TWICE AS NICE
Carnitine is gaining clout for its role in healthy hearts and minds.
Carnitine has earned its stripes as a helpful player in brain and heart health, with proven benefits for many of the symptoms tied to heart disease. So confident are nutritional experts, they are adding carnitine to the list of nutrients needed to keep the heart going strong.
It is also considered a potent addition to popular brain nutrients, such as CoQ10 and alpha-lipoic acid. Like its brethren, carnitine is involved with energy production in the cell. More specifically, it helps move fatty acids into the powerhouse of the cell, the mitochondria. From there, the fatty acids can be used in the energy production cycle.
Carnitine is made in the body from two amino acids, lysine and methionine, and is produced, in part, by vitamin C. Dietary sources include beef and pork, as well as small amounts found in chicken, fish and milk.
The major benefits of supplementation are those to the heart. Research has shown that carnitine benefits patients with heart failure and chest pain, and protects patients from further heart damage following a heart attack [1, 2, 3, 4]. In particular, data has pointed to benefits for patients with kidney failure and heart disease [5]. One small study has documented benefit to heart volumes by decreasing the rate of heart enlargement with a combination of CoQ10, carnitine, and a vitamin called taurine [8]. Carnitine supplementation is becoming much more common for patients with heart disease as nutritional cardiologists such as Dr. Stephen Sinatra, author of the The Sinatra Solution: New Hope for Preventing and Treating Heart Disease and L- Carnitine and the Heart, include carnitine in the vitamin team approach for heart disease.
Acetyl-L-carnitine has shown some benefit for overall brain function [9]. Additionally, research has shown that acetyl-L-carnitine aided in recovery after stroke in animals [10]. Similar to heart treatment programs, acetyl-L-carnitine is typically used in combination with other nutrients that target the brain such as alpha-lipoic acid, CoQ10 and vitamins E, B-12 and folate.
Carnitine is typically available in L-carnitine form, or acetyl-L-carnitine. L-carnitine is typically recognized for its contributions to a healthy heart. For patients with heart disease, the typical recommendation is 1,500-2,000 mg daily. Acetyl-L-carnitine is used for brain health. The dosage for this form is also 1,500–2,000 mg daily. Both are typically well tolerated, though acetyl-L-carnitine can, rarely, cause an upset stomach.
Medications that might decrease carnitine effectiveness, include valproic acid, used to treat seizures [6, 7]. Patients should discuss the interaction of these medications with their physician. Conversely, L-carnitine is thought to raise the risk for seizures in those with epilepsy, though this is rarely shown in clinical studies. Patients on dialysis, or others with specific genetics, can run the risk of carnitine deficiency. Signs include children with fatigue, heart problems or growth delay. Carnitine levels can be evaluated through blood work, and proper supplementation can be prescribed.
Research continues to look at carnitine’s potential benefits for the heart as well as the brain. Target groups for supplementation include those with heart disease, heart failure and angina (chest pain from heart disease). Vegetarians with a history of heart disease should strongly consider L-carnitine, as they may not have enough nutrients from their diet to maintain adequate levels. Those who want to improve brain function and health can consider acetyl-L-carnitine as part of their supplement regimen.
References:
1. Iliceto, S., Scrutinio, D., Bruzzi, P., et al. (1995). Effects of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: The L-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) Trial. J Am Coll Cardiol, 26:380-387.
2. Singh, R.B., Niaz, M.A., Agarwal, P., Beegum, R., Rastogi, S.S., Sachan, D.S. (1996). A randomized, double-blind, placebo-controlled trial of L-carnitine in suspected myocardial infarction. Postgrad Med J, 72:45-50.
3. Iyer, R.N., Khan, A.A., Gupta, A., Vajifdar, B.U., Lokhandwala, Y.Y. (2000). L-carnitine moderately improves the exercise tolerance in chronic stable angina. J Assoc Physicians India, 48:1050-1052.
4. Rizos, I. (2000). Three-year survival of patients with heart failure caused by dilated cardiomyopathy and L-carnitine administration. Am Heart J, 139:S120-S123.
5. Pauly, D.F. (2003). The role of carnitine in myocardial dysfunction. Am J Kidney Dis, 41(4 Suppl 4):S35-43.
6. Campistol, J., Chavez, B., Vilaseca, M.A., Artuch, R. (2000). Antiepileptic drugs and carnitine. Rev Neurol, (suppl 1):105–109.
7. Komatsu, M., Kodama, S. (1986). A study on valproate-induced hyperammonemia. Med J Kobe Univ, 47:235–242.
8. Jeejeebhoy, F., Keith, M., Freeman, M., et al. (2002). Nutritional supplementation with Myo Vive repletes essential cardiac myocyte nutrients and reduces left ventricular size in patients with left ventricular dysfunction. Am Heart J, 143:1092-100.
9. Hudson, S. (2003). Acetyl-L-carnitine for dementia. Cochrane Database Syst Rev, CD003158.
10. Lolic, M.M. (1997). Neuroprotective effects of acetyl-L-carnitine after stroke in rats. Ann Emerg Med, 29(6):758-65.
Other Trusted Sources:
National Institutes of Health Office of Dietary Supplements
University of Maryland Medical Center
