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Home > Health Library > Acetyl L Carnitine
Acetyl L Carnitine
Overview
Acetyl-L-Carnitine (ALC or ALCAR) is a naturally occurring compound that is primarily used for energy production in the body. Common food sources include vegetables, grains, lamb and beef. ALC supplementation has been shown to provide positive support for:
arw Mental performance
arw Memory maintenance
arw Acetylcholine neurotransmitter synthesis
 
Acetyl-L-Carnitine is produced in small amounts in the body. Although deficiencies are rare, vegetarians could be at risk because significant dietary sources that contain Acetyl-L-Carnitine are few. An ALC deficiency might result in muscle fatigue, cramping, tiredness and heart irregularities.
 
Some studies indicate ALCAR may support healthy cardiac function owing to its antioxidant and anti-apoptotic activity. Acetylcarnitine and carnitine play important roles in the human body. These nutrients shuttle acetyl groups and fatty acids into mitochondria for energy production. Without carnitine, fatty acids cannot easily enter into mitochondria. The acetyl group is used to form acetyl-CoA, the most important intermediary in the generation of energy from amino acids, fats, and carbohydrates. Therefore it serves as an energy reservoir of acetyl groups and both nutrients help improve energy production. The acetyl group is also used to make the important brain chemical acetylcholine. Some studies suggest that perhaps acetyl l-carnitine can even act as a neurotransmitter itself. This nutrient is sometimes abbreviated as ALC or ALCAR.
Individuals taking carnitine pills notice an increase in physical energy but not as much mental energy. Acetyl L-carnitine has a more immediate and noticeable mental effect than carnitine because it crosses into the brain much effectively and swiftly. The mind boosting effect of ALC is often noticed within a few hours, or even within an hour. Most people report feeling mentally sharper, with more mental stamina, better focus and being more alert. Some observed a mild mood enhancement.

 
What is Acetyl-L-carnitine?
3-acetyloxy-4-trimethylammonio-butanoate
3-acetyloxy-4-trimethylammonio-butanoate
 

Acetyl-L-carnitine or ALCAR, is an acetylated form of L-carnitine. It is a dietary supplement and occurs naturally in plants and animals. Glucose metabolism increases with administration of either ALCAR or L-carnitine. A portion of L-carnitine is converted to ALCAR after ingestion in humans. It functions similarly to carnitine but more effectively and efficiently.

 
Chemically, acetyl-L-carnitine is known as beta-acetoxy-gamma-N, N, N-trimethylaminobutyrate. Other names for acetyl-L-carnitine include: acetyl-levocarnitine, acetylcarnitine, l-acetylcarnitine, levacecarnine, and ST-200. Acetyl L-Carnitine is a modified amino acid that supports cellular energy production by assisting in the transport of fat into the mitochondria where it is oxidized and converted into ATP (chemical energy for the cell). Acetyl L-carnitine is in a highly bioavailable form of L-Carnitine antioxidant effect, helps to maintain healthy cellular energy metabolism and supports brain function.
 
Where is it Found?
Acetyl-L-carnitine is a dietary supplement used to boost memory. It occurs naturally in animal products. The principal dietary source of acetyl-L-carnitine is red meat. The highest concentrations are found in mutton.
 
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Product related PDF file
Acetyl L-Carnitine Fact Sheet
Acetyl-L-Carnitine Metabolism & Application

Benefits / Uses
Acetyl-L-carnitine helps the body produce energy. It is important for heart and brain function, muscle movement, and many other body processes. The following medical researches elucidate its various benefits.
 
Alzheimer's disease patients unresponsive to acetylcholinesterase inhibitors
Acetylcarnitine appears to have neuroprotective properties and it has been shown to reduce attention deficits in patients with Alzheimer's disease (AD) after long-term treatment. An open study was conducted to evaluate the effect of 2 g/day orally for 3 months in association with donepezil or rivastigmine in 23 patients with mild AD who had not responded to treatment with acetylcholinesterase inhibitors (AChE-I). Clinical effects were evaluated by assessing cognitive functions, functional status and behavioral symptoms. The response rate, which was 38% after AChE-I treatment, increased to 50% after the addition of acetylcarnitine, indicating that the combination of these two drugs may be a useful therapeutic option in AD patients.
 
Attention deficit hyperactivity disorder in children (American Journal of Medical Genetics 2008)
L-acetylcarnitine may help with attention deficit hyperactivity disorder in children with the genetic disorder known as fragile X syndrome which results from an inherited genetic defect on the X chromosome. It is associated with mental retardation and may also cause autism and ADHD, Dr. Giovanni Neri from Universita Cattolica in Rome studied boys between 6 and 13 years old for a period one year. Twenty four received l-acetylcarnitine and 27 received placebo. There was a more effective reduction of hyperactivity and improvement of social behavior.
 
Study of the efficacy and tolerability of L-acetylcarnitine therapy in the senile brain.
(Bonavita E. Int J Clin Pharmacol Ther Toxicol 1986 Sep;24(9):511-6.)
The aim of this study was to evaluate the efficacy and tolerability of L-acetylcarnitine therapy in the senile brain. The trial was conducted on a double-blind basis, with a total of 40 patients divided into two groups of 20, treated for 40 days -- the therapeutic regimen being two 500 mg tablets three times daily. Short-term, intensive acetyl l carnitine treatment can determine a significant improvement of the main mental parameters of the senile brain, without incidence of significant side-effects.

 
Anti-aging and longevity with alpha lipoic acid.
Scientists at the Division of Biochemistry and Molecular Biology, University of California, Berkeley, CA rejuvenated aging rats by giving them a combination of alpha lipoic acid and acetylcarnitine. Lead researcher Dr Bruce Ames, said the results were astonishing: "With the two supplements together, these old rats got up and did the Macarena. The brain looks better, they are full of energy - everything we looked at looks more like a young animal." The animals' memories were also significantly improved.
 
Chronic fatigue syndrome
(Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome. Psychosom Med. 2004 Mar-Apr;66(2):276-82)
In an open, randomized fashion a comparison between 2 g/d acetyl-L-carnitine, 2 g/d propionyl-L-carnitine, and its combination in 3 groups of 30 chronic fatigue syndrome patients was conducted over 24 weeks. Clinical global impression of change after treatment showed considerable improvement in 59% of the patients in the acetylcarnitine group and 63% in the propionylcarnitine group, but less in the acetylcarnitine plus propionylcarnitine group (37%). Acetylcarnitine significantly improved mental fatigue and propionylcarnitine improved general fatigue.

 
Diabetic neuropathy
(Acetyl-L-carnitine in the treatment of diabetic neuropathy. A long-term, randomized, double-blind, placebo-controlled study. De Grandis D, Minardi C. Department of Neuroscience, Ospedale Civile, Rovigo, Italy. Drugs R D. 2002)
This was a multicentre, randomised, double-blind, placebo-controlled, parallel-group study. 333 patients meeting clinical and/or neurophysiological criteria for diabetic neuropathy were enrolled. Acetylcarnitine (or placebo) was started intramuscularly at a dosage of 1000 mg/day for 10 days and continued orally at a dosage of 2000 mg/day for the remainder of the study (355 days). Acetylcarnitine was effective and well tolerated in improving neurophysiological parameters and in reducing pain over a 1-year period. It is, therefore, a promising treatment remedy in patients with diabetic neuropathy.

 
Neuropathy
(A pilot study on the effect of acetylcarnitine in paclitaxel- and cisplatin-induced peripheral neuropathy. Tumori. 2005 Mar-Apr;91(2):135-8)
In addition to bone marrow suppression and renal toxicity, neurotoxicity is a commonly occurring side-effect of widely used chemotherapeutic agents like taxanes, cisplatin and vinca alkaloids. The aim of the present exploratory study was to investigate the activity of acetyl L-carnitine in reversing peripheral neuropathy in patients with chemotherapy-induced peripheral neuropathy. Twenty-seven patients (16 males and 11 females) with paclitaxel and/or cisplatin-induced neuropathy (according to WHO recommendations for the grading of acute and subacute toxic effects) were enrolled. Patients received at least one cisplatin or one paclitaxel based regimen, or a combination of both. Patients with chemotherapy-induced peripheral neuropathy were treated with acetyl-L-carnitine 1 g/die i.v. infusion over 1-2 hours for at least 10 days. Acetylcarnitine seems to be an effective and well-tolerated agent for the treatment of chemotherapy-induced peripheral neuropathy.

 
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. 2005 Jan;28(1):89-94)
Frozen databases were evaluated from two 52-week randomized placebo-controlled clinical diabetic neuropathy trials testing two doses of acetyl-carnitine: 500 and 1,000 mg/day three times a day. Data showed significant improvements in sural nerve fiber numbers and regenerating nerve fiber clusters. Nerve conduction velocities and amplitudes did not improve, whereas vibration perception improved in both studies. Pain as the most bothersome symptom showed significant improvement in one study and in the combined cohort taking 1,000 mg acetyl-l-carnitine. These studies demonstrate that treatment is efficacious in alleviating symptoms, particularly pain, and improves nerve fiber regeneration and vibration perception in patients with established diabetic neuropathy.

 

Erectile dysfunction, impotence
(Acetylcarnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy.
Urology. 2005 Nov;66(5):1080-5. Operative Unit of Andrology, Societa Italiana di Medicina della Riproduzione, Bologna, Italy)
To determine whether propionyl-L-carnitine plus acetylcarnitine improve the effectiveness of sildenafil in restoring sexual potency after bilateral nerve-sparing radical retropubic prostatectomy. We analyzed the data from 96 patients who had undergone bilateral nerve-sparing radical retropubic prostatectomy: 33 were given placebo (group 1), 32 used propionyl-L-carnitine 2 g/day plus acetylcarnitine 2 g/day plus sildenafil 100 mg when needed (group 2), and 35 used sildenafil alone (group 3). Placebo proved ineffective and sildenafil and sildenafil plus acetyl-l-carnitine and PLC proved effective. Propionyl-L-carnitine and acetylcarnitine proved to be safe and reliable in improving the efficacy of sildenafil in restoring sexual potency after bilateral nerve-sparing radical retropubic prostatectomy.

 

Sexual dysfunction treatment
This brain enhancer may also have a positive influence on sexuality.
(Carnitines versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Urology) 2004 Apr;63(4):641-6.
To compare testosterone undecanoate versus propionyl-L-carnitine plus acetyl-L-carnitine and placebo in the treatment of male aging symptoms a total of 120 patients were randomized into three groups. The mean patient age was 66 years (range 60 to 74). Group 1 was given testosterone undecanoate 160 mg/day; the second group was given propionyl-L-carnitine 2 grams per day plus acetyl-l-carnitine 2 g/day. The third group was given a placebo (starch). Drugs and placebo were given for six months. The assessed variables were total prostate-specific antigen, prostate volume, peak systolic velocity, end-diastolic velocity, resistive index of cavernosal penile arteries, nocturnal penile tumescence, total and free testosterone, prolactin, luteinizing hormone, International Index of Erectile Function score, Depression Melancholia Scale score, fatigue scale score, and incidence of side -effects. The assessment was performed at intervals before, during, and after therapy. Testosterone and carnitines significantly improved the peak systolic velocity, end-diastolic velocity, resistive index, nocturnal penile tumescence, International Index of Erectile Function score, Depression Melancholia Scale score, and fatigue scale score. Carnitines proved significantly more active than testosterone in improving nocturnal penile tumescence and International Index of Erectile Function score. Testosterone significantly increased the prostate volume and free and total testosterone levels and significantly lowered serum luteinizing hormone; carnitines did not. No drug significantly modified prostate-specific antigen or prolactin. Carnitines and testosterone proved effective for as long as they were administered, with suspension provoking a reversal to baseline values.

 
Sperm health, number and volume
(Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combined in men with idiopathic asthenozoospermia. Fertility & Sterility 2005 Sep;84(3):662-71.)

Sixty infertile men, ages 20 to 40 years, with the following baseline sperm selection criteria: concentration > 20 x 10(6)/mL, sperm forward motility < 50%, and normal sperm morphology > 30%. Patients underwent a double-blind therapy of L-carnitine 3 g/d, acetylcarntine 3 g/d, a combination of carnitine 2 g/d and ALCAR1 g/d, or placebo. Sperm cell motility increased in patients to whom acetylcarnitine was administered both alone or in combination with carnitine; combined carnitine + acetyl-l-carnitine therapy led to a significant improvement of straight progressive velocity after 3 months. Patients with lower baseline values of motility and total oxyradical scavenging capacity of the seminal fluid had a significantly higher probability of responding to the treatment. The administration of carnitine and l-acetylcarnitine is effective in increasing sperm kinetic features in patients affected by idiopathic asthenozoospemia and improves the total oxyradical scavenging capacity of the seminal fluid in the same population.

 
Peyronie's disease
ALCAR is more effective than tamoxifen in the therapy of acute and early chronic Peyronie's disease.
 
Hypertension and insulin resistance
(Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy. Hypertension. 2009 Sep; Mario Negri Institute for Pharmacological Research, Via Gavazzeni 11, Bergamo, Italy.)
Insulin resistance, a key component of the metabolic syndrome, is a risk factor for diabetes mellitus and cardiovascular disease. Acetyl-L-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance. In this sequential off-on-off pilot study, a prospective evaluation studied the effects of 24-week oral acetyl-L-carnitine (1 g twice daily) therapy on the glucose disposal rate (GDR), assessed by hyperinsulinemic euglycemic clamps, and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori. Systolic blood pressure decreased. Acetyl-L-carnitine safely ameliorated arterial hypertension, insulin resistance, impaired glucose tolerance, and hypoadiponectinemia in subjects at increased cardiovascular risk.

 
Memory
Studies in aging rats shows chronic administration of acetyl-l-carnitine increases cholinergic synaptic transmission and consequently enhances learning capacity. The memory of aging rats is rejuvenated by giving them a combination of acetylcarnitine and lipoic acid.
 
Multiple sclerosis
Patients with multiple sclerosis may benefit with a reduction in their fatigue.
(Comparison of the effects of acetylcarnitine and amantadine for the treatment of fatigue in multiple sclerosis: results of a pilot, randomised, double-blind, crossover trial.
J Neurol Sci. 2004 Mar 15;218(1-2):103-8)
To compare the efficacy of acetyl carnitine with that of amantadine, one of the drugs most widely used to treat MS-related fatigue, 36 MS patients presenting fatigue were enrolled in a randomised, double-blind, crossover study. Patients were treated for 3 months with either amantadine (100 mg twice daily) or acetylcarnitine (1 g twice daily). After a 3-month washout period, they crossed over to the alternative treatment for 3 months. Six patients withdrew from the study because of adverse reactions (five on amantadine and one on acetylcarnitine). Statistical analysis showed significant effects of acetyl carnitine compared with amantadine for the Fatigue Severity Scale. The results of this study show that this nutrient is better tolerated and more effective than amantadine for the treatment of MS-related fatigue.

 

Thyroid Caution is advised when combining medicines, hormones, and supplements. If your doctor approves you can open a capsule of the acetyl l carnitine 300 mg and use a third of it the first day. Most medications and supplements can be used together if the dosages are low.

Weight loss
Some people notice ALC reduces appetite but no formal studies using this supplement as an effective weight loss pill have been conducted. However it also acts as base l carnitine and converts fat in to energy, which may result in weight loss.

In combination with alpha lipoic acid
Both have health benefits, it is not essential they be taken together but some studies do show additional benefits when used in combination. If taken together half of normal dose of each is recommended. There has not been enough research with each of these forms of ALCAR to determine which are best for long term human consumption.

 
Dosage
arw For Alzheimer's disease: 1500-4000 mg daily, usually divided into two or three doses during the day.
   
arw In age-related memory loss: 1500-2000 mg daily.
   
arw For depression in the elderly: 1500-3000 mg daily in divided doses.
   
arw For male infertility:1 gram of acetyl-L-carnitine plus 2 grams of L-carnitine daily.
   
arw 4000 mg daily has been used to improve sperm function.
   
arw For male infertility secondary to abacterial prostatovesiculoepididymitis: acetyl-L-carnitine 500 mg plus carnitine 1 gram every 12 hours has been used following 2 months of treatment with nonsteroidal anti-inflammatory drugs.
   
arw For Peyronie's disease: 1 gram twice daily for 3 months.
   
arw For symptoms of age-related testosterone deficiency: 2 grams of acetyl-L-carnitine plus 2 grams of propionyl-L-carnitine daily.
   
arw For diabetic neuropathy: 1500 to 3000 mg per day in divided doses.
 
Possible Side-Effects / Precautions / Possible Interactions:
Side-effects of overstimulation, restlessness, and nausea may occur at high dosages. Even higher doses may cause insomnia. If one experiences nausea, just use acetyl l-carnitine with food or lesser dose is recommended.
 
Research Studies / References
arw ^ Steiber A, Kerner J, Hoppel C (2004). "Carnitine: a nutritional, biosynthetic, and functional perspective". Mol. Aspects Med. 25 (5-6): 455-73.
doi:10.1016/j.mam.2004.06.006. PMID 15363636.
   
arw ^ A. J. Liedtke, S. H. Nellis, L. F. Whitesell and C. Q. Mahar (1 November 1982). "Metabolic and mechanical effects using L- and D-carnitine in working swine hearts". Heart and Circulatory Physiology 243 (5): H691-H697. PMID 7137362. http://ajpheart.physiology.org/cgi/content/abstract/243/5/H691.
   
arw ^ "L-Carnitine". Archived from the original on 2007-05-08. http://web.archive.org/web/20070508224849/http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/lca_0060.shtml.
Retrieved 2007-06-01.
   
arw ^ Cederblad, G; Niklasson, A; Rydgren, B; Albertsson-Wikland, K; Olegård, R; "Carnitine in Maternal and Neonatal Plasma"; Acta Pædiatrica; Published Online: 21 Jan 2008; Volume 74, Issue 4: Pp 500 - 504
   
arw ^ Cederblad, G; Fahraeus, L; Lindgren, K; "Plasma carnitine and renal-carnitine clearance during pregnancy"; American Journal of Clinical Nutrition; 1986; Volume 44:Pp
   
arw

^ Olpin S (2005). "Fatty acid oxidation defects as a cause of neuromyopathic disease in infants and adults". Clin. Lab. 51 (5-6): 289-306. PMID 15991803.

   
arw ^ Claudio Cavazza, Composition for the Prevention and Treatment of Osteoporosis due to Menopause Syndrome (2002), US Patent 6,335,038, column 4.
   
arw ^ Claudio Cavazza, Composition for the Prevention and Treatment of Osteoporosis due to Menopause Syndrome (2002), US Patent 6,335,038, columns 3-4.
   
arw ^ Claudio Cavazza, Composition for the Prevention and Treatment of Osteoporosis due to Menopause Syndrome (2002), US Patent 6,335,038, column 3.
   
arw ^ Cacciatore L, Cerio R, Ciarimboli M, Cocozza M, Coto V, D'Alessandro A, D'Alessandro L, Grattarola G, Imparato L, Lingetti M (1991). "The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: a controlled study.". Drugs Exp Clin Res 17 (4): 225-235. PMID 1794297.
   
arw ^ Bartels GL, Remme WJ, Pillay M, et al. (July 1994). "Effects of L-propionylcarnitine on ischemia-induced myocardial dysfunction in men with angina pectoris". The American Journal of Cardiology 74 (2): 125-130. doi:10.1016/0002-9149(94)90084-1. PMID 8023775.
   
arw ^ Michael A. Arsenian (November - December 1997). "Carnitine and its derivatives in cardiovascular disease". Progress in Cardiovascular Diseases 40 (3): 265-286. doi:10.1016/S0033-0620(97)80037-0. PMID 9406679.
   
arw ^ Kamyar Kalantar-Zadeh, MPHa, Stefan D. Anker, Tamara B. Horwich and Gregg C. Fonarow (June 2008). "Nutritional and Anti-Inflammatory Interventions in Chronic Heart Failure". The American Journal of Cardiology 101 (11): S89-S103. doi:10.1016/j.amjcard.2008.03.007. PMID 18514634.
   
arw ^ Geltrude Mingrone, Aldo V. Greco, Esmeralda Capristo, Giuseppe Benedetti, Annalisa Giancaterini, Andrea De Gaetano, and Giovanni Gasbarrini (1 February 1999). "L-Carnitine Improves Glucose Disposal in Type 2 Diabetic Patients". Journal of the American College of Nutrition 18 (1): 77-82. PMID 10067662. http://www.jacn.org/cgi/content/full/18/1/77.
   
arw ^ Wei Huang, Sobia N. Shaikh, Malliga E. Ganapathy, Ullrich Hopfer, Frederick H. Leibach, A. Lee Carter and Vadivel Ganapathy (October 1999). "Carnitine transport and its inhibition by sulfonylureas in human kidney proximal tubular epithelial cells". Biochemical Pharmacology 58 (8): 1361-1370. doi:10.1016/S0006-2952(99)00219-1. PMID 10487540.
   
arw ^ Lenzi A, Lombardo F, Sgro P, Salacone P, Caponecchia L, Dondero F, Gandini L (2003). "Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial.". Fertility and Sterility (2003), Volume 79 , Issue 2 , Pages 292 - 300 79 (2): 292-300. PMID 12568837.
   
arw ^ Seo JT, Kim KT, Moon MH, Kim WT (April 2010). "The significance of microsurgical varicocelectomy in the treatment of subclinical varicocele". Fertil. Steril. 93 (6): 1907-10. doi:10.1016/j.fertnstert.2008.12.118. PMID 19249033.
   
arw ^ "University of Maryland Medical Centre, April 2002". http://www.umm.edu/altmed/articles/carnitine-l-000291.htm. Retrieved 2008-05-20.
   
arw ^ Mariano Malaguarnera, Lisa Cammalleri, Maria Pia Gargante, Marco Vacante, Valentina Colonna and Massimo Motta: "L-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial", American Journal of Clinical Nutrition, Volume 86, No. 6, 1738-1744, December 2007
   
arw ^ "Toxicity, Valproate: Treatment & Medication". http://emedicine.medscape.com/article/819315-treatment.
   
arw ^ Linus Pauling Institute at Oregon State University
   
arw ^ http://www.encyclopedia.com/doc/1G1-131086133.html
   
arw ^ "NHPD Monthly Communique, Vol. 1, Issue 1, September 2005". http://www.hc-sc.gc.ca/dhp-mps/prodnatur/bulletins/_communiques/communique_sep05-eng.php. Retrieved 2007-06-01.[dead link]