A big blog post on Acetyl-L-Carnitine: benefits and side

effects
mygenefood.com/acetyl-l-carnitine-benefits-side-effects

Last updated on August 17, 2018

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Aaron Gardner

Acetyl-L-Carnitine (ALCAR) is the acetylated form of the amino acid L-carnitine (LC), which
means it is tagged with an acetyl molecule. Whilst both forms can be used as a supplement
ALCAR is often preferred due to its ability to cross the blood-brain barrier allowing it to
interact with nerves in the brain, and also donate its acetyl molecule, a key step in
neurotransmitter formation, required for healthy brain activity.

ALCAR and LC are naturally produced in the body and occur naturally in the diet, usually
when we eat animal protein. However, ALCAR is commonly taken as a nutritional
supplement due to numerous potential health benefits.

A major function of ALCAR is to transport fatty acids across the membrane of the
mitochondria (the powerhouse of the cell) in order to generate ATP (the energy currency of
the body). During this process it is converted into LC as it donates its acetyl group.
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Where it comes from
ALCAR can be produced or sourced in several ways. A major source are the liver and
kidneys which produce ALCAR from the amino acids lysine and methionine, although the
majority of LC is actually stored in skeletal muscle tissue.

In the body, ALCAR is converted into L-carnitine once it has donated its acetyl group to help
with fatty acid transport into the mitochondria. However, it is possible to revert this reaction
and convert L-carnitine back into ALCAR, and this frequently occurs in the cell as part of
normal metabolism. The final natural source of ALCAR is the diet, with red meats,
especially leaner muscle rich cuts being, a particularly high source. Other foods such as
white meats, cheeses and some fruits and vegetables like avocados and asparagus also
contain L-carnitine, although to a much lesser degree.

Supplementation
Whilst ALCAR deficiency is very rare, ALCAR supplementation is very common and popular
due to numerous potential health benefits. ALCAR is preferred to LC as a supplement due
to its increased bio-availability (R), meaning it is more readily absorbed from the gut, and its
ability to cross the blood-brain barrier allowing it to modulate numerous functions in the
brain (R).

Benefits and Effects

Numerous health benefits have been described for ALCAR and LC, below we cover the
potential major benefits and inform you of the latest research.

Enhanced cognition and neuroprotection

A major function of ALCAR and LC in the brain is in the formation of neurotransmitters,
required for proper function of the brain. Several promising studies in animal models
demonstrated a marked improvement in cognition. (R,R) A similar improvement was seen
in elderly populations (R) and those suffering from Alzheimer’s Disease ( R). Of particular
interest was the ability of ALCAR to slow the progression of Alzheimer’s Disease in early
onset patients.

Together these findings suggest that ALCAR is a potent neuroprotectant, facilitated by its
ability to cross the blood brain barrier. It is not yet clear how ALCAR exerts its protective
effect in the brain, but potential hypotheses include improved neurotransmitter synthesis,
or improved energy generation in neurons preventing their damage.

What is also unknown is the effect on cognition, and any neuroprotective benefit, in
younger or healthy individuals remains unknown, some positive results have been reported
(R), however a large scale confirmatory study is still required (R).

Mood Boosting
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Due to its important role in the brain as a supplement for neurotransmitter formation
another logical investigation was the role of ALCAR and LC on mood.

In both animal (R) and human studies (R) a significant improvement in mood was observed
following ALCAR supplementation.

A review of numerous studies recommended that a large scale clinical trial be performed to
identify exactly who may be of benefit. However, they suggest that ALCAR may be an
important antidepressant therapy, either alone or in conjunction with other mood
enhancers, especially in those with other medical conditions who may not tolerate high
dose antidepressants (R).

Improved sleep quality

Rather than a general improvement of sleep quality, ALCAR has been shown to have several
highly specific benefits. In those suffering from narcolepsy, a rare disorder where the brain
cannot regulate the normal sleep cycle, LC treatment promoted daytime wakefulness (R). A
beneficial effect in those who suffer from sleep apnea was also observed (R,R). Again, its
benefit in healthy individuals remain unknown.

Fat busting and muscle promotion

Due to its role in energy generation, specifically involving fat metabolism, and its
abundance in muscle tissue there was much excitement about using ALCAR as a fat buster
or muscle builder. However, several studies in both animal models (R) and humans (R),
have shown no benefit on either activity, or even on muscle LC content in normal
individuals. Some studies have reported a benefit in elite endurance athletes with a high
energy intake and expenditure. In these athletes, LC is thought to promote the usage of fat
in energy generation, preserving some of the muscles natural energy source, therefore
delaying the point when they “hit the wall” (R,R).

Interestingly in a rat model, ALCAR and alpha-lipoic acid co-supplementation was able to
improve metabolic function, burning energy more efficiently, whilst also reducing oxidative
stress (R). No similar improvement was observed in a human trial looking at depression
(R). Again their role in healthy individuals remains un-investigated.

Genes and SNPs

At the genetic level ALCAR has been shown to be of significant direct benefit to those
carrying the risk ‘C’ allele of rs5770917, located between the CPT1B and CHKB genes,
which is associated with narcolepsy (R,R). In these individuals a daily dose of 510 mg
ALCAR was effective at reducing daytime sleepiness.

Due to ALCAR’s important role in energy generation it may be of interest to those who carry
risk SNPs in the IL-4, IL-6, IL-1β, IL-10, TNFα, TRPM3 and TRPA1 genes (R,R,R), although to
date no studies have been performed to investigate this effect.

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Our mitochondria within our cells contain their own DNA, and this DNA DNA is also subject
to variation in the form of SNPs like our main genome. Two SNPs within the mitochondrial
genome have been identified which associate with fatigue, but again no studies
investigating ALCAR as a potential therapeutic have been performed (R).

Dosing Advice
ALCAR is approved by the FDA for the treatment of certain LC deficiency syndromes. It is
also available as an over the counter nutritional supplement. No official dosing advice has
been provided however doses of 500 – 2000 mg per day are typically used (R).

Any described side effects?

At doses of approximately 3,000 mg per day, carnitine supplements can cause nausea,
vomiting, abdominal cramps, diarrhea, and a “fishy” body odor. Rarer side effects include
muscle weakness in uremic patients and seizures in those with seizure disorders (R).

Furthermore, some research indicates that intestinal bacteria can break down carnitine to
form a substance called TMAO that might increase the risk of cardiovascular disease,
particularly in those who eat a meat rich diet (R). Interestingly a study published by the
Mayo Clinic (R) reported seemingly opposite findings, showing a protective cardiac effect.

Whilst these may seem counterintuitive the negative reference refers to the formation of
TMAO from intestinal bacteria rather than from cells within the body. It is possible
therefore that a poor gut biome, or indeed even the source of ALCAR/LC may be important
in describing outcomes. A diet rich in red meat has been shown to disrupt the gut biome
(R,R) and so other ALCAR/LC sources may be preferred.

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