Phosphatidylcholine Benefits: Brain, Liver, Gut And Cellular Function

Phosphatidylcholine, or PC for short, is an important phospholipid in the body. A phospholipid simply describes a molecule with a head containing phosphorus and two fatty tails. It’s a little known nutrient, but incredibly important for each and every cell in the body. PC has many key roles in the body and I’m going to cover six of the top ones today, including:

• Membrane structure
• Liposomes
• Choline and Neurological Function
• Methylation
• Cholesterol metabolism and liver health
• Colon health 

Let’s dive into the details of each of these areas to understand why it’s so critical to optimize your intake of phosphatidylcholine through food and potentially supplements as well.

The Top Six Reasons To Optimize Phosphatidylcholine

Here are six important roles PC plays in the body and human health:

1. PC Provides The Main Building Block For Cell Membranes And Mitochondria

First and foremost, the cell membrane, or outer shell, is what maintains the cell’s integrity. The membrane acts as a barrier around the exterior, separating and protecting the contents of the cell from the external environment. It also acts as a gatekeeper making sure that the cell receives the nutrients it needs to thrive, while keeping all the bad stuff, such as toxins, out.

Another key function of membranes is communicating messages. Embedded in the cell membranes are receptors which are activated or blocked by molecules which bind to them. When a receptor is activated, it begins to carry out a chain of reactions that send a message to the interior of the cell. This message leads to action by the cell, such as making a new protein or enhancing energy production.

Membranes aren’t just for cells, the tiny organelles inside of cells also contain their own membranes. The double membrane phosphatidylcholine structure of each and every mitochondria is important for energy production.

Mitochondria in our cells and are responsible for the final steps of converting the macronutrients we eat – carbohydrates, fats and protein - into energy in the form of ATP, the common currency of energy our cells use.

This final step of energy production, called oxidative phosphorylation, occurs in the mitochondria between its inner and outer membranes. These two membranes are phospholipid bilayers where a series of reactions carried out by the electron transport chain for the ultimate purpose of making energy for the entire cell. Hydrogen ions are pumped out generating a positive charge electrical potential between the two membranes. When the hydrogen ion is allowed to re-enter the mitochondria, the energy generated is captured in the form of ATP.

(To learn more about mitochondria, the citric acid cycle and electron transport chain, see my recent article here.)

Now, here is the phosphatidylcholine connection: PC is the main component of the cell and mitochondrial membrane structure. Mitochondrial and cell membranes are all made up of the same basic components: phospholipids.

Importantly, the inner and outer membranes need to be intact, but they are constantly being bombarded and damaged by the generation of free radicals like superoxide, an oxygen with an unpaired electron, generated by the energy producing process itself. You can think of these free radicals as the “exhaust” of the mitochondria, causing damage to the mitochondria and its membranes. This causes more inefficiency, more exhaust and more damage creating a vicious cycle.

How does the mitochondria repair and maintain its membrane? Phospholipids, and phosphatidylcholine specifically, are key.

Phospolipids are unique molecules. The typical phospholipid structure involves a water soluble phosphate “heads” connected to a lipid (fat) soluble “tail”. When they are exposed to an aqueous environment like the extracellular space (outside of the cell), phospholipids immediately coalesce into a sphere much like an oil and vinegar mixture, but at a microscopic level. Phospholipids function primarily to organize and form a membrane around the perimeter of the sphere with the phosphate “heads” pointing to the aqueous extra-cellular (outside of the cell) and intra-cellular  (inside of the cell, or cytosol) while the lipid soluble “tails” join together as well to form the center of the membrane forming what is called the lipid bilayer.

Phospatidylcholine (PC) is the most abundant phospholipid building block, making up 50% of cell membranes. Other phospholipids, such as phosphatidylethanolamine (PE), phosphatidylserine (PS), and phosphatidylinositol (PI) join forces with PC to support and complete the cell and mitochondrial membranes, offering strength, support and fluidity.

2. PC Is The Main Building Block Of Liposomes 

When phospholipids like PC, PE and PI, together knows as “PC Complex”, coalesce in the presence of water, they form a spherical structure called a liposome. This seemingly simple science is fascinating to me, especially as a functional medicine doctor, interested in the delivery of nutrients to the cells that need them. A liposome is an obvious choice for superior absorbability and bioavailability of supplemental nutrients because a liposome mimics the cell membrane structure and is easily recognized by the body.

Let me explain a little more. The contents trapped in the interior of the liposome – such as glutathione, vitamin C, vitamin B Complex, minerals or phytonutrients like curcumin - are protected from the external environment. This “trapping”, also called encapsulation, is very useful. As the liposomes pass through the digestive tract, the contents are protected against destruction by stomach acid and digestive enzymes. (Source 1, 2)

Because liposomes’ building blocks resemble cell membranes so much, they fuse with the cell membranes of small intestinal cells and their contents are assimilated by intestinal cells, then released into the blood circulation where the contents can be delivered to the cells that need them. (Source 1, 2)

Liposomes containing vitamin C, glutathione, B vitamins and curcumin increase the absorption poorly absorbed molecules. (Source 2, 3) The liposomes themselves are also very nutritious, delivering PC complex as the building blocks for restoring and repair cell and mitochondrial membranes and choline to support brain health, methylation and cellular function.

Speaking of choline, that brings me to #3.

3. PC Provides Choline

Phosphatidylcholine (PC) is the main source of choline in our bodies. In fact, 95% of the choline in the body is found in PC. While not exactly a vitamin, per se, choline is an essential nutrient. The human body can produce choline from scratch in small amounts, but it is unable to make enough to supply the body with all the choline it needs to function properly. For that reason choline is considered “essential” nutrient: humans have to eat choline-containing foods, such as eggs or liver, to make sure they get enough of this nutrient in their diet.

One of choline’s main roles in the body is brain and nervous system function. Choline gives rise to the neurotransmitter Acetylcholine (Ach). In the brain Ach controls our ability to focus and retain information. Outside of the brain, Ach is the main communicator of messages in our conscious and unconscious (or autonomic) nervous systems.

The conscious nervous system uses Ach for things like a voluntary muscle contraction, while the Autonomic Nervous System (ANS) regulates all of our organ functions like heart rate, blood pressure, breathing, sweating, gut motility, kidney and bladder function, among others.

In addition, how quickly we think and react has to do with the speed of nerve electrical signal transmission. Choline is also used to manufacture sphingomyelin, a component of the myelin sheath surrounding nerve cells—a fatty envelope responsible for speeding up the transmission of nerve signals. Without sphingomyelin, nerve signals would travel much more slowly. Myelin becomes damaged in multiple sclerosis, causing decreased processing speed, muscle weakness, loss of balance and generalized fatigue.

It’s not surprising that low levels of PC and choline lead to acetylcholine (Ach) and sphingomyelin depletion. This leaves us feeling lethargic, unable to focus, and weak due to muscle fatigue. Adequate levels of choline are also required for proper cognition.

In a Finish study, higher levels of Phosphatidylcholine (PC) and choline intake have recently been shown to lower the risk of dementia and improve performance on cognitive tests in a prospective study involving 2497 individuals. (Source 4)  

4. PC Is Important For The Methylation Cycle

Methylation is the process of attaching a one carbon “methyl”, or –CH3 group, to a wide variety of molecules in our bodies ranging from neurotransmitters, to hormones to DNA. Carried our millions of times per second in all of our cells, methylation is indispensable to our ability to function.

Methylation regulates neurotransmitters (energy, mood), hormone synthesis (estrogen), glutathione production (detoxification), immunity and inflammation. At the DNA level, methylation is indispensable, ensuring expression and stability of our genome.

The methylation cycle’s end product is a molecule called SAMe (s-adenosyl-methionine) which is the universal donor of methyl groups.

See the below visual of this process and note the importance of choline. For more information on methylation, and the nutrients involved, please read my recent article on methylation.

Our bodies use up a great deal of “methylation power” to synthesize phosphatidylcholine (PC) by the methylation of its precursor phosphatidylethanolamine (PE). (Source 5) The enzyme that catalyzes this reaction called phosphatidylethanoloamine N-Methyl transferase, or PEMT for short, uses three methyl donors in the form of SAMe. Many of us have PEMT genes that have small mutations called SNPs, leading to PEMT enzymes that are sluggish in making PC.

Other well-known enzymes MTHFR (folate cycle) MTR (methionine synthase) and MTRR (methionine synthase reductase) are involved in the proper functioning of the methylation cycle. Single base mutations (SNPs) in these enzymes can slow down methylation in general, resulting in a lower ability to make methyl the methyl donors in the form of SAMe available.

Here’s where choline comes in. Choline can be converted to betaine, which in turn can be a direct methyl donor facilitating the direct conversion of homocysteine to methionine, maintaining the methylation cycle going.

Whether dealing with a PEMT mutation, or an SNP in any of the other enzymes mentioned above, we have to make extra sure that we have adequate intake of fresh PC directly in our diets.

Here’s the bottom line: having sufficient amounts of PC and choline bypass these metabolic slowdowns and improve methylation function. It takes the pressure off of the methylation cycle to make PC and frees up methylation for other important functions including maintaining hormone, neurotransmitter, immune, detoxification and DNA function.

5. PC Affects Liver And Cholesterol Metabolism

Another reason to maintain adequate intake of phosphatidylcholine in our diets on a daily basis is to protect our liver function. PC plays a vital role in the processing of fat from a recently ingested meal. PC is used to manufacture fat transporter molecules called lipoproteins including chylomicrons, which shuttle fat and cholesterol from the digestive tract to the liver. In addition, they build the structure for the lipoproteins that transport cholesterol from the liver to the tissues as needed. These include very-low-density lipoproteins or VLDLs. These lipoprotein structures are similar to cell membranes and liposomes that we’ve discussed.

Without adequate levels of PC in the picture, the liver would lack one of the key ingredients it needs to package and process fats and cholesterol for use elsewhere in the body. This could cause fat and cholesterol to accumulate inside the liver and lead to diseases such as non-alcoholic fatty liver disease (NAFLD), commonly called “fatty liver”.

Lower-than-normal PC and choline levels have been directly implicated in the development of fatty liver, which is associated with obesity, diabetes and metabolic syndrome. Fatty liver is on the rise in the United States.

The accumulation of fat in liver cells (steatosis) is associated with altered mitochondrial function, lowered ability of liver cells to process fatty acids to generate energy and with increased oxidative stress, lowered glutathione and NAD levels. (Source 6) Elevated liver enzymes, such as AST and ALT, can signal stressed liver cells in fatty liver disease.

The liver is our main filter and detoxification organ. It processes drugs, toxins like pesticides and pollutants as well as hormones that need to be eliminated. When our livers don’t function properly it can wreak havoc on cholesterol, hormone balance and contribute to build up of toxins in the system that lead to oxidative stress. Left unchecked, fatty liver inflammation may potentially lead to liver failure, or non-alcoholic steatohepatitis (NASH) in about a third of those diagnosed with fatty liver (NAFLD).

Re-establishing proper PC and choline supply is important in reversing the damage involved in fatty liver and lowering liver enzymes back to normal.

Fish, beef, eggs, poultry, and nuts are the richest sources of PC; however, fruits, vegetables, grains, and dairy products also contain choline. Phosphatidylcholine  supplements (non-oil based) can also be helpful—especially in cases of choline deficiencies.

Women should consume at least 425 mg of choline a day for optimal health, while men need to get 550 mg or higher each day to keep their engines running smoothly.

The maximum recommended daily dose of choline is 3,500 mg. At doses of 7,500 or higher, signs of choline overdose include excessive sweating, a fishy body odor, a drop in blood pressure, and indigestion. However these doses are quite high and are not likely to be exceeded with a balanced diet or additional supplementation.

6. PC’s Role In Healing Ulcerative Colitis And Relieving Symptoms 

We have all heard of stomach ulcers. These deep erosions that occur when the stomach lining breaks down. Just like stomach ulcers, inflammation in the large intestine, or colon, can break down leading to formation of ulcers that bleed and cause severe abdominal pain, diarrhea, fatigue, and even cancer in a condition named ulcerative colitis (UC). About 1 million people in the US have been diagnosed with UC.

One of the first protective layers covering the lining of the colon against ulceration is the mucous layer, made up of mucin. Given PC’s near-ubiquitous presence in the human body, it’s no surprise that these molecules are also plentiful in the mucous membrane lining the gut. In fact, PC makes up 90% of the mucus barrier lining the digestive tract.

Oral administration of PC has been shown to induce healing of ulcers and remission in 53% of patients treated with 6 grams per day of oral PC Complex in a randomized, double blind study involving 60 UC patients. (Source 7) In a more recent study published in the Journal of Gastroenterology, 156 patients with UC showed 50% improvement in symptoms and 31% remission rate when given a lower dose of 3.2 grams of PC complex per day. (Source 8)

PC Complex refers to a mixture primarily composed on phosphatidylcholine (PC), but also containing other phospholipids like phosphatidyletahnolamine (PE) and phosphatidylinositol (PI). For patients with UC, and for all of us wanting to protect our intestinal mucosal barrier and the health of our intestinal tract, an adequate amount of dietary PC Complex in addition to oral supplementation could be beneficial.

Core Med Science’s PC Complex is physician formulated, by yours truly, and 3^rd party tested for quality and purity. PC Complex is also free of GMOs, soy, gluten and dairy and made in the United States. I recommend starting with 2 teaspoons of PC Complex with your first meal of the day and then noticing how you feel about 30-45 minutes later.

Your body can make PC, but to do so it pulls resources away from other biological processes including neurotransmitter and hormone production. Adding in PC through a supplement, takes this burden off of the body. The biggest improvements you might see with supplementation are more energy and better brain function, but, since PC is critical for every cell in the body, these just might be the tip of the ice burg when it comes to health improvements.

References

1. Akbarzadeh, A., Rezaei-Sadabady, R., Davaran, S., Joo, S. W., Zarghami, N., Hanifehpour, Y., Samiei, M., Kouhi, M., & Nejati-Koshki, K. (2013). Liposome: classification, preparation, and applications. Nanoscale research letters, 8(1), 102. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599573/
2. Shade C. W. (2016). Liposomes as Advanced Delivery Systems for Nutraceuticals. Integrative medicine (Encinitas, Calif.), 15(1), 33–36. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818067/
3. Serrano, G., Almudéver, P., Serrano, J. M., Milara, J., Torrens, A., Expósito, I., & Cortijo, J. (2015). Phosphatidylcholine liposomes as carriers to improve topical ascorbic acid treatment of skin disorders. Clinical, cosmetic and investigational dermatology, 8, 591–599. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687614/
4. Ylilauri, M.P.T, Voutilainen, S., Lönnroos, E., Virtanen, H.E.K., Tuomainen, T.-P., Salonen, J.T., Virtanen, J.K. Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study, The American Journal of Clinical Nutrition. 110(6), 1416–1423. Abstract: https://academic.oup.com/ajcn/advance-article-abstract/doi/10.1093/ajcn/nqz148/5540729?redirectedFrom=fulltext
5. Obeid R. (2013). The metabolic burden of methyl donor deficiency with focus on the betaine homocysteine methyltransferase pathway. Nutrients, 5(9), 3481–3495. Full text:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798916/
6. Rolo, A. P., Teodoro, J. S., & Palmeira, C. M. (2012). Role of oxidative stress in the pathogenesis of nonalcoholic steatohepatitis. Free radical biology & medicine, 52(1), 59–69. Abstract: https://pubmed.ncbi.nlm.nih.gov/22064361/
7. Stremmel, W., Merle, U., Zahn, A., Autschbach, F., Hinz, U., & Ehehalt, R. (2005). Retarded release phosphatidylcholine benefits patients with chronic active ulcerative colitis. Gut, 54(7), 966–971. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774598/
8. Karner, M., Kocjan, A., Stein, J., Schreiber, S., von Boyen, G., Uebel, P., Schmidt, C., Kupcinskas, L., Dina, I., Zuelch, F., Keilhauer, G., & Stremmel, W. (2014). First multicenter study of modified release phosphatidylcholine "LT-02" in ulcerative colitis: a randomized, placebo-controlled trial in mesalazine-refractory courses. The American journal of gastroenterology, 109(7), 1041–1051. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085478/