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Carnitine
Overview

Carnitine was first discovered over a hundred years ago, it wasn’t until the 70’s that we began to realize just how important this coenzyme is - it’s a crucial component in the production of your energy. Research suggests that 90 to 95% of our body’s energy is produced by the mitochondria (each cell in your body contains up to a thousand of them). These mitochondria produce energy through a process known as ATP - it transports energy within the cells. Without ATP, life would not be possible. Natural L carnitine is an important part of this process. Carnitine acts as a transporter; picking up the fatty acid “fuel” which flows through our blood’s plasma, and delivering it to the mitochondria (which can then turn it into energy). While short and medium chain fats can enter the mitochondrial membrane by themselves, the long-chain fatty acids need carnitine to transport it.

What is L-Carnitine?

What is L-Carnitine?
 

Systematic (IUPAC) name 3-hydroxy-4-(trimethylazaniumyl) butanoate
A derivative of the amino acid, lysine, healthy individuals manufacture enough of this substance which plays an important role in cellular activity, converting long chain fatty acids so the body can use them.

How is it Made?
In animals, carnitine is biosynthesized primarily in the liver and kidneys from the amino acids lysine (via trimethyllysine) or methionine. Vitamin C (ascorbic acid) is essential to the synthesis of carnitine. During growth or pregnancy, the requirement of carnitine might exceed its natural production.

Where is it Found?
Dietary sources of carnitine include foods of animal origin, such as meat and dairy products. Red meat (particularly lamb) and dairy products are the primary sources of carnitine. Carnitine can also be found in fish, poultry, tempeh (fermented soybeans), wheat, asparagus, avocados, and peanut butter. Cereals, fruits, and vegetables contain little or no carnitine. Carnitine can be manufactured in the body provided the requisite vitamins and minerals are also present. A typical Western diet supplies about 100mg of carnitine per day. It is found mostly in red meats and dairy products. Plant foods are not good sources of carnitine.

L carnitine deficiency symptoms
If you frequently experience fatigue, get tired easily, have low energy during physical activity, or have muscle aches, these may be signs of a deficiency. It has been said that L carnitine supplements can help replenish deficiency and support your health. L carnitine is often recommended to take carnitine supplements before 3 pm, so they wear off by the time you go to sleep.

 
 See L-Carnitine related video:
video icon What Is L-Carnitine?  (video module - 2.04 minutes)
video icon L-Carnitine and weight loss (video module - 9.23  minutes)
Product related PDF file
Carnitine-Plus
L-Carnitine For Treating Congestive Heartfailure
L-Carnitine-Factsheet
 

Benefits / Uses
Through research and clinical trials, there is a vast data which suggests L carnitine benefits our health in more ways than one. Some of the alleged benefits are:

Brain
The “acetyl” part of acetyl L carnitine benefits the brain through the formation of a neurotransmitter known as acetylcholine which is vital for the proper functioning of the brain and nervous system. In addition, L carnitine has antioxidant properties which may help neutralize free radical damage. There have even been studies which point to L carnitine possibly being beneficial for degenerative brain conditions like Alzheimer’s, but further research will be needed to interrogate further. For these reasons, L carnitine supplements have been nicknamed anti-aging “brain food” and have been highly recommended by many for supporting brain health.

Weight
Most of us obsess on what we consume (calories, fats, carbs, etc) but what we really should take into account our metabolism. A “good” metabolism is why some people seem to consume whatever they want without gaining a pound while others become overweight from merely eating an average amount. There have been studies which have demonstrated that the obese have lower levels of L carnitine. World-renowned nutritionist Robert Crayhon has claimed it’s the most important supplement for enhancing weight loss. Reportedly consuming healthy omega-3 fatty acids along with L carnitine benefits the metabolism by supporting energy production.

Heart
As mentioned, the heart is a muscle which reportedly gets up to 70% of its energy through metabolizing fatty acids, so it’s obvious why many claim L carnitine is so beneficial for it. But in addition, there are several other reasons why it might support the heart.
Studies including some placebo-controlled, double-blind clinical trials have shown vast evidence that suggests L carnitine may help angina, hardening of the arteries, heart failure, post-heart attack survival, and more.

Male infertility
Carnitine has also been used for male infertility. Low sperm count and abnormal motility have been linked to low carnitine levels in men. Several studies have shown that L-carnitine helped increase sperm counts and motility.
Other conditions L-carnitine supplementation may be of benefit include:



arw Down's syndrome


arw Alcohol-related Liver Disease


arw Kidney Disease and Hemodialysis
 
Several large clinical trials conducted in Italy have shown favorable effects in helping people recover more quickly from heart attacks. According to the well-renowned tome The Pill Book Guide to Natural Medicines written by Michael Murray N.D. who states:

"Subjects taking carnitine showed significant improvements in heart rate, blood pressure, angina attacks, rhythm disturbances, and clinical signs of impaired heart function compared to the subjects taking placebo."

Carnitine (L-propionylcarnitine) has been used in connection with intermittent claudication, a peripheral vascular disease of the legs. At least one well-designed study suggests that carnitine supplements, particularly proprinylcarnitine, may improve muscle function and exercise capacity in those with peripheral vascular disease (PVD).

Dosage
Carnitine is not an essential amino acid and, since it is not a vitamin or a mineral, no RDA or dietary reference intake (DRI) values have been established. The L-isomer of carnitine (L-carnitine) is the only physiologically useful form of carnitine. Recommended doses of l-carnitine supplements vary depending on the health condition being treated. The normal recommended dose appears to be 500 milligrams (MG) to 1,000 mg per day. Then gradually work up to 2 to 4 grams (2,000 to 4,000 mg) per day.

Possible Side-Effects / Precautions / Possible Interactions
Taking normal levels of L-carnitine does not cause any negative effect on your body. Generally, the prescribed dosage of L-carnitine is not more than 5 grams per day. The dosage needs to be strictly followed. Some discomfort was reported where higher levels L-carnitine were taken. Thus, the possibility of L-carnitine side-effects is rare but not nil. Following is a list of possible side-effects of L-carnitine:



arw Many people say that they feel energetic after taking L-carnitine. Taking it at night or late evening might cause difficulty in falling asleep.


arw Taking more than prescribed doses of L-carnitine often causes diarrhea along with a noticeable increase in appetite.


arw Many patients on long term prescription of L-carnitine complain of 'fishy' smell from their bodies. Some of them also develop skin problems like irritation, itching and skin rashes.


arw In case you are a patient of peripheral vascular disease, diabetes, hypertension, kidney disease and cirrhosis, you should inform your doctor about it if he is prescribing you L-carnitine, as it is believed to interact with the medications for the same.


arw .L-carnitine is not recommendable to a person who is on cancer medications like doxorubicin. This is because it tends to protect the heart cells from the toxic effects of doxorubicin, and thus reduces its effectiveness.


arw .Since L-carnitine takes part in the metabolic processes, some mild, uncomfortable experiences are quite natural. Many people feel nauseous and dizzy in the initial days of its intake. Usually, such L-carnitine side effects disappear as the body gets used to it.


arw Many people who are on regular dosage of L-carnitine suffer from frequent skin rash, vomiting, diarrhea and agitation.
 
Possible Interactions:


arw Acenocoumarol (Sintrom) interacts with L-CARNITINE


arw Acenocoumarol (Sintrom) is used to slow blood clotting. L-carnitine might increase the effectiveness of acenocoumarol (Sintrom). Increasing the effectiveness of acenocoumarol (Sintrom) might slow blood clotting too much. The dose of your acenocoumarol (Sintrom) might need to be changed.


arw Thyroid hormone interacts with L-CARNITINE


arw L-carnitine seems to decrease how well thyroid hormone works in the body. Taking L-carnitine with thyroid hormone might decrease the effectiveness of the thyroid hormone.


arw Warfarin (Coumadin) interacts with L-CARNITINE


arw Warfarin (Coumadin) is used to slow blood clotting. L-carnitine might increase the effects of warfarin (Coumadin) and increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
 
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.