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Acetyl-l-Carnitine (Carnitine)
Research and Studies

• The Townsend Letter: Twenty-six boys (aged 6-13 years) with attention-deficit hyperactivity disorder (ADHD) were randomly assigned to receive, in double-blind fashion, one of two treatment protocols: placebo-carnitine-placebo or carnitine-placebo-carnitine. Each treatment period lasted eight weeks, for a total of 24 weeks. The dose of L-carnitine was 100 mg per kg of body weight per day, with a maximum of 4 g/day, taken in two divided doses after meals. Patients were considered treatment responders if there was either 1) a 30% decrease in the Child Behavior Checklist (CBCL; a parental rating scale) score, compared with baseline, or a normalization of this score, or 2) a 30% decrease in the number of "most severe" ratings on the Conners teacher (CT)-rating scale, compared with baseline. Among the 24 boys who completed at least two of the three treatment periods, the proportion of responders according to the CBCL rating scale was 54% in the L-carnitine group and 13% in the placebo group (p < 0.02). The proportion of responders according to the CT rating scale was 50% in the L-carnitine group and 17% in the placebo group (p < 0.05). L-Carnitine was generally well tolerated, although one patient experienced an unpleasant body odor. This side effect was thought to be due to the formation of trimethylamine. The authors had previously found that the development of this body odor could be prevented by treatment with riboflavin, but riboflavin was not used in the present study.
The results of this study indicate that supplementation with L-carnitine significantly decreases attention problems and aggressive behavior in boys with ADHD. Although the mechanism of action is not clear, low plasma carnitine concentrations have been found in some children with ADHD. Because this nutrient plays a key role in energy metabolism, correction of carnitine deficiency might enhance overall performance, thereby improving attention span and other aspects of behavior. Carnitine is also involved in blood-sugar regulation, which may be abnormal in some children with ADHD. A relatively large dose of L-carnitine was used in the present study. Additional research should focus on whether lower doses would be effective, when used as a component of a comprehensive dietary and nutritional-supplement regimen. Van Oudheusden LJ, Scholte HR. Efficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids 2002;67:33-38.

Importance of attentional factors in sport performance has been recognised by athletes and coaches, only in recent years have researchers begun to investigate the nature of attention-performance relationship (Roberts et al, 1999).
Carnitine is involved in fatty acid metabolism, and it has been claimed that carnitine supplementation can delay fatigue by stimulating greater use of fat as a fuel for exercise. These claims have not been supported by the best research studies (Brass, 2000).

The mind boosting effect of acetylcarnitine is often noticed within a few hours, or less. Most people report feeling mentally sharper, having more focus and being more alert. Acetyl-l-carnitine may be used as an overall mind booster. Carnitine, or L-carnitine, is a naturally occurring substance found in most cells of the body, particularly the brain and neural tissues, muscles, and heart. Acetyl-l-carnitine has significantly more noticeable effect on the mind than carnitine. In addition to producing energy, these two nutrients remove toxic accumulations of fatty acids from mitochondria, keeping these organelles healthy and functioning at their best. Energy production in the mitochondria is not a perfect process and toxic metabolites can often accumulate. Adequate acetyl-l-carnitine intake can help minimize this accumulation.Dr. Ray Sahelian

Acetyl-L-carnitine is a molecule found naturally throughout the body that helps to transport fats into the mitochondria, the tiny energy "factories" in all living cells. ALC is closely related to carnitine, a natural amino acid that is also available as a nutritional supplement (ALC is considered the more potent of the two); it is also related to choline, in both chemical structure and clinical effects. ALC enhance cognition and stimulate creativity--it is thought to improve communication between the right and left hemispheres of the brain, thereby promoting intuitive and balanced thinking. Though the action of ALC in the brain is not yet fully understood, some researchers believe it works by helping to facilitate the activity of important neurotransmitters such as acetylcholine and dopamine in the brain.
Clinical studies with ALC have shown it to be effective in restoring memory and cognitive ability in patients with Alzheimer's disease, and a few recent studies even suggest that ALC may produce a similar effect in healthy adults. In a placebo-controlled clinical study on 279 patients suffering from mild to moderate cognitive decline, those taking ALC significantly improved their scores on cognitive function tests, while those taking the placebo showed no improvement. In a 1992 study in Italy on a group of 8 males and 9 females, ages 22 to 27, ALC was shown to improve reflex speed and increase accuracy in playing a video game.

ALC is found in various concentrations in the brain and its levels are significantly reduced with aging. In numerous animal studies ALC has been shown to have the remarkable ability of improving not only cognitive changes, but also morphological (structural) and neurochemical changes. ALC has varied effects on cholinergic activity.F. Maccari, A. Arseni, P. Chiodi, et al, Exp Geront 1990; 25: 127-134.

ALC also significantly reduces damaged fats, such as lipofuscin, in the brains of aged rats. In addition to accumulating in the aging brain, lipofuscin also accumulates in the skin as 'aging spots,' those brownish pigmented blemishes that accumulate in the backs of hands of many people over fifty. The reduction of these deposits following consumption of ALC may be evidence of a slowing in the aging process in the brain.Ramacci MT, De Rossi M, Lucreziotti MR, Mione MC, Amenta F. Effect of long-term treatment with acetyl-L-carnitine on structural changes of aging rat brain. Drugs Exp Clin Res 1988;14(9):593-601.)

ALC also has the ability to cross into the brain where it acts as a powerful antioxidant, preventing the deterioration of brain cells that normally occurs with age. Because of this protective effect, ALC may be beneficial in the prevention and treatment of free-radical mediated diseases, such as Alzheimer's and Parkinson's disease. Puca FM, Genco S, Specchio LM, et al. Clinical pharmacodynamics of acetyl-L-carnitine in patients with Parkinson's disease. Int J Clin Pharmacol Res 1990;10(1-2):139-43.)

Restoring Nerve Growth Factor Function: One of the most exciting areas of brain research has been the functions of Nerve Growth Factor (NGF). NGF mediates many of its effects through a receptor system (NGF receptor system). Unfortunately, aging is associated with a significant drop in the number of NGF receptors in certain brain regions, as well as a decrease in the amount of NGF produced. Because NGF is important for the growth and continued maintenance of neurons, the age-related decline in NGF function is thought to be directly involved in brain aging. ALC has the ability to partially reverse both of these changes, and has even been shown to positively effect both neuronal survival and growth. ALC's ability to enhance NGF effects suggests a tremendous potential for this natural compound in many diseases and conditions affecting the brain and nervous system. G. Taglialetela, L. Angelucci, M.T. Ramacci, et al, Brain Res Dev Brain Res 1991; 59: 221-230

• Deficiencies of acetyl-L-carnitine has also been linked to cognitive impairment. Administering it for a period of three months, Passeri and associates at the University of Parma, Italy, found improvements in dementia and memory, as well as in attention and verbal skills. When given to Alzheimer's patients, Pettegrew and colleagues at the University of Pittsburgh School of Medicine found that acetyl-L-carnitine exerted a protective action, stabilizing test scores from mental assessments.

A 1987 Italian study published in Drugs Under Experimental and Clinical Research reported on the administration of carnitine to low-spirited mature subjects for a period of two months. The participants were given either carnitine or placebo. The experimental results revealed that the benefits of carnitine were “statistically significant.” An elevation in mood was observed in those given carnitine, and researchers found that the effects were the most profound in those subjects most challenged by “the blues” (Tempesta 1987).

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