Indications

N Acetyl l-Carnitine SAP may help prevent symptoms of Alzheimer's disease or dementia.(2)
N Acetyl l-Carnitine SAP may help prevent pain and fatigue associated with fibromyalgia.(3)
N Acetyl l-Carnitine SAP may help improve energy in elderly patients.(4)
N Acetyl l-Carnitine SAP may help prevent decreases in luteinizing hormone (LH) associated with hypothalamic amenorrhea.(5)
N Acetyl l-Carnitine SAP may help prevent mental fatigue associated with chronic fatigue syndrome.(6 )

Ingredients

Each capsule contains:
l Carnitine 500 mg
From 750 mg of N Acetyl-l carnitine hydrochloride

Contains no: Preservatives, artificial flavor or color, sugar, dairy, starch, wheat, gluten, yeast, soy, citrus, corn, or eggs.

Description

N Acetyl-l carnitine is an active form of carnitine that is synthesized in the body or obtained through dietary sources, in particular red meats. For this reason, many people who eat a vegetarian diet may have a relative deficiency. N Acetyl-l carnitine has the ability to cross the blood-brain barrier and neural cell membranes, and therefore can be helpful in conditions affecting the nervous system.(1) There are studies that document N acetyl-l carnitine may be useful in the prevention of Alzheimer's symptoms. N Acetyl-l carnitine may also be able to assist in preventing mental fatigue associated with fibromyalgia and chronic fatigue syndrome. Compared to l carnitine, it has the ability to assist in cognition, which has not been attributed to the l carnitine form.

N Acetyl-l carnitine, when dosed orally, absorbs in the jejunum by simple diffusion.(1) N Acetyl-l carnitine is an active form of carnitine that has the ability to cross the blood-brain barrier and nervous tissue membranes.(1) The precise mechanism of action is still unknown, but one theory is that N acetyl-l carnitine has the ability to enhance neuronal metabolism in the mitochondria via its cholinergic neural transmission activity.(1) N Acetyl-l carnitine may also help by acting as an antioxidant and reducing the oxidative stress in cerebral spinal fluid, which in turn would prevent cell death and neuronal damage.(1)

FIBROMYALGIA
Fibromyalgia is characterized as a chronic condition that manifests with sleep and energy disturbances, and widespread pain.(2) In a double-blind, placebo-controlled study, patients with fibromyalgia were given 500 mg of N acetyl-l carnitine orally twice a day for 2 weeks, plus 1 intramuscular injection of 500 mg N Acetyl-l carnitine, or placebo; then oral dosing increased to 3 times a day for 8 weeks or placebo.(2) Patients where monitored at 2, 6, and 10 weeks, and assessed for tender points, sum of pain threshold, self-perceived stiffness, fatigue, sleep, work status, and depression on the Hamilton scale.(2) Researchers found the number of positive tender points reduced significantly in both groups until 6 weeks of treatment; however, at 10 weeks, the N acetyl-l carnitine group continued to improve, whereas the placebo group remained unchanged.(2) In the parameters of depression and musculoskeletal pain, there was a statistically significant difference noted between the groups.(2) Researchers concluded that N acetyl-l carnitine may be beneficial for patients with fibromyalgia to assist with pain and mental health.(2)

ALZHEIMER'S DISEASE
Some studies have found that supplementing with N acetyl-l carnitine in patients with Alzheimer's disease may help in slowing progression, predominantly in younger onset patients.(3) In a study to assess the outcome of N acetyl-l carnitine supplementation on patients with probable Alzheimer's disease, researchers designed a 1 year-long, double-blind, placebo-controlled trial.(3) Patients were treated with 1 g of N acetyl-l carnitine three times a day or placebo. Patients were assessed using the Alzheimer's disease assessment scale cognitive component and the clinical dementia rating scale.(3) The overall assessment found that both groups declined at the same rate based on the measures used; however, in a sub-analysis by age, researchers found that patients under age 65 on N acetyl-l carnitine declined more slowly than their counterparts on placebo.(3) This study suggests that younger patients with onset of Alzheimer's may benefit from N acetyl-l carnitine supplementation; however, further studies in this subset of patients are needed.(3)

HYPOTHALAMIC AMENORRHEA
Hypothalamic amenorrhea (HA) is a condition characterized by neuroendocrine impairment that negatively impacts endocrine function, mainly within the reproductive axis.(4) Patients usually present with low estrogen and low LH. Researchers looked at participants with HA and divided them into 2 groups based on their LH levels.(4) Participants with an LH under 3 mIU/ml (low LH) were placed in group A, and participants with LH over 3 mIU/ ml (normal LH) were placed in group B.(4) Both groups then received 1 g/d of N acetyl-l carnitine for 16 weeks. Participants baseline hormonal assessment, naloxone test (LH, FSH, cortisol), and pulsatility test (LH and FSH) were measured both before and after the 16 weeks of treatment.(4) Researchers found that group A showed a statistically significant increase in LH levels from an average of 1.4 to 3.1 mIU/ml, as well as improvement in the LH pulse amplitude.(4) There were no changes reported in group B.(4) Researchers concluded that there may be a specific role of N acetyl-l carnitine on reducing stress-induced abnormalities in patients with low LH affected by hypothalamic amenorrhea.(4)

FATIGUE
Fatigue is an extremely common complaint in elderly patients. Researchers explored supplementing N acetyl-l carnitine in elderly patients with fatigue.(5) Fatigue was measured in patients meeting 4 or more of the Holmes major criteria, or at least 6 of Fukuda minor criteria.(5) At the end of the treatment period, there were statistically significant differences in physical fatigue, muscle pain, mental fatigue, and the severity of fatigue.(5) There was an improvement in functional status and cognitive function, as well as improvements in mini mental state examination.(5) Researchers concluded that administering N acetyl-l carnitine may improve both physical and mental status in elderly patients.(5)

CHRONIC FATIGUE SYNDROME (CFS)
In an open randomized trial, patients with CFS were divided into 3 groups. Group A received 2 g/d N acetyl-l carnitine, group B received 2 g/d propionyl-l carnitine, and group C received a combination of both.(6) Patients were monitored over 24 weeks and rated on global clinical impression of change, as well as secondary endpoints including multidimensional fatigue inventory and the McGill pain questionnaire.(6) Researchers found that treatment yielded considerable improvements in clinical global impression in 59% of group A patients, 63% of group B patients, and 37% of group C patients.(6) Group showed a significant improvement in mental fatigue, whereas group B showed an improvement in general fatigue.(6) Researchers found that in group A, the changes in plasma carnitine levels correlated with clinical improvement, an association not observed in the other 2 groups.(6) Researchers concluded that N acetyl-l carnitine showed a beneficia

Quantity

Each bottle contains 90 capsules.

Dose

Start with 1 capsule twice daily with food and gradually increase to 3 capsules daily with food or as directed by your health care practitioner. Do not exceed 3 capsules in a 24 hour period.

Potential side effects/Safety

Overall, N acetyl-l carnitine is considered to be a safe supplement, with rare side effects that can include nausea or gastric upset. N Acetyl-l carnitine may interact with some medications; therefore, if you are taking medications used to treat thyroid dysfunction or seizures, or blood-thinning medications such as coumadin, please speak with your health care practitioner before taking N acetyl-l carnitine.

References

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1. [No authors listed]. “Acetyl-l carnitine monograph”. Alternative Medicine Review Vol. 15, No. 1 (2010): 76–83.
2. Rossini, M., et al. “Double-blind, multicenter trial comparing acetyl l carnitine with placebo in the treatment of fibromyalgia patients”. Clinical and Experimental Rheumatology Vol. 25, No. 2 (2007): 182–188.
3. Thal, L.J., et al. “A 1 year multicenter placebo-controlled study of acetyl-l carnitine in patients with Alzheimer's disease”. Neurology Vol. 47, No. 3 (1996): 705–711.
4. Genazzani, A.D., et al. “Acetyl-l carnitine (ALC) administration positively affects reproductive axis in hypogonadotropic women with functional hypothalamic amenorrhea”. Journal of Endocrinological Investigation Vol. 34, No. 4 (2011): 287–291.
5. Malaguarnera, M., et al. “Acetyl l carnitine (ALC) treatment in elderly patients with fatigue”. Archives of Gerontology and Geriatrics Vol. 46, No. 2 (2008): 181–190.
6. Vermeulen, R.C. and H.R. Scholte. “Exploratory open-label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome”. Psychosomatic Medicine Vol. 66, No. 2 (2004): 276–282.