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Understanding PEMT and Why It Matters for Your Health

The PEMT gene makes an enzyme called phosphatidylethanolamine N-methyltransferase. This enzyme helps convert phosphatidylethanolamine into phosphatidylcholine, a critical phospholipid used in cell membranes, bile secretion, and lipid transport. Each conversion uses three molecules of S-adenosylmethionine (SAMe), linking PEMT activity directly to your body’s methylation demand.

When PEMT works well, your liver can produce phosphatidylcholine internally and conserve dietary choline for other needs like neurotransmitter synthesis, DNA methylation, and detoxification. When PEMT activity is reduced, your body depends more on dietary choline. Low choline availability or combined inefficiencies in other methylation genes can strain liver function, impair lipid metabolism, and weaken membrane integrity.

How to Read Your PEMT rs7946 Result

The rs7946 variant in the PEMT gene is commonly reported as three potential genotypes: TT, CT, or CC. Each affects enzyme activity differently and influences how much dietary choline and methyl donor support you may need.

2 effect alleles (TT) — Reduced PEMT activity

If your genotype is TT, you carry two copies of the effect allele. This is associated with reduced PEMT enzyme function. Reduced PEMT means less internal production of phosphatidylcholine and an increased reliance on dietary choline. Because each PEMT reaction uses SAMe, inefficiency here can also lower available methyl groups for other methylation-dependent processes.

Practical implications:

  • Higher dietary choline needs to support liver function, bile production, and membrane health
  • Greater benefit from choline-containing supplements when dietary intake is low
  • Potential increased methylation demand; supporting folate, B12, betaine, riboflavin (B2), and zinc can help
  • Important considerations during pregnancy when choline needs rise
1 effect allele (CT) — Intermediate PEMT activity

If your genotype is CT, you carry one effect allele and one non-effect allele. This typically results in moderately reduced PEMT activity. Many people with CT maintain adequate methylation on a normal diet, but under higher demand situations your choline needs can increase.

Practical implications:

  • May benefit from modest increases in choline-rich foods, especially during pregnancy or prolonged physical stress
  • Consider balanced intake of methyl donors and cofactors to preserve methylation capacity
  • Watch liver health and lipid markers if dietary choline is low
0 effect alleles (CC) — Typical PEMT activity

If your genotype is CC, you carry two copies of the non-effect allele and generally have normal PEMT enzyme function. Your liver should be able to synthesize phosphatidylcholine effectively, helping conserve dietary choline for other pathways.

Practical implications:

  • Standard dietary choline recommendations typically suffice
  • Maintain adequate folate and B vitamin intake to support methylation
  • Continue routine monitoring of liver health and lipid metabolism as part of regular care

Dietary Recommendations

  • Prioritize choline-rich foods: eggs (especially yolks), beef and chicken liver, salmon, cod, shrimp, and soy products.
  • Include plant sources: cruciferous vegetables (broccoli, Brussels sprouts), nuts, legumes, and whole grains provide supporting nutrients and some choline.
  • Balance macronutrients: adequate protein supports phospholipid production; avoid very low-fat diets that can impair lipid transport if choline is limited.
  • During pregnancy or breastfeeding, increase choline intake because fetal development and milk production require more choline.

Supplement Suggestions

  • Consider dietary supplements only after discussing with your healthcare provider.
  • Choline forms: phosphatidylcholine, CDP-choline (citicoline), or choline bitartrate can raise choline status. Phosphatidylcholine and CDP-choline may be more effective at supporting cell membranes and brain function.
  • Methyl donor support: folate (methylfolate if indicated), vitamin B12, betaine (trimethylglycine), riboflavin (B2), and zinc help preserve SAMe availability and overall methylation.
  • SAMe supplementation can sometimes be considered under medical guidance to support methylation, but only with professional oversight.

Lifestyle and Monitoring

  • Limit excess alcohol intake because alcohol increases liver stress and choline demand.
  • Maintain a balanced exercise routine; severe or prolonged physical stress increases nutrient needs, including choline.
  • If you have symptoms such as persistent fatigue, memory issues, or unexplained liver enzyme elevations, discuss testing with your provider.
  • Regular blood tests to monitor liver function tests, lipid panel, and B vitamin status may be helpful when adjusting diet or supplements.

When to Talk With a Healthcare Provider

  • If you are pregnant, planning pregnancy, or breastfeeding — choline needs increase and targeted guidance is important.
  • If you have a history of liver disease, elevated liver enzymes, or abnormal lipid profiles.
  • Before starting supplements, especially high-dose methyl donors or SAMe, or if you take medications that affect methylation.

Limitations and Important Disclaimer

PlexusDx provides educational information about genetic predispositions only. This information is not medical advice and is not a substitute for consultation with your healthcare provider. Genetic results reflect only one part of your health picture. Environment, diet, lifestyle, medications, and other genes all contribute to outcomes. Always discuss genetic findings and any changes to diet, supplements, or medications with a qualified healthcare professional before making decisions.