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What does l-carnitine do?
L-carnitine is made in the body from the amino acids lysine and methionine, and is needed to release energy from fat. It transports fatty acids into mitochondria, the powerhouses of cells. In infancy, and in situations of high energy needs, such as pregnancy and breast-feeding, the need for L-carnitine can exceed production by the body. Therefore, L-carnitine is considered a "conditionally essential" nutrient.1

L-carnitine’s actions appear to be particularly important in the heart. As an example, patients with diabetes and high blood pressure were given 4 grams of L-carnitine per day in an preliminary study.2 After 45 weeks, irregular heartbeat and abnormal heart functioning decreased significantly compared with nonsupplemented patients. For congestive heart failure, much of the research has used a modified form of carnitine called propionyl-L-carnitine (PC). In one double-blind trial, using 500 mg PC per day led to a 26% increase in exercise capacity after six months.3 In other research, patients with congestive heart failure given 1.5 grams PC daily for 15 days had a 21% increase in exercise tolerance and a 45% increase in oxygen consumption.4

Research shows that people who supplement with L-carnitine while engaging in an exercise regimen are less likely to experience muscle soreness.5However, the belief that carnitine’s effect on energy release will help build muscle or improve athletic performance has, so far, not been supported by most research.6 7 In a double-blind study of trained athletes, supplementation with 2 grams of L-carnitine two hours before and after a 20 km run failed to improve physical performance or exercise recovery.8

L-carnitine has been given to people with chronic lung disease in trials investigating how the body responds to exercise, however.9 10 In these double-blind reports, 2 grams of L-carnitine taken twice per day for two to four weeks led to positive changes in lung function and metabolism during exercise.

Beta thalassemia major is an inherited, fatal form of anemia commonly seen in people of Mediterranean descent. People with beta thalassemia major invariably require blood transfusions, which can eventually result in iron overload.11 L-carnitine stabilizes red blood cells and supplementation may decrease the need for blood transfusions. In a preliminary study, children with beta thalassemia major who took 100 mg of L-carnitine per 2.2 pounds of body weight per day for three months had a significantly decreased need for blood transfusions.12

Where is l-carnitine found?
Dairy and red meat contain the greatest amounts of carnitine. Therefore, people who have a limited intake of meat and dairy products tend to have lower L-carnitine intakes.

L-carnitine has been used in connection with the following conditions
(refer to the individual health concern for complete information)

Rating Health Concerns
Attention deficit–hyperactivity disorder
Congestive heart failure (propionyl-L-carnitine)
Heart attack
Intermittent claudication (propionyl-L-carnitine)
Anemia (for thalassemia)
Chronic fatigue syndrome
Chronic obstructive pulmonary disease (COPD)
High triglycerides
Infertility (male)
Intermittent claudication (L-carnitine)
Sprains and strains (for preventing exercise-related muscle injury
Athletic performance (for ultra-endurance only)
Beta thalassemia major
Cardiomyopathy (only for children with inherited cardiomyopathy)
Chemotherapy-induced fatigue
High cholesterol
Liver cirrhosis
Mitral valve prolapse
Raynaud’s disease
Weight loss
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

Who is likely to be deficient of l-carnitine?
Carnitine deficiencies are rare, even in strict vegetarians, because the body produces carnitine relatively easily.

Rare genetic diseases can cause a carnitine deficiency. Also, deficiencies are occasionally associated with other diseases, such as diabetes and cirrhosis.13 14 Among people with diabetes, carnitine deficiency is more likely to be found in persons experiencing complications of diabetes (such as retinopathy, hyperlipidemia, or neuropathy), suggesting that carnitine deficiency may play a role in the development of these complications.15 A carnitine deficiency can also result from oxygen deprivation which can occur in some heart conditions. In Italy, L-carnitine is prescribed for heart failure, heart arrhythmias, angina, and lack of oxygen to the heart.16

How much l-carnitine is usually taken?
Most people do not need carnitine supplements. For therapeutic use, typical amounts are 1–3 grams per day.

It remains unclear whether the propionyl-L-carnitine form of carnitine used in congestive heart failure research has greater benefits than the L-carnitine form, since limited research in both animals and humans with the more common L-carnitine has also shown very promising effects.17

Are there any side effects or interactions with l-carnitine?
L-carnitine has not been consistently linked with any toxicity.

The body needs lysine, methionine, vitamin C, iron, niacin, and vitamin B6 to produce carnitine.

Are there any drug interactions?
Certain medicines may interact with L-carnitine. Refer to drug interactions for a list of those medicines.