Generic Name: Levocarnitine Tartrate, Levocarnitine Fumarate
Brand Names: L-Carnitine, Volcarn 2000, Carnitor
Available Dosage Forms: Oral tablet, capsule, liquid, powder, and intravenous injection or infusion
What is L-Carnitine?
L-carnitine is a critical facilitator of phospholipid synthesis in the neuronal membrane. It elicits the following actions in the central nervous system:
-Modulates neurochemical mechanisms involved in the neurotransmission of various neurotransmitters
-Regulates brain energy processes
-Limits stress prompted lipid peroxidation in the brain
Insufficient levels of L-carnitine were frequently reported in depressed patients during clinical trials evaluating the possible role of L-Carnitine in major depression.1 Treatment-resistant depression in females and those with a history of childhood trauma had the lowest documented levels of L-Carnitine. Attempts have been made to inspect the role of the novel molecule as a possible biomarker in depression. Analysis of assorted studies has disclosed that L-carnitine ameliorates depression by acetylating histone proteins, enhancing neuronal plasticity, and upregulating the expression of brain neurotrophic factors.1 Carnitine is FDA authorized for use in primary carnitine deficiency.
Neuroprotective implications of L-carnitine include:
-Reduction of neuronal atrophy in hippocampus and amygdala
-Elimination of oxidative metabolites toxic to neurons
-Protection against hypoxic injury to neurons
-Promoting the function of peripheral nerves and upregulates conduction velocity
In one study, supplementation with 1000 mg/day of L-Carnitine took only two weeks to achieve remission in mood disturbances and neuropathic pain. Patients with chronic joint pathologies (such as osteoarthritis) also appeared to have lower levels of Carnitine.2 Co-administration of L-carnitine with therapeutic medications has abrogated depression in patients with fibromyalgia and mild encephalopathy. L-Carnitine has also exhibited promising anti-anxiety effects in zebrafish; however, its potential as an anxiolytic in humans needs to be evaluated further.
How to use L-Carnitine?
-L-Carnitine can be taken in the form of oral tablets or solutions. The recommended dosage for people with L-Carnitine deficiencies is 900 mg two to three times a day
-It can also be taken intravenously in divided doses of 50 mg/kg every 3 to 4 hours for 24 hours.
-Dosages in infants and children are initiated at 50 mg and gradually increased based on therapeutic sufficiency and tolerability
-Sugar-free oral solution can be administered alone or mixed in other beverages or liquid food.
-The total dosage is usually split and administered in 3-4 portions throughout the day
-Take the supplements during meals or immediately after them
What are the side effects of L-Carnitine?
-Nausea
-Vomiting
-Abdominal pain
-Diarrhea
-Headache
-Muscle pain
-Fishy body odor
Who should not use L-Carnitine?
Contraindications of Carnitine have not been established at present. However, it should be used cautiously and discussed with the health care provider in the following conditions:
-Pregnant and breastfeeding women
-Liver impairment
-Renal issues
-Seizures
References
- Nasca C, Bigio B, Lee FS, et al. Acetyl-l-carnitine deficiency in patients with major depressive disorder. Proc Natl Acad Sci U S A. 2018;115(34):8627-8632. doi:10.1073/pnas.1801609115
- Freo U, Brugnatelli V, Turco F, Zanette G. Analgesic and Antidepressant Effects of the Clinical Glutamate Modulators Acetyl-L-Carnitine and Ketamine. Front Neurosci. 2021;15:584649. Published 2021 May 11. doi:10.3389/fnins.2021.584649
