Phosphatidylcholine - Monograph

Alternative Medicine Review, April, 2002

Hepatitis C

In a multicenter, double-blind trial, 176 patients with chronic viral hepatitis (B or C) were begun on interferon alpha for 24 weeks then randomized to PC (1.8 g/day) or placebo for 24 weeks. Significantly more patients responded to PC, particularly in the hepatitis C subgroup. In addition, PC supplementation sustained a longer-term improvement from hepatitis C over another 24 weeks. (26)

A long-term, multicenter, double-blind trial of PC for liver disease is ongoing; its results could signal a breakthrough in nutritional management of this life-threatening disease. (27)

Respiratory Distress Syndrome

The surfactant of premature babies is abnormally low in PC. Treatment with exogenous, mature-profile surfactant (with PC 70-80% of the total phospholipids) is the standard therapy for infants with, or at risk of having, respiratory distress syndrome (RDS). A meta-analysis of clinical trials suggests improved survival and overall better outcome from natural surfactant over synthetic forms. (28) In another randomized trial with 78 RDS babies, natural suffactant proved superior after six hours, and by 24 hours normalized the surfactant PC profile. (14)

Necrotizing Enterocolitis, Gastrointestinal Protection

As the major intrinsic surfactant of the gastrointestinal tract, PC helps maintain the acid barrier properties of the gastric epithelium. Animal research suggests PC helps protect against the adverse GI effects of aspirin and other non-steroidal anti-inflammatory drugs without blocking their efficacy. (15,29,30) Carlson et al reported a lower incidence of necrotizing enterocolitis in pre-term infants fed with formula high in PC and other phospholipids. (31)

Central Nervous System Cholinergic Imbalances

In contrast to persistent anecdotal claims, PC failed to benefit cognition in ten double-blind, placebo-controlled trials. (32) There are indications the "therapeutic window" for PC might be very narrow, (33) which could also explain the disappointing trial results against ataxias, tardive dyskinesia, and other CNS conditions that feature cholinergic imbalances.

Toxicity and Side Effects

PC is freely compatible with other nutrients, and when co-administered may enhance their absorption. Standard toxicological assessments indicate no significant acute or chronic toxicity from PC, as well as no mutagenicity and no teratogenicity. PC is well tolerated at daily intakes of up to 18 grams. (7) Symptoms of intolerance are almost exclusively restricted to GI discomfort -- diarrhea, excessive fullness, and nausea.

Dosage

The therapeutic range of intake is 800-2,400 mg daily, and 4.6 grams or higher for liver salvage. For subjects with severe liver damage, best results may be obtained by initiating therapy with intravenous and oral PC, then maintaining on oral supplementation after improvement has begun. In cases of liver damage from deathcap mushroom poisoning this procedure has proved lifesaving. (34)

References

(1.) Kidd PM. Dietary phospholipids as anti-aging nutraceuticals. In: Klatz RA, Goldman R, eds. Anti-Aging Medical Therapeutics. Chicago, IL: Health Quest Publications; 2000:283-301.