Lecithin is a ubiquitous term in the health and food industry, often touted for its beneficial properties. Found in everything from supplements to food additives, it’s recognized for its emulsifying capabilities and potential health benefits. However, amidst the praise, questions arise about its safety and potential negative effects. So, is lecithin bad for you? This article delves into the science to explore the potential downsides of lecithin, helping you make informed decisions about its consumption.
What is Lecithin?
Lecithin is not a single substance, but rather a blanket term for a group of fatty substances called phospholipids. These are vital components of cell membranes in both plants and animals. Commercially, lecithin is often derived from sources like soybeans, sunflowers, eggs, and rapeseed. It’s rich in phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, and phosphatidic acid. Due to its amphipathic nature – meaning it attracts both water and fat – lecithin is widely used as an emulsifier in food production, preventing the separation of fats and water.
Potential Benefits of Lecithin (Context Before Concerns)
Before we address the potential negatives, it’s important to acknowledge why lecithin is often viewed positively. Lecithin, particularly phosphatidylcholine, is a source of choline, an essential nutrient vital for various bodily functions, including:
- Cell Structure: Phospholipids are key building blocks of cell membranes.
- Nerve Function: Choline is a precursor to acetylcholine, a neurotransmitter important for memory, muscle control, and other functions.
- Fat Metabolism: Choline helps transport fats from the liver.
- Brain Health: Some studies have explored lecithin’s potential role in cognitive function and neurological disorders, although research is ongoing and often inconclusive. Several studies listed in the provided references explore lecithin’s effect on Alzheimer’s disease and dementia, with mixed results [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173].
Soy lecithin is a common source of lecithin, widely used in the food industry.
Potential Downsides and Concerns of Lecithin
While generally recognized as safe (GRAS) by the FDA [104], and found naturally in many foods, lecithin is not without potential drawbacks, especially when consumed in concentrated forms or by certain individuals.
1. Allergic Reactions
Soy and egg are common sources of lecithin, and allergies to these foods are prevalent. While processed lecithin often contains minimal soy or egg proteins, individuals with severe allergies may still experience reactions [95]. Symptoms can range from mild skin rashes and gastrointestinal upset to more severe anaphylaxis. If you have a known soy or egg allergy, it’s crucial to be cautious with lecithin-containing products.
2. Digestive Issues
For some individuals, especially when consumed in large doses, lecithin can cause gastrointestinal side effects. These may include:
- Bloating and Gas: Lecithin can be fermented by gut bacteria, potentially leading to increased gas production.
- Diarrhea: As a fatty substance, lecithin can have a laxative effect in some people, especially at higher doses.
- Nausea: Some individuals may experience nausea, particularly when starting lecithin supplementation.
These digestive issues are typically mild and temporary, resolving as the body adjusts or with reduced dosage.
3. TMAO and Cardiovascular Health: A Growing Concern
One of the more significant concerns surrounding lecithin consumption is its potential link to increased levels of Trimethylamine N-oxide (TMAO). Lecithin is a source of choline, which, when metabolized by gut bacteria, can be converted into TMAO. Elevated TMAO levels have been associated with an increased risk of cardiovascular disease, including atherosclerosis, heart attacks, and strokes [170].
Elevated TMAO levels, potentially linked to lecithin consumption, are a concern for cardiovascular health.
Zhang et al. (1999) [170] explored dietary precursors of trimethylamine, highlighting lecithin as a significant contributor. While this research and subsequent studies raise concerns, it’s crucial to consider the context:
- Individual Gut Microbiome: The extent to which lecithin contributes to TMAO production varies significantly based on an individual’s unique gut bacteria composition.
- Dosage and Source: The amount of lecithin consumed and its source (dietary vs. supplemental) may influence TMAO levels.
- Overall Dietary Pattern: A diet high in saturated fat and low in fiber may exacerbate the potential negative effects of TMAO, while a heart-healthy diet rich in fruits, vegetables, and fiber might mitigate risks.
- Further Research Needed: The link between dietary lecithin, TMAO, and cardiovascular events is still an area of active research. More long-term studies are needed to fully understand the implications, particularly for different populations and dietary contexts.
4. Source and Processing Concerns
The majority of commercially available lecithin, particularly in North America, is derived from soy. Much of this soy is genetically modified (GMO). While scientific consensus is that GMO foods currently available are safe to eat, some individuals prefer to avoid them due to environmental or ethical concerns. If you prefer non-GMO lecithin, look for sunflower lecithin or lecithin derived from certified non-GMO soy.
Furthermore, the processing of lecithin can involve chemical solvents like hexane. While residual hexane levels are typically considered very low and safe, some consumers may prefer lecithin extracted using mechanical or other solvent-free methods.
Lecithin in Supplements vs. Food Additives
It’s important to distinguish between lecithin consumed as a supplement and lecithin used as a food additive. In supplements, lecithin is often taken in higher doses to potentially achieve specific health benefits. In food, lecithin is used in small amounts primarily as an emulsifier. The potential risks associated with lecithin are more likely to be relevant for individuals taking lecithin supplements regularly and in higher doses, rather than from typical dietary intake as a food additive.
Who Should Be Cautious with Lecithin?
While most people can consume lecithin in moderate amounts without significant issues, certain individuals should exercise caution:
- Individuals with Soy or Egg Allergies: Read labels carefully and consider allergen-free alternatives like sunflower lecithin.
- Individuals with Digestive Sensitivities: Start with low doses and monitor for gastrointestinal side effects.
- Individuals with Increased Cardiovascular Risk Factors: Those with pre-existing heart disease or multiple risk factors should be mindful of their choline and lecithin intake and discuss with their healthcare provider, especially if considering lecithin supplements.
- Individuals Concerned about TMAO: If you are concerned about TMAO levels, consider limiting high-choline/lecithin supplements and focusing on a heart-healthy dietary pattern.
Conclusion: A Balanced Perspective on Lecithin
So, is lecithin bad for you? The answer is nuanced. For most people, lecithin consumed in typical dietary amounts as a food additive is unlikely to pose significant health risks. It can even offer some benefits due to its choline content. However, potential downsides exist, particularly with high-dose lecithin supplementation and for specific populations.
The most significant concern emerging from current research is the potential link between lecithin, TMAO production, and cardiovascular disease. While more research is needed, especially regarding long-term effects and individual variability, it’s prudent to be aware of this potential risk, especially if you have pre-existing cardiovascular concerns.
Ultimately, like many nutrients and food components, moderation and individual considerations are key. A balanced diet, awareness of potential sensitivities, and informed decision-making are the best approaches when it comes to lecithin consumption. If you have concerns about lecithin and your health, consulting with a healthcare professional or registered dietitian is always recommended.
References:
[List of references as provided in the prompt, formatted for markdown]
[1] Barbeau, A. Emerging treatments: replacement therapy with choline or lecithin in neurological diseases. Can.J.Neurol.Sci. 1978;5(1):157-160. View abstract.
[2] Barbeau, A. Lecithin in neurologic disorders. N.Engl.J Med 7-27-1978;299(4):200-201. View abstract.
[3] Bellelli, A., Giomini, M., Giuliani, A. M., Giustini, M., Lorenzon, I., Rusconi, V., Sezzi, M. L., Trotta, E., and Belleli, L. Antitumor effect and cardiotoxicity of a doxorubicin-lecithin association. Anticancer Res 1988;8(1):177-186. View abstract.
[4] Benton, D. and Donohoe, R. T. The influence on cognition of the interactions between lecithin, carnitine and carbohydrate. Psychopharmacology (Berl) 2004;175(1):84-91. View abstract.
[5] Branconnier, R. J., Dessain, E. C., Cole, J. O., and McNiff-Langille, M. E. An analysis of dose-response of plasma choline to oral lecithin. Biol.Psychiatry 1984;19(5):765-770. View abstract.
[6] Brinkman, S. D., Pomara, N., Goodnick, P. J., Barnett, N., and Domino, E. F. A dose-ranging study of lecithin in the treatment of primary degenerative dementia (Alzheimer disease). J Clin Psychopharmacol. 1982;2(4):281-285. View abstract.
[7] Caine, E. D. Cholinomimetic treatment fails to improve memory disorders. N.Engl.J Med 9-4-1980;303(10):585-586. View abstract.
[8] Canter, N. L., Hallett, M., and Growdon, J. H. Lecithin does not affect EEG spectral analysis or P300 in Alzheimer disease. Neurology 1982;32(11):1260-1266. View abstract.
[9] Chuaqui, P. and Levy, R. Fluctuations of free choline levels in plasma of Alzheimer patients receiving lecithin: preliminary observations. Br.J.Psychiatry 1982;140:464-469. View abstract.
[10] Crapper McLachlan, D. R., Dalton, A. J., Kruck, T. P., Bell, M. Y., Smith, W. L., Kalow, W., and Andrews, D. F. Intramuscular desferrioxamine in patients with Alzheimer’s disease. Lancet 6-1-1991;337(8753):1304-1308. View abstract.
[11] Davidson, M., Mohs, R. C., Hollander, E., Zemishlany, Z., Powchik, P., Ryan, T., and Davis, K. L. Lecithin and piracetam in Alzheimer’s disease. Biol.Psychiatry 1987;22(1):112-114. View abstract.
[12] Duffy, F. H., McAnulty, G., Albert, M., Durwen, H., and Weintraub, S. Lecithin: absence of neurophysiologic effect in Alzheimer’s disease by EEG topography. Neurology 1987;37(6):1015-1019. View abstract.
[13] Dysken, M. W., Fovall, P., Harris, C. M., Davis, J. M., and Noronha, A. Lecithin administration in Alzheimer dementia. Neurology 1982;32(10):1203-1204. View abstract.
[14] Foster, N. L., Petersen, R. C., Gracon, S. I., and Lewis, K. An enriched-population, double-blind, placebo-controlled, crossover study of tacrine and lecithin in Alzheimer’s disease. The Tacrine 970-6 Study Group. Dementia 1996;7(5):260-266. View abstract.
[15] Gauthier, S., Bouchard, R., Bacher, Y., Bailey, P., Bergman, H., Carrier, L., Charbonneau, R., Clarfield, M., Collier, B., Dastoor, D., and . Progress report on the Canadian Multicentre Trial of tetrahydroaminoacridine with lecithin in Alzheimer’s disease. Can.J Neurol.Sci 1989;16(4 Suppl):543-546. View abstract.
[16] Gauthier, S., Bouchard, R., Lamontagne, A., Bailey, P., Bergman, H., Ratner, J., Tesfaye, Y., Saint-Martin, M., Bacher, Y., Carrier, L., and . 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 5-3-1990;322(18):1272-1276. View abstract.
[17] Gelenberg, A. J., Doller-Wojcik, J. C., and Growdon, J. H. Choline and lecithin in the treatment of tardive dyskinesia: preliminary results from a pilot study. Am J Psychiatry 1979;136(6):772-776. View abstract.
[18] Growdon, J. H., Wheeler, S., and Graham, H. N. Plasma choline responses to lecithin-enriched soup. Psychopharmacol.Bull 1984;20(3):603-606. View abstract.
[19] Hallett, M., Canter, N., and Growdon, J. Neurophysiologic Parameters in Alzheimer Disease: Effect of Lecithin. Neurology 1982;32(2):a126.
[20] Halliday, H. L., McClure, G., Reid, M. M., Lappin, T. R., Meban, C., and Thomas, P. S. Controlled trial of artificial surfactant to prevent respiratory distress syndrome. Lancet 3-3-1984;1(8375):476-478. View abstract.
[21] Holford, N. H. and Peace, K. The effect of tacrine and lecithin in Alzheimer’s disease. A population pharmacodynamic analysis of five clinical trials. Eur J Clin Pharmacol 1994;47(1):17-23. View abstract.
[22] Jackson, I. V., Nuttall, E. A., Ibe, I. O., and Perez-Cruet, J. Treatment of tardive dyskinesia with lecithin. Am J Psychiatry 1979;136(11):1458-1460. View abstract.
[23] Kaye, W. H., Sitaram, N., Weingartner, H., Ebert, M. H., Smallberg, S., and Gillin, J. C. Modest facilitation on memory in dementia with combined lecithin and anticholinerestase treatment. Biol.Psychiatry 1982;17(2):275-280. View abstract.
[24] Kushnir, S. L., Ratner, J. T., and Gregoire, P. A. Multiple nutrients in the treatment of Alzheimer’s disease. J Am Geriatr.Soc 1987;35(5):476-477. View abstract.
[25] Lampe, T. H., Norris, J., Risse, S. C., Owen-Williams, E., and Keenan, T. Therapeutic Potential of Thyrotropin-Releasing Hormone (TRH) and Lecithin Co-administration in Alzheimer’s Disease. Neurobiology of Aging 1990;11:346.
[26] Levin, H. S. and Peters, B. H. Long-term administration of oral physostigmine and lecithin improve memory in Alzheimer’s disease. Ann.Neurol. 1984;15(2):210. View abstract.
[27] Levy, R., Little, A., Chuaqui, P., and Reith, M. Early results from double-blind, placebo controlled trial of high dose phosphatidylcholine in Alzheimer’s disease. Lancet 4-30-1983;1(8331):987-988. View abstract.
[28] Lieber, C. S., DeCarli, L. M., Mak, K. M., Kim, C. I., and Leo, M. A. Attenuation of alcohol-induced hepatic fibrosis by polyunsaturated lecithin. Hepatology 1990;12(6):1390-1398. View abstract.
[29] McLachlan, D. R., Smith, W. L., and Kruck, T. P. Desferrioxamine and Alzheimer’s disease: video home behavior assessment of clinical course and measures of brain aluminum. Ther.Drug Monit. 1993;15(6):602-607. View abstract.
[30] Melancon, S. B., Dallaire, L., Potier, M., Vanasse, M., Marois, P., Geoffroy, G., and Barbeau, A. Oral lecithin and linoleic acid in Friedreich’s ataxia: I. Design of the study, material and methods. Can.J Neurol.Sci 1982;9(2):151-154. View abstract.
[31] Nair, M. P., Kudchodkar, B. J., Pritchard, P. H., and Lacko, A. G. Purification of recombinant lecithin: cholesterol acyltransferase. Protein Expr.Purif. 1997;10(1):38-41. View abstract.
[32] Pentland, B., Martyn, C. N., Steer, C. R., and Christie, J. E. Lecithin treatment in Friedreich’s ataxia. Br Med J (Clin Res Ed) 4-11-1981;282(6271):1197-1198. View abstract.
[33] Perez-Cruet, J., Menendez, I., Alvarez-Ghersi, J., Falcon, J. R., Valderrabano, O., Castro-Urrutia, E. C., Ifarraguerri, C., and Perez, L. L. Double-blind study of lecithin in the treatment of persistent tardive dyskinesia. Bol.Asoc.Med P.R. 1981;73(11):531-537. View abstract.
[34] Perryman, K. M. and Fitten, L. J. Delayed matching-to-sample performance during a double-blind trial of tacrine (THA) and lecithin in patients with Alzheimer’s disease. Life Sci 1993;53(6):479-486. View abstract.
[35] Perryman, K. M. and Fitten, L. J. Quantitative EEG during a double-blind trial of THA and lecithin in patients with Alzheimer’s disease. J Geriatr Psychiatry Neurol. 1991;4(3):127-133. View abstract.
[36] Peters, B. H. and Levin, H. S. Effects of physostigmine and lecithin on memory in Alzheimer disease. Ann Neurol. 1979;6(3):219-221. View abstract.
[37] Sannita, W. G., Balestra, V., Rosadini, G., Salama, M., and Timitilli, C. Quantitative EEG and neuropsychological effects of piracetam and of the association piracetam-lecithin in healthy volunteers. Neuropsychobiology 1985;14(4):203-209. View abstract.
[38] Smith, R. C., Vroulis, G., Johnson, R., and Morgan, R. Comparison of therapeutic response to long-term treatment with lecithin versus piracetam plus lecithin in patients with Alzheimer’s disease. Psychopharmacol.Bull. 1984;20(3):542-545. View abstract.
[39] Sorgatz, H. [Effect of lecithin on health status and concentration. Placebo-controlled double-blind study in healthy probands]. Fortschr Med 4-10-1988;106(11):233-236. View abstract.
[40] Stoll, A. L., Sachs, G. S., Cohen, B. M., Lafer, B., Christensen, J. D., and Renshaw, P. F. Choline in the treatment of rapid-cycling bipolar disorder: clinical and neurochemical findings in lithium-treated patients. Biol.Psychiatry 9-1-1996;40(5):382-388. View abstract.
[41] Thal, L. J., Fuld, P. A., Masur, D. M., and Sharpless, N. S. Oral physostigmine and lecithin improve memory in Alzheimer disease. Ann Neurol. 1983;13(5):491-496. View abstract.
[42] Thal, L. J., Masur, D. M., Sharpless, N. S., Fuld, P. A., and Davies, P. Acute and chronic effects of oral physostigmine and lecithin in Alzheimer’s disease. Prog.Neuropsychopharmacol.Biol.Psychiatry 1986;10(3-5):627-636. View abstract.
[43] Tudorache, B., Lupulescu, R., Dutan, I., and Sarbulescu, A. Assessment of various psychopharmacological combinations in the treatment of presenile and senile primary degenerative dementia. Rom.J Neurol.Psychiatry 1990;28(4):277-294. View abstract.
[44] Tuzhilin, S. A., Dreiling, D. A., Narodetskaja, R. V., and Lukash, L. K. The treatment of patients with gallstones by lecithin. Am J Gastroenterol. 1976;65(3):231-235. View abstract.
[45] Uney, J. B., Jones, G. M., Rebeiro, A., and Levy, R. The effect of long-term high dose lecithin on erythrocyte choline transport in Alzheimer patients. Biol.Psychiatry 3-15-1992;31(6):630-633. View abstract.
[46] Vida, S., Gauthier, L., and Gauthier, S. Canadian collaborative study of tetrahydroaminoacridine (THA) and lecithin treatment of Alzheimer’s disease: effect on mood. Can.J Psychiatry 1989;34(3):165-170. View abstract.
[47] Vinarova, E. and Vinar, O. Lecithin in a Psychiatric Out-patient Clinic. Activ nerv sup (Prana) 1987;29(3):219-221.
[48] Volz, H. P., Hehnke, U., and Hauke, W. [Improvement in quality of life in the elderly. Results of a placebo-controlled study on the efficacy and tolerability of lecithin fluid in patients with impaired cognitive functions]. MMW Fortschr Med 12-9-2004;146(Suppl 3-4):99-106. View abstract.
[49] von Allworden, H. N., Horn, S., Kahl, J., and Feldheim, W. The influence of lecithin on plasma choline concentrations in triathletes and adolescent runners during exercise. Eur.J.Appl.Physiol Occup.Physiol 1993;67(1):87-91. View abstract.
[50] Vroulis, G. A., Smith, R. C., Brinkman, S., Schoolar, J., and Gordon, J. The effects of lecithin on memory in patients with senile dementia of the Alzheimer’s type [proceedings]. Psychopharmacol Bull 1981;17(1):127-128. View abstract.
[51] Vroulis, G., Smith, R. C., Schoolar, J. C., Dahlen, G., Katz, E., and Misra, C. H. Reduction of cholesterol risk factors by lecithin in patients with Alzheimer’s disease. Am J Psychiatry 1982;139(12):1633-1634. View abstract.
[52] Weintraub, S., Mesulan, M. M., Auty, R., Baratz, R., Cholakos, B. N., Kapust, L., Ransil, B., Tellers, J. G., Albert, M. S., LoCastro, S., and Moss, M. Lecithin in the treatment of Alzheimer’s disease. Arch Neurol. 1983;40(8):527-528. View abstract.
[53] Wurtman, R. J., Hirsch, M. J., and Growdon, J. H. Lecithin consumption raises serum-free-choline levels. Lancet 7-9-1977;2(8028):68-69. View abstract.
[54] Zhang, A. Q., Mitchell, S. C., and Smith, R. L. Dietary precursors of trimethylamine in man: a pilot study. Food Chem.Toxicol. 1999;37(5):515-520. View abstract.
[55] Andrioli G, Carletto A, Guarini P, et al. Differential effects of dietary supplementation with fish oil or soy lecithin on human platelet adhesion. Thromb Haemost 1999;82:1522-7. View abstract.
[56] Brinkman SD, Smith RC, Meyer JS, et al. Lecithin and memory training in suspected Alzheimer’s disease. J Gerontol 1982;37:4-9. View abstract.
[57] Buchman AL, Awal M, Jenden D, et al. The effect of lecithin supplementation on plasma choline concentrations during a marathon. J Am Coll Nutr 2000;19:768-70. View abstract.
[58] Buchman AL, Dubin M, Jenden D, et al. Lecithin increases plasma free choline and decreases hepatic steatosis in long-term total parenteral nutrition patients. Gastroenterology 1992;102:1363-70. View abstract.
[59] 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. View abstract.
[60] Cohen BM, Lipinski JF, Altesman RI. Lecithin in the treatment of mania: double-blind, placebo-controlled trials. Am J Psychiatry 1982;139:1162-4. View abstract.
[61] Conte A, Ronca G, Petrini M, et al. Effect of lecithin on epicutaneous absorption of diclofenac epolamine. Drugs Exp Clin Res 2002;28:249-55. View abstract.
[62] Domino EF, May WW, Demetriou S, et al. Lack of clinically significant improvement of patients with tardive dyskinesia following phosphatidylcholine therapy. Biol Psychiatry 1985;20:1189-96. View abstract.
[63] Drachman DA, Glosser G, Fleming P, et al. Memory decline in the aged: treatment with lecithin and physostigmine. Neurology 1982;32:944-50. View abstract.
[64] Electronic Code of Federal Regulations. Title 21, Chapter 1, Subchapter B, Part 184: Direct food substances affirmed as Generally Recognized as Safe. Subpart B – listing of specific substances affirmed as GRAS. Sec. 184.1400 Lecithin. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1400
[65] Etienne P, Dastoor D, Gauthier S, et al. Alzheimer disease: lack of effect of lecithin treatment for 3 months. Neurol 1981;31:1552-4. View abstract.
[66] Evans M, Njike VY, Hoxley M, et al. Effect of soy isoflavone protein and soy lecithin on endothelial function in healthy postmenopausal women. Menopause 2007;14:141-9. View abstract.
[67] Facts and Comparisons, loose leaf edition. St. Louis, MO: Wolters Kluwer Co., 1999.
[68] Fioravanti A, Cicero MR, Nerucci F, et al. Double-blind controlled clinical study of the efficacy and tolerability of diclofenac-N-(2-hydroxyethyl)-pyrrolidine lecithin gel compared with diclofenac-N-(2-hydroxyethyl)-pyrrolidine gel in patients with peri and extraarticular inflammatory diseases. Drugs Exp Clin Res 1999;25:235-40. View abstract.
[69] Fisman M, Merskey H, Helmes E, et al. Double blind study of lecithin in patients with Alzheimer’s disease. Can.J Psychiatry 1981;26:426-28. View abstract.
[70] 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. View abstract.
[71] Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: https://books.nap.edu/books/0309065542/html/.
[72] Gelenberg AJ, Dorer DJ, Wojcik JD, et al. A crossover study of lecithin treatment of tardive dyskinesia. J Clin Psychiatry 1990;51:149-53. View abstract.
[73] Goldberg AC, Ostlund RE, Bateman JH, et al. Effect of plant stanol tablets on low-density lipoprotein cholesterol lowering in patients on statin drugs.Am J Cardiol. 2-1-2006;97:376-79. View abstract.
[74] Gremaud G, Dalan E, Piguet C, et al. Effects of non-esterified stanols in a liquid emulsion on cholesterol absorption and synthesis in hypercholesterolemic men. Eur J Nutr 2002;41:54-60. View abstract.
[75] Growdon JH, Corkin S, Huff FJ, et al. Piracetam combined with lecithin in the treatment of Alzheimer’s disease. Neurobiol Aging 1986;7:269-76. View abstract.
[76] 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;9:699-703. View abstract.
[77] Harris CM, Dysken MW, Fovall P, Davis JM. Effect of lecithin on memory in normal adults. Am J Psychiatry 1983;140:1010-2. View abstract.
[78] Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
[79] Hellhammer J, Fries E, Buss C, et al. Effects of soy lecithin phosphatidic acid and phosphatidylserine complex (PAS) on the endocrine and psychological responses to mental stress. Stress. 2004;7:119-26. View abstract.
[80] Heyman A, Schmechel D, Wilkinson W, et al. Failure of long term high-dose lecithin to retard progression of early-onset Alzheimer’s disease. J Neural Transm Suppl 1987;24:279-86. View abstract.
[81] Higgins JP, Flicker L. Lecithin for dementia and cognitive impairment. Cochrane Database Syst Rev 2000;4:CD001015. View abstract.
[82] Higgins JP, Flicker L. Lecithin for dementia and cognitive impairment. Cochrane Database Syst Rev 2003;(3):CD001015. View abstract.
[83] Holan KR, Holzbach RT, Hsieh JY, et al. Effect of oral administration of essential phospholipid, beta-glycerophosphate, and linoleic acid on biliary lipids in patients with cholelithiasis. Digestion 1979;19:251-8. View abstract.
[84] Jenike MA, Albert MS, Heller H, et al. Combination therapy with lecithin and ergoloid mesylates for Alzheimer’s disease. J Clin Psychiatry 1986;47:249-51. View abstract.
[85] Jenkins PJ, Portmann BP, Eddleston AL, Williams R. Use of polyunsaturated phosphatidyl choline in HBsAg negative chronic active hepatitis: results of prospective double-blind controlled trial. Liver 1982;2:77-81. View abstract.
[86] Kapen S, Fleming PD, Drachman DA. Cholinergic enhancement and REM sleep latency in the aged: lecithin does not reproduce physostigmine effect. Neurology 1986;36:1079-83. View abstract.
[87] Kraft JN, Lynde CW. Moisturizers: what they are and a practical approach to product selection. Skin Ther Lett 2005;10(5):1-8.
[88] Krag A, Israelsen H, von Ryberg B, et al. Safety and efficacy of Profermin® to induce remission in ulcerative colitis. World J Gastroenterol 2012;18(15):1773-80.View abstract.
[89] Krag A, Munkholm P, Israelsen H, von Ryberg B, Andersen KK, Bendtsen F. Profermin is efficacious in patients with active ulcerative colitis–a randomized controlled trial. Inflamm Bowel Dis. 2013;19(12):2584-92. View abstract.
[90] Ladd SL, Sommer SA, LaBerge S, Toscano W. Effect of phosphatidylcholine on explicit memory. Clin Neuropharmacol 1993;16:540-9. View abstract.
[91] Levin HS, Peters BH, Kalisky Z, et al. Effects of oral physostigmine and lecithin on memory and attention in closed head-injured patients. Cent.Nerv.Syst.Trauma 1986;3:333-42. View abstract.
[92] 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. View abstract.
[93] Mahler P, Mahler F, Duruz H, et al. Double-blind, randomized, controlled study on the efficacy and safety of a novel diclofenac epolamine gel formulated with lecithin for the treatment of sprains, strains and contusions. Drugs Exp Clin Res 2003;29:45-52. View abstract.
[94] Maltby N, Broe GA, Creasey H, et al. Efficacy of tacrine and lecithin in mild to moderate Alzheimer’s disease: double-blind trial. BMJ 1994;308:879-83. View abstract.
[95] Palm M, Moneret-Vautrin DA, Kanny G, et al. Food allergy to egg and soy lecithins. Allergy 1999;54:1116-7. View abstract.
[96] Melancon SB, Vanasse M, Geoffroy G, et al. Oral lecithin and linoleic acid in Friedreich’s ataxia: II. Clinical results. Can.J Neurol.Sci 1982;9:155-64. View abstract.
[97] 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. View abstract.
[98] Ostlund RE Jr, Spilburg CA, Stenson WF. Sitostanol administered in lecithin micelles potently reduces cholesterol absorption in humans. Am J Clin Nutr 1999;70:826-31. View abstract.
[99] Pomara N, Domino EF, Yoon H, et al. Failure of single-dose lecithin to alter aspects of central cholinergic activity in Alzheimer’s disease. J Clin Psychiatry 1983;44:293-5. View abstract.
[100] Sidhu N, Davies S, Nadarajah A, et al. Oral choline supplementation for postoperative pain. Br J Anaesth 2013;111(2):249-55. View abstract .
[101] Simons LA, Hickie JB, Ruys J. Treatment of hypercholesterolaemia with oral lecithin. Aust N Z J Med 1977;7:262-6. View abstract.
[102] Sourkes TL. The discovery of lecithin, the first phospholipid. Bull Hist Chem. 2004;29(1):9-15.
[103] Spilburg CA, Goldberg AC, McGill JB, et al. Fat-free foods supplemented with soy stanol-lecithin powder reduce cholesterol absorption and LDL cholesterol. J Am Diet Assoc 2003;103:577-81. View abstract.
[104] Electronic Code of Federal Regulations. Title 21, Chapter 1, Subchapter B, Part 184: Direct food substances affirmed as Generally Recognized as Safe. Subpart B – listing of specific substances affirmed as GRAS. Sec. 184.1400 Lecithin. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1400
[105] Tweedy JR and Garcia CA. Lecithin treatment of cognitively impaired Parkinson’s patients. Eur J Clin Invest 1982;12:87-90. View abstract.
[106] Volavka J, O’Donnell J, Muragali R,et al. Lithium and lecithin in tardive dyskinesia: an update. Psychiatry Res 1986;19:101-4. View abstract.
[107] Wade A, Weller PJ, eds. Handbook of Pharmaceutical Excipients. 2nd ed. Washington, DC: Am Pharmaceutical Assn, 1994.
[108] Wu Y, Wang T. Soybean lecithin fractionation and functionality. JAOCS 2003;80(4):319-326.