Carnitine is a compound synthesized by the liver and kidneys from the amino acids lysine and methionine that was first isolated from meat, which is the origin of its name. L-carnitine, the biologically active forms of the compound, helps shuttle long-chain fatty acids into the mitochondria where they can be oxidized for the production of ATP, the body’s primary energy currency. L-carnitine is important for normal functions of the brain, heart, and muscles; 98% of the body’s stores of carnitine are in muscle.

There are several genetic disorders that result in primary and secondary carnitine deficiencies or depletions as well as medical conditions and medications that can result in acquired carnitine deficiency, including kidney impairment, dialysis, long-term use of pivalate antibiotics, valproic acid, HIV/AIDS medications, chemotherapy agents, and deficiencies in the nutrients required for the production of carnitine such as amino acids, iron, niacin, vitamin B6, and vitamin C.

The acetyl L-carnitine (ALCAR) form of supplemental L-carnitine passes through the blood-brain barrier increasing energy production in the brain. It also appears to restore age or disease related mitochondrial function by increasing protein content in mitochondria as well as increasing production of ATP/energy within mitochondria. Long-term clinical trials on patients with Alzheimer’s disease found that supplemental ALCAR improved short-term memory and slowed down deterioration compared to the placebo groups. In clinical trials on patients with ME/CFS, significant improvement in mental fatigue and brain fog were seen and clinical trials on alcoholics found improvements on all measured brain functions, including language, logic and deduction, memory, and visuospatial functions with ALCAR supplementation. Clinical trials on patients with fibromyalgia found that ALCAR significantly improved all myalgia measures, including  tender points, muscular-skeletal pain, stiffness, fatigue, sleep issues, and depression, compared to placebo and ALCAR was as effective as cymbalta at improving physical function and depression. In clinical trials on patients with type II diabetes, ALCAR decreased blood pressure, improved insulin sensitivity, increased glucose tolerance, and increased adiponectin levels, a hormone produced by fall cells that is involved in glucose regulation and fatty acid oxidation. Low levels of adiponectin is associated with cancer, dyslipidemia, fatty liver disease, heart disease,inflammation, and insulin resistance, though there are too many confounders to prove causation.

Adverse effects to ALCAR may include changes in body odor, dry mouth, headache, nausea, restlessness, stomach pain, and vomiting. Contraindications include anticoagulant and antiplatelet medications, neuropathy caused by taxanes chemotherapy agents, pregnancy and lactation, and seizure disorders. L-carnitine may interfere with thyroid hormone production, so caution should be used in those with hypothyroidism or under-active thyroid. Those on anti-diabetes or anti-hypertensive medications should check blood glucose or blood pressure levels carefully after starting ALCAR.

Standard dosing of oral acetyl L-carnitine is 500-1000mg twice a day. Some forms of L-carnitine are available by prescription.

Disclaimer: The content herein is not intended to be a substitute for professional medical advice. It is not meant to diagnosis, cure, or treat any medical condition. Always consult a physician or other qualified healthcare provider with questions regarding a medical condition and before starting new diets and dietary supplements. Not all diets or supplements are appropriate for all people or all health conditions.


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