Carnitine

Science

Acetyl-L-carnitine supplies L-carnitine, which is important in the transport of long chain fatty acids across mitochondrial membranes. In addition, the acetyl moiety can be transferred to provide acetyl CoA. Therefore, acetyl-L-carnitine improves cerebral oxidative energy production and fatty acid oxidation in muscles. It has shown beneficial effects in models of traumatic brain and spinal cord injury, cerebral ischemia, stroke and patients with Alzheimer’s disease. In primary motor neuron cultures from rats, acetyl-L-carnitine was found to protect against kainate and NMDA-induced toxicity. In light of this, a randomized double blind placebo-controlled trial was performed in small number of patients with ALS to investigate the effects of add-on acetyl-L-carnitine to riluzole vs. riluzole only treatment. Patients tolerated the combination well and had a better score in the ALS Functional Rating Scale1

Mechanisms:2

  • Enhanced exercise performance
  • Reduced oxidative stress
  • Enhanced mitochondrial energy production
  • Protection against excitotoxicity
  • Neurotrophic effects
  • Increased heat shock proteins

Articles

2020 - ALS Untangled No. 53: Carnitine Supplements

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In conclusion, there are good theoretical mechanisms for carnitines, some pre-clinical evidence for LC and ALCAR, and a single clinical trial that suggested ALCAR could slow disease progression in PALS. All three carnitines appear to be well-tolerated, generally safe and inexpensive. We believe that there is a need for future clinical trials of carnitines in PALS to further elucidate their efficacy. Until there is further data, we cannot endorse any of these supplements as a definite way to slow ALS progression; however, oral ALCAR at 1000mg three times daily (3000mg total daily dose) appears to be a theoretically promising supplement available for PALS whom would like to self-experiment

2013 - Randomised double-blind placebo controlled trial of acetyl-L-carnitine

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Trial referenced in the ALS Untangle review

Suggested Dose

Acetyl-L-Carnitine: 1000mg three times daily (3000mg total daily dose)

Natural Sources

Animal-based foods are good sources of carnitine, including:3

  • Beef, 4 oz cooked - 56-162 mg
  • Chicken, 4 oz cooked - 3-5 mg
  • Milk, 1 cup whole - 8 mg
  • Cheese, 2 oz cheddar - 2 mg
  • Cheese, 2 oz cheddar - 2 mg

Supplements

Consumerlab acetyl-l-carnitine product review

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  1. excerpt from https://www.frontiersin.org/articles/10.3389/fnins.2016.00611/full#B59 ↩︎

  2. excerpt from https://www.tandfonline.com/doi/full/10.1080/21678421.2020.1726565 ↩︎

  3. excerpt from https://www.webmd.com/vitamins-and-supplements/acetyl-l-carnitine-uses-risks#1-3 ↩︎