Carnitine
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Carnitine Usage

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Usages

Effect of Carnitine on Erectile Dysfunction

Carnitine is best known and researched as an energy-boosting substance. The body uses it to turn fat into energy. Supplemental carnitine is used to improve the ability of certain tissues, such as...

Read more about Erectile Dysfunction and Carnitine.

Effect of Carnitine on Alzheimer's Disease

Acetyl-L-Carnitine is a substance used by the body uses to turn fat into energy. Acetyl-L-Carnitine, in theory, could improve the ability of certain tissues to produce energy, including brain tissue...

Read more about Alzheimer's Disease and Acetyl-L-Carnitine (ALC).

Effect of Carnitine on Coronary Artery Disease (CAD) and Angina

Carnitine plays a role in the cellular production of energy. Although carnitine does not address the cause of angina, it appears to help the heart produce energy more efficiently, thereby enabling it...

Read more about Coronary Artery Disease (CAD) and Angina and L-Carnitine.

Effect of Carnitine on Chronic Fatigue Syndrome (CFS)

Early studies reported decreased carnitine levels in people with chornic fatigue syndrome.18 So naturally, supplementing it is thought to possibly help in the treatment of the condition.

Read more about Chronic Fatigue Syndrome (CFS) and Carnitine.

Effect of Carnitine on Heart Attack

Carnitine may have a few effects on the heart after a heart attack, including helping to improve heart function and decreasing the enlargement that often follows an attack.

Read more about Heart Attack and L-Carnitine.

Therapeutic Uses

Carnitine is primarily used for heart-related conditions. Some evidence suggests that it can be used along with conventional treatment for angina to improve symptoms and reduce medication needs. 1 2 3 4 5 When combined with conventional therapy, it may or may not help prevent medical complications or sudden cardiac death in the months following a heart attack . 6 7 Lesser evidence suggests that it may be helpful for a condition called intermittent claudication (pain in the legs after walking due to narrowing of the arteries), 8 9 10 11 12 13 14 15 16 17 as well as congestive heart failure . 18 In addition, a few studies suggest that carnitine may be useful for cardiomyopathy . 19 Carnitine may also be helpful for improving exercise tolerance in people with chronic pulmonary obstruction disease (COPD), more commonly known as emphysema. 20

Warning:You should not attempt to self-treat any of these serious medical conditions, nor should you use carnitine as a substitute for standard drugs.

Growing, if not entirely consistent, evidence suggests that L-carnitine or acetyl-L-carnitine, or their combination, may be helpful for improving sperm function and thereby provide benefits in male infertility. 21 22 23 Carnitine has also shown promise for improving male sexual function 24 and improving mental and physical fatigue in seniors. 25 Two studies found evidence that carnitine is helpful for Peyronie’s disease , a condition affecting the penis. 26 Some studies have found evidence that one particular form of carnitine, acetyl-L-carnitine, might be helpful in Alzheimer's disease , 27 28 29 30 31 32 but the two most recent and largest studies found no benefit. 33 One review evaluated published and unpublished double-blind, placebo-controlled trials, and concluded that acetyl-L-carnitine may only be helpful for very mild Alzheimer's disease. 34 In preliminary trials, acetyl-L-carnitine has shown some promise for treatment of depression or dysthymia (a milder condition related to depression). 35 36 Some evidence suggests that carnitine may be useful for improving blood sugar control in people with type 2 (adult-onset) diabetes . 37 38 Better evidence suggests benefit with acetyl-L-carnitine for a major complication of diabetes, diabetic peripheral neuropathy (injury to nerves of the extremities caused by diabetes). 39 Acetyl-L-carnitine might help prevent diabetic cardiac autonomic neuropathy (injury to the nerves of the heart caused by diabetes). 40 However, one study found that carnitine supplements had an adverse effect on triglyceride levels in people with diabetes. 41 Much weaker evidence suggests possible benefits for neuropathy caused by the chemotherapy drugs cisplatin and paclitaxel. 42 Weak evidence hints that carnitine might help reduce liver and heart toxicity caused by the chemotherapy drug adriamycin . 43 Some evidence suggests that carnitine may be able to improve cholesterol profile . 44 One small study demonstrated a beneficial effect of L-carnitine on anemia and high cholesterol in patients on hemodialysis for chronic renal failure. 45 A genetic condition called fragile X syndrome can cause behavioral disturbances such as hyperactivity, along with mental retardation, autism, and alterations in appearance. A preliminary study of 17 boys found that acetyl-L-carnitine might help to reduce hyperactive behavior associated with this condition. 46 Evidence for the effectiveness of L-carnitine in attention deficit and hyperactivity disorder (ADHD) has been mixed. 47 Celiac disease is an autoimmune disease affecting the digestive tract. Fatigue is a common symptom of the disease. One small double-blind trial found evidence that use of L-carnitine at a dose of 2 g daily might help alleviate this symptom. 48 Weak evidence hints that carnitine may help people with degeneration of the cerebellum (the structure of the brain responsible for voluntary muscular movement). 49 One very small study suggests carnitine may be helpful for reducing symptoms of chronic fatigue syndrome . 50 Another study suggests that carnitine may be of value for treating hyperthyroidism 51 and for severe liver disease. 52 A substantial study marred by poor design (specifically, far too many primary endpoints) found equivocal evidence that L-carnitine, taken at dose of 500 mg three times daily, might be more effective than placebo for the treatment of fibromyalgia . 53 Other weak evidence suggests that carnitine may be helpful for decreasing the muscle toxicity of AZT (a drug used to treat HIV infection ). 54 Other weak evidence hints that the acetyl-L-carnitine might reduce nerve-related side effects caused by HIV drugs in general. 55 One study failed to find carnitine effective for promoting weight loss , 56 although another found that carnitine might lead to improvements in body composition (fat-muscle ratio). 57 Carnitine is widely touted as a physical sports performance enhancer , but there is no real evidence that it is effective and some research indicates that it is not. 58 Little to no evidence supports other claimed benefits such as treating irregular heartbeat, Down's syndrome, muscular dystrophy, and alcoholic fatty liver disease. However, in a randomized trial involving 25 patients with liver cirrhosis and early brain dysfunction (hepatic encephalopathy) associated with severe forms of this condition, carnitine appeared to significantly improve the function of both the liver and the brain after 3 months of treatment. 59

References

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  2. Bartels GL, Remme WJ, Pillay M, Schönfeld DH, Kruijssen DA. Effects of L-propionylcarnitine on ischemia-induced myocardial dysfunction in men with angina pectoris. Am J Cardiol. 74(2):125-30.
  3. Bartels GL, Remme WJ, den Hartog FR, et al. Additional anti-ischemic effects of long-term L-propionylcarnitine in anginal patients treated with conventional antianginal therapy. Cardiovasc Drugs Ther. 1995;9:749-753.
  4. Bartels GL, Remme WJ, Holwerda KJ, Kruijssen DA. Anti-ischaemic efficacy of L-propionylcarnitine--a promising novel metabolic approach to ischaemia? Eur Heart J. 17(3):414-20.
  5. Cherchi A, Lai C, Angelino F, Trucco G, Caponnetto S, Mereto PE, Rosolen G, Manzoli U, Schiavoni G, Reale A. Effects of L-carnitine on exercise tolerance in chronic stable angina: a multicenter, double-blind, randomized, placebo controlled crossover study. Int J Clin Pharmacol Ther Toxicol. 23(10):569-72.
  6. Davini P, Bigalli A, Lamanna F, Boem A. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res. 18(8):355-65.
  7. Villani RG, Gannon J, Self M, et al. L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women. Int J Sport Nutr Exerc Metab. 2000;10:199-207.
  8. Brevetti G, Perna S, Sabbá C, Martone VD, Condorelli M. Propionyl-L-carnitine in intermittent claudication: double-blind, placebo-controlled, dose titration, multicenter study. J Am Coll Cardiol. 26(6):1411-6.
  9. Bolognesi M, Amodio P, Merkel C, Godi L, Gatta A. Effect of 8-day therapy with propionyl-L-carnitine on muscular and subcutaneous blood flow of the lower limbs in patients with peripheral arterial disease. Clin Physiol. 15(5):417-23.
  10. Brevetti G, Perna S, Sabbà C, Rossini A, Scotto di Uccio V, Berardi E, Godi L. Superiority of L-propionylcarnitine vs L-carnitine in improving walking capacity in patients with peripheral vascular disease: an acute, intravenous, double-blind, cross-over study. Eur Heart J. 13(2):251-5.
  11. Greco AV, Mingrone G, Bianchi M, Ghirlanda G. Effect of propionyl-L-carnitine in the treatment of diabetic angiopathy: controlled double blind trial versus placebo. Drugs Exp Clin Res. 18(2):69-80.
  12. Brevetti G, Chiariello M, Ferulano G, Policicchio A, Nevola E, Rossini A, Attisano T, Ambrosio G, Siliprandi N, Angelini C. Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: a double-blind, cross-over study. Circulation. 77(4):767-73.
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  17. Brevetti G, Diehm C, Lambert D. European multicenter study on propionyl-L-carnitine in intermittent claudication. J Am Coll Cardiol. 34(5):1618-24.
  18. Cacciatore L, Cerio R, Ciarimboli M, Cocozza M, Coto V, D'Alessandro A, D'Alessandro L, Grattarola G, Imparato L, Lingetti M. The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: a controlled study. Drugs Exp Clin Res. 17(4):225-35.
  19. Pepine CJ. The therapeutic potential of carnitine in cardiovascular disorders. Clin Ther. 13(1):2-21; discussion 1.
  20. Dal Negro R, Pomari G, Zoccatelli O, et al. L-carnitine and rehabilitative respiratory physiokinesitherapy: metabolic and ventilatory response in chronic respiratory insufficiency. Int J Clin Pharmacol. 1986;24:453-456.
  21. Loumbakis P, Anezinis P, Evangeliou A, et al. Effect of L-carnitine in patients with asthenospermia [abstract]. Eur Urol. 1996;30(suppl 2):255.
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  23. Garolla A, Maiorino M, Roverato A, Roveri A, Ursini F, Foresta C. Oral carnitine supplementation increases sperm motility in asthenozoospermic men with normal sperm phospholipid hydroperoxide glutathione peroxidase levels. Fertil Steril. 83(2):355-61.
  24. Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G. Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Urology. 63(4):641-6.
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  26. Cavallini G, Biagiotti G, Koverech A, Vitali G. Oral propionyl-l-carnitine and intraplaque verapamil in the therapy of advanced and resistant Peyronie's disease. BJU Int. 89(9):895-900.
  27. Passeri M, Cucinotta D, Bonati PA, Iannuccelli M, Parnetti L, Senin U. Acetyl-L-carnitine in the treatment of mildly demented elderly patients. Int J Clin Pharmacol Res. 10(1-2):75-9.
  28. Calvani M, Carta A, Caruso G, Benedetti N, Iannuccelli M. Action of acetyl-L-carnitine in neurodegeneration and Alzheimer's disease. Ann N Y Acad Sci. 663():483-6.
  29. Sano M, Bell K, Cote L, Dooneief G, Lawton A, Legler L, Marder K, Naini A, Stern Y, Mayeux R. Double-blind parallel design pilot study of acetyl levocarnitine in patients with Alzheimer's disease. Arch Neurol. 49(11):1137-41.
  30. Spagnoli A, Lucca U, Menasce G, Bandera L, Cizza G, Forloni G, Tettamanti M, Frattura L, Tiraboschi P, Comelli M. Long-term acetyl-L-carnitine treatment in Alzheimer's disease. Neurology. 41(11):1726-32.
  31. Campi N, Todeschini GP, Scarzella L. Selegiline versus L-acetylcarnitine in the treatment of Alzheimer-type dementia. Clin Ther. 12(4):306-14.
  32. Vecchi GP, Chiari G, Cipolli C, et al. Acetyl-l-carnitine treatment of mental impairment in the elderly: evidence from a multicenter study. Arch Gerontol Geriatr. 1991;(suppl 2):159-168.
  33. Thal LJ, Carta A, Clarke WR, Ferris SH, Friedland RP, Petersen RC, Pettegrew JW, Pfeiffer E, Raskind MA, Sano M, Tuszynski MH, Woolson RF. A 1-year multicenter placebo-controlled study of acetyl-L-carnitine in patients with Alzheimer's disease. Neurology. 47(3):705-11.
  34. Montgomery SA, Thal LJ, Amrein R. Meta-analysis of double blind randomized controlled clinical trials of acetyl-L-carnitine versus placebo in the treatment of mild cognitive impairment and mild Alzheimer's disease. Int Clin Psychopharmacol. 18(2):61-71.
  35. Bella R, Biondi R, Raffaele R, Pennisi G. Effect of acetyl-L-carnitine on geriatric patients suffering from dysthymic disorders. Int J Clin Pharmacol Res. 10(6):355-60.
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  37. Mingrone G, Greco AV, Capristo E, Benedetti G, Giancaterini A, De Gaetano A, Gasbarrini G. L-carnitine improves glucose disposal in type 2 diabetic patients. J Am Coll Nutr. 18(1):77-82.
  38. Rahbar AR, Shakerhosseini R, Saadat N, Taleban F, Pordal A, Gollestan B. Effect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitus. Eur J Clin Nutr. 59(4):592-6.
  39. Sima AA, Calvani M, Mehra M, Amato A, Acetyl-L-Carnitine Study Group. Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: an analysis of two randomized placebo-controlled trials. Diabetes Care. 28(1):89-94.
  40. Turpeinen AK, Kuikka JT, Vanninen E, Yang J, Uusitupa MI. Long-term effect of acetyl-L-carnitine on myocardial 123I-MIBG uptake in patients with diabetes. Clin Auton Res. 10(1):13-6.
  41. Rahbar AR, Shakerhosseini R, Saadat N, Taleban F, Pordal A, Gollestan B. Effect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitus. Eur J Clin Nutr. 59(4):592-6.
  42. Maestri A, De Pasquale Ceratti A, Cundari S, Zanna C, Cortesi E, Crinò L. A pilot study on the effect of acetyl-L-carnitine in paclitaxel- and cisplatin-induced peripheral neuropathy. Tumori. 91(2):135-8.
  43. Strauss M, Porras N. Differential expression of HSP70 and ultrastructure of heart and liver tissues of rats treated with adriamycin: protective role of L-carnitine. Invest Clin. 48(1):33-43.
  44. Davini P, Bigalli A, Lamanna F, Boem A. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res. 18(8):355-65.
  45. Mitwalli AH, Al-Wakeel JS, Alam A, Tarif N, Abu-Aisha H, Rashed M, Al Nahed N. L-carnitine supplementation in hemodialysis patients. Saudi J Kidney Dis Transpl. 16(1):17-22.
  46. Torrioli MG, Vernacotola S, Mariotti P, Bianchi E, Calvani M, De Gaetano A, Chiurazzi P, Neri G. Double-blind, placebo-controlled study of L-acetylcarnitine for the treatment of hyperactive behavior in fragile X syndrome. Am J Med Genet. 87(4):366-8.
  47. Van Oudheusden LJ, Scholte HR. Efficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids. 67(1):33-8.
  48. Ciacci C, Peluso G, Iannoni E, Siniscalchi M, Iovino P, Rispo A, Tortora R, Bucci C, Zingone F, Margarucci S, Calvani M. L-Carnitine in the treatment of fatigue in adult celiac disease patients: a pilot study. Dig Liver Dis. 39(10):922-8.
  49. Sorbi S, Forleo P, Fani C, Piacentini S. Double-blind, crossover, placebo-controlled clinical trial with L-acetylcarnitine in patients with degenerative cerebellar ataxia. Clin Neuropharmacol. 23(2):114-8.
  50. Plioplys AV, Plioplys S. Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome. Neuropsychobiology. 35(1):16-23.
  51. Benvenga S, Ruggeri RM, Russo A, Lapa D, Campenni A, Trimarchi F. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Metab. 86(8):3579-94.
  52. Malaguarnera M, Pistone G, Elvira R, Leotta C, Scarpello L, Liborio R. Effects of L-carnitine in patients with hepatic encephalopathy. World J Gastroenterol. 11(45):7197-202.
  53. Rossini M, Di Munno O, Valentini G, Bianchi G, Biasi G, Cacace E, Malesci D, La Montagna G, Viapiana O, Adami S. Double-blind, multicenter trial comparing acetyl l-carnitine with placebo in the treatment of fibromyalgia patients. Clin Exp Rheumatol. 25(2):182-8.
  54. Semino-Mora MC, Leon-Monzon ME, Dalakas MC. Effect of L-carnitine on the zidovudine-induced destruction of human myotubes. Part I: L-carnitine prevents the myotoxicity of AZT in vitro. Lab Invest. 71(1):102-12.
  55. Youle M, Osio M, ALCAR Study Group. A double-blind, parallel-group, placebo-controlled, multicentre study of acetyl L-carnitine in the symptomatic treatment of antiretroviral toxic neuropathy in patients with HIV-1 infection. HIV Med. 8(4):241-50.
  56. Villani RG, Gannon J, Self M, et al. L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women. Int J Sport Nutr Exerc Metab. 2000;10:199-207.
  57. Pistone G, Marino A, Leotta C, Dell'Arte S, Finocchiaro G, Malaguarnera M. Levocarnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue. Drugs Aging. 20(10):761-7.
  58. Heinonen OJ. Carnitine and physical exercise. Sports Med. 22(2):109-32.
  59. Cacciatore L, Cerio R, Ciarimboli M, Cocozza M, Coto V, D'Alessandro A, D'Alessandro L, Grattarola G, Imparato L, Lingetti M. The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: a controlled study. Drugs Exp Clin Res. 17(4):225-35.
 
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