Lecithin Supplements: Weighing Risks vs. Benefits

By Dov Michaeli, MD, PhD | Published 7/2/2020 222

lecithin capsules closeup photo

Lecithin supplements have been touted as being beneficial for many different things but there is almost no evidence that this is the case. (Photo source: iStock)

Lecithin is a very popular dietary supplement. But what do we know about its risks and benefits?

With regard to benefits, we know that lecithin supplements are 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

I have always been suspicious of promotions that promise to cure all human ailments. So it doesn’t surprise me to find that a recent review of a number of scientific papers on PubMed reveals that the researchers still refer to hoped for lecithin benefits with terms like “may,” “might,” “theoretically could” and not with “does.” Further, most papers and credible health-related websites point out that there is a woeful lack of research about the efficacy of this particular dietary supplement.

So, I believe that, at this point in time, it is safe to say that none of the claims about lecithin have any credible evidence to back them up.

There are two possible but minor exceptions

    1. Lecithin is a natural emulsifier, so claims that it dissolves gallstones may be credible. However, I haven’t come across a good study documenting it. And, WebMD gives lecithin treatment of gallstones an unenthusiastic “recommendation” of possibly ineffective.
    2. A small study out of Tokyo recently found that high-dose (1200 mg/day) soy lecithin increased “vigor” in middle-aged women who presented with fatigue compared to a placebo. The study was funded by Kikkoman, a Japanese food producer that makes a variety of soy products, such as soy sauce and soy milk.

What is lecithin?

Lecithin is actually a mixture of different fatty substances called glycerophospholipids, including: 

      • phosphatidylcholine (often thought synonymous with lecithin)
      • phosphatidylethanolamine
      • phosphatidylinositol
      • phosphatidylserine
      • phosphatidic acid

Lecithin is found in egg yolk, meats, soy, seeds, such as sunflower and rapeseed, and some vegetables, such as corn. Soy is the source of most commercial lecithin, although sunflower lecithin is increasingly popular because of concerns about GMOs in soy and food allergy labeling regulations.

Is there really lecithin in your lecithin supplement?

You probably assume that when you take lecithin supplements, you are actually getting lecithin. However, as is the case with many nutritional supplements, commercial preparations vary widely in the amount the substance that is actually in their product.

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.

Only a fraction of commercial lecithin is made up of the real thing. So, what makes up the rest? The answer: fatty acids!

Not exactly the stuff to help in weight reduction, cardiovascular health, or good liver function. In fact, theoretically, they could work against all those potentially wonderful benefits.

Metabolomics

Before we go any further, let me introduce a relatively new medical term: metabolomics. 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.

Similarly, the sum total of chemicals, substrates, and metabolites in the body is called the metabolome. Metabolomics is the study of those substances in health and disease. The advantage of taking an all-inclusive approach is that it is unbiased.

The classical scientific approach is 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.

On the other hand, studying the whole genome or the whole metabolome gives a complete picture of everything that is involved in the process being studied.

For instance, for many years, only one or two genes were thought to be involved in the development of type 2 diabetes. 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. This was a complete surprise.

What’s the downside of lecithin supplements?

So, let’s return to the question at hand. If lecithin supplements don’t cause any harm, why not give it the benefit of the doubt? After all, a future study may prove its benefit.

In a paper published in Nature, Wang and his collaboratorsat the Cleveland Clinic studied the metabolic fate of lecithin. They 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. Then they compared those results with the blood of people who had not had those serious cardiovascular events.

They found major differences in choline, betaine, and trimethylamine (TMA).It turns out that gut bacteria produce these metabolites from lecithin. And then they convert them to trimethylamine-N-oxide (TMAO).

This terminal metabolite, TMAO, is a known atherogenic substance.

That means it is involved in atherosclerotic plaque formation.

None of the metabolites appeared in the blood after the gut flora was wiped out with an antibiotic. 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.

Based on this study alone, we still can’t tell if these lecithin metabolites are causative factors, or whether they are just markers of the disease. This is because correlative studies can show only correlations, not cause and effect.

Lecithin is not the only culprit that leads to TMAO

Is lecithin the only culprit that produces TMAO? Red meat contains another triethylamine. This molecule, called L-Carnitine, is similar to choline and lecithin. Like them, it should be metabolized by the gut flora into MAO and then converted to TMAO in the circulation.

The same Cleveland Clinic group examined the production of TMAO by omnivores, vegans, and vegetarians following the ingestion of L-carnitine.

They found that the omnivorous humans had higher levels of circulating TMAO. The reason? Meat eaters have gut bacterial flora different than vegetarians and vegans.

It contains species that feast on triethylamines:

      • choline
      • lecithin
      • carnitine

 

Confirmation that the gut microbiome is key to the production of TMAO

Let’s look at an interesting study published in the prestigious New England Journal of Medicine by Tang and colleagues. It had two phases.

In the first phase, the investigators gave healthy participants a phosphatidylcholine challenge using a stable isotope-labeled form of the phospholipid. They then used mass spectrometry to monitor choline metabolites before and after the suppression of gut microbiota with broad-spectrum antibiotics.

They found that the phosphatidylcholine challenge increased all choline metabolites. Antibiotics suppressed the generation of TMAO metabolites. After the antibiotics were discontinued, they reappeared.

TMAO also found to correlate with cardiovascular events

In the second phase, the researchers examined the relationship between fasting plasma TMAO levels and incident cardiovascular events over a 3-year period. They studied more than 4,000 participants undergoing elective coronary angiography.

They found an independent, dose-dependent relationship between the metabolite and the risk of a cardiovascular event on the basis of the TMAO quartile. The highest quartile had 2.54 times the risk over the lowest quartile.

The bottom line when it comes to the risks and benefits of lecithin supplementation

Here is what we know about lecithin:

  • The phospholipid phosphatidylcholine (lecithin) is the major dietary source of choline, an essential nutrient that is part of the B-complex vitamin family. Choline has various metabolic roles, ranging from its critical involvement in lipid metabolism and cell-membrane structure to its role as a precursor for the synthesis of the neurotransmitter acetylcholine.
  • Red meat, processed meats, and egg yolk contain high levels of lecithin.
  • Gut flora metabolizes phosphatidylcholine (lecithin) into three metabolites that show up at high concentrations in people who have had a heart attack or a stroke. They are choline, betaine, and trimethylamine. We metabolize those bacterial metabolites into TMAO, a known atherogenic substance.
  • A large 4,000-patient study over 3 years showed a significant correlation between TMAO levels and cardiac events and stroke.

Causality vs correlation

One could argue that that the gold standard for demonstrating causality, namely a randomized, placebo-controlled study has not been done. Fair enough. But the accumulating evidence, both epidemiological and observational, and the detailed mechanistic studies provide a solid foundation for the clinical observation. This puts the onus of proof on the companies that make money off it and the “true believers” who fall for their unsubstantiated claims.

So, how does one make a decision about whether to take lecithin supplements?

Since the lecithin metabolite, TMAO, is a known atherogenic substance, I believe that until we better understand whether it actually causes atherosclerosis, the prudent approach would call for moderation.

That means limiting your intake of the foodstuffs that have high levels of lecithin.

Further, since there is no credible evidence supporting claims of health benefits, there is no reason to take high doses of lecithin in the form of nutritional supplements. If you do choose to take them, based on what we know now, you could be increasing your risk of a heart attack or stroke in exchange for no known benefit. It’s not a good trade-off, in my opinion.


First published – 01/25/2012. The author last updated it on 7/2/20 to include findings from the latest scientific studies.

Dov Michaeli, MD, PhD

Dov Michaeli, M.D., Ph.D. (now retired) was a professor and basic science researcher at the University of California San Francisco. In addition to his clinical and research responsibilities, he also taught biochemistry to first-year medical students for many years.

During this time he was also the Editor of Lange Medical Publications, a company that developed and produced medical texts that were widely used by health professionals around the world.

He loves to write about the brain and human behavior as well as translate knowledge and complicated basic science concepts into entertainment for the rest of us.

He eventually left academia 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 that developed products to improve post-surgical pain control.

Now that he is retired, he enjoys working out for two hours every day. He also follows the stock market, travels the world, and, of course, writes for TDWI.

Comments:

  • 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).

  • 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.

  • 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.

  • 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.

    • Hi, can you tell me how much you were taking as I have gallstone too! I bought sunflower lecithin 1200 mg. but I don’t know how many to take a day. Can you please reply!

    • Do what you must ! But read more…. Find the book Vitamin C and how to use it
      by Stephen Sheffrey, D.D.S. Vitamin C can help remove that stone too….

    • Jay this is Darlene Again, can you tell me how much sunflower lecithin to take for gallstone relief

    • Best forum comments on it pointed to using up to 2-4 GRAMS of phosphatidylcholine per day (basically lots as much as needed), and GB-3 (from endomet labs) to get the bile moving.
      It softens the stones and lets them move out.

    • I too was diagnosed with gallstones in 2010. Since then I had 2 emergency trips to accident and emergency. The last in 2012. My doctor made me sign a disclaimer for refusing to have my gall bladder removed. My reason for refusal is that we have keloid skin in our family and even laparoscopic surgery would mean I would be left with at least 4 tumour style scars that would continue to grow and are painful. I researched on the internet about gallstones under conventional and natural remedies. Went in to health shops and asked. One natural remedy stood out. Soy Lecithin. And the health shop recommended it also. I bought the Mega Lecithin from Holland and Barratt 1360mg. Started taking it. After 2 weeks my gallbladder was no longer irritated, no pain or discomfort. It is now May 2017 and I have not had a Gall Bladder attack since 2012. I am not on Lecithin constantly. Once or twice a year I go on a course for a month and that’s it. Unfortunately, taking out the Gall Bladder does not necessarily solve the pain problem. Some people still have pain? Really don’t know why that is? Others can develop Type 2 Diabetes but Doctors don’t warn you about this! Of course, in an emergency situation, where your life is at stake it is a doctors decision to take out your Gall Bladder. My suggestion is don’t wait for the next attack. Take Soy Lecithin 1360mg. It work by thinning the bile in the body. thick bile in the body causes stones to form in the Gall Bladder and also causes them to move and block the ducts causing a Gall Bladder Attack.. It is no wonder that thinning the bile will prevent more stones from forming. Taking Soy Lecithin does not get rid of the stones you already have, unfortunately. Since healthy thin bile helps other organs in the body function at optimum levels it means you may feel a greater sense of wellbeing as organs are functioning better. I wish you improved health!

  • 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’.

  • 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!).

    • Does anyone know if sunflower lecithin is a good form to take? Pros and cons?

    • Its safer especially if you’re taking higher doses because it’s soy-free. Some conditions require high doses like 10-20 grams. I’ve taken it for around 3 months now and I’ve had no side affects. I take around 10g per day. Not gonna say what for it’s personal but please do own research because there’s many uses with different doses for each. Shop online its way cheaper. I got a good sale from piping rock.com and it had same nutritional facts as the NOW brand. There’s many good reasons to supplement with it and not many side affects.

    • Hi Ryan, I totally agree with you. I really don’t get it why some medical doctors poop on natural and holistic medicine? I guess we have to take our own health into our own hands, because if we rely on the conventional doctors and medications we are for a big disappointment. I don’t care what they say, I go with my own instinct, and do my own research after all if I don’t no body will.

      Bless you

    • Hi Ryan or anyone who can answer my question. How do you know the lecithin is high quality and contains 95% phosphatides?

    • Yep right on the money.

      Perhaps this is why trigylceride-based omega-3’s dont perform as well as phospholipid-based omega 3’s in lipid metabolism tests.

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