L- Carnitine

What is it and where does it come from?

L-carnitine is very similar to the nonessential amino acid carnitine. It performs some of the same functions, such as helping metabolize food into energy.*

L-carnitine is synthesized in the body from the amino acids lysine and methionine. L-Carnitine is available as a high quality supplement from Bodybuilding.com, as well as from natural and synthetic sources. It is also found in avocados, dairy products, and red meats (especially lamb and beef).

What does it do and what scientific studies
give evidence to support this?

L-carnitine transfers long-chain fatty acids, such as triglycerides into mitochondria a cell energy powerhouse, where they may be oxidized to produce energy. L-carnitine is a very popular supplement that promotes growth and development. It is also used for fat-burning, increasing energy, and improving resistance to muscle fatigue. L-carnitine also helps to build muscle.* It is also great in dieting, as it reduces feelings of hunger and weakness.

Studies have been conducted on L-carnitine since as early as 1937. Those studies yielded positive results suggesting that the body's cardiovascular system can greatly benefit from its intake. There are a variety of published studies that suggest L-carnitine is useful in increasing the heart's output and improving it's functioning, as well as stimulating the heart's energy supply and supporting cardiac performance.

Carnitine is a nutrient that helps the body turn fat into energy. It is produced by the body in the liver and kidneys and stored in the skeletal muscles, heart, brain, and sperm.

Usually, the body can make all the carnitine it needs. Some people, however, may be deficient in carnitine because their bodies cannot make enough carnitine or transport it into tissues so it can be used. Some other conditions, such as angina or intermittent claudication, can also cause insufficient carnitine in the body, as can some medications.

Carnitine has been proposed as a treatment for many conditions. Some of the conditions carnitine may help treat are serious, and in those cases the supplement should be taken under the supervision of your doctor, as an adjunct therapy to conventional medicine. For other conditions, such as fatigue or improving exercise performance, carnitine appears safe but seems to have little effect.

Heart Conditions

• Angina -- The best evidence for carnitine's use for heart disease is as an addition to conventional treatment for stable angina. Several clinical trials indicate that L-carnitine and propionyl-L-carnitine can help reduce symptoms of angina and improve the ability of those with angina to exercise without chest pain. You should not self-treat chest pain with carnitine, however; see your doctor for diagnosis and conventional treatment, and take carnitine only under your doctor's supervision.
• Heart attack -- There is little evidence for using carnitine after a heart attack due to a lack of well-designed studies. Some small studies suggest that people who take L-carnitine supplements soon after a heart attack may be less likely to suffer a subsequent heart attack, die of heart disease, experience chest pain and abnormal heart rhythms, or develop heart failure. However, other studies have found no benefit. Carnitine should be used along with conventional medication under your doctor's supervision.
• Heart Failure -- A few small studies have suggested that carnitine (usually propionyl-L-carnitine) can help reduce symptoms of heart failure and improve exercise capacity in people with heart failure. However, more and larger studies are needed to confirm any benefit.

Peripheral Vascular Disease

Decreased blood flow to the legs from atherosclerosis (plaque build up) often causes an aching or cramping pain in the legs while walking or exercising. This pain is called intermittent claudication, and the diminished blood flow to the legs is called peripheral vascular disease (PVD). A number of studies show that carnitine can help reduce symptoms and increase the distance that people with intermittent claudication can walk. Most studies have used propionyl-L-carnitine; it isn't known whether L-carnitine would have the same effect.

Diabetic Neuropathy

When high blood sugar levels damage nerves in the body, especially the arms, legs, and feet, the condition is called diabetic neuropathy. Some small preliminary studies suggest acetyl-L-carnitine may help reduce pain and increase normal feeling in affected nerves. It is also possible that carnitine can help nerves regenerate; however, more and better studies are needed to say for sure.

Exercise Performance

Although carnitine is often taken to improve exercise performance, there is no evidence it works.

Weight Loss

Although L-carnitine has been marketed as a weight loss supplement, there is no scientific evidence to show that it improves weight loss.

Alzheimer's Disease and Memory Impairment

The evidence is mixed as to whether carnitine is useful in treating Alzheimer's disease. Several early studies showed that acetyl-L- carnitine, might help delay the progression of Alzheimer's disease, relieve depression related to senility and other forms of dementia, and improve memory in the elderly. Unfortunately, larger and better-designed studies found no benefit. Taking carnitine for Alzheimer's and other forms of dementia should only be done under the supervision of your doctor.

Kidney Disease and Dialysis

Because the kidneys produce carnitine, kidney disease could lead to a deficiency of carnitine in the body. If you have kidney disease, your doctor may prescribe carnitine; however, do not take it without medical supervision.

Male Infertility

Low sperm counts have been linked to low carnitine levels in men. Several studies suggest that L-carnitine supplementation may increase sperm count and mobility.

Erectile Dysfunction

Preliminary studies suggest propionyl-L-carnitine may help improve male sexual function. One study found that carnitine significantly improved the effectiveness of sidenafil (Viagra) in men with diabetes who had not previously responded to Viagra. More studies are needed, however.

Chronic Fatigue Syndrome (CFS)

Some researchers speculate that chronic fatigue syndrome may be caused by deficiencies in a variety of nutrients, including carnitine. L-carnitine has been compared to a medication for fatigue in a study of 30 people with CFS. Those who took L-carnitine did much better than those who took the medication, particularly after receiving the supplement for 4 - 8 weeks. However, the study was not well-designed, and many of those who took the prescription medication dropped out of the study. More research is needed to determine whether carnitine has any true benefit for CFS.

Peyronie's Disease

Peyronie's disease is characterized by a curvature of the penis that leads to pain during an erection because of blocked blood flow. One promising study compared acetyl-L-carnitine to tamoxifen in 48 men with this condition. Acetyl-L-carnitine worked better than the medication at reducing pain during intercourse and minimizing the curve of the penis. Acetyl-L-carnitine also had fewer side effects than tamoxifen. Although the study results are encouraging, more research is needed.

Hyperthyroidism

Some research suggests that L-carnitine may prove useful for preventing or reducing symptoms of an overactive thyroid, such as insomnia, nervousness, elevated heart rate, and tremors. In fact, in one study, a small group of people with hyperthyroidism had improvement in these symptoms, as well as normalization of their body temperature, when taking carnitine. But a larger, well-designed clinical trial is needed before carnitine can be recommended for hyperthyroidism.

Dietary Sources:

Red meat (particularly lamb) and dairy products are the primary sources of carnitine. It can also be found in fish, poultry, tempeh, wheat, asparagus, avocados, and peanut butter.

Precautions:

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable health care provider.

Side effects are generally mild. High doses (5 or more grams per day) may cause diarrhea. Other rare side effects include increased appetite, body odor, and rash.

People with the following conditions should talk to their doctor before taking carnitine:

• Peripheral vascular disease
• Hypertension (high blood pressure)
• Alcohol-induced liver disease (cirrhosis)
• Diabetes
• Kidney disease

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