Optimal Result: 1 - 9 micromol/g creatinine.

Phosphoethanolamine is an intermediate in the serine-to-choline sequence. It is both a precursor and byproduct of phospholipid biosynthesis and breakdown. As a precursor to the phospholipid phosphatidylethanolamine, phosphoethanolamine plays a key role in myelination. Elevated phosphoethanolamine reflects brain phospholipid turnover, an indicator of neural membrane synthesis and signal transduction. Research into neurologic conditions like Alzheimer’s disease and Huntington’s disease suggests that depletions of both phosphoethanolamine and ethanolamine accompany neuronal death. Phosphoethanolamine is also important in cartilage structure and function, especially in bone and teeth.


- Henneberry AL, McMaster CR. Cloning and expression of a human choline/ethanolaminephosphotransferase: synthesis of phosphatidylcholine and phosphatidylethanolamine. Biochem J. 1999;339 ( Pt 2)(Pt 2):291-298.

- Horibata Y, Hirabayashi Y. Identification and characterization of human ethanolaminephosphotransferase1. J Lipid Res. 2007;48(3):503-508.

- Kawamura N, Shinoda K, Sato H, et al. Plasma metabolome analysis of patients with major depressive disorder. Psych Clin Neurosci. 2018;72(5):349-361.

- Ellison DW, Beal MF, Martin JB. Phosphoethanolamine and ethanolamine are decreased in Alzheimer’s disease and Huntington’s disease. Brain Res. 1987;417(2):389-392.

- Roberts SJ, Stewart AJ, Sadler PJ, Farquharson C. Human PHOSPHO1 exhibits high specific phosphoethanolamine and phosphocholine phosphatase activities. Biochem J. 2004;382(Pt 1):59-65.

- Nowicki EM, O’Brien JP, Brodbelt JS, Trent MS. Extracellular zinc induces phosphoethanolamine addition to Pseudomonas aeruginosa lipid A via the ColRS twocomponent system. Molec Microbiol. 2015;97(1):166-178.

- Jo S-H, Park H-G, Song W-S, et al. Structural characterization of phosphoethanolamine-modified lipid A from probiotic Escherichia coli strain Nissle 1917. RSC Adv. 2019;9(34):19762-19771.

- Mornet E. Hypophosphatasia. Metab: Clin Exp. 2018;82:142- 155.

- Weismann K, Høyer H. Serum alkaline phosphatase and serum zinc levels in the diagnosis and exclusion of zinc deficiency in man. Am J Clin Nutr. 1985;41(6):1214-1219.

- Ray CS, Singh B, Jena I, Behera S, Ray S. Low alkaline phosphatase (ALP) in adult population an indicator of zinc (Zn) and magnesium (Mg) deficiency. Curr Res Nutr Food Sci J. 2017;5(3):347-352.

- Fukushima K, Kawai-Kowase K, Yonemoto Y, et al. Adult hypophosphatasia with compound heterozygous p.Phe327Leu missense and c.1559delT frameshift mutations in tissue-nonspecific alkaline phosphatase gene: a case report. J Med Case Rep. 2019;13(1):101.

What does it mean if your Phosphoethanolamine result is too low?

Decreased levels of precursors in the production of phosphoethanolamine, or lack of cofactors needed within the pathway, may contribute to low levels. Clinically, reduced plasma levels of phosphoethanolamine have been significantly correlated with depressed mood, diminished interest or pleasure, psychomotor change, psychomotor retardation, and major depressive disorder (MDD), making this a potential biomarker for MDD. Habitual alcohol intake was also a related to low phosphoethanolamine levels.

What does it mean if your Phosphoethanolamine result is too high?

Magnesium and manganese are enzymatic cofactors in the metabolism of phosphoethanolamine. Deficiencies in these nutrients may contribute to elevated levels.

The precursor to phosphoethanolamine is ethanolamine. Gut microbiome imbalances can influence ethanolamine levels. With that, elevated phosphoethanolamine has also been associated with gastrointestinal microbiome imbalance. Clinically, elevated phosphoethanolamine is associated with a rare condition called hypophosphatasia which results in the abnormal development of teeth and bones. Zinc and magnesium deficiencies further complicate this condition.

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