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.
Linus Pauling Institute, Oregon State University.L-CARNITINE:Under certain conditions,
the demand for L-carnitine may exceed an individual's capacity to synthesize
it, making it a conditionally essential nutrient L-Carnitine is synthesized
primarily in the liver and also in the kidneys, and must be transported to other
tissues. It is most concentrated in tissues that use fatty acids as their primary
dietary fuel, such as skeletal and cardiac (heart) muscle. In this regard,
L-carnitine plays an important role in energy production by chaperoning
activated fatty acids (acyl-CoA) into the mitochondrial matrix for metabolism
and chaperoning intermediate compounds out of the mitochondrial matrix to prevent
their accumulation.In addition to providing L-carnitine, it provides acetyl
groups, which may be used in the formation of the neurotransmitter,
acetylcholine. In general L-carnitine appears to be well tolerated. Toxic effects
related to L-carnitine overdose have not been reported. Reviewed by: Tory
M. Hagen, Ph.D. Principal Investigator, Linus Pauling Institute - Assistant
Professor, Dept. of Biochemistry and Biophysics Oregon State University.
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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