AIDS, AL 721, AND LECITHIN
Update 1989: Today there is little interest in lecithin as an antiviral, although it has not been definitely ruled out.
This writer's research into the experimental AIDS treatment AL 721, and the scientific background behind it, turned up unexpected information that ordinary lecithin, widely available in health-food stores, probably has the same kind of effect as AL 721, and may help to strengthen the body's defenses against certain virus infections, including AIDS.
Six weeks ago I sent this information to more than a hundred AIDS experts. Of over ten who responded, almost all were encouraging; no one found any reason that it couldn't work. But unfortunately, it is unlikely that anyone will test this possibility scientifically, due to bureaucratic and commercial constraints. So rather than see it dropped, I decided to present
the information to everyone, hoping that alternative healers and AIDS/ARC support groups can see if it works, and report to each other by word of mouth, as a kind of direct democracy in medical research. This article is the first published report of the possible usefulness of lecithin -- still an unproven possibility, since no one has yet tried it for AIDS or ARC.
Briefly, scientific studies suggest that lecithin and some related substances change the membranes of cells in ways that make it harder for viruses to get in. The treatment does not kill the virus, but helps prevent new cells from being infected. And animal experiments with one form of lecithin have shown that it does cross the blood-brain barrier and affect brain
cells in a way likely to be protective; we don't have more direct evidence on its usefulness in the brain, because no studies have been done.
Three completely separate bodies of information support the theory that lecithin might be helpful in treating certain viral diseases. First, laboratory tests of AL 721, which is a form of lecithin, have shown that it inhibits AIDS virus infection of human cells. Second, there have been four published clinical studies which used the main ingredient of lecithin to
treat viral hepatitis in humans; all of these were controlled studies, and all reported clearly successful results. Third, there are fragmentary anecdotal reports of lecithin being useful in treating viral conditions such as herpes.
Here we will only summarize the information. For a technical paper with the literature references, see AIDS Treatment News, Issue Number 2.
AL 721 and Lecithin
The general public first heard of AL 721 from news reports of a letter published in the New England Journal of Medicine, November 14, 1985. Several scientists, including some of the leaders in AIDS research, reported finding that AL 721 reduced infection of human blood cells by the AIDS virus, apparently by interfering with the process by which the virus
first binds to the cell.
AL 721, developed as a "membrane fluidizer" by the Weizmann Institute of Science in Israel, had been used experimentally for several years. It had been used in humans at least once, to reverse certain immune deficiencies resulting from the normal aging process.
AL 721 is a mixture of three ingredients, all of them extracted from egg yolks. The two active ingredients -- phosphatidylcholine (PC) and phosphatidylethanolamine (PE) -- are also the active ingredients of lecithin. Under the electron microscope, AL 721 dispersed in water forms little balls within the PC and PE on the surface. The third ingredient apparently
forms a framework which presents the PC and PE to cell membranes more effectively.
Scientists believe that AL 721 works by increasing the ration PC and PE to cholesterol in the membranes of cells and/or viruses. Reducing the cholesterol increases the "fluidity" of the membrane, making it harder for viruses to attach to receptor sites, which are protein molecules in the membrane which the virus must use to enter the cell.
Does ordinary lecithin do what AL 721 does? This question is controversial. AL 721 was developed to have the best ratio of its three ingredients, for membrane fluidization in the test tube. But when used orally, the usual route, digestion breaks AL 721 into its components. Since the special structure has been destroyed, and the special ratio has been changed
because all three ingredients are also found in many ordinary foods, there may be less difference between AL 721 and lecithin in the body than in the test tube.
Another question is whether soybean lecithin, the kind easily available in health-food stores, is as effective as the egg lecithin used to make AL 721. There is a small chemical difference; no one knows whether it has any practical consequence. Most medical research on lecithin has used the soybean variety, but the AL 721 work used egg lecithin instead.
The big advantage of lecithin, of course, is that you canget it. It is virtually impossible to get AL 721, in any country at any price, and it may be impossible for years.
Lecithin and Hepatitis
All four published attempts to treat viral hepatitis with purified phosphatidylcholine (the main ingredient of lecithin) were unsuccessful. But these studies are not well known in this country, because the papers are hard to get. One is in Italian, and one in Czech; of the two in English, one, which reports research in Nigeria, was published in an Indian medical journal received by only four libraries in the
United States. The remaining paper, published in England, is readily available but four years old.
The English study (Jenkins et al., Liver, 1982) was a double-blind trial with 30 patients with chronic active hepatitis; it measured effectiveness by examining liver biopsies. Fifteen patients were given three grams of PC per day, and the other fifteen received a placebo, for one year; all received standard hepatitis treatments in addition. After the year, biopsies showed that the treatment group clearly did better. In
addition, none of the treated patients but two of the controls suffered relapses during the study.
The Nigerian study (Atoba et al., Tropical Gastroenterology, 1985) used smaller doses, 1.8 grams or less for six weeks, probably because the cost of the drug was a serious burden to the patients, who had to buy their own. The treated patients showed faster improvement in almost all measures than the controls. After six weeks, blood tests were normal in 93
percent of the treatment group, but only 53 percent of the controls. (All of the 60 patients had hepatitis B.)
We have obtained the Czech and Italian papers, which were published in 1981 and 1985 respectively, but have only been able to read their English abstracts. Both were controlled studies giving PC to substantial numbers of persons with viral hepatitis, and both reported that the treatment was successful.`
How does this evidence that lecithin helps against viral hepatitis relate to AIDS? It relates because the membrane fluidization theory of the action of lecithin is not specific to the AIDS virus. The hepatitis work shows that the antiviral effect predicted by the membrane fluidization theory, and demonstrated against the AIDS virus in laboratory cultures by the
AL 721 work cited above, can in fact be used clinically against a virus disease.
Anecdotal Information
The following reports are not persuasive like the scientific studies above. We present them not as evidence, but as leads which could be followed up.
One health-food store in Texas ran a customer survey and asked those who bought lecithin what they were using it for. Two women answered that they had each discovered by accident that it made their herpes sores go away. The other report comes from this writer's personal experience. For several years I had a repeating virus-like condition which caused sweating and
extreme fatigue, with sleeping up to 14 hours a day. It kept getting worse until it was seldom possible to get through a day at work without naps. Attempts to get a medical diagnosis were unsuccessful. Vitamin C, garlic, and echinacea did little good, if any.
After learning about some of the work cited above, I started using four tablespoons of lecithin and three eggs per day. Within two weeks there was a dramatic improvement, and for several months since I have been almost entirely free of the problem, for the first time in years.
Lecithin Safety and Cautions
Lecithin is found in many foods, and is used as an additive in processed foods. The U.S. Food and Drug Administration lists it as "generally recognized as safe." Still, some cautions should be noted.
The quality control for commercial lecithin is very poor, and often the substance is rancid when sold to customers. Rancid foods contain potentially dangerous chemicals and should be avoided. One way to reduce the risk is to become familiar with the various smells of different batches of lecithin, and throw away any which has gone bad. Lecithin should be stored under
refrigeration, and away from light and air. Some high-priced commercial preparations are supposed to resist spoilage; we don't know how good these are.
Too much lecithin can produce unpleasant side effects, such as nausea, diarrhea, loss of appetite, and mental depression. One medical paper warned doctors to be particularly careful of depression if they give large doses.
Pregnant women should use special care. Animal studies have shown that large amounts of lecithin can harm the fetus.
Could there be any special dangers for persons with AIDS or ARC? There is no information either way about this risk. It would seem prudent to be careful about loss of appetite, one of the side effects mentioned above, because of the importance of maintaining good nutrition.
Forrtunately, the doses of PC used in the hepatitis studies are consistent with the standard doses commonly recommended for commercial lecithin. The largest dose cited above, 3 grams of PC per day, is equivalent to about 14 grams of lecithin granules, which contain about 22 percent PC. Fourteen grams happens to be about equal to two tablespoons of the
granules, which many of the commercially available packages recommend as the maximum daily amount.
Lecithin is commonly divided into two portions given about 12 hours apart. Those who have never tried it before may want to start with small amounts.
Medical studies have given up to 100 grams of commercial lecithin per day, and found that most patients can tolerate up to about 25 grams without side effects. Much larger amounts of PC can be given if purified preparations are used; but pure PC is expensive and not readily available.
On the low-dose end, the average diet already supplies about one to five grams of lecithin per day. Therefore very small amounts, such as the half-gram or so pills often sold in health-food stores, would probably have little effect.
The Bottom Line
None of this information proves that lecithin will be useful for treating AIDS or ARC. But it certainly suggests that the possibility should be investigated. Unfortunately, researchers have virtually ignored this area; of the nearly 4000 articles on AIDS and over 4000 on PC found by a recent computer search of the medical literature for the last eight years, only a
single one concerned both: the AL 721 letter cited above.
Until scientists get the political, administrative, and financial support to do this job, we will have to do it ourselves.
Probably the best forum for researching this and other possible treatments is the AIDS/ARC support groups. Individuals can get advice from others before beginning any therapy; and reports of results can spread easily within the groups by word of mouth. Scientific studies are more precise, but group experience should be able to determine whether or not there are any major
benefits, which is what we need to know.
We do not recommend specific treatments, which must be determined separately for each person. But we do hope that this article will stimulate discussion both in the support groups, and in the medical and scientific communities.
