L-carnitine is a nutrient that the body needs in order to keep it functioning properly.

In recent years, this amino acid has been promoted as an effective weight loss aid because of its ability to turn fat into energy and lower our levels of insulin – which can make you feel more comfortable about continuing with your fitness routine.

We’ll discuss what Acetyl L Carnitines (ALC) do for us here alongside why they’re important when looking at brain health over time; but first, let’s take care of the basics.

Where To Buy ALCAR

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What Is L-Carnitine

We can refer to carnitine as the umbrella term that includes other amino acid forms that include L-carnitine, acetyl-L-carnitine, and propionyl-L-carnitine.

L-carnitine comes from red meat and dairy, and if a person eats enough of these food items, the body can make enough L-carnitine it needs to.

The kidneys, liver, and brain are the main organs where carnitine is synthesized from a balanced diet that includes animal protein, especially red meat, and dairy products like milk and cheese.

Trace amounts can also be found in some non-animal foods like whole-wheat bread and asparagus¹Gustavo C. Ferreira and Mary C. McKennaL-Carnitine and acetyl-L-carnitine roles and neuroprotection in developing brain Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201; Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD 21201. 2017

Who Needs ALCAR?

Since carnitine is mostly found in animal foods, it should be supplemented by vegetarians and vegans to reach the recommended daily allowance.²Institute of Medicine; Food and Nutrition Board; Panel on Macronutrients; Panel on the Definition of Dietary Fiber; Subcommittee on Upper Reference Levels of Nutrients; Subcommittee on Interpretation and Uses of Dietary Reference Intakes; Standing Committee on the Scientific Evaluation of Dietary Reference IntakesDietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids Institute of Medicine. 2005.³ U.S. Department of Health and Human Services and U.S. Department of AgricultureDietary Guidelines for Americans, Eighth Edition, 2015-2020, Appendix 7. Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes and Dietary Guidelines RecommendationsU.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. 2015.

Premature infants, the elderly, persons with diabetes, and genetic conditions also need to supplement the body with adequate L-carnitine levels for the proper development and functioning of the brain.⁴Gustavo C. Ferreira and Mary C. McKennaL-Carnitine and acetyl-L-carnitine roles and neuroprotection in developing brain Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201; Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD 21201. 2017

It has also been found that the administration of ALCAR can improve memory, which explains its potential as a means to improve the brain performance of persons with Alzheimer’s Disease.⁵Carlo Ori, Ulderico Freo, Gilberto Pizzolato, Mauro Dam Effects of acetyl-l-carnitine on regional cerebral glucose metabolism in awake rats Department of Anesthesiology, University of Padova, Padova, Italy; Department of Neurology, University of Padova, Padova, Italy. 2002

Difference Between ALCAR, L-Carnitine, and Free Carnitine

The main difference between Acetyl-L-carnitine and L-carnitine is an acetyl unit that increases the central nervous system (brain and spinal cord).

Acetyl L-Carnitine (ALCAR) is an endogenous short-chain acetyl ester of free carnitine that crosses the blood-brain barrier⁶J W Pettegrew, J Levine & R J McClure Acetyl-L-carnitine physical-chemical, metabolic, and therapeutic properties: relevance for its mode of action in Alzheimer’s disease and geriatric depression Department of Psychiatry, Neurophysics Laboratory, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Beersheva Mental Health Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheva, Israel. 2000 resulting in the improvement of major depressive disorders and Alzheimer’s Disease.⁷J W Pettegrew, J Levine & R J McClure Acetyl-L-carnitine physical-chemical, metabolic, and therapeutic properties: relevance for its mode of action in Alzheimer’s disease and geriatric depression Department of Psychiatry, Neurophysics Laboratory, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Beersheva Mental Health Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheva, Israel. 2000

ALCAR is believed to have a positive effect on cerebral energy metabolism. One study showed that it regulates glucose metabolism and stimulates glycogen production in rats.⁸Susanna Scafidi, Gary Fiskum, Steven L. Lindauer, Penelope Bamford, Da Shi, Irene Hopkins, and Mary C. McKennaMetabolism of acetyl-L-carnitine for energy and neurotransmitter synthesis in the immature rat brain Department of Pediatrics, University of Maryland, Baltimore, MD 21201, USA; Department of Anesthesiology, University of Maryland, Baltimore, MD 21201, USA; Center for Shock Trauma and Anesthesiology Research, University of Maryland, Baltimore, MD 21201, USA; Corresponding Author: Mary C. McKenna, Ph.D., Department of Pediatrics, University of Maryland School of Medicine, 655 W. Baltimore St., R 13-019, Baltimore, MD 21201, Phone: (410) 706-1990, Fax: (410) 706-0020. 2010

However, carnitine and ALCAR work together to improve the motility of spermatozoa in boars and man.⁹Jeulin C, Soufir JC, Marson J, Paquignon M, Dacheux JL Acetylcarnitine and spermatozoa: relationship with epididymal maturation and motility in the boar and man. Reproduction, Nutrition, Developpement. 1988

By increasing the energy efficiency of the sperm, it can maintain its motility, resulting in better reproductive capacity,¹⁰Steven P.Brinsko, Terry L.Blanchard, Dickson D.Varner, JamesSchumacher, Charles C.Love, KatrinHinrichs, David L.HartmanExamination of the Stallion for Breeding Soundness College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas; Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee; Hartman Equine Reproduction Center, Whitesboro, Texas. 2011 though this observation may not be true to all species.

L-Carnitine For Depression

Acetyl L-Carnitine has been shown to promote rapid antidepressant responses in rodent models.¹¹Nadia M Tsankova, Olivier Berton, William Renthal, Arvind Kumar, Rachel L Neve, Eric J NestlerSustained hippocampal chromatin regulation in a mouse model of depression and antidepressant action. Nature neuroscience. 2006

Evidence points to those suffering from MDD (major depressive disorder) are significantly deficient in ALCAR compared to healthy controls.¹²Carla Nasca, Benedetta Bigio, Francis S. Lee, Sarah P. Young, Marin M. Kautz, Ashly Albright, James Beasley, David S. Millington, Aleksander A. Mathé, James H. Kocsis, James W. Murrough, Bruce S. McEwen, and Natalie RasgonAcetyl-l-carnitine deficiency in patients with major depressive disorder Proceedings of the National Academy of Sciences of the United States of America. 2018

It was also found out that the low level of L-carnitine in the blood is strongly linked with depression. In the same study, the administration of L-carnitine has improved the symptoms of depression in just a few days.¹³Natalie RasgonStudy links depression to low blood levels of acetyl-L-carnitine Stanford Neurosciences Institute. 2018

LAC exerts rapid antidepressant actions by acetylating histones to regulate key genes’ expression important for synaptic plasticity, including BDNF,¹⁴T. Lau, B. Bigio, D. Zelli, BS. McEwen, and C. NascaStress-induced structural plasticity of medial amygdala stellate neurons and rapid prevention by a candidate antidepressant Laboratory of Neuroendocrinology, The Rockefeller University, New York; 10065, USA.; The Rockefeller University, Center for Clinical & Translational Science, New York, USA. 2017 while also regulating the release of glutamate.¹⁵Carla Nasca, Dionysios Xenos, Ylenia Barone, Alessandra Caruso, Sergio Scaccianoce, Francesco Matrisciano, Giuseppe Battaglia, Aleksander A. Mathé, Anna Pittaluga, Luana Lionetto, Maurizio Simmaco, and Ferdinando NicolettiL-acetylcarnitine causes rapid antidepressant effects through the epigenetic induction of mGlu2 receptors Proceedings of the National Academy of Sciences of the United States. 2013

In many studies on animals, LAC supplementation has shown improvement in glutamatergic neurons’ function and the associated decrease in the neurons’ size in the hippocampus and medial amygdala.¹⁶Sheng-Min Wang, Changsu Han, Soo-Jung Lee, Ashwin A Patkar, Prakash S Masand, Chi-Un Pae. A review of current evidence for acetyl-l-carnitine in the treatment of depression Journal of Psychiatric Research. 2014

Cases of MDD tied to early childhood trauma also show ALCAR deficiency, especially in women.¹⁷Myriam Garcia, Itziar Montalvo, Marta Creus, Ángel Cabezas, Montse Solé, Maria José Algora, Irene Moreno, Alfonso Gutiérrez-Zotes, Javier LabadSex differences in the effect of childhood trauma on the clinical expression of early psychosis Comprehensive Psychiatry. 2016

Childhood trauma can be evaluated through the Childhood Trauma Questionnaire.

ALCAR and Anxiety

L-Carnitine has demonstrated anxiolytic effects in animal studies.

However, the effect seems to mimic a U-shaped curve, meaning moderate doses showed significantly lower anxiety, and a high dose led to more anxiety.¹⁸Joseph Levine, Zeev Kaplan, Jay W Pettegrew, Richard J McClure, Samuel Gershon, Igor Buriakovsky, Hagit CohenEffect of intraperitoneal acetyl-L-carnitine (ALCAR) on anxiety-like behaviors in rats The International Journal of Neuropharmacology. 2004

There is a lot of evidence that demonstrates L-carnitine can lower anxiety by lowering oxidative stress and inflammation.¹⁹Majid S. Koozehchian, Amin Daneshfar, Ebrahim Fallah, Hamid Agha-Alinejad, Mohammad Samadi, Mojtaba Kaviani, Maryam Kaveh B, Y. Peter Jung, Mozhgan Hassanzadeh Sablouei, Najmeh Moradi, Conrad P. Earnest, T. Jeff Chandler, and Richard B. KreiderEffects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power, and exercise-induced oxidative stress in resistance-trained males Department of Kinesiology, Jacksonville State University, Alabama, USA; School of Health Science, University of Canterbury, Christchurch, New Zealand; Kinesiology, Tarbiat Modares University, Tehran, Iran; Exercise Physiology Research Center, Baqiyatallah University of Medical Science, Tehran, Iran; School of Nutrition and Dietetics, Acadia University, Wolfville, Canada; Department of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran; Department of Pharmacy Practice, Karnataka College of Pharmacy, Bangalore, India; Exercise & Sport Nutrition Lab, Texas A&M University, Texas, USA; Department of Kinesiology, Azad University, Tehran, Iran; Kinesiology, Azad University, Isfahan, Iran. 2018²⁰Chieh-Hsin Lee and Fabrizio GiulianiThe Role of Inflammation in Depression and Fatigue Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada; Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada. 2019

Typically anxiety and depression come together, so it’s reasonable to think that if ALCAR lowers depression, it should do the same with anxiety.²¹Shixun Wang, Jingtao Xu, Jiahui Zheng, Xincai Zhang, Jingbo Shao, Luyan Zhao, and Junqiang HaoAnti-Inflammatory and Antioxidant Effects of Acetyl-L-Carnitine on Atherosclerotic Rats Second Department of Cardiology, Weifang People’s Hospital, Weifang, Shandong, P.R. China. 2020

ALCAR and Memory

ALCAR can help memory and learning capabilities through its ability to boost acetylcholine synthesis.²²Helen L. White, Philip W. Scates Acetyl-L-carnitine as a precursor of acetylcholine Neurochemical Research. 1990

In a study conducted on aging rats, ALCAR improved their learning capacity, suggesting the strong link between long-term administration of ALCAR and improved cognitive function.²³S. Ando, T. Tadenuma, Y. Tanaka, F. Fukui, S. Kobayashi, Y. Ohashi, T. Kawabata Enhancement of learning capacity and cholinergic synaptic function by carnitine in aging rats Journal of Neuroscience Research. 2001

When the brain’s cholinergic pathways located in the thalamus and the hippocampus are impaired or have degenerated due to aging or trauma, the memory and the cognitive processes are affected.²⁴Sara V. Maurer and Christina L. Williams The Cholinergic System Modulates Memory and Hippocampal Plasticity via Its Interactions with Non-Neuronal Cells Frontiers in Immunology. 2017

The damage also results in the inflammation of the neurons, which is linked to Alzheimer’s disease. Attention span and learning capabilities are also affected.²⁵Sara V. Maurer and Christina L. WilliamsThe Cholinergic System Modulates Memory and Hippocampal Plasticity via Its Interactions with Non-Neuronal Cells Frontiers in Immunology. 2017

Essentially, if the cholinergic pathways are healthy in part due to the antioxidative protection from a steady administration of ALCAR, the brain’s learning and memory performance significantly increase.²⁶Fumihiko Yasui, Seiichi Matsugo, Masaru Ishibashi, Takahiro Kajita, Yoshiharu Ezashi, Yutaka Oomura, Shosuke Kojod, Kazuo SasakiEffects of chronic acetyl-L-carnitine treatment on brain lipid hydroperoxide level and passive avoidance learning in senescence-accelerated mice Department of Applied Chemistry and Biotechnology, Faculty of Engineering, Yamanashi University, Yamanashi 400-8511, Japan; Division of Bio-Information Engineering, Faculty of Engineering, Toyama University, 3190 Gofuku Toyama 930-8555, Japan; Department of Physiology, Faculty of Medicine, Kyushu University, Fukuoka 812-8582, Japan; Department of Food Science and Nutrition, Nara Women’s University, Nara 630-8506, Japan. 2002

Another important factor in enhancing memory and cognitive learning that is strongly linked to ALCAR is dopamine. We know dopamine as a stress hormone, but it actually serves as a neurotransmitter and is associated with learning, long-term memory formation, and working memory.²⁷J K Seamans, S B Floresco, A G PhillipsD1 receptor modulation of hippocampal-prefrontal cortical circuits integrating spatial memory with executive functions in the rat The Journal of Neuroscience. 1998

Studies conducted in senescent rats showed improved levels of dopamine in the cortex and hippocampus after carnitine administration.²⁸JPackiasamy A. R. Juliet, Deepak Balasubramaniam, Naveen Balasubramaniam, and Chinnakannu Panneerselvam Carnitine: A Neuromodulator in Aged Rats Journal of Gerontology: Biological Sciences. 2003

ALCAR and ADHD

The overall benefits of ALCAR for ADHD are largely mixed.

Results from clinical studies are not conclusive because much of the research was done with L-carnitine paired with ADHD drugs.

Without looking at ALCAR in isolation, it is hard to determine it’s effectiveness for ADHD.

However, some studies show the benefits of improved ADHD symptoms with ALCAR supplementation.

Children with ADHD given ALCAR and methylphenidate showed improvement in their social skills and reported less frequent headaches and irritability as a side effect of medication.²⁹Seyed-Hesameddin Abbasi, Shahram Heidari, Mohammad-Reza Mohammadi, Mina Tabrizi, Ali Ghaleiha, Shahin AkhondzadehAcetyl-L-carnitine as an adjunctive therapy in the treatment of attention-deficit/hyperactivity disorder in children and adolescents: a placebo-controlled trial Child Psychology and Human Development. 2011

In another study of children with Fragile X syndrome, administration of methylphenidate and LAC (20-50 mg/kg/day) resulted in better social interaction and more attention to their activities than children given the placebo.

Attention deficit hyperactivity disorder (ADHD) is one of the manifestations of a child with Fragile X syndrome.³⁰M Giulia Torrioli, Silvia Vernacotola, Laura Peruzzi, Elisabetta Tabolacci, Montserrat Mila, Roberto Militerni, Sebastiano Musumeci, Feliciano J Ramos, Marìa Frontera, Giovanni Sorge, Elisabetta Marzullo, Giusi Romeo, Louis Vallee, Edvige Veneselli, Elena Cocchi, Eleonora Garbarino, Umberto Moscato, Pietro Chiurazzi, Stefania D’Iddio, Menotti Calvani, Giovanni NeriA double-blind, parallel, multicenter comparison of L-acetylcarnitine with placebo on the attention deficit hyperactivity disorder in fragile X syndrome boys American Journal of Modern Genetics. 2008

One systematic review shows ALCAR positively affects the inattentive type of ADHD over behavioral issues tied to ADHD.³¹Kirstie DominiqueIs Acetyl-L-Carnitine Effective and Safe in Treating Children with ADHD? Philadelphia College of Osteopathic Medicine. 2019

There is also evidence of carnitine’s ability to reduce headaches, irritability, and improve the inattention and social skills commonly experienced by children with ADHD.³²Kirstie DominiqueIs Acetyl-L-Carnitine Effective and Safe in Treating Children with ADHD? Philadelphia College of Osteopathic Medicine. 2019

While it cannot be considered a primary treatment for ADHD, acetyl L-Carnitine can be effective as part of a more comprehensive plan.

ALCAR is Neuroprotective

L-Carnitine has demonstrated an ability to be neuroprotective and neuroregenerative by preventing decay and accelerating neurons’ ability to regenerate both in vitro and in vivo studies.³³A Manfridi, G L Forloni, E Arrigoni-Martelli, M ManciaCulture of dorsal root ganglion neurons from aged rats: effects of acetyl-L-carnitine and NGF International Journal of Developmental Neuroscience. 1992

One example of hyperammonemia is characterized by seizures caused by overly high ammonia levels in the bloodstream that may be primary or secondary.³⁴Cecilia Maldonado, Natalia Guevara, Alicia Silveira, Pietro Fagiolino, Marta VázquezL-Carnitine supplementation to reverse hyperammonemia in a patient undergoing chronic valproic acid treatment: A case report The Journal of International Medical Research. 2017

Patients with epilepsy, severe migraine headaches, and mood conditions due to hyperammonemia may be prescribed valproic acid to manage these conditions. However, the side effects may also be life-threatening after long-term use.

Carnitine supplementation was shown to potentially reverse hyperammonemia.³⁵Cecilia Maldonado, Natalia Guevara, Alicia Silveira, Pietro Fagiolino, Marta VázquezL-Carnitine supplementation to reverse hyperammonemia in a patient undergoing chronic valproic acid treatment: A case report The Journal of International Medical Research. 2017

Interest in further research on L-carnitine’s therapeutic potential and acetyl-L-carnitine (ALCAR) for neuroprotection was sparked in the last decade after finding out that the positive effects of ALCAR in treating chronic degenerative diseases.³⁶Lauren L Jones, David A McDonald, Peggy R BorumAcylcarnitines: role in brain Progress in Lipid Research. 2009

While there are no lipids in the brain itself, the improved metabolism of lipids in the other parts of the body feeds the brain, and adequate L-carnitine and ALCAR levels result in improved cerebral bioenergetics and cholinergic neurotransmission. This shows the importance of L-carnitine and ALCAR in proper brain function and protection.³⁷Masato Inazu 1, Teruhiko MatsumiyaPhysiological functions of carnitine and carnitine transporters in the central nervous system Japanese Journal of Psychopharmacology. 2008

Brain Injuries

ALCAR was also found to specifically protect cells from death and damage during hypoxic-ischemic encephalopathy, oxygen deprivation, and other brain injuries.³⁸Thomas F. Rau, Qing Lu, Shruti Sharma, Xutong Sun, Gregory Leary, Matthew L. Beckman, Yali Hou, Mark S. Wainwright, Michael Kavanaugh, David J. Poulsen, and Stephen M. Black, Valentin Ceña, EditorOxygen Glucose Deprivation in Rat Hippocampal Slice Cultures Results in Alterations in Carnitine Homeostasis and Mitochondrial Dysfunction Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, Montana, United States of America; Vascular Biology Center, Medical College of Georgia, Augusta, Georgia, United States of America; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Children’s Memorial Hospital, 2300 Children’s Plaza, Chicago, Illinois, United States of America, Universidad de Castilla-La Mancha, Spain. 2012

Not only that, but it also promotes neurogenesis (formation of new neurons) in the adult brain by balancing cell survival and cell death in patients with Parkinson’s Disease.³⁹Sonu Singh, Akanksha Mishra, Sandeep Kumar Mishra, Shubha ShuklaALCAR promote adult hippocampal neurogenesis by regulating cell-survival and cell death-related signals in rat model of Parkinson’s disease like-phenotypes Neurochemistry International. 2017

Anti-Inflammatory

ALCAR has anti-inflammatory properties as it lowers oxidative stress markers in both brain tissue and cerebrospinal fluid resulting in delayed cell death.⁴⁰Santina A Zanelli 1, Nina J Solenski, Robert E Rosenthal, Gary FiskumMechanisms of ischemic neuroprotection by acetyl-L-carnitine Annals of the New York Academy of Sciences. 2005

There is compelling evidence that the administration of ALCAR after injury in the developing brain can attenuate injury and improve long-term functional outcomes.⁴¹Gustavo C. Ferreira and Mary C. McKennaL-Carnitine and acetyl-L-carnitine roles and neuroprotection in developing brain Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201; Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD 21201. 2017

This is achieved by improving the brain’s energy status, decreasing the oxidative stress, and preventing cell death from brain injury.⁴²Gustavo C. Ferreira and Mary C. McKennaL-Carnitine and acetyl-L-carnitine roles and neuroprotection in developing brain Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201; Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD 21201. 2017

Also, L-carnitine significantly reverses NMDA antagonists’ negative results that cause both acute and delayed cell death. NMDA antagonists are used as anesthetics in animals and are often used as a hallucinatory recreational drug.

Alzheimer’s and Multiple Sclerosis

ALCAR supplementation shows promise in treating Alzheimer’s and Multiple Sclerosis.⁴³Gustavo C Ferreira, Mary C McKennaL-Carnitine and Acetyl-L-carnitine Roles and Neuroprotection in Developing Brain Neurochemical Research. 2017

In multiple sclerosis, ALCAR used with dexamethasone as a treatment was found to improve cell lifespan as signaled by the change in the indicator numbers and the improvement of immunosuppressive effect as exhibited by the decrease in CD4+ T cells.⁴⁴Amr Zidan, Sabeha E.Hedya, Dina M. Elfeky, Amany A. AbdinThe possible anti-apoptotic and antioxidant effects of acetyl l-carnitine as add-on therapy on a relapsing-remitting model of experimental autoimmune encephalomyelitis in rats Department of pharmacology, Faculty of Medicine, Tanta University, Egypt. 2018

ALCAR treatment has shown decreased inflammatory markers such as Reactive Oxygen Species, peroxide hydroxyl radical, superoxide radical, iNOS expression, nitrite content, and lipid peroxidation and increased the glutathione content in the hippocampus and PFC regions.

ALCAR demonstrates the ability to enhance nerve growth factors that improve overall cognitive function and ameliorate age-related cognitive decline.⁴⁵Sonu Singh 1, Akanksha Mishra, Neha Srivastava, Rakesh Shukla, Shubha ShuklaAcetyl-L-Carnitine via Upregulating Dopamine D1 Receptor and Attenuating Microglial Activation Prevents Neuronal Loss and Improves Memory Functions in Parkinsonian Rats Molecular Neurobiology. 2018⁴⁶L Angelucci, M T Ramacci, G Taglialatela, C Hulsebosch, B Morgan, K Werrbach-Perez, R Perez-PoloNerve growth factor binding in aged rat central nervous system: effect of acetyl-L-carnitine Journal of Neuroscience Research. 1988

ALCAR is also helpful in slowing the age-related degradation of mice’s central nervous system by improving the rats’ cognitive performance.

With age, the carnitine concentration in the brain decreases, resulting in the degradation of memory capacity, but this can be mitigated with carnitine administration in the diet.⁴⁷M Castorina, L FerrarisAcetyl-L-carnitine affects aged brain receptorial system in rodents Life Sciences. 1994

Alzheimer’s Patients diagnosed with Alzheimer’s Disease who were unresponsive to acetylcholinesterase inhibitors were given oral ALCAR (2g/daily for three months) along with donepezil or rivastigmine showed positive results.

Though the study was not conclusive, it does show promise that ALCAR can improve the cognitive processes, functional status, and behavior of persons with mild AD.⁴⁸A Bianchetti, R Rozzini, M TrabucchiEffects of acetyl-L-carnitine in Alzheimer’s disease patients unresponsive to acetylcholinesterase inhibitors Current Medical Research and Opinion. 2003

L-Carnitine and Insulin Resistance

L-Carnitine helps lower insulin resistance, which has been tied to depression.⁴⁹Benedetta Bigio, Aleksander A Mathé, Vasco C Sousa, Danielle Zelli, Per Svenningsson, Bruce S McEwen, Carla Nasca Epigenetics and energetics in ventral hippocampus mediate rapid antidepressant action: Implications for treatment resistance Proceedings of the National Academy of Sciences of the United States of America. 2016

A study shows that the brain synapses’ ability to adapt to their activity can be the root of depression.

Known as synaptic plasticity, it is regulated by insulin actions in the brain.

Suppose the brain response is too rigid, and it suddenly goes through a stressful situation. In that case, the brain insulin resistance can affect the brain’s reward system, resulting in depressive symptoms.⁵⁰Natalia de M. Lyra e Silva, Minh P. Lam, Claudio N. Soares, Douglas P. Munoz, Roumen Milev, and Fernanda G. De FeliceInsulin Resistance as a Shared Pathogenic Mechanism Between Depression and Type 2 Diabetes Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada; Department of Psychiatry, Queen’s University, Kingston, ON, Canada; Institute of Medical Biochemistry Leopoldo De Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 2019

LAC controls glutamate toxicity, which rapidly reduces depression.

It is also seen as a potential treatment for insulin resistance in people diagnosed with depression.⁵¹Benedetta Bigio, Aleksander A Mathé, Vasco C Sousa, Danielle Zelli, Per Svenningsson, Bruce S McEwen, Carla Nasca Epigenetics and energetics in ventral hippocampus mediate rapid antidepressant action: Implications for treatment resistance Proceedings of the National Academy of Sciences of the United States of America. 2016

It has been found that oral L-carnitine supplementation has varied effects on healthy and diabetic patients.

Still, there is also evidence that L-carnitine supplementation on glucose metabolism can positively affect parameters for lipid and oxidative stress.⁵²Judit Bene, Kinga Hadzsiev & Bela Melegh Role of carnitine and its derivatives in the development and management of type 2 diabetes Nutrition and Diabetes. 2018

L-Carnitine For Aging and Resilience

In humans, while frailty is associated with aging, there is also a strong indication that carnitine levels in the body can cause weakness.⁵³Nicholas J. W. Rattray, Drupad K. Trivedi, Yun Xu, Tarani Chandola, Caroline H. Johnson, Alan D. Marshall, Krisztina Mekli, Zahra Rattray, Gindo Tampubolon, Bram Vanhoutte, Iain R. White, Frederick C. W. Wu, Neil Pendleton, James Nazroo & Royston GoodacreMetabolic dysregulation in vitamin E and carnitine shuttle energy mechanisms associate with human frailty Nature Communications. 2019

This state includes the body’s weakness, a decline of cognitive function, high risk of falls and fractures, impairment of vision and hearing, and even increased depression levels, not to mention chronic diseases that come with age.⁵⁴Nicholas J. W. Rattray, Drupad K. Trivedi, Yun Xu, Tarani Chandola, Caroline H. Johnson, Alan D. Marshall, Krisztina Mekli, Zahra Rattray, Gindo Tampubolon, Bram Vanhoutte, Iain R. White, Frederick C. W. Wu, Neil Pendleton, James Nazroo & Royston GoodacreMetabolic dysregulation in vitamin E and carnitine shuttle energy mechanisms associate with human frailty Nature Communications. 2019

This is achieved by maintaining a healthy level of ALCAR in the body, which serves as a precursor for acetylcholine, increasing cholinergic transmission.⁵⁵Gustavo C. Ferreira and Mary C. McKennaL-Carnitine and acetyl-L-carnitine roles and neuroprotection in developing brain Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201; Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD 21201 2017

L-Carnitine and Alcoholism

L-carnitine has exhibited positive effects of neurodegeneration after prolonged alcohol intake.

Based on this observation, L-carnitine has a potential to help an alcoholic having withdrawal symptoms.⁵⁶P M Abdul Muneer, Saleena Alikunju, Adam M Szlachetka, James Haorah Inhibitory effects of alcohol on glucose transport across the blood-brain barrier leads to neurodegeneration: preventive role of acetyl-L: -carnitine Psychopharmacology. 2011⁵⁷Tempesta E, Troncon R, Janiri L, Colusso L, Riscica P, Saraceni G, Gesmundo E, Calvani M, Benedetti N, Pola P Role of acetyl-L-carnitine in the treatment of cognitive deficit in chronic alcoholism Department of Psychiatry and Pharmacology, Catholic University of Rome, Italy.1990

Aside from the brain, the liver is also one of the organs most damaged after long-term alcohol intoxication.

L-carnitine can be an effective way to treat the diseased liver after prolonged alcohol exposure.⁵⁸Kępka A, Szajda SD, Waszkiewicz N, Płudowski P, Chojnowska S, Rudy M, Szulc A, Ladny JR, Zwierz K Carnitine: function, metabolism and value in hepatic failure during chronic alcohol intoxication Zakład Biochemii i Medycyny Doświadczalnej, Instytut Pomnik-Centrum Zdrowia Dziecka w Warszawie. 2011

However, it should be noted that studies also show an elevated amount of carnitine in acylcarnitine in the plasma of alcoholic persons and persons with alcoholic liver disease.⁵⁹Richard K. Fuller MD Charles L. Hoppel MD Plasma Carnitine in AlcoholismAlcoholism Clinical and Experimental Research. 1988

This means that carnitine supplementation has little effect in stopping neurodegeneration since it will only be eliminated from the body.

L-Carnitine Stacking Options

L-carnitine has been proven to work well with Alpha Lipoic Acid (ALA), a polyunsaturated fatty acid, in neuroprotection.⁶⁰Gregory E Bigford, Gianluca Del RossiSupplemental substances derived from foods as adjunctive therapeutic agents for treatment of neurodegenerative diseases and disorders Advances in Nutrition. 2014

From a naturopathic standpoint,  L-carnitine supplementation also works well with flavonoids like curcuminoids (turmeric), rosmarinic acid (chiefly from rosemary), and resveratrol (from grapes).⁶¹Gregory E Bigford, Gianluca Del RossiSupplemental substances derived from foods as adjunctive therapeutic agents for treatment of neurodegenerative diseases and disorders Advances in Nutrition. 2014

Choline has also been found to decrease oxidative stress in women if used with carnitine.

It acts in promoting the conservation of retinol and alpha-tocopherol in women, both of which are known as good antioxidants.⁶²Dileep S. SachanDecreasing Oxidative Stress with Choline and Carnitine in Women Journal of the American College of Nutrition. 2005

It has also been proven that carnitine and choline enhance acetylcholine synthesis.⁶³A Wawrzeńczyk, K A Nałecz, M J NałeczSynergistic effect of choline and carnitine on acetylcholine synthesis in neuroblastoma NB-2a cells Biochemical and Biophysical Research Communications. 1994

Caffeine has also been proven to increase the fat oxidation process leading to better performance in athletes administered with the combination.⁶⁴Y S Cha, S K Choi, H Suh, S N Lee, D Cho, K LiEffects of carnitine coingested caffeine on carnitine metabolism and endurance capacity in athletes Journal of Nutritional Science and Vitaminology. 2001

How L-Carnitine Works In The Brain

Carnitine is an important factor for fat metabolism and energy production for essential body processes.⁶⁵Carla Nasca, Benedetta Bigio, Francis S. Lee, Sarah P. Young, Marin M. Kautz, Ashly Albright, James Beasley, David S. Millington, Aleksander A. Mathé, James H. Kocsis, James W. Murrough, Bruce S. McEwen, and Natalie Rasgon Acetyl-l-carnitine deficiency in patients with major depressive disorder Proceedings of the National Academy of Sciences of the United States of America. 2018

 

The mitochondria are considered the powerhouse of the body’s cells.

To function properly, it should be adequately fed with long-chain fatty acids, which is the function of carnitine.

The oxidation of these long-chain fatty acids, in turn, supplies the necessary energy needed to sustain the brain’s metabolism and the rest of the body.⁶⁶Bruce S. McEwen, Nicole P. Bowles, Jason D. Gray, Matthew N. Hill, Richard G. Hunter, Ilia N. Karatsoreos, and Carla NascaMechanisms of stress in the brain Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY 10065; Hotchkiss Brain Institute, University of Calgary, Calgary AB, Canada T2N4N1; Department of Psychology, University of Massachusetts Boston, Boston, USA; Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, 99164. 2015⁶⁷SP Chapela, N. Kriguer, EH Fernandez, CA Stella Involvement of L-carnitine in cellular metabolism: beyond Acyl-CoA transport Mini Reviews in Medical Chemistry. 2009

The Carnitine Shuttle

The carnitine shuttle plays an important role in the accumulation of long-chain fatty acids in the cells.

If not enough carnitine is present in the body, the transport of these fatty acids to the mitochondria is delayed.

The fatty acids accumulate in the cells⁶⁸Gustavo C. Ferreira and Mary C. McKennaL-Carnitine and acetyl-L-carnitine roles and neuroprotection in developing brain 1Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201; Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD 21201. 2017 leading to impaired homeostasis and mitochondrial dysfunction, therefore starving the cells.⁶⁹Thomas F Rau, Qing Lu, Shruti Sharma, Xutong Sun, Gregory Leary, Matthew L Beckman, Yali Hou, Mark S Wainwright, Michael Kavanaugh, David J Poulsen, Stephen M BlackOxygen glucose deprivation in rat hippocampal slice cultures results in alterations in carnitine homeostasis and mitochondrial dysfunction National Library of Medicine; National Center of Biotechnology Information. 2012

Synthesis of fatty acids in the adult brain is preferred to be through the carbons from the acetyl moiety.⁷⁰K A Nałecz , M J NałeczCarnitine–a known compound, a novel function in neural cells Acta Neurobiologiae Experimentalis. 1996

In the developing brain, the acetyl moiety may be oxidized for energy and incorporated into neurotransmitters and lipids⁷¹Susanna Scafidi, Gary Fiskum, Steven L Lindauer, Penelope Bamford, Da Shi, Irene Hopkins, Mary C McKennaMetabolism of acetyl-L-carnitine for energy and neurotransmitter synthesis in the immature rat brain Journal of Neurochemistry. 2010

Carnitine has also been found to be important in the synthesis of acetylcholine, a neurotransmitter that controls the smooth muscles, blood vessels, bodily secretions, and heart rate.⁷²Helen L. White & Philip W. Scates Acetyl-L-carnitine as a precursor of acetylcholine Neurochemical Research. 1990

Carnitine also stimulates the release of acetylcholine by mimicking its functions to control the muscles mentioned above and organs.⁷³A Imperato , M T Ramacci, L AngelucciAcetyl-L-carnitine enhances acetylcholine release in the striatum and hippocampus of awake freely moving rats Neuroscience Letters. 1989

It also increases dopamine, glycine, serine, threonine, alanine, and glutamine in selected brain regions.

By stimulating these amino acids to perform their necessary functions, the brain benefits largely from it.⁷⁴E Toth, L G Harsing Jr, H Sershen, M T Ramacci, A LajthaEffect of acetyl-L-carnitine on extracellular amino acid levels in vivo in rat brain regions Neurochemical Research. 1993

ALCAR was also proven to reduce glutamate oxidation, which can result in neurotoxicity leading to cell death.⁷⁵V Felipo, M D Miñana, H Cabedo, S GrisolíaL-carnitine increases the affinity of glutamate for quisqualate receptors and prevents glutamate neurotoxicity Neurochemical Research. 1994

L-carnitine is important in energy metabolism. In mammals, the carnitine level is maintained by producing adequate liver, kidneys, and brain levels.

It can also be absorbed from the diet or reabsorbed from the kidneys.⁷⁶Frédéric M Vaz, Ronald J A WandersCarnitine biosynthesis in mammals The Biochemical Journal. 2002

Carnitine Deficiency Deficiency in the OCTN2 carnitine transporter is a rare inherited disease that leads to systemic primary carnitine deficiency⁷⁷Nicola LongoPrimary Carnitine Deficiency and Newborn Screening for Disorders of the Carnitine Cycle Annals of Nutrition and Metabolism. 2016 which can result in autism and improper brain development.⁷⁸Caroline Demarquoy and Jean DemarquoyAutism and carnitine: A possible link World Journal of Biological Chemistry. 2019

L-Carnitine Safety

ALCAR is considered safe with no serious adverse reactions but always should be taken with medical supervision.⁷⁹RxListACETYL-L-CARNITINE RxList

However, stay away from ALCAR if you are pregnant or are breastfeeding since there is no adequate information to its effect on these situations.⁸⁰RxListACETYL-L-CARNITINE RxList

It should not also be used when diagnosed with hyperthyroidism or when having nerve pains following chemotherapy.⁸¹RxListACETYL-L-CARNITINE RxList

If you have seizures or have experienced one in the past, do not take ALCAR, unless under medical supervision.⁸²RxListACETYL-L-CARNITINE RxList

Drug Interactions Acenocoumarol (Sintrom) – Possible blood clotting issues Warfarin (Coumadin)- Possible Blood clotting issues.⁸³RxListACETYL-L-CARNITINE RxList

Suggested Dose

A daily dose of 1500-2000mg for most cognitive enhancement issues for 3-12 months is recommended with close medical supervision.⁸⁴RxList ACETYL-L-CARNITINE RxList