L-carnitine

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

1. 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
2. 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