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L-CARNITINE:
L-CARNITINE AND HEART HEALTH
by Lynn Hinderliter CN, LDN |
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Of the nutrients that support the health of
the heart, in first place I position Coenzyme Q10 , and second on
the list I would place L-Carnitine. I have been recommending
it for many years now, but we live in exciting times nutritionally,
and new research is continually being published that underscores its
vital part in the cardiovascular system, and for other health
conditions. In fact, it is a little hard to limit an article on l-Carnitine
JUST to the heart, because this substance has been positively linked
to improvements in health problems as apparently far removed as
obesity and Parkinsonism.
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Vegetarians are
likely to be deficient in L-Carnitine, since the best source is red
meat.
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I would urge
parents to be very careful when raising their children as vegetarians
from birth, because of the effect a deficiency of Carnitine could
have on the growth pattern and development of the child.
(Arch Fr Pediatr. 1984 Dec;41(10):715-9.)
When one considers
the problems attached to congenital defects in Carnitine metabolism,
such as heart damage, its importance in the developing body is
clear.
First, however, what it is. The prefix "L" would
lead one to suppose that it is an amino acid - but strictly
speaking, although its structure is similar to amino acids , it is
more closely related to the B vitamins, and it plays no role in
protein structures.
It is considered a
nonessential nutrient in the sense that the body can manufacture it
from other nutrients present in the body (Lysine, Methionine, B6
among others, with Vitamin C being a limiting factor), but it is
highly essential in its actions. In the diet it is found mostly in
muscle meats ( as the name would suggest, coming from the Latin root
for meat), and while it is rare for an actual clinical deficiency to
exist, sub-optimal levels can lead to many problems associated with
diabetes, obesity, cardiovascular disease and possibly Alzheimer
and muscular dystrophy.
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The reason L-Carnitine
can be involved in such a wide range of problems, and the reason for
its extreme importance in the maintenance of heart health, is its
influence on the destiny of the massive amounts of carbohydrates in
the average American diet.
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Excess carbohydrates are stored as fat, and Carnitine facilitates the
burning of fat for energy by making it possible for the long chain
fatty acids it transports to enter the cell . After all, if the
fatty acids cannot reach the mitochondria where they are transformed
to cellular energy, it stands to reason they are going to be
deposited in places where the body will suffer from their presence,
as happens in fatty liver disease, fatty build-up in the heart, and
your plain old everyday variety obesity, where fatty build-up occurs
in the muscles..
As science advances, new forms of L-Carnitine are
becoming available. We now have Carnitine bounds to Arginine,
with perhaps a greater affinity for brain energy, and an exciting
new compound called Ester Carnitine, which is Propionyl L Carnitine
bound to Glycine.
| A 2001 study in Cardiovascular research by
study by Lango et al said " It has also been shown that
propionyl-L-carnitine, which penetrates faster than carnitine
into myocytes, is effective in inhibiting production of
free radicals. Beneficial effects of carnitine supplementation
have been demonstrated under a variety of clinical conditions
such as acute cardiac ischemia, during extracorporeal
circulation, in carnitine-dependent cardiomyopathy as well as
in patients with chronic circulatory failure and in
cardiogenic shock. |
The two commonly available forms
of L-Carnitine are Carnitine fumarate, and Carnitine tartrate.
The former is made by Sigma-Tau, and the latter by Lonza.
They are both of high quality, if there can be said to be a
difference in the carriers, it is that the tartrate is
perhaps more on the side of an antioxidant, while the
fumarate (which converts to malate in the Krebs cycle) leans
more towards energy.
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My hero Dr. Whitaker
compares the heart deficient in Carnitine
to a car without a fuel pump!
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However, as you can
plainly see, the heart is not the only organ that can benefit from
more efficient burning of fats for energy: Carnitine has its uses in
the following conditions: angina, myocardial infarction, recovery
from heart surgery, hypertension and high cholesterol levels, also
high triglycerides, Alzheimer's, liver disease (including alcohol
induced liver problems) diabetes, diabetic neuropathy male
infertility, diabetic neuropathy, Parkinson's and many other more
obscure afflictions.
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L-Carnitine and Thyroid
function |
Dr. Stephen deFelice has done some very interesting research into
the effect of L-Carnitine on hyperthyroidism,
which you will find here. The bottom line,
Three female patients with classic hyperthyroidism were
selected. All had the common manifestations of tremors, weight loss,
nervousness, insomnia, heat intolerance, excessive sweating and
emotional instability.
I treated them with carnitine, and within a ten-day period all
three were virtually without signs and symptoms.
In fact, Carnitine deficiencies may play a role in both hypo and
hyper thyroidism
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In his book, The Carnitine Miracle, Robert
Crayhon MS, CN says
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" Nearly one-third of all deaths related to
heart disease occur because of arrhythmias. Carnitine is a valuable
nutrient for the control of arrhythmias ..." and he goes on to
recommend also taurine, magnesium and fish liver oils. This
combination, he states, has eliminated every case of arrhythmia he
has seen in his practice.
A Jan 1998 article by Dr. Richard Podell M.D.
touches on the excellent research which enables him to say that he
is now able to recommend L-Carnitine as standard treatment for
intermittent claudication, an extremely painful condition that
causes great pain in the legs during exercise. He based this on
studies in Italy using a Carnitine derivative where double-blind,
placebo controlled research with 245 patients showed not only that
Carnitine helped the condition, but that the more severe the
problem, the greater the degree of relief. The initial dose was
500mg twice a day, and the highest dose used ( incremental
increases) where no improvement occurred at lower doses was 1500mg
twice a day.
It is very useful and helpful for people trying to
lose weight, but only if their diet is deficient in Carnitine. To quote from a release by the Lonza
Group ( who manufacture L-Carnitine):" Studies in obese people have
shown that only low calorie diets together with exercise will
guarantee long term weight loss. Both of these measure induce
a deficiency in L-Carnitine. Sub-optimal levels of L-Carnitine may
also cause fatigue and strongly impair beta-oxidation.
Clinical studies demonstrate the effectiveness of supplementary
L-Carnitine for weight management, the improvement of exercise
performance and maintenance of a healthy heart."
As a less scientific side-note, when people are on
a low carbohydrate diet, we have found that supplementary
L-Carnitine lessens the irritability and nervousness that such an
extreme change in body chemistry often brings.
The average amount of Carnitine found in the daily
diet is app. 50 mgs: therapeutic levels range from 500 to 2000 mgs.
Deficiencies may be due to a genetic error in Carnitine synthesis,
or to low levels of lysine, high levels of homocysteine, or
vegetarianism . There do not appear to be any side effects from its
use even at high dosages, but it is wise to increase Vitamin C
supplementation, since some studies show that high amounts of
Carnitine cause loss of Vitamin C from the body.
Athletes have known about Carnitine's ability to
burn fat for energy for some time, but heart disease sufferers are
just beginning to realize the benefits that come from using a
substance that provides the heart with its main fuel: the heart gets
two thirds of its energy from burning fat! Less pain and more
endurance can be associated with supplementing with L-Carnitine,
specifically the propionyl carnitine, whichi s the more active form
in muscle tissue,
with no downside. It works synergistically with Coenzyme Q 10.
L-Carnitine may be upsetting to the stomach,
so make sure to take it with a meal. Dr. Podell also urges caution
if a person has any kidney or liver problems, or is pregnant or
lactating.
Lactic acid build-up can really be a villain, not
just for athletic performance but for energy production generally:
particularly unfortunate are its repercussions on brain function.
Fortunately there is a nutrient so effective at addressing it that
it has also been developed as a "drug". That nutrient is
Acetyl-L-Carnitine (ALC), the form of Carnitine which
appears to have more specificity for neurons, which can be produced in the liver
from 2 amino acids (Lysine and Cysteine) but is often not available
in sufficient quantities because its synthesis requires several
vitamins which our diets are often inadequate to provide: B6, Folic
acid, Pantothenic acid, Biotin and C.
The Acetyl form of Carnitine is more expensive
than plain vanilla L-Carnitine, but also more effective for energy
related problems because it is better assimilated, and also has been
shown to pass the blood/brain barrier more efficiently. (This, of
course, accounts for the studies that have found an influence on
Alzheimer's, where lactic acid build-up in the brain is being
studied as a causative factor -
more here).
ALC has been shown to boost the activity of an
enzyme, carnitine acetyltransferase, which increases the burning of
fatty acids for fuel in the mitochondria. It is therefore helpful
at two levels, as a remover of waste, and as a provider of fuel
- both positively affecting energy levels. Whether this is the case
throughout the body, or mainly in the brain, has not yet been
determined.
Since I have had a few queries
related to PEYRONIE' DISEASE, which at the time I had little
advise for, other than vitamin E and anti-inflammatory enzymes, I am
appending this information here. Studies have been completed in
Italy comparing Acetyl-L-Carnitine and the only medication which has
had any effect on PEYRONIE' DISEASE to date - Tamoxifen. Since Tamoxifen
has real dangers attached to its use, I am glad to report that there
was absolutely no doubt about the results: at the end of the study,
participants were asked about pain during erection. About 50% of
the drug group reported lessened pain, while over 90% of the
Carnitine users were improved. The drug had no effect on PEYRONIE' DISEASE, curvature
of the penis, while the Acetyl-L-Carnitine users experienced a 47%
improvement. Plaque ( the cause of the curvature) was also
significantly reduced. This is excellent! Remember, too,
that ACL has other benefits for the brain, the mood and vision. The
study was published in BJU Int., 2001; 88:63-67, and the
recommended dosage is half a gram four times a day for a total of 2
grams, with meals and at bedtime.
Here is the study abstract
For further help with PEYRONIE' DISEASE,
go
here
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Research Articles for
L-Carnitine
Acetyl-L-Carnitine Research articles
L-Propionyl carnitine has been shown to improve the heart's
mechanical recovery
Alpha Lipoic Acid and Acetyl-L-Carnitine
for youthful energy.
A study.
Acetyl-l-Carnitine and
energy in the Elderly
L-Carnitine and Hyperthyroidism
Related articles you may find
interesting:
A program for
help with Peyronie's Disease
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