( and I don’t mean Metamucil) for this you need to visit a real health food store.
        Eat lots of clean protein such as skinless chicken or turkey breast, wild caught fish never farm-raised (Tilapia has natural low levels of mercury) get a chart that indicates fish with lowest level of mercury, and last but not least get a good clean whey isolate powder product, use it in between your solid food meals 1 serving (30g) in the morning and another after your workouts, also as you said drink lots of water (squeeze a couple of good size lemons in every gallon of water).
        Your total daily caloric intake must be based on the weight target you want to achieve, make sure your physical training or “reasonable amount of activity” provides the necessary caloric deficit on a day to day basis. Divide your total daily caloric intake into 5 to 6 meals a day, am guessing you should at least be around 2200 cal. no less perhaps more, remember that extreme calorie-restricted diets don’t work ( 1200-1600 cal.)
        This eating plan will raise your metabolism (BMR) and will promote an overall healthy Ph (7.0 – 7.5) chemistry level in you body.

  9. Supplementing with soy lectithins has helped a lot with my recent symptoms of irregular heart beats, shortness of breath, and constant discomfort in my chest. I was on a very healthy diet before these symptoms, as well as participating in vigorous exercise. I went to many doctors and cardiologists and a lady recommended lecithins so I decided to try it. I was going through symptoms everyday for 4 months but once I started supplementing, it probably only took 1-2 weeks to notice relief from this horrible experience. I’m looking forward to getting back to my regular self again. But I truly believe this has benefited my health. I literally had to put my life on hold for months, and had made too many expensive visits to specialists,ER’s ,and even Hopkins (which was going nowhere).

  10. Folks this says DOV. NOT DR. Lady you are full of crap. I take this stuff daily. If I miss a week because of vacation, I notice it. My Blood pressure has gone down, I think clearer. So stuff it. I bet you also believe the FAD. I didn’t know just anyone could post crap on the Internet and call it the truth… Do your research…better yet. Just shut up.

    • True, it says “Dov”, bur following the last name it says MD, PhD.

      HOWEVER, I take nonGMO lecithin granules, and have taken it as pure oil and capsuled oil. When I take the oil form 1TBSP, i have an incredible amount of energy! In fact, I made the mistake of taking it in the evening and was bustling around till the wee hours of the morning! That happened to my mom, as well. We learned to take it in the morning!

      Whether or not it has a negative impact in the lives of others, I don’t know. All a person can do is say what works for them.

      I decided and it will remain a part of my healthy lifestyle choices.

  11. Doc, there is no evidence that you accept because there is no money in studying it using the ultra-expensive studies that you will accept. Open your eyes.

    • If you read carefully this Brazilian study you find out that the study was conducted with 30 subjects, woefully inadequate sample size for drawing any statistical inferences. Furthermore, they were “selected”, not randomly assigned. Thirty out of how many? What were the selection criteria? We are not told.
      I am not impugning the authors’ intentions, only their experimental procedures. As to the substance, they claim a significant reduction in LDL cholesterol. The paper I am quoting in the post does not claim causation, only association, with TMAO, a lecithin metabolite that is associated with heart disease. Is LDL the sole culprit in heart disease? Definitely not. With all the research going into cardiovascular disease, we still don’t know more than we do.

      • Lethicin was a god sent for my son. He has tourette syndrome and as long as he takes lecithin capsules in a maximum form, by that I mean all at once. The dose increases as body weight goes up. In grade 4 he took 9 capsules of 1200mg capsules and like I said as his age and weight went up so did the number of capsules. It did without doubt took away his symptoms like the swearing and the involuntary muscle movements and the jerking and his concentration was much better. After this worked for my son, I wanted to shout it from the roof top but a lot of people are not open minded when it comes to natural health remodies. I encourage anyone who knows someone suffering with tourette syndrome to pass this on. When I questioned the doctor about this, he said he could not percribe this but what it did was block the dopamine going to the brain and tourette syndrome is too much dopamine going to the brain. I don’t know how accurate that is but what I do know is it works to take away or reduce symptoms of tourette syndrome.

  12. Incredibly unscientific, this claim. Since lecithin is in everyone and not just provided by supplements, we need to know if people suffering from heart conditions have faulty lecithin metabolism. Secondly, we need to know if those who have been found with elevated levels of these metabolites were, in fact, on lecithin supplements. Since these supplements are less commonly taken than they were in the past, my guess is that most of them probably were not.

  13. In the erstwhile, you’re going to prescribe your patients medicines with clinical evidence of causing heart attacks, like Meloxicam. Right, Doc?

  14. One thing I do have to tell you is that since I started Lecithin, my orgasms are a lot stronger I believe because of the larger load of semen released. Not trying to be funny or anything, this product works.. At least when it comes to that.

  15. I doubt lecithin is a cure-all for all of life’s problems, and I know that most supplement manufacturers are a bit crooked — but yikes! What a scare tactic here.

    I bet water is found in large concentrations within the bodies of heart attack and stroke victims. Let’s petition the government to ban that awful awful dihydrogen monoxide.

    • In fact, water is not found in abnormal concentrations in heart attack and stroke victims. The study I cited did not make any any recommendations, pro or con. It just presented the facts. It is up to every individual to weigh the evidence, consider the pros and cons, and makes his or her mind.

  16. I have made a commitment to try lecithin for a whole year with 2 or 3 heaping tablespoons a day. I started on Halloween day. Already i’ve noticed a difference in my mood and complexion. Will also see in a later date if my ldl cholesterol comes down or not.

  17. I read a rebuttal to the paper in Nature that stated though Lecithin metabolism does in fact generate “some” TMAO (which the body apparently eliminates quite swiftly), most all forms of seafood have been shown to cause remarkably higher spikes of blood TMAO. The implication being, if lecithin is bad, most any/all forms of seafood would be dreadful. No more seafood for you!

    Choline has also recently been reclassified as an essential nutrient and one of the earliest symptoms of choline deficiency is the development of fatty liver. Eliminate dietary (or supplemental if your diet is deficient) choline at your peril. It may produce trivial amounts of TMAO, but it’s not an optional nutrient if you wish to enjoy good health!

  18. The apparently slightly negative general impression you convey about Lecithin seems to relate to the fact that some of it must comprise “fatty acids”.

    As we know not all “fatty acids” are bad. I would even argue that oxidants (as differing from antioxidants) are needed by the immune system (for example)!

    The formulaeic concepts, often espoused by medical professionals – this good, that bad – must surely be considered simplistic at the very least.

    The presence of metabolites of Phosphatidyl Choline in people with heart disease etc. might well indicate that the body is utilising the PC to combat damage or disease in them. Precisely because they are under attack from these diseases.

    There is no logical correlation (so far shown) that shows whether PC (and therefore Lecithin) is helpful or harmful.

    Your article seems to underline the dilemma that conservative medicine finds itself in. Doctors, , I believe, on the whole, “weigh in” against alternative experiential “evidence” and reject self-treating and benign self-experimentation by their patients. To not consider widespread “unscientific” testimony is possibly one of the biggest mistakes our “modern” medical professionals and the pharmaceutical industry make.

    • Frank, you are absolutely right that correlations don’t make causation, and the study I cited falls into this category. Having said that, I think that it was appropriate, even incumbent upon us, to report on the study and leave the decision to the reader. In a more general vein, you really don’t know that what you are taking contains the amount of lecithin that is on the label, or that there is any lecithin at all in the bottle. Study after study carried out by reputable investigators and laboratories (not industry) showed that depending on the supplement between 20-80% of the samples were outright fraudulent. The problem doesn’t lie with the drug industry, or the “medical establishment”. Rather, it is our corrupt congress that received billions of dollars from the supplement industry and passed a law that prohibit the FDA from requiring the supplements industry from documenting safety and efficacy. Wouldn’t you want to know that the lecithin you think you are taking is actually there? that it is in the amount stated on the label? that it is safe? that its claims of efficacy are true? Ignorance is not bliss, and the vociferous defense of the supplements industry by people conned into blindly trusting their claims plays into the hands of a corrupt congress and corrupting industry money. If you want to see a damning account of supplements watch the latest PBS Frontline. Investigative journalism at its best.

  19. Approach of your article too negative and i used lecithin for many years…..it certainly increase your semen quantity…….and protect your fat consumption after a heavy fat meal of beef…i am heart patient i can only eat beef if i add little lecithin after meal………..

    • As I said in many of my posts and reply to comments, association does not causation make. Having said that, when I see claims that something, lecithin or otherwise, can protect your heart from animal fat, make your thinking clear, increase your semen count, to name a few of those miraculous effects, my index of suspicion rises significantly. So I check the legitimate literature, and behold: other than claims and testimonials there is absolutely nothing to substantiate the claims. Now, unlike the true believers, I don’t have the certitude on the matter that they have. So I am looking for evidence, and I until it comes -I have grave doubts.
      In term of your specific case of consuming animal fat with the hope that lecithin will neutralize its effect, I suggest you consult your cardiologist.

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