Your Nutrients

When medical researchers use the term “lecithin,” they are referring to a purified substance called phosphatidyl choline (PC) that belongs to a special category of fat-soluble substances called phospholipids.

Choline, the major constituent of PC, is found in soybeans, liver, oatmeal, cabbage, and cauliflower. Soybeans, egg yolks, meat, and some vegetables contain PC. Lecithin (containing 10–20% PC) is added to many processed foods in small amounts for the purpose of maintaining texture consistency.

Although choline deficiencies have been artificially induced in people, little is known about human deficiency in the real world.

High homocysteine Liver cirrhosis Neural tube defects (prevention) Tardive dyskinesia Alzheimer’s disease Bipolar disorder Gallbladder attacks Hepatitis High cholesterol

With several grams of choline per day, some people will experience abdominal discomfort, diarrhea, or nausea. Supplementing choline in large amounts (over 1,000 mg per day) can lead to a fishy body odor. PC does not have this effect. Depression has been reported as a side effect in people taking large amounts of choline, such as 9 grams per day. The body uses both PC and pantothenic acid to form acetylcholine. At the time of writing, there were no well-known drug interactions with Lecithin/Phosphatidylcholine/Choline.

Small amounts of choline are present in many B-complex and multivitamin supplements.

Alpha-ketoglutarate (AKG) is the nitrogen-free portion of the amino acids known as glutamine and glutamic acid. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells. AKG is used by cells during growth and in healing from injuries and other wounds, and is especially important in the healing of muscle tissue. A controlled study found that intravenous AKG prevented a decline in protein synthesis in the muscles of patients recovering from surgery. For these reasons, it has been speculated that oral AKG supplements might help improve strength or muscle-mass gains by weightlifters, but no research has been done to test this theory.

AKG is present in many foods and is synthesized for use in dietary supplements.

AKG is not an essential nutrient, and no deficiency has been reported.

Athletic performance Surgery

No side effects have been reported with the use of AKG. No clear interactions between AKG and other nutrients have been established. At the time of writing, there were no well-known drug interactions with alpha ketoglutarate (AKG).

Only intravenous AKG has been used in research studies; no reliable information about desirable oral amounts is available.

Adenosine monophosphate (AMP) is an intermediary substance formed during the body’s process of creating energy in the form of adenosine triphosphate (ATP) from food.

The body creates AMP within cells during normal metabolic processes. AMP is also found as a supplement, although it is not widely available.

Preliminary research suggests that people with herpes simplex or herpes zoster (shingles) infections may have low levels of AMP; however, the clinical significance of this finding is unclear.

Photosensitivity Shingles

The limited number of human studies involving oral AMP have not indicated any side effects. However, some researchers have expressed concern that supplemental intake of AMP could, in theory, increase levels of adenosine, a substance related to AMP that may interfere with immune function. Doctors using AMP injections report that too-rapid intravenous administration or inadvertent administration of an intramuscular injection into a vein could cause life-threatening arrhythmias of the heart. At the time of writing, there were no well-known drug interactions with Adenosine Monophosphate.

The trials using AMP for photosensitivity have used 160–200 mg of AMP per day; however, the ideal intake of this supplement has not been determined. Research with shingles has used a special gel form of AMP injected into muscle; a doctor should be consulted for this form of AMP.

The fat-soluble vitamin D’s most important role is maintaining blood levels of calcium, which it accomplishes by increasing absorption of calcium from food and reducing urinary calcium loss. Both effects keep calcium in the body and therefore spare the calcium that is stored in bones. When necessary, vitamin D transfers calcium from the bone into the bloodstream, which does not benefit bones. Although the overall effect of vitamin D on the bones is complicated, some vitamin D is necessary for healthy bones and teeth.

Cod liver oil is an excellent dietary source of vitamin D, as are vitamin D-fortified foods. Traces of vitamin D are found in egg yolks and butter. However, the majority of vitamin D in the body is created during a chemical reaction that starts with sunlight exposure to the skin. Cholecalciferol (vitamin D3) is the animal form of this vitamin.

In adults, vitamin D deficiency may result in a softening of the bones known as osteomalacia. This condition is treated with vitamin D, sometimes in combination with calcium supplements. Osteomalacia should be diagnosed, and its treatment monitored, by a doctor. In people of any age, vitamin D deficiency causes abnormal bone formation. It occurs more commonly following winter, owing to restricted sunlight exposure during that season. Living in an area with a lot of atmospheric pollution, which can block the sun’s ultraviolet rays, also appears to increase the risk of vitamin D deficiency. Vitamin D deficiency is more common in strict vegetarians (who avoid vitamin D-fortified dairy foods), dark-skinned people, alcoholics, and people with liver or kidney disease. People with liver and kidney disease can make vitamin D but cannot activate it. Vitamin D deficiency is more common in people suffering from intestinal malabsorption, which may have occurred following previous intestinal surgeries, or from celiac disease. People with insufficient pancreatic function (e.g., those with pancreatitis or cystic fibrosis) tend to be deficient in vitamin D. Vitamin D deficiency is also common in individuals with hyperthyroidism (Graves’ disease), particularly women. In children, vitamin D deficiency is called rickets and causes a bowing of bones not seen in adults with vitamin D deficiency. Vitamin D deficiency is common among people with hyperparathyroidism, a condition in which the parathyroid gland is overactive. In a study of 124 people with mild hyperparathyroidism, vitamin D levels were below normal in 7% of them and suboptimal in 53% of them. Vitamin D deficiency is also common in men with advanced prostate cancer. In one study, 44% of 16 men with advanced prostate cancer had decreased blood levels of vitamin D. One in seven adults has been reported to be deficient in vitamin D. In one study, 42% of hospitalized patients under age 65 were reported to be vitamin D deficient. In this same study, 37% of the people were found to be deficient in vitamin D, despite the fact they were eating the currently recommended amount of this nutrient. Vitamin D deficiency is particularly common among the elderly. Age-related decline in vitamin D status may be due to reduced absorption, transport, or liver metabolism of vitamin D.

Crohn’s disease Cystic fibrosis Osteoporosis Rickets/osteomalacia Burns (severe) Celiac disease (for deficiency only) Depression Hypertension (for deficiency only) Prostate cancer Seasonal affective disorder Type 1 diabetes Type 2 diabetes Alcohol withdrawal support Amenorrhea (calcium for preventing bone loss) Breast cancer (reduces risk) Cardiac arrhythmia Colon cancer (reduces risk) Migraine headaches Multiple sclerosis Parkinson’s disease Vitiligo (topical calcipotriol only)

People with hyperparathyroidism should not take vitamin D without consulting a physician. People with sarcoidosis should not supplement with vitamin D, unless a doctor has determined that their calcium levels are not elevated. Too much vitamin D taken for long periods of time may lead to headaches, weight loss, and kidney stones. Rarely, excessive vitamin D may even lead to deafness, blindness, increased thirst, increased urination, diarrhea, irritability, children’s failure to gain weight, or death. Most people take 400 IU per day, a safe amount for adults. Some researchers believe that amounts up to 10,000 IU per day are safe for the average healthy adult, although adverse effects may occur even at lower levels among people with hypersensitivity to vitamin D (e.g. hyperparathyroidism). In fact, of all published cases of vitamin D toxicity for which a vitamin D amount is known, only one occurred at a level of intake under 40,000 IU per day. Nevertheless, people wishing to take more than 1,000 IU per day for long periods of time should consult a physician. People should remember the total daily intake of vitamin D includes vitamin D from fortified milk and other fortified foods, cod liver oil, supplements that contain vitamin D, and sunlight. People who receive adequate sunlight exposure do not need as much vitamin D in their diet as do people who receive minimal sunlight exposure. Vitamin D increases both calcium and phosphorus absorption and has also been reported to increase absorption of aluminum. Increased blood levels of calcium (which may be a marker for vitamin D status) have been linked to heart disease. Some, but not all, research suggests that vitamin D may slightly raise blood levels of cholesterol in humans. Certain medicines may interact with vitamin D. Refer to drug interactions for a list of those medicines.

People who get plenty of sun exposure do not require supplemental vitamin D, since sunlight increases vitamin D synthesis when it strikes bare skin. Although the recommended dietary allowance for vitamin D is 200 IU per day for adults, there is some evidence that elderly people need 800 to 1,000 IU per day for maximum effects on preserving bone density and preventing fractures. Sun-deprived people should take no less than 600 IU per day and ideally around 1,000 IU per day.

Atherosclerosis Warts (topical application) BPH (Kastamonu Garlic) Breast-feeding support Colon cancer (reduces risk of stomach, esophageal, and colon cancers) Common cold High blood pressure High cholesterol High triglycerides Intermittent claudication Athlete’s foot Chronic candidiasis Ear infections (recurrent) HIV support Infection Parasites Peptic ulcer Sickle cell anemia

Many people enjoy eating garlic. However, some people who are sensitive to it may experience heartburn and flatulence. Because of garlic’s anti-clotting properties, people taking anticoagulant drugs should check with their doctor before taking garlic. Those scheduled for surgery should inform their surgeon if they are taking garlic supplements. Garlic appears to be safe during pregnancy and breast-feeding. In fact, two studies have shown that babies like breast milk better from mothers who eat garlic. Certain medicines may interact with garlic. Refer to drug interactions for a list of those medicines.

People who wish to consume garlic and have no aversion to its odor can chew from one to two whole cloves of raw garlic daily. For those who prefer it with less odor, enteric-coated tablets or capsules with approximately 1.3% allin are available. Clinical trials have used 600–900 mg (delivering approximately 5,000–6,000 mcg of allicin potential) per day in two or three divided amounts. Aged-garlic extracts have been studied in amounts ranging from 2.4–7.2 grams per day.

Methylsulfonylmethane (MSM) is a naturally occurring, organic, sulfur-containing compound related to another sulfur-containing substance, dimethyl sulfoxide (DMSO). MSM is found in small amounts throughout nature and has been detected in small amounts in the blood and urine of humans.

A precursor of MSM is formed initially by ocean plankton and released into the atmosphere, where it interacts with ozone and sunlight and returns to earth as MSM in rainfall. MSM can be taken up by plants and incorporated into their structure, but no measurement of the MSM content of foods has been done. Supplements containing MSM are available.

Although MSM is present in food, it is not an essential nutrient, so deficiency is not likely.

Osteoarthritis

According to some anecdotal reports, MSM has been used in human research for many years in amounts above 2000 mg per day with no significant adverse effects. However, diarrhea, skin rash, headache, and fatigue may be experienced in less than 20% of people, according to other anecdotal reports. Detectable levels of MSM in the brain of a person taking MSM supplements have been reported, but the significance of this finding, if any, is unclear. At the time of writing, there were no well-known drug interactions with methylsulfonylmethane.

Some authorities report anecdotally that 250–500 mg per day has beneficial effects on a variety of health problems. However, the only controlled trial using MSM used over 2000 mg per day to treat osteoarthritis. More research is needed before reliable recommendations for MSM supplementation can be made.

Cysteine is a nonessential amino acid (protein building block), meaning that cysteine can be made in the human body. Cysteine is one of the few amino acids that contains sulfur. This allows cysteine to bond in a special way and maintain the structure of proteins in the body. Cysteine is a component of the antioxidantglutathione. The body also uses cysteine to produce taurine, another amino acid.

The body can synthesize cysteine from methionine and other building blocks. Cysteine, the amino acid from which NAC is derived, is found in most high-protein foods.

According to several studies, blood levels of cysteine and glutathione are low in people infected with HIV. Cysteine has a role in the proper function of the immune system, so a deficiency of this amino acid may either contribute to, or result from, immune suppression associated with HIV.

No consistent adverse effects of NAC have been reported in humans. One small study found that daily amounts of 1.2 grams or more could lead to oxidative damage. Extremely large amounts of cysteine, the amino acid NAC is derived from, may be toxic to nerve cells in rats. Adequate amounts of methionine are needed in the diet, as the precursor to cysteine, to prevent cysteine deficiency. At the time of writing, there were no well-known drug interactions with cysteine.

Most people do not need to supplement with cysteine. Almost nothing is known about appropriate supplemental levels, in part because almost all clinical research has been done with N-acetyl cysteine and not cysteine itself.

Vitamin C is a water-soluble vitamin that has a number of biological functions.

Broccoli, red peppers, currants, Brussels sprouts, parsley, potatoes, citrus fuit, and strawberries are good sources of vitamin C.

Although scurvy (severe vitamin C deficiency) is uncommon in Western societies, many doctors believe that most people consume less than optimal amounts. Fatigue, easy bruising, and bleeding gums are early signs of vitamin C deficiency that occur long before frank scurvy develops. Smokers have low levels of vitamin C and require a higher daily intake to maintain normal vitamin C levels. Women with preeclampsia have been found to have lower blood levels of vitamin C than women without the condition. Women who have lower blood levels of vitamin C have an increased risk of gallstones. People with kidney failure have an increased risk of vitamin C deficiency. However, people with kidney failure should take vitamin C only under the supervision of a doctor.

Anemia (if deficient) Athletic performance (if deficient, or to reduce pain and speed up muscle strength recovery after intense exercise) Bronchitis Bruising (for deficiency) Burns (in combination with vitamin E for prevention of sunburn only) Capillary fragility Common cold/sore throat Gingivitis (periodontal disease) (for deficiency only) Glaucoma Heart attack (for deficiency) High cholesterol (protection of LDL cholesterol) Infection Infertility (male) (for sperm agglutination) Reflex sympathetic dystrophy (prevention) Scurvy Stress Sunburn (oral, in combination with vitamin E) Wound healing Asthma Atherosclerosis Athletic performance (for exercise recovery) Autism Cataracts Childhood intelligence (for deficiency) Cold sores Dysmenorrhea (plus vitamin B3 [niacin] and rutin) Endometriosis (in combination with vitamin E) Gastritis Gingivitis (periodontal disease) (in combination with flavonoids) Gout Immune function Infertility (female) Influenza Iron-deficiency anemia (as an adjunct to supplemental iron) Lead toxicity Pancreatic insufficiency Parkinson’s disease (in combination with Vitamin E) Pre- and post-surgery health (if deficient) Preeclampsia (in combination with vitamin E; for high risk only) Pregnancy support (if the diet is low in vitamin C) Schizophrenia Skin ulcers Sprains and strains Sunburn (topical, in combination with vitamin E) Type 1 diabetes Type 2 diabetes Age-related cognitive decline Alcohol withdrawal support Amenorrhea Anemia (for thalassemia if deficient) Bipolar disorder/manic depression Boils (recurrent furunculosis) Childhood diseases Chronic obstructive pulmonary disease (COPD) Colon cancer (reduces risk) Ear infections (recurrent) Eczema Gallstones Halitosis (if gum disease and deficient) Hay fever Heart attack (for those not deficient) Hepatitis High blood pressure HIV support (oral and topical) Hives Hypoglycemia Leukoplakia Low back pain Macular degeneration Menopause Menorrhagia (heavy menstruation) Morning sickness Peptic ulcer Progressive pigmented purpura (in combination with rutoside) Prostatitis (acute bacterial prostatitis, chronic bacterial prostatitis) Retinopathy (in combination with selenium, vitamin A and vitamin E) Sickle cell anemia Sinusitis Tardive dyskinesia Urinary tract infection Vitiligo

Some people develop diarrhea after as little as a few grams of vitamin C per day, while others are not bothered by ten times this amount. Strong scientific evidence to define and defend an upper tolerable limit for vitamin C is not available. A review of the available research concluded that high intakes (2–4 grams per day) are well-tolerated by healthy people. However, intake of large amounts of vitamin C can deplete the body of copper an essential nutrient. People should be sure to maintain adequate copper intake at higher intakes of vitamin C. Copper is found in many multivitamin-mineral supplements. Vitamin C increases the absorption of iron and should be avoided by people with iron overload diseases (e.g., hemochromatosis, hemosiderosis). Vitamin C helps recycle the antioxidant, vitamin E. It is widely (and mistakenly) believed that mothers who consume large amounts of vitamin C during pregnancy are at risk of giving birth to an infant with a higher-than-normal requirement for the vitamin. The concern is that the infant could suffer “rebound scurvy,” a vitamin C deficiency caused by not having this increased need met. Even some medical textbooks have subscribed to this theory. In fact, however, the concept of “rebound scurvy” in infants is supported by extremely weak evidence. Since the publication in 1965 of the report upon which this mistaken notion is based, millions of women have consumed high amounts of vitamin C during pregnancy and not a single new case of rebound scurvy has been reported. A preliminary study found that people who took 500 mg per day of vitamin C supplements for one year had a greater increase in wall thickness of the carotid arteries (vessels in the neck that supply blood to the brain) than those who did not take vitamin C. Thickness of carotid artery walls is an indicator of progression of atherosclerosis. Currently, no evidence supports a cause-and-effect relationship for the outcome reported in this study. The vast preponderance of research suggests either a protective or therapeutic effect of vitamin C for heart disease, or no effect at all. People with the following conditions should consult their doctor before supplementing with vitamin C: glucose-6-phosphate dehydrogenase deficiency, iron overload (hemosiderosis or hemochromatosis), history of kidney stones, or kidney failure. It has been suggested that people who form calcium oxalate kidney stones should avoid vitamin C supplements, because vitamin C can be converted into oxalate and increase urinary oxalate. Initially, these concerns were questioned because of potential errors in the laboratory measurement of oxalate. However, using newer methodology that rules out this problem, recent evidence shows that as little as 1 gram of vitamin C per day can increase the urinary oxalate levels in some people, even those without a history of kidney stones. In one case, 8 grams per day of vitamin C led to dramatic increases in urinary oxalate excretion and kidney stone crystal formation causing bloody urine. People with a history of kidney stones should consult a doctor before taking large amounts (1 gram or more per day) of supplemental vitamin C. Despite possible therapeutic effects of vitamin C in people with diabetes at lower intakes, one case of increased blood sugar levels was reported after taking 4.5 grams per day. Certain medicines may interact with vitamin C. Refer to drug interactions for a list of those medicines.

The recommended dietary allowance (RDA) for vitamin C in nonsmoking adults is 75 mg per day for women and 90 mg per day for men. For smokers, the RDAs are 110 mg per day for women and 125 mg per day for men. Most clinical vitamin C studies have investigated the effects of a broad range of higher vitamin C intakes (100–1,000 mg per day or more), often not looking for (or finding) the “optimal” intake within that range. In terms of heart disease prevention, as little as 100–200 mg of vitamin C appears to be adequate. Although some doctors recommend 500–1,000 mg per day or more, additional research is needed to determine whether these larger amounts are necessary. Some vitamin C experts propose that adequate intake be considered 200 mg per day because of evidence that the cells of the human body do not take up any more vitamin C when larger daily amounts are used. Some scientists have recommended that healthy people take multi-gram amounts of vitamin C for the prevention of illness. However, little or no research supports this point of view and it remains controversial. Supplementing more results in an excretion level virtually identical to intake, meaning that consuming more vitamin C does not increase the amount that remains in the body. On the basis of extensive analysis of published vitamin C studies, researchers at the Linus Pauling Institute at Oregon State University have called for the RDA to be increased, but only to 120 mg. This same report reveals that “. . . 90–100 mg vitamin C per day is required for optimum reduction of chronic disease risk in nonsmoking men and women.” Thus, the multiple gram amounts of vitamin C taken by many healthy people may be superfluous. The studies that ascertained approximately 120–200 mg daily of vitamin C is correct for prevention purposes in healthy people have typically not investigated whether people suffering from various diseases can benefit from larger amounts. In the case of the common cold, a review of published trials found that amounts of 2 grams per day in children appear to be more effective than 1 gram per day in adults, suggesting that large intakes of vitamin C may be more effective than smaller amounts, at least for this condition.

Docosahexaenoic acid (DHA), an omega-3 fatty acid, belongs to the class of nutrients called essential fatty acids.

Cold-water fish, such as mackerel, salmon, herring, sardines, black cod, anchovies, and albacore tuna, are rich sources of DHA and EPA. Similarly, cod liver oil contains large amounts of DHA and EPA. Certain microalgae contain DHA and are used as a vegetarian source of this nutrient in some supplements. Most fish oil supplements contain 12% DHA.

Premature infants who are not breast-fed are often DHA-deficient. A link has appeared between DHA deficiency and Alzheimer’s disease; however, no evidence at this time indicates that supplementation with DHA will help Alzheimer’s patients. Similarly, preliminary evidence shows that children with attention deficit disorder (ADD) have low DHA levels. However, no evidence demonstrates that DHA supplementation improves ADD. Preliminary evidence suggests that people with a variety of rare but related congenital diseases (Zellweger’s syndrome, neonatal adrenoleukodystrophy, and infantile Refsum’s disease) may be DHA-deficient, and may even benefit from DHA supplementation. Many doctors believe the diets of most people eating a Western diet do not provide optimal amounts of omega-3 fatty acids. At least four studies have reported a reduced blood level of omega-3 fatty acids in people with depression.

Childhood intelligence High blood pressure High triglycerides Peroxisomal disorders Rheumatoid arthritis Stress Depression Epilepsy (given in combination with EPA) Lupus Psoriasis Angina Chronic obstructive pulmonary disease (COPD) Dysmenorrhea (painful menstruation) Migraine headaches Osteoarthritis Type 2 diabetes

While those with heart disease and diabetes often benefit from fish oil (the primary source of DHA in the diet), such people should check with their doctor before taking more than 3 or 4 grams of fish oil per day for several months. Elevations in blood sugar have sometimes been reported, though this may simply be due to small increases in weight resulting from high dietary fish oil. While DHA combined with EPA from fish oil consistently lowers triglycerides, it occasionally increases LDL cholesterol. Fish oil is easily damaged by oxygen, so small amounts of vitamin E are often included in fish oil supplements to prevent such oxidative damage. Doctors often recommend that people who supplement with fish oil or DHA take vitamin E supplements to protect EPA and DHA within the body from oxidative damage. Some evidence indicates that vitamin E may be protective against oxidative damage caused by fish oil. However, animal researchers have reported that the oxidative damage caused by DHA alone was not prevented with vitamin E supplementation. The level of oxidative damage caused by DHA has not been shown to result in significant health problems. Some evidence suggests that adding vitamin E to EPA/DHA may prevent the fish oil-induced increase in serum glucose. Similarly, the impairment of glucose tolerance sometimes caused by the omega-3 fatty acid has been prevented by the addition of half an hour of moderate exercise three times a week. The effect of DHA by itself on glucose levels has not been adequately studied. People who take fish oil containing EPA and DHA and who also take 15 grams of pectin per day have been reported to have reductions in LDL cholesterol. This suggests that pectin may overcome the occasional problem of increased LDL cholesterol from fish oil supplementation. The LDL cholesterol-raising effect of EPA and DHA may also be successfully prevented by taking garlic supplements (or presumably adding garlic to the diet) along with EPA and DHA. Adding pectin or garlic when people supplement with DHA by itself has yet to be studied. According to a report in a Japanese medical journal, three people at high risk for colon cancer developed a variety of cancers after one to two years of supplementation with DHA. To date, this report has not been confirmed by other researchers. To the contrary, test tube studies report that DHA is toxic to cancer cells and may someday be considered as an adjunct to conventional treatment for cancer. Similarly, animal studies suggest that DHA may inhibit cancer. At the time of writing, there were no well-known drug interactions with docosahexaenoic acid.

Most healthy people do not supplement with fish oil containing DHA or vegetarian sources of DHA. The level of DHA given to premature infants who are not breast-fed should be determined by a pediatrician. Much of the research in adults has been based on 1–3 grams per day of DHA from fish oil, although higher levels have been taken when isolated DHA from microalgae sources is used. Because cod liver oil contains large amounts of vitamin A and vitamin D, women who are or who could become pregnant should consult a doctor before taking cod liver oil. Adults should make sure the total amount of vitamin A and vitamin D from cod liver oil and other supplements does not exceed 25,000 IU (7,500 mcg) per day for vitamin A (15,000 IU per day for those over age 65) and 800 IU per day for vitamin D, unless they are being supervised by a doctor.

When medical researchers use the term “lecithin,” they are referring to a purified substance called phosphatidyl choline (PC) that belongs to a special category of fat-soluble substances called phospholipids.

Choline, the major constituent of PC, is found in soybeans, liver, oatmeal, cabbage, and cauliflower. Soybeans, egg yolks, meat, and some vegetables contain PC. Lecithin (containing 10–20% PC) is added to many processed foods in small amounts for the purpose of maintaining texture consistency.

Although choline deficiencies have been artificially induced in people, little is known about human deficiency in the real world.

High homocysteine Liver cirrhosis Neural tube defects (prevention) Tardive dyskinesia Alzheimer’s disease Bipolar disorder Gallbladder attacks Hepatitis High cholesterol

With several grams of choline per day, some people will experience abdominal discomfort, diarrhea, or nausea. Supplementing choline in large amounts (over 1,000 mg per day) can lead to a fishy body odor. PC does not have this effect. Depression has been reported as a side effect in people taking large amounts of choline, such as 9 grams per day. The body uses both PC and pantothenic acid to form acetylcholine. At the time of writing, there were no well-known drug interactions with Lecithin/Phosphatidylcholine/Choline.

Small amounts of choline are present in many B-complex and multivitamin supplements.