L-Carnitine

Other Name(s):

3-carboxy-2-hydroxy-N,N,N-trimethyl-1-propanaminium inner salt, (3-carboxy2-hydroxypropyl) trimethylammonium hydroxide inner salt, 3-hydroxy-4-N-trimethylaminobutyrate, B-hydroxy-N-trimethyl aminobutyric acid, Beta-hydroxy-gamma-trimethylammonium butyrate, B(t) Factor, Carnitine,Carnitor, D-Carnitine, DL-Carnitine, Facteur B(t), L-3-hydroxy-4-(trimethylammonium)-butyrate, Levocarnitine, Lévocarnitine, Levocarnitine Fumurate, L-Carnitina, L-Carnitine Fumarate, L-Carnitine L-Tartrate, L-Carnitine Tartrate, (R)-(3-carboxy-2-hydroxypropyl) trimethylammonium hydroxide, (R)-3-hydroxy-4-trimethylammonio-butyrate, Vitacarn, Vitamin B(t), Vitamine B(t).

Overview

L-carnitine is an amino acid that is naturally produced in the body. L-carnitine helps the body turn fat into energy. The body can convert L-carnitine to other amino acids called acetyl-L-carnitine and propionyl-L-carnitine. But, no one knows whether the benefits of carnitines are interchangeable. Until more is known, don't substitute one form of carnitine for another.

补充左卡尼汀是增加口服ease L-carnitine levels in people whose natural level of L-carnitine is too low because they have a genetic disorder, are taking certain drugs (such as valproic acid for seizures or certain antibiotics for tuberculosis), or because they are undergoing a medical procedure (hemodialysis for kidney disease) that uses up the body's L-carnitine. It is also used as a replacement supplement in strict vegetarians, dieters, and low-weight or premature infants.

L-carnitine is taken by mouth for conditions of the heart and blood vessels including heart-related chest pain, congestive heart failure (CHF), heart complications of a disease called diphtheria, heart attack, heart disease, leg pain caused by circulation problems (intermittent claudication), reduced circulation in the arms and legs due to narrowed blood vessels (peripheral vascular disease), irregular heartbeat, and high cholesterol.

有些人用左卡尼汀口服肌肉disorders associated with certain AIDS medications, difficulty fathering a child (male infertility), a brain development disorder called Rett syndrome, anorexia, body weakness and wasting due to an illness, weight loss, chronic fatigue syndrome and fatigue associated with multiple sclerosis, celiac disease, cancer, aging, diabetes, metabolic syndrome, overactive thyroid, attention deficit-hyperactivity disorder (ADHD), autism, leg ulcers, Lyme disease, a blood disorder called beta-thalassemia, loss of brain function due to liver damage, hepatitis C, non-alcoholic liver disease, memory, migraine headache, to improve athletic performance and endurance in healthy people and people with a lung condition called chronic obstructive pulmonary disease (COPD). It is also taken by mouth for narcolepsy and for spinal muscle weakness in children.

左卡尼汀我们静脉注射(IV)增加ease L-carnitine levels in people whose natural level of L-carnitine is too low because they have a genetic disorder, are taking certain drugs (valproic acid for seizures), or because they are undergoing a medical procedure (hemodialysis for kidney disease) that uses up the body's L-carnitine. It is also given by IV to improve immune function in people with HIV/AIDS, and to people who have had a heart attack. It is also used as a supplement for people on a feeding tube, and in low-weight or premature infants with breathing problems.

L-carnitine is applied to the skin for acne and hair loss.

L-carnitine is also used in eye drops for dry eyes.

How does it work?

L-carnitine helps the body produce energy. It is important for heart and brain function, muscle movement, and many other body processes.

SLIDESHOW

Heart Disease: Symptoms, Signs, and CausesSee Slideshow

Uses & Effectiveness

Effective for...

  • L-carnitine deficiency。The FDA has approved the use of L-carnitine, either taken by mouth or given intravenously (by IV), for treating L-carnitine deficiency caused by certain genetic diseases or other disorders.

Possibly Effective for...

  • Chest pain (angina)。Taking L-carnitine by mouth or intravenously (by IV) seems to improve exercise tolerance in people with chest pain. Taking L-carnitine along with standard treatment also seems to reduce chest pain and improve exercise ability in people with cardiac syndrome X. People with this condition have chest pain but not blocked arteries.
  • Heart failure。Taking L-carnitine by mouth or intravenously (by IV) seems to improve symptoms and increase exercise ability in people with heart failure. Taking a specific product containing L-carnitine and coenzyme Q10 (Carni Q-Gel, Tishcon Corporation, Westbury, NY) also appears to improve symptoms of heart failure.
  • Serious kidney disease。People in the last stage of long-term, serious kidney disease need to undergo hemodialysis, which can lower L-carnitine levels. The US Food and Drug Administration (FDA) has approved giving L-carnitine intravenously (by IV) but not by mouth to treat and prevent L-carnitine deficiency in these patients. There is mixed evidence about the effects of L-carnitine in treating disorders caused by low carnitine levels in people with serious kidney disease undergoing hemodialysis. Taking L-carnitine by mouth or giving L-carnitine intravenously might improve markers of anemia and inflammation in people with this condition. But L-carnitine does not seem to improve quality of life, muscle cramping, low blood pressure, breathing function, or exercise performance.
  • High thyroid hormone levels (hyperthyroidism)。Taking L-carnitine seems to improve symptoms such as rapid or pounding heartbeat, nervousness, and weakness in people with high thyroid hormone levels.
  • Male infertility。Most research shows that taking L-carnitine, alone or in combination with acetyl-L-carnitine, increases sperm count and sperm movement in men with fertility problems.
  • Inflammation of the heart (myocarditis)。Taking D,L-carnitine by mouth seems to reduce the risk of death from myocarditis.
  • Preventing side effects caused by valproic acid (Depacon,Depakene,Depakote, VPA), a seizure medication。毒性引起的丙戊酸似乎林ked with L-carnitine deficiency. Giving L-carnitine intravenously (by IV) can prevent severe liver toxicity in people who accidentally ingested or took too much valproic acid.

Insufficient Evidence to Rate Effectiveness for...

  • Acne。Early research suggests that applying a product containing L-carnitine to the face twice daily for 8 weeks reduces acne and improves quality of life in people with acne.
  • Age-related fatigue。Early research shows that taking L-carnitine daily for 30 days improves physical and mental fatigue, increase muscle mass, and decrease fat mass in elderly people.
  • Hair loss (androgenic alopecia)。Early research suggests that applying an L-carnitine solution twice daily for 6 months increases hair on the scalp in people with male or female pattern hair loss.
  • Toxicity from tuberculosis drugs。Some drugs used to treat tuberculosis have been linked to liver damage. Early research suggests that taking L-carnitine by mouth along with these drugs for 4 weeks reduces the risk for liver damage.
  • Athletic performance。Intense exercise has been linked to a decrease in L-carnitine blood levels. However, research on the use of L-carnitine for improving athletic performance is inconsistent. Some studies suggest that L-carnitine improves athletic performance and endurance. However, other research suggests L-carnitine provides no benefits.
  • 注意力缺陷多动障碍(ADHD)。Research suggests that taking L-carnitine does not appear to reduce ADHD symptoms in most children.
  • Autism。Early research suggests that taking L-carnitine by mouth daily for 3 months reduces the severity of autism in children according to some but not all scales.
  • Irregular heartbeat (arrhythmia)。Early research suggests that L-carnitine might reduce irregular heartbeat.
  • Blood disorder called beta-thalassemia。Early research suggests that L-carnitine might reduce symptoms of a blood disorder called beta-thalassemia.
  • Wasting syndrome (cachexia)。Early research suggests that taking L-carnitine can increase body mass index (BMI) and improve lean body mass in people with cancer and wasting syndrome. Also, taking L-carnitine in combination with antioxidants and certain prescription drugs used to increase appetite seems to improve lean body mass better than taking the prescription drugs alone.
  • Weakening heart muscle (cardiomyopathy)。Early research suggests that L-carnitine improves heart function in adults or children with a weak heart muscle.
  • Cancer-related fatigue。Some cancer patients have low blood levels of L-carnitine, which might reduce energy and lead to fatigue. Some early research suggests that taking L-carnitine might improve fatigue in advanced cancer patients. However, other research suggests that it has no benefit.
  • Celiac disease-related fatigue。Some celiac disease patients have low blood levels of carnitine, which might reduce energy and lead to fatigue. Some research shows that taking L-carnitine reduces fatigue associated with celiac disease. However, L-carnitine does not seem to improve depression or quality of life.
  • Chronic fatigue syndrome。Early research suggests that taking L-carnitine for 2 months can improve symptoms of fatigue.
  • Lung disease (chronic obstructive pulmonary disease)。Early research suggests that L-carnitine can improve exercise performance in people with chronic obstructive pulmonary disease (COPD).
  • Clogged arteries (coronary artery disease)。Early research suggests that taking L-carnitine before exercise does not improve endurance in people with clogged arteries.
  • Diabetes。Although some research suggests that L-carnitine might improve blood sugar control in people with diabetes, most research shows that L-carnitine does not have this effect. However, L-carnitine might improve blood sugar control and decrease body weight in people with diabetes when taken along with certain weight loss medications. There is mixed evidence regarding the effects of L-carnitine on cholesterol levels in people with diabetes. Some research shows that L-carnitine can decrease cholesterol levels, but other research shows no benefit.
  • Fatigue。Early research shows that taking L-carnitine daily for 8 days does not reduce fatigue in healthy people.
  • Declining brain function related to liver disease。Early research shows that taking L-carnitine daily for 60-90 days reduces ammonia levels and improves brain function in people with declining brain function related to severe liver disease.
  • Fatigue due to hepatitis。Early research shows that taking L-carnitine daily reduces fatigue in people with hepatitis C who are also being treated with medication.
  • Hepatitis B。Research suggests that taking a specific vitamin complex containing L-carnitine (Godex, Celltrion Pharm, Seoul) together with the drug entecavir daily for 12 months improve liver function in people with hepatitis B. But it does not seem to affect the amount of hepatitis B virus in the blood.
  • Hepatitis C。Taking L-carnitine with the medications interferon-alpha and ribavirin seems to improve the response to treatment in people with hepatitis C.
  • High blood fats。Early research shows that taking L-carnitine daily can reduce total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol, and triglycerides in children with high blood fat levels. Also, taking L-carnitine can reduce levels of lipoprotein(a), a possible risk factor for cardiovascular disease, in people with high levels of lipoprotein(a).
  • High triglycerides。Early research suggests that L-carnitine does not reduce triglyceride levels in people with high triglyceride levels.
  • Low birth weight。Some research suggests that giving premature infants L-carnitine by mouth or intravenously (by IV) can increase weight. However, other research suggests that it does not increase body weight in premature infants.
  • Memory。Early research shows that taking L-carnitine daily for 3 days does not improve memory in young adult females.
  • Metabolic syndrome。Early research suggests that L-carnitine given intravenously (by IV) daily for 7 days increases weight loss and reduces waist circumference in people with metabolic syndrome. But it does not seem to affect blood pressure in people with this condition.
  • Migraine headache。Early research suggests that taking L-carnitine daily, with or without magnesium oxide for 12 weeks, does not reduce migraines.
  • Multiple sclerosis-related fatigue。Some people with multiple sclerosis have low blood levels of L-carnitine, which might cause low energy and fatigue. Early research shows that taking L-carnitine daily decreases some aspects of fatigue in people with multiple sclerosis who also have low L-carnitine levels.
  • Heart attack。There is inconsistent evidence about the effects of using of L-carnitine after a heart attack. Some research suggests that taking L-carnitine by mouth after a heart attack improves heart function and reduces the risk of death. However, other studies suggest that it provides no benefit.
  • Excessive daytime sleepiness (narcolepsy)。Early research suggests that taking L-carnitine in the morning and evening for 8 weeks reduces dozing off during the day in people with narcolepsy. But it does not seem to affect the number of naps needed, quality of life, or sleepiness.
  • Breathing problems while sleeping in infants。Early research suggests that adding L-carnitine to intravenous (IV) nutrition does not reduce breathing problems while sleeping in infants.
  • Nonalcoholic liver disease (nonalcoholic steatohepatitis, NASH)。Early research suggests that L-carnitine improves some aspects of liver function in people with liver disease not related to drinking alcohol.
  • Blocked blood vessels not in the heart or brain。一些早期的研究表明,左卡尼汀might improve walking in people with blocked blood vessels not in the heart or brain. However, other research suggests that it does not provide any benefits.
  • A rare inherited disorder that affects the nervous system (Rett syndrome)。Taking L-carnitine might improve well-being and movement in girls with Rett syndrome.
  • Weight loss。Taking L-carnitine by itself does not appear to reduce body weight in overweight or obese people. However, taking L-carnitine with certain weight loss medications or supplements appears to reduce body weight and body mass index better than taking the weight loss medications or supplements alone.
  • Eating disorders
  • 勒g ulcers
  • Lyme disease
  • Spinal muscle loss
  • Other conditions
More evidence is needed to rate L-carnitine for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate(detailed description of each of the ratings).

Side Effects

L-carnitine isLIKELY SAFEwhen taken by mouth for up to 12 months, and when used as an injection, with the approval of a healthcare provider. It can cause side effects such as nausea, vomiting, stomach upset, heartburn, diarrhea, and seizures. It can also cause the urine, breath, and sweat to have a "fishy" odor. Avoid using D-carnitine and DL-carnitine. These forms of carnitine might block the effects of L-carnitine and cause symptoms that resemble L-carnitine deficiency.

QUESTION

In the U.S., 1 in every 4 deaths is caused by heart disease.See Answer

Special Precautions & Warnings

Pregnancy and breast-feeding: There is not enough reliable information about the safety of using L-carnitine if you are pregnant. Stay on the safe side and avoid use.

Taking L-carnitine isPOSSIBLY SAFEin breast-feeding women when taken by mouth in the amounts recommended. Small amounts of L-carnitine have been given to infants in breast milk and formula with no reported side effects. The effects of large amounts taken by a breast-feeding mother are unknown.

Children: L-carnitine isPOSSIBLY SAFEwhen used appropriately by mouth or intravenously (by IV), short-term. It has been used safely by mouth for up to 6 months.

Under-active thyroid (hypothyroidism): Taking L-carnitine might make symptoms of hypothyroidism worse.

Kidney failure: Using DL-carnitine has been reported to cause symptoms such as muscle weakness and eye drooping when administered intravenously (by IV) after dialysis. L-carnitine does not seem have this effect.

Seizures: L-carnitine seems to make seizures more likely in people who have had seizures before. If you have had a seizure, do not use L-carnitine.

Interactions


Acenocoumarol (Sintrom)Interaction Rating:ModerateBe cautious with this combination.Talk with your health provider.

Acenocoumarol (Sintrom) is used to slow blood clotting. L-carnitine might increase the effectiveness of acenocoumarol (Sintrom). Increasing the effectiveness of acenocoumarol (Sintrom) might slow blood clotting too much. The dose of your acenocoumarol (Sintrom) might need to be changed.


Thyroid hormoneInteraction Rating:ModerateBe cautious with this combination.Talk with your health provider.

L-carnitine seems to decrease how well thyroid hormone works in the body. Taking L-carnitine with thyroid hormone might decrease the effectiveness of the thyroid hormone.


Warfarin (Coumadin)Interaction Rating:ModerateBe cautious with this combination.Talk with your health provider.

Warfarin (Coumadin) is used to slow blood clotting. L-carnitine might increase the effects of warfarin (Coumadin) and increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

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Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • For L-carnitine deficiencies: 990 mg two to three times daily in tablets or as an oral solution.
  • For chest pain (angina): Doses of 900 mg to 2 grams of L-carnitine have been taken in one to two divided doses daily for 2 weeks to 6 months.
  • For heart failure: 1.5 to 3.0 grams of L-carnitine has been taken in one to two divided doses daily for up to about 34 months. A specific product (Carni Q-Gel, Tishcon Corporation,Westbury, NY) containing 2250 mg of carnitine and 270 mg of coenzyme Q10 has been taken daily for 12 weeks.
  • For people with serious kidney disease undergoing hemodialysis: Doses of 0.64-3 grams or 10 mg/kg of L-carnitine has been used daily for 3-52 weeks. Taking L-carnitine by mouth is not FDA approved to treat carnitine deficiency in people with serious kidney disease.
  • For high thyroid hormone levels (hyperthyroidism): 2-4 grams of L-carnitine has been taken daily for 2-4 months.
  • For male infertility: 2-3 grams of L-carnitine has been taken in up to three divided doses daily, with or without vitamin E, for 2 to 24 weeks. Also, 2 grams of L-carnitine plus 1 gram of acetyl-L-carnitine has been taken daily, with or without a 300 mg cinnoxicam suppository every 4 days, for 3-6 months.
  • For inflammation of the heart (myocarditis): 100 mg/kg of D,L-carnitine has been taken daily for 4 days.
  • For preventing side effects caused by valproic acid (Depacon, Depakene, Depakote, VPA): 50 to 100 mg/kg has been taken in three or four divided doses daily up to a maximum of 3 grams daily.
BY IV:
  • For chest pain (angina): An infusion of 3 grams of L-carnitine in 500 mL of 5%dextrosehas been given once daily for 14 days. 40mg/kg of D,L-carnitine has also been given by IV 30 minutes before exercise.
  • 左卡尼汀不足:剂量50毫克/公斤L-carnitine have been given as a slow injection or by infusion followed by 50 mg/kg of L-carnitine in divided doses every 3 to 4 hours over the next 24 hours. In the following days, daily maintenance doses are usually in the range of 50 mg/kg. For people with L-carnitine deficiency related to hemodialysis, 10 to 20 mg/kg of L-carnitine adjusted for L-carnitine blood levels is used.
  • For heart failure: 5 grams of L-carnitine has been given by IV daily for 7 days in addition to conventional treatment.
  • For serious kidney disease: Doses of 10 to 20 mg/kg of L-carnitine given as a slow injection is FDA-approved for use for L-carnitine deficiency in people with serious kidney disease. For treating disorders related to low levels of carnitine in hemodialysis patients, 1.8 grams of L-carnitine weekly to 3 grams daily or 30-120 mg/kg/week have been given by IV for 2 weeks to 12 months. Doses were usually given three times weekly after dialysis sessions. Also, 1 gram of L-carnitine has been given by IV three times weekly after each dialysis session together with 100 mg of coenzyme Q10 taken by mouth daily for 3 months.
  • For preventing side effects caused by valproic acid (Depacon, Depakene, Depakote, VPA): 150-500 mg/kg has been taken daily. A maximum of 3 grams daily.

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Derosa, G., Maffioli, P., Ferrari, I., D'Angelo, A., Fogari, E., Palumbo, I., Randazzo, S., and Cicero, A. F. Orlistat and L-carnitine compared to orlistat alone on insulin resistance in obese diabetic patients. Endocr.J 2010;57(9):777-786. View abstract.

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Tsambalas Dimitriadis, F。,。,Tsounapi, P,川mura, H., Vlachopoulou, E., Haliasos, N., Gratsias, S., Watanabe, T., Saito, M., Miyagawa, I., and Sofikitis, N. Effects of phosphodiesterase-5 inhibitors on Leydig cell secretory function in oligoasthenospermic infertile men: a randomized trial. BJU.Int. 2010;106(8):1181-1185. View abstract.

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El Beshlawy, A., Abd, El Raouf, Mostafa, F., Talaat, M., Isma'eel, H., Aoun, E., Hoffbrand, A. V., and Taher, A. Diastolic dysfunction and pulmonary hypertension in sickle cell anemia: is there a role for L-carnitine treatment? Acta Haematol. 2006;115(1-2):91-96. View abstract.

El Beshlawy, A., Mohtar, G., Abd El, Ghafar E., Abd El Dayem, S. M., El Sayed, M. H., Aly, A. A., and Farok, M. Assessment of puberty in relation to L-carnitine and hormonal replacement therapy in beta-thalassemic patients. J Trop.Pediatr. 2008;54(6):375-381. View abstract.

El-Beshlawy, A., El, Accaoui R., Abd El-Sattar, M., Gamal El-Deen, M. H., Youssry, I., Shaheen, N., Hamdy, M., El-Ghamrawy, M., and Taher, A. Effect of L-carnitine on the physical fitness of thalassemic patients. Ann.Hematol. 2007;86(1):31-34. View abstract.

El-Beshlawy, A., Youssry, I., El-Saidi, S., El, Accaoui R., Mansi, Y., Makhlouf, A., and Taher, A. Pulmonary hypertension in beta-thalassemia major and the role of L-carnitine therapy. Pediatr.Hematol.Oncol. 2008;25(8):734-743. View abstract.

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Fan, J. P., Kim, H. S., and Han, G. D. Induction of apoptosis by L-carnitine through regulation of two main pathways in Hepa1c1c 7 cells. Amino.Acids 2009;36(2):365-372. View abstract.

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Fatouros, I. G., Douroudos, I., Panagoutsos, S., Pasadakis, P., Nikolaidis, M. G., Chatzinikolaou, A., Sovatzidis, A., Michailidis, Y., Jamurtas, A. Z., Mandalidis, D., Taxildaris, K., and Vargemezis, V. Effects of L-carnitine on oxidative stress responses in patients with renal disease. Med.Sci Sports Exerc. 2010;42(10):1809-1818. View abstract.

Feillet, F., Ogier, H., Cheillan, D., Aquaviva, C., Labarthe, F., Baruteau, J., Chabrol, B., de, Lonlay P., Valayanopoulos, V., Garnotel, R., Dobbelaere, D., Briand, G., Jeannesson, E., Vassault, A., and Vianey-Saban, C. [Medium-chain acyl-CoA-dehydrogenase (MCAD) deficiency: French consensus for neonatal screening, diagnosis, and management]. Arch.Pediatr 2012;19(2):184-193. View abstract.

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Fietta, P. and Manganelli, P. Carnitine: a therapeutic option for childhood psoriatic onycho-pachydermo-periostitis (POPP). Clin Rheumatol. 2007;26(1):93-94. View abstract.

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Foitzik, K., Hoting, E., Heinrich, U., Tronnier, H., and Paus, R. Indications that topical L-carnitin-L-tartrate promotes human hair growth in vivo. J Dermatol.Sci 2007;48(2):141-144. View abstract.

Footitt, E. J., Stafford, J., Dixon, M., Burch, M., Jakobs, C., Salomons, G. S., and Cleary, M. A. Use of a long-chain triglyceride-restricted/medium-chain triglyceride-supplemented diet in a case of malonyl-CoA decarboxylase deficiency with cardiomyopathy. J Inherit.Metab Dis 6-15-2010; View abstract.

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Galvano, F., Li, Volti G., Malaguarnera, M., Avitabile, T., Antic, T., Vacante, M., and Malaguarnera, M. Effects of simvastatin and carnitine versus simvastatin on lipoprotein(a) and apoprotein(a) in type 2 diabetes mellitus. Expert.Opin.Pharmacother. 2009;10(12):1875-1882. View abstract.

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Gentile, V., Antonini, G., Antonella, Bertozzi M., Dinelli, N., Rizzo, C., Ashraf, Virmani M., and Koverech, A. Effect of propionyl-L-carnitine, L-arginine and nicotinic acid on the efficacy of vardenafil in the treatment of erectile dysfunction in diabetes. Curr Med Res Opin. 2009;25(9):2223-2228. View abstract.

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Gibault, J. P., Frey, A., Guiraud, M., Schirardin, H., Bouletreau, P., and Bach, A. C. Effects of L-carnitine infusion on intralipid clearance and utilization. Study carried out in septic patients of an intensive care unit. JPEN J Parenter.Enteral Nutr 1988;12(1):29-34. View abstract.

Goetz, C. G., Tanner, C. M., Cohen, J. A., Thelen, J. A., Carroll, V. S., Klawans, H. L., and Fariello, R. G. L-acetyl-carnitine in Huntington's disease: double-blind placebo controlled crossover study of drug effects on movement disorder and dementia. Mov Disord. 1990;5(3):263-265. View abstract.

Goldenberg, N. A., Krantz, M. J., and Hiatt, W. R. L-Carnitine plus cilostazol versus cilostazol alone for the treatment of claudication in patients with peripheral artery disease: a multicenter, randomized, double-blind, placebo-controlled trial. Vasc.Med 2012;17(3):145-154. View abstract.

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Gonzalez-Ortiz, M., Hernandez-Gonzalez, S. O., Hernandez-Salazar, E., and Martinez-Abundis, E. Effect of oral L-carnitine administration on insulin sensitivity and lipid profile in type 2 diabetes mellitus patients. Ann.Nutr.Metab 2008;52(4):335-338. View abstract.

Gorostiaga, E. M., Maurer, C. A., and Eclache, J. P. Decrease in respiratory quotient during exercise following L-carnitine supplementation. Int J Sports Med 1989;10(3):169-174. View abstract.

Gramignano, G., Lusso, M. R., Madeddu, C., Massa, E., Serpe, R., Deiana, L., Lamonica, G., Dessi, M., Spiga, C., Astara, G., Maccio, A., and Mantovani, G. Efficacy of l-carnitine administration on fatigue, nutritional status, oxidative stress, and related quality of life in 12 advanced cancer patients undergoing anticancer therapy. Nutrition 2006;22(2):136-145. View abstract.

Grandis, D. D. Tolerability and efficacy of L-acetylcarnitine in patients with peripheral neuropathies: a short-term, open multicentre study. Clin Drug Investig. 1998;15(2):73-79. View abstract.

Graziano F, Renato B, Catalano V, and et al. Potential role of levocarnitine supplementation for treatment of chemotherapy-induced fatigue in non-anemic cancer patients. (pre-publication author's copy, via correspondence) 2002;1-14.

Greco, A. V., Mingrone, G., Bianchi, M., and Ghirlanda, G. Effect of propionyl-L-carnitine in the treatment of diabetic angiopathy: controlled double blind trial versus placebo. Drugs Exp Clin Res 1992;18(2):69-80. View abstract.

Greig, C., Finch, K. M., Jones, D. A., Cooper, M., Sargeant, A. J., and Forte, C. A. The effect of oral supplementation with L-carnitine on maximum and submaximum exercise capacity. Eur J Appl Physiol Occup.Physiol 1987;56(4):457-460. View abstract.

Guan, Y., Zheng, X. M., Yang, Z. W., and Li, S. W. [Protective effects of L-carnitine upon testicular ischemia-reperfusion damage in rats]. Zhonghua Yi.Xue.Za Zhi. 7-14-2009;89(26):1858-1861. View abstract.

Guarnieri, G. F., Ranieri, F., Toigo, G., Vasile, A., Ciman, M., Rizzoli, V., Moracchiello, M., and Campanacci, L. Lipid-lowering effect of carnitine in chronically uremic patients treated with maintenance hemodialysis. Am J Clin Nutr 1980;33(7):1489-1492. View abstract.

Guevara-Campos, J., Gonzalez-Guevara, L., Parada, Y., and Urbaez-Cano, J. [Infantile encephalopathy associated with the MELAS A3243G mutation. Case report]. Invest Clin 2007;48(2):243-248. View abstract.

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Gunal, A. I., Celiker, H., Donder, E., and Gunal, S. Y. The effect of L-carnitine on insulin resistance in hemodialysed patients with chronic renal failure. J Nephrol. 1999;12(1):38-40. View abstract.

Gurlek, A., Tutar, E., Akcil, E., Dincer, I., Erol, C., Kocaturk, P. A., and Oral, D. The effects of L-carnitine treatment on left ventricular function and erythrocyte superoxide dismutase activity in patients with ischemic cardiomyopathy. Eur J Heart Fail. 2000;2(2):189-193. View abstract.

Gwak, J. H., Lee, J. H., Lee, S. J., Park, H. W., Kim, Y., and Hyun, Y. J. The effect of L-carnitine and isoflavone supplementation on weight reduction and visceral fat accumulation in overweight women. Korean J.Nutrition 2007;40(7):630-638.

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Harper, P., Elwin, C. E., and Cederblad, G. Pharmacokinetics of intravenous and oral bolus doses of L-carnitine in healthy subjects. Eur J Clin Pharmacol 1988;35(5):555-562. View abstract.

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Head, E., Nukala, V. N., Fenoglio, K. A., Muggenburg, B. A., Cotman, C. W., and Sullivan, P. G. Effects of age, dietary, and behavioral enrichment on brain mitochondria in a canine model of human aging. Exp.Neurol. 2009;220(1):171-176. View abstract.

Heil, S. G., Hogeveen, M., Kluijtmans, L. A., van Dijken, P. J., van de Berg, G. B., Blom, H. J., and Morava, E. Marfanoid features in a child with combined methylmalonic aciduria and homocystinuria (CblC type). J Inherit.Metab Dis 2007;30(5):811. View abstract.

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Helms, R. A., Mauer, E. C., Hay, W. W., Jr., Christensen, M. L., and Storm, M. C. Effect of intravenous L-carnitine on growth parameters and fat metabolism during parenteral nutrition in neonates. JPEN J Parenter.Enteral Nutr 1990;14(5):448-453. View abstract.

Helms, R. A., Whitington, P. F., Mauer, E. C., Catarau, E. M., Christensen, M. L., and Borum, P. R. Enhanced lipid utilization in infants receiving oral L-carnitine during long-term parenteral nutrition. J Pediatr 1986;109(6):984-988. View abstract.

Heringer, J., Boy, S. P., Ensenauer, R., Assmann, B., Zschocke, J., Harting, I., Lucke, T., Maier, E. M., Muhlhausen, C., Haege, G., Hoffmann, G. F., Burgard, P., and Kolker, S. Use of guidelines improves the neurological outcome in glutaric aciduria type I. Ann.Neurol. 2010;68(5):743-752. View abstract.

Herrmann, W. M., Dietrich, B., and Hiersemenzel, R. Pharmaco-electroencephalographic and clinical effects of the cholinergic substance--acetyl-L-carnitine--in patients with organic brain syndrome. Int J Clin Pharmacol Res 1990;10(1-2):81-84. View abstract.

Hiatt, W. R., Creager, M. A., Amato, A., and Brass, E. P. Effect of propionyl-L-carnitine on a background of monitored exercise in patients with claudication secondary to peripheral artery disease. J Cardiopulm.Rehabil.Prev. 2011;31(2):125-132. View abstract.

Hlais, S., Reslan, D. R., Sarieddine, H. K., Nasreddine, L., Taan, G., Azar, S., and Obeid, O. A. Effect of lysine, vitamin B(6), and carnitine supplementation on the lipid profile of male patients with hypertriglyceridemia: a 12-week, open-label, randomized, placebo-controlled trial. Clin Ther 2012;34(8):1674-1682. View abstract.

Ho, J. Y., Kraemer, W. J., Volek, J. S., Fragala, M. S., Thomas, G. A., Dunn-Lewis, C., Coday, M., Hakkinen, K., and Maresh, C. M. l-Carnitine l-tartrate supplementation favorably affects biochemical markers of recovery from physical exertion in middle-aged men and women. Metabolism 2010;59(8):1190-1199. View abstract.

Hoffman, J. R., Ratamess, N. A., Gonzalez, A., Beller, N. A., Hoffman, M. W., Olson, M., Purpura, M., and Jager, R. The effects of acute and prolonged CRAM supplementation on reaction time and subjective measures of focus and alertness in healthy college students. J Int.Soc.Sports Nutr. 2010;7:39. View abstract.

Holzhauer, P. Casuistry: medical nutrition intervention with specific micronutrient and exercise therapy in pancreatic cancer. Zeitschrift für Orthomolekulare Medizin 2009;7(3):22-24.

Hooshmand, S., Balakrishnan, A., Clark, R. M., Owen, K. Q., Koo, S. I., and Arjmandi, B. H. Dietary l-carnitine supplementation improves bone mineral density by suppressing bone turnover in aged ovariectomized rats. Phytomedicine. 2008;15(8):595-601. View abstract.

Horvath, G. A., Davidson, A. G., Stockler-Ipsiroglu, S. G., Lillquist, Y. P., Waters, P. J., Olpin, S., Andresen, B. S., Palaty, J., Nelson, J., and Vallance, H. Newborn screening for MCAD deficiency: experience of the first three years in British Columbia, Canada. Can.J Public Health 2008;99(4):276-280. View abstract.

Hsieh, C. T., Hwu, W. L., Huang, Y. T., Huang, A. C., Wang, S. F., Hu, M. H., and Chien, Y. H. Early detection of glutaric aciduria type I by newborn screening in Taiwan. J Formos.Med.Assoc. 2008;107(2):139-144. View abstract.

Huang, W. W., Wang, M. Y., Shi, H. M., Peng, Y., Peng, C. S., Zhang, M., Li, Y., Lu, J., and Li, X. B. Comparative study of bioactive constituents in crude and processed Glycyrrhizae radix and their respective metabolic profiles in gastrointestinal tract in vitro by HPLC-DAD and HPLC-ESI/MS analyses. Arch.Pharm Res 2012;35(11):1945-1952. View abstract.

Huang, Y., Huang, L. C., and Zhan, F. Clinical analysis of therapeutic effect of levocarnitine on dialysis patients. China Tropical Med 2007;7(5):753-754.

Huidekoper, H. H., Schneider, J., Westphal, T., Vaz, F. M., Duran, M., and Wijburg, F. A. Prolonged moderate-intensity exercise without and with L-carnitine supplementation in patients with MCAD deficiency. J Inherit.Metab Dis 2006;29(5):631-636. View abstract.

Ishii, K., Komaki, H., Ohkuma, A., Nishino, I., Nonaka, I., and Sasaki, M. Central nervous system and muscle involvement in an adolescent patient with riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency. Brain Dev. 2010;32(8):669-672. View abstract.

Isidori, A. M., Pozza, C., Gianfrilli, D., and Isidori, A. Medical treatment to improve sperm quality. Reprod.Biomed.Online. 2006;12(6):704-714. View abstract.

Iyer, R. N., Khan, A. A., Gupta, A., Vajifdar, B. U., and Lokhandwala, Y. Y. L-carnitine moderately improves the exercise tolerance in chronic stable angina. J Assoc Physicians India 2000;48(11):1050-1052. View abstract.

Iyer, R., Gupta, A., Khan, A., Hiremath, S., and Lokhandwala, Y. Does left ventricular function improve with L-carnitine after acute myocardial infarction? J Postgrad Med 1999;45(2):38-41. View abstract.

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Liammongkolkul, S., Kuptanon, C., Wasant, P., Vatanavicharn, N., Sawangareetrakul, P., Keeratichamroen, S., Cairns, J. R. K., Srisomsap, C., and Svasti, J. Novel mutation of methylmalonyl-CoA mutase gene in a Thai infant with methylmalonic acidemia (mut0). Siriraj Med.J. 2009;61(4):215-217.

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Maillart, E., Acquaviva-Bourdain, C., Rigal, O., Brivet, M., Jardel, C., Lombes, A., Eymard, B., Vianey-Saban, C., and Laforet, P. [Multiple acyl-CoA dehydrogenase deficiency (MADD): a curable cause of genetic muscular lipidosis]. Rev.Neurol.(Paris) 2010;166(3):289-294. View abstract.

Malaguarnera, M., Bella, R., Vacante, M., Giordano, M., Malaguarnera, G., Gargante, M. P., Motta, M., Mistretta, A., Rampello, L., and Pennisi, G. Acetyl-L-carnitine reduces depression and improves quality of life in patients with minimal hepatic encephalopathy. Scand.J Gastroenterol. 2011;46(6):750-759. View abstract.

Malaguarnera, M., Gargante, M. P., Cristaldi, E., Colonna, V., Messano, M., Koverech, A., Neri, S., Vacante, M., Cammalleri, L., and Motta, M. Acetyl L-carnitine (ALC) treatment in elderly patients with fatigue. Arch.Gerontol.Geriatr. 2008;46(2):181-190. View abstract.

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Malaguarnera, M., Gargante, M. P., Russo, C., Antic, T., Vacante, M., Malaguarnera, M., Avitabile, T., Li, Volti G., and Galvano, F. L-carnitine supplementation to diet: a new tool in treatment of nonalcoholic steatohepatitis--a randomized and controlled clinical trial. Am.J Gastroenterol. 2010;105(6):1338-1345. View abstract.

Malaguarnera, M., Pistone, G., Astuto, M., Dell'Arte, S., Finocchiaro, G., Lo, Giudice E., and Pennisi, G. L-Carnitine in the treatment of mild or moderate hepatic encephalopathy. Dig.Dis. 2003;21(3):271-275. View abstract.

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Malaguarnera, M., Risino, C., Cammalleri, L., Malaguarnera, L., Astuto, M., Vecchio, I., and Rampello, L. Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study. Eur.J Gastroenterol.Hepatol. 2009;21(7):762-770. View abstract.

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Malaguarnera, M., Vacante, M., Bertino, G., Neri, S., Malaguarnera, M., Gargante, M. P., Motta, M., Lupo, L., Chisari, G., Bruno, C. M., Pennisi, G., and Bella, R. The supplementation of acetyl-L-carnitine decreases fatigue and increases quality of life in patients with hepatitis C treated with pegylated interferon-alpha 2b plus ribavirin. J Interferon Cytokine Res 2011;31(9):653-659. View abstract.

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McMackin, C. J., Widlansky, M. E., Hamburg, N. M., Huang, A. L., Weller, S., Holbrook, M., Gokce, N., Hagen, T. M., Keaney, J. F., Jr., and Vita, J. A. Effect of combined treatment with alpha-Lipoic acid and acetyl-L-carnitine on vascular function and blood pressure in patients with coronary artery disease. J Clin Hypertens.(Greenwich.) 2007;9(4):249-255. View abstract.

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