Oral L-carnitine Supplementation Research Articles

Effects of oral Lcarnitine supplementation on liver enzymes in pediatric acute lymphoblastic leukemia patients in the maintenance phase of treatment: a randomized clinical trial study

Effects of oral Lcarnitine supplementation on liver enzymes in pediatric acute lymphoblastic leukemia patients in the maintenance phase of treatment: a randomized clinical trial study

The effects of oral L-carnitine supplementation on echocardiographic parameters in hemodialysis patients with pulmonary hypertension; a double-blind clinical trial investigation

The effects of oral L-carnitine supplementation on echocardiographic parameters in hemodialysis patients with pulmonary hypertension; a double-blind clinical trial investigation

Association between fatigue, peripheral serotonin, and L-carnitine in hypothyroidism and in chronic fatigue syndrome.

Fatigue of unknown origin is a hallmark symptom in chronic fatigue syndrome (CFS) and is also found in 20% of hypothyroidism patients despite appropriate levothyroxine treatment. Here, we suggest that in these disorders, peripheral serotonin levels are low, and elevating them to normal range with L-carnitine is accompanied with reduced fatigue. We conducted a retrospective analysis of follow-up clinical data (CFS N=12; hypothyroidism with fatigue N=40) where serum serotonin and fatigue levels were compared before vs. after 7 weeks of oral L-carnitine supplementation. After L-carnitine, serotonin increased (8-fold in CFS, Sig. = 0.002, 6-fold in hypothyroidism, Sig. < 0.001) whereas fatigue decreased (2-fold in both CFS and hypothyroidism, Sig. = 0.002 for CFS, Sig. < 0.001 for hypothyroidism). There was a negative correlation between serotonin level and fatigue (for CFS, rho = -0.49 before and -0.67 after L-carnitine; for hypothyroidism, rho = -0.24 before and -0.83 after L-carnitine). These findings suggest a new link between low peripheral serotonin, L-carnitine, and fatigue.

A comparative study of preimplantation embryos development of young and aged mice treated with L-carnitine

Female aging is one of the main factors influencing reproductive fertility. The existing experimental study was planned to investigate the L-carnitine (LC) treatment effect on the body weight of adult young 8–10 weeks old and aged 26–28 weeks old female mice and the preimplantation embryonic development of their embryos. This study involved 40 mature young (n=20) and aged (n=20) old female mice. The animals were weighed and divided into 4 groups according to their age (n = 10). The control groups of young and aged mice groups were orally administered distilled water, while the young and aged mice that were treated orally with 10 mg/kg LC daily for 2-3 estrous cycles were considered as treated groups. Then, all female mice were mated with adult males. The weight of pregnant mice on 1-day post coitum was recorded and then euthanized to harvest early cleavage embryos. The embryo development was examined and evaluated their grading according to A, B, C and D. The results showed that the body weight of mice in both young LC and aged LC groups reduced significantly (P≤0.01). The grade A embryo in 1-day post coitum in young and aged LC groups improved significantly (P≤0.01). However, the development of embryos grade A in the young LC group was higher than that of the aged LC group. It was concluded from these findings that the oral supplementation of LC can reduce body weight and improve the preimplantation embryonic development proportions.

Effect of exogenous l-carnitine on aortic stiffness in dyslipidemic adolescents: Design of a quadruple-blind, randomized, controlled interventional trial

BackgroundAtherosclerotic cardiovascular disease (ASCVD) risk factors including vascular remodeling leading to hypertension and dyslipidemia are prevalent among children and adolescents. Conflicting observational and Mendelian randomization data suggest endogenous carnitine may affect arterial stiffness and lipid traits. Because of this, we developed a study to evaluate the causal role for carnitine in arterial stiffness at a point when the lifecourse trajectory to hypertension can be modified. MethodsThis study is a mechanistic, double-blinded, randomized control trial (RCT) in 166 adolescents with dyslipidemia for the effect of 6 months of maximum dose 3 g daily oral l-carnitine supplementation (CS+) versus placebo (CS-) on aortic stiffness measured as carotid-femoral pulse wave velocity (CFPWV) and pulse pressure (PP); lipid concentrations (total cholesterol, HDL-C, triglycerides, and LDL-C) and serum fatty acid oxidation biomarkers by metabolomic analysis. ConclusionsThe simultaneous evaluation of endogenous carnitine genetic effects and exogenous l-carnitine supplementation may facilitate future therapies for youth with cardiometabolic derangement to arrest atherosclerotic changes.

Evaluation of Treatment Modalities for Pure Asthenospermia Regarding Changes in Seminal Fluid Parameters

Background: Asthenospermia is one of the most common findings in the seminal fluid analysis of patients with infertility. In spite of a full diagnostic workup, the causes of Asthenospermia are not always clear; accordingly, there are a lot of controversies about the best treatment for such a condition. Aim of the study: To evaluate the validity of two treatment modalities for patients with pure Asthenospermia, one surgical (varicocelectomy) and the other medical (L-carnitine supplementation), by following changes in seminal fluid parameters. Patients and methods: A prospective study was conducted at AL-Yarmouk Teaching Hospital/Urology Department from 23rd August 2021 to 18th April 2022. One hundred eighteen infertile male patients were included. Patients were divided in two groups: Surgical arm (71 patients with different grades of varicoceles) and the medical arm (47 patients with no overt clinical varicoceles). For all patients, a full assessment had been done, including at least two seminal fluid analyses as a baseline (to document the presence of pure Asthenospermia). Surgical arm patients were treated with subinguinal varicocelectomy, and medical arm patients were treated with oral supplementation of L-carnitine 1 gm/day. Patients in both groups were followed for 6-12 months by repeated seminal fluid analyses to check the changes in sperm motility. Adverse effects of the treatment were also checked during follow-up visits. Results and Discussion: Surgical arm patients included were 26,23, and 12 patients with varicocele grades 1,2, and 3, respectively, and ten patients with subclinical varicoceles. Medical arm patients included were 32 patients with no varicoceles and 15 patients with subclinical varicoceles. Changes in seminal fluid parameters (total Sperms motility status) after treatment were statistically significant in the varicocelectomy group, and improvement in the seminal fluid parameters was directly related to the grade of the varicoceles with no significant improvement in the patients with subclinical varicoceles. In the medical arm, we achieved an improvement in sperm motility status, but it was not statistically significant. Conclusion: Patients with pure Asthenospermia and clinically detected varicoceles are best treated by varicocelectomy, and the more grade varicoceles, the better results are achieved. L-carnitine supplementation for patients with pure Asthenospermia proved to be beneficial and safe, but when given alone, it was not enough to raise sperm motility status to normal values.

Treatment of glutaric aciduria type I (GA-I) via intracerebroventricular delivery of GCDH

Glutaric aciduria type I (GA-I) is an autosomal recessive genetic disorder caused by a deficiency in glutaryl-CoA dehydrogenase (GCDH). Patients who do not receive proper treatment may die from acute encephalopathic crisis. Current treatments for GA-I include a low-lysine diet combined with oral supplementation of L-carnitine. A mouse model of Gcdhc.422_428del/c.422_428del (Gcdh−/−) was generated in our laboratory using CRISPR/Cas9. Gcdh−/− mice had significantly higher levels of glutaric acid (GA) in the plasma, liver, and brain than those in wild-type C57BL/6 mice. When given a high-protein diet (HPD) for two days, approximately 60% of Gcdh−/− mice did not survive the metabolic stress. To evaluate whether GCDH gene replacement therapy could be used to provide sustained treatment for patients with GA-1, we prepared a recombinant adeno-associated virus (rAAV) carrying a human GCDH expression cassette and injected it into Gcdh−/− neonates for a proof-of-concept (PoC) study. Our study demonstrated that delivering rAAV to the central nervous system (CNS), but not the peripheral system, significantly increased the survival rate under HPD exposure. Our study also demonstrated that rAAVPHP.eB mediated a higher efficiency than that of rAAV9 in increasing the survival rate. Surviving mice showed dose-dependent GCDH protein expression in the CNS and downregulation of GA levels. Our study demonstrated that AAV-based gene replacement therapy was effective for GA-I treatment and provided a feasible solution for this unmet medical need.

Effect of Acute and Chronic Oral l-Carnitine Supplementation on Exercise Performance Based on the Exercise Intensity: A Systematic Review.

l-Carnitine (l-C) and any of its forms (glycine-propionyl l-Carnitine (GPL-C) or l-Carnitine l-tartrate (l-CLT)) has been frequently recommended as a supplement to improve sports performance due to, among others, its role in fat metabolism and in maintaining the mitochondrial acetyl-CoA/CoA ratio. The main aim of the present systematic review was to determine the effects of oral l-C supplementation on moderate- (50–79% O2 max) and high-intensity (≥80% O2 max) exercise performance and to show the effective doses and ideal timing of its intake. A structured search was performed according to the PRISMA® statement and the PICOS guidelines in the Web of Science (WOS) and Scopus databases, including selected data obtained up to 24 October 2021. The search included studies where l-C or glycine-propionyl l-Carnitine (GPL-C) supplementation was compared with a placebo in an identical situation and tested its effects on high and/or low–moderate performance. The trials that used the supplementation of l-C together with additional supplements were eliminated. There were no applied filters on physical fitness level, race, or age of the participants. The methodological quality of studies was evaluated by the McMaster Critical Review Form. Of the 220 articles obtained, 11 were finally included in this systematic review. Six studies used l-C, while three studies used l-CLT, and two others combined the molecule propionyl l-Carnitine (PL-C) with GPL-C. Five studies analyzed chronic supplementation (4–24 weeks) and six studies used an acute administration (<7 days). The administration doses in this chronic supplementation varied from 1 to 3 g/day; in acute supplementation, oral l-C supplementation doses ranged from 3 to 4 g. On the one hand, the effects of oral l-C supplementation on high-intensity exercise performance variables were analyzed in nine studies. Four of them measured the effects of chronic supplementation (lower rating of perceived exertion (RPE) after 30 min at 80% O2 max on cycle ergometer and higher work capacity in “all-out” tests, peak power in a Wingate test, and the number of repetitions and volume lifted in leg press exercises), and five studies analyzed the effects of acute supplementation (lower RPE after graded exercise test on the treadmill until exhaustion and higher peak and average power in the Wingate cycle ergometer test). On the other hand, the effects of l-C supplementation on moderate exercise performance variables were observed in six studies. Out of those, three measured the effect of an acute supplementation, and three described the effect of a chronic supplementation, but no significant improvements on performance were found. In summary, l-C supplementation with 3 to 4 g ingested between 60 and 90 min before testing or 2 to 2.72 g/day for 9 to 24 weeks improved high-intensity exercise performance. However, chronic or acute l-C or GPL-C supplementation did not present improvements on moderate exercise performance.

Effect of L-Carnitine Supplementation on Inflammatory Markers and Serum Glucose in Hemodialysis Children: A Randomized, Placebo-Controlled Clinical Trial

Chronic inflammation is present in a high proportion of the chronic kidney disease (CKD) population, which can increase the risk of cardiovascular disease. Moreover, it is known as the leading cause of death in these patients. In addition, change in glucose metabolism is another common problem among CKD population. In this regard, it was found that insulin resistance and inflammation can perpetuate each other and simultaneously cause atherosclerosis. Because some studies have previously shown the positive effects of L-carnitine on reducing inflammation and controlling blood sugar, in the present study, we examined the effects of L-carnitine supplementation on serum inflammatory markers, fasting blood sugar (FBS), free carnitine (FC), albumin levels, and quality of life score among children on hemodialysis. Twenty-four children on hemodialysis (aged between 6 and 18 years) were enrolled in this randomized clinical trial study. Thereafter, 12 patients received 50 mg/kg of L-carnitine and 12 patients received placebo for a 10-week period. Afterward, we determined serum FC, interleukin-6 (IL-6), high-sensitivity C-reactive protein, FBS, and albumin and Pediatrics Quality of Life scores once at the baseline and once after performing intervention for 10 weeks. Moreover, the one-way repeated measures analysis was used to evaluate the effects of L-carnitine supplementation. Although oral L-carnitine supplementation led to the decreased high-sensitivity C-reactive protein, this change was not significant compared with the placebo. Also, L-carnitine supplementation has significantly reduced serum levels of IL-6 and FBS, which has also raised serum FC and Pediatrics Quality of Life scores compared with the placebo. Notably, no significant change was observed in serum albumin levels. Given the significant reductions in IL-6 and FBS levels, L-carnitine supplementation appeared to have some positive effects on the inflammation, blood glucose control, and prevention of cardiovascular events in these patients, as well as the improvement of quality of life. In this regard, L-carnitine therapy with a longer duration is recommended to obtain more effective results.

Effect of L-carnitine supplementation on lipid profile and apolipoproteins in children on hemodialysis: a randomized placebo-controlled clinical trial

Cardiovascular disease (CVD) is the leading cause of death in children with chronic kidney disease (CKD) and accounts for 40% of all deaths among pediatric patients with stage5 chronic kidney disease (CKD5). Dyslipidemia is common in children with CKD and is considered one of the major causes of CVD in these patients. As carnitine plays a key role in lipid metabolism and because plasma levels are reduced in hemodialysis patients, the aim of this study was to determine the effects of L-carnitine supplementation on serum lipid profiles, apolipoproteins, and free carnitine (FC) levels. A total of 30 children on hemodialysis (6-18 years) were enrolled and 24 completed the study. Twelve patients received 50 mg/kg/day L-carnitine, while the other 12 patients received placebo for 10 weeks. Serum FC, total cholesterol (TC), LDL-C, HDL-C, TG, Apolipoprotein B (ApoB), and Apolipoprotein A1 (ApoA1) were determined at the baseline and after the intervention. One-way repeated measures analysis was used to evaluate the effects of L-carnitine supplementation. Oral L-carnitine supplementation led to decreased ApoB levels and ApoB/ApoA1 ratio, but these changes were not significant compared to placebo. Meanwhile, L-carnitine supplementation significantly reduced serum LDL-C and TC and increased serum FC compared to placebo. No significant changes were observed in serum TG and HDL-C levels. Given the significant reduction in LDL-C and TC levels, L-carnitine supplementation had positive effects on improving hyperlipidemia in children receiving hemodialysis. For more decisive results, studies with longer duration of L-carnitine therapy on children receiving hemodialysis with significant dyslipidemia are recommended. We registered the present trial in the Iranian Registry of Clinical Trials website (available at: http://www.irct.ir , identifier: IRCT20170202032367N2).

L-carnitine reduces hospital admissions in patients with hepatic encephalopathy.

The aim of this study was to determine whether oral L-carnitine administration reduces the blood ammonia concentration and number of hospital admissions for hepatic encephalopathy in patients with advanced cirrhosis. Of 68 patients with hepatic encephalopathy treated with oral L-carnitine supplementation from April 2013 to March 2016, we enrolled 19 patients who had received full standard treatment. We analyzed blood ammonia concentration, number of hospital admissions, and prognosis to determine how effective L-carnitine was in achieving mid-term to long-term suppression of recurrent hepatic encephalopathy. Median blood ammonia concentrations at the start, 1 week, 12 weeks, 24 weeks, and 48 weeks were 159, 79, 75, and 82 μg/dL, respectively. Blood ammonia concentrations 12 week, 24 weeks, and 48 weeks after L-carnitine administration were significantly lower than those at the start (P < 0.0001, respectively). During the 3 years prior to oral L-carnitine administration, the enrolled patients were hospitalized a total of 29 times for hepatic encephalopathy. However, during the 3 years following oral L-carnitine administration, they were admitted a total of six times for hepatic encephalopathy (P < 0.001). Median survival time was 40.9 months. Child-Pugh scores before and after oral L-carnitine administration differed significantly, whereas liver reserve function, nutritional status, and muscle index did not change significantly. Oral L-carnitine administration is effective and free of adverse effects in patients with hyperammonemia and reduces the number of hospital admissions for hepatic encephalopathy.

The effect of L-carnitine supplementation on blood pressure in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled trial

ObjectivesDiabetic patients with hypertension are at a high risk of cardiovascular complications. The present study made an attempt to determine the effect of oral L-carnitine supplementation on blood pressure in patients with type 2 diabetes mellitus (T2DM). Materials and methodsIn this randomized, double-blind, placebo-controlled trial, 70 patients with T2DM at the age range of 41–75 years were randomly allocated to two groups: L-carnitin group (LG) (n = 35) receiving 1000 mg/day L-carnitin, and placebo group (PG) (n = 35) receiving 1000 mg/day wheat starch as placebo for 12 weeks. The systolic and diastolic blood pressures, mean arterial blood pressure and pulse pressure were examined before and after the intervention. ResultsSixty-four participants completed the study. At the end of the study period, LG compared with the PG, showed no significant difference in SBP (−1.14 ± 2.45 mmHg vs. −2.42 ± 2.79 mmHg), DBP (−3.2 ± 1.94 mmHg vs. −6±2.30 mmHg), MAP (−2.51 ± 1.84 mmHg vs. −4.80 ± 2.11 mmHg) and PP (2.05 ± 2.23 mmHg vs. 3.57 ± 2.73 mmHg). ConclusionThe oral supplementation of L-carnitine 1000 mg/day fails to affect blood pressure after 12 weeks of treatment in diabetes patients.*This was a randomized, controlled clinical trial (RCT) which was registered October 28, 2017 in the Iranian Registry of Clinical Trials (http://www.irct.ir, identifer: IRCT2017100936681N1).

Can L-carnitine supplementation and exercise improve muscle complications in patients with liver cirrhosis who receive branched-chain amino acid supplementation?

The aim of this study was to elucidate the efficacy of the combination of L-carnitine and exercise, reported to prevent muscle wasting, for muscle complications (function, volume, and cramping) in patients with liver cirrhosis (LC) who received branched-chain amino acid supplementation. From December 2017 to April 2018, 18 patients with LC who had been given branched-chain amino acid granule supplementation (12.45 g/day) were enrolled (mean age 68.4±10.8 years; 10 males and eight females; Child-Pugh A : B=9 : 9). After evaluating the average number of daily steps, oral L-carnitine supplementation (1000 mg/day) and additional exercise (plus 2000 steps/day) were added for 6 months. Every 4 weeks, a pedometer, a hand dynamometer, ergometer, and bioelectrical impedance analysis were used to evaluate daily steps, muscle function and muscle volume, and muscle cramps were recorded using a numerical rating scale. Average steps and serum levels of total and free carnitine were increased from before treatment to the final measurement (1883.5±1211.6 vs. 3165.1±1800.0/day, 62.6±16.5 vs. 110.9±28.6 μmol/l, and 47.7±15.2 vs. 83.2±21.5 μmol/l, respectively; P<0.01), whereas there were no significant changes in the ratios of handgrip strength, leg strength, and muscle volume after 6 months [1.00±0.13 (P=0.991), 1.07±0.13 (P=0.073), and 0.992±0.036 (P=0.390), respectively]. However, the frequency of complaints of muscle cramping was reduced as compared with the start of therapy (baseline, 3 months, and 6 months: 6.3±4.8, 3.1±3.3, and 2.1±2.0, respectively) (P=0.025, Holm's method), whereas numerical rating scale did not show any significant improvement. L-Carnitine may have an important role for prevention of muscle wasting and reducing the frequency of muscle cramping.

Effects of Oral L-carnitine Supplementation on Visceral Proteins, C-reactive Protein, Homocysteine and Blood Lipid of Hemodialysis Patients: A Randomized Clinical Trial

Effects of Oral L-carnitine Supplementation on Visceral Proteins, C-reactive Protein, Homocysteine and Blood Lipid of Hemodialysis Patients: A Randomized Clinical Trial

L-Carnitine Supplementation Increases Trimethylamine-N-Oxide but not Markers of Atherosclerosis in Healthy Aged Women

Background: L-carnitine can be metabolized to trimethylamine N-oxide (TMAO), a molecule that promotes atherogenesis through its interaction with macrophages and lipid metabolism. Objective: The aim of the present study was to assess whether L-carnitine supplementation may promote changes in selected serum biomarkers of atherosclerosis. Methods: Before the start, in the mid-point and after completing the 24-weeks supplementation protocol, fasting blood samples were taken from the antecubital vein. Plasma free L-carnitine and TMAO were determined by the UPLC/MS/MS method. Serum proteins were determined by the enzyme immunoassay method using commercially available kits. Total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and triglycerides have been determined using standard automatic analyzer. Results: L-carnitine supplementation elevated fasting plasma carnitine in the mid-point of our study and it remained increased until the end of supplementation period. Moreover, it induced tenfold increase in plasma TMAO concentration but did not affect serum C-reactive protein, interleukin-6, tumour necrosis factor-α, L-selectin, P-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1 or lipid profile markers. Conclusion: We demonstrated that ­although oral L-carnitine supplementation significantly ­increased plasma TMAO concentration, no lipid profile changes or other markers of adverse cardiovascular events were detected in healthy aged women over the period of 24 weeks.

L-Carnitine for the Treatment of Overt Hepatic Encephalopathy in Patients with Advanced Liver Cirrhosis.

Hepatic encephalopathy is a major complication in patients with advanced cirrhosis and is associated with poor prognosis. To evaluate the effectiveness of L-carnitine supplementation in patients with overt hepatic encephalopathy (OHE), outcomes were retrospectively analyzed in patients with OHE who were treated with intravenous branched-chain amino acids (BCAA), with or without intravenous L-carnitine. Twenty-six patients were treated with intravenous BCAA in addition to conventional agents such as lactulose and non-absorbable antibiotics (Group A), and 19 patients were treated with these agents plus intravenous L-carnitine (Group L). Changes in blood ammonia concentrations, hepatic coma grade and the Glasgow Coma Scale (GCS) were compared in the two groups. Recurrence-free survival (RFS) was evaluated in the two groups and in patients who were and were not administered oral L-carnitine supplementation. At baseline, GCS scores were significantly lower and deterioration in liver function greater in Group L. After 3 d of intravenous L-carnitine, however, GCS showed a significantly greater improvement in Group L than in Group A. Blood ammonia levels improved stably over time in Group L. Overall survival and RFS were similar in Group L and Group A, but median RFS was significantly longer in patients who did than did not receive oral L-carnitine supplementation (735 versus 497 d, p=0.03). Although these findings are preliminary, L-carnitine supplementation may be a therapeutic option for patients with OHE and disturbed consciousness.

Marked elevation in plasma trimethylamine-N-oxide (TMAO) in patients with mitochondrial disorders treated with oral l-carnitine

Oral supplementation with l-carnitine is a common therapeutic modality for mitochondrial disorders despite limited evidence of efficacy. Recently, a number of studies have demonstrated that a gut microbiota-dependent metabolite of l-carnitine, trimethylamine oxide (TMAO), is an independent and dose-dependent risk factor for cardiovascular disease (CVD). Given the limited data demonstrating efficacy with oral l-carnitine therapy and the newly raised questions of potential harm, we assessed plasma TMAO levels in patients with mitochondrial disease with and without oral l-carnitine supplementation. Nine subjects were recruited and completed the study. Eight out of 9 subjects at baseline had plasma TMAO concentrations <97.5th percentile (<15.5 μM). One subject with stage 3 renal disease, had marked elevation in plasma TMAO (pre 33.98 μm versus post 101.6 μm). Following at least 3 months of l-carnitine supplementation (1000 mg per day), plasma TMAO levels were markedly increased in 7out of 9 subjects; overall, plasma TMAO significantly increased 11.8-fold (p < 0.001) from a baseline median level of 3.54 μm (interquartile range (IQR) 2.55–8.72) to 43.26 (IQR 23.99–56.04) post supplementation. The results of this study demonstrate that chronic oral l-carnitine supplementation markedly increases plasma TMAO levels in subjects with mitochondrial disorders. Further studies to evaluate both the efficacy and long term safety of oral l-carnitine supplementation for the treatment of mitochondrial disorders are warranted.

Oral administration of l-carnitine improves the clinical outcome of fertility in patients with IVF treatment

Age-dependent decline of mitochondrial function has been proposed to be a main cause of decline of embryo quality. Then, l-carnitine plays important roles in reducing the membranous toxicity of free-fatty acids by forming acyl-carnitine and promoting β-oxidation, preventing cell damage. Recent research revealed that l-carnitine played important roles in vitro in oocyte growth, oocyte maturation and embryo development. However, such beneficial effects of l-carnitine in vivo have yet to be verified. The effect of oral l-carnitine supplementation on embryo quality and implantation potential was examined. A total of 214 patients were included in this study. They all previously received in vitro fertilization-embryo transfer (IVF-ET) and failed to conceive. Then they were administered l-carnitine for 82 days on average and underwent IVF-ET again. There were no significant differences in the total number of retrieved oocytes, and their maturation and fertilization rates between before and after l-carnitine administration. The quality of embryos on Days 3 and 5 after insemination was improved following l-carnitine administration (p < .05) in cycles after l-carnitine administration compared with previous cycles. Healthy neonates were born after IVF-ET following l-carnitine administration. Our data suggested that oral administration of l-carnitine to fertility patients improved the developmental competence of their oocytes after insemination.

Protective Effects of L-Carnitine Against Delayed Graft Function in Kidney Transplant Recipients: A Pilot, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial

Delayed graft function (DGF) is an early complication after deceased donor kidney transplantation with significant adverse effects on graft outcomes. Ischemia-reperfusion injury during transplantation is a major cause of DGF. Tissue concentrations of carnitine, an antioxidant and regulator of cellular energy supply, decrease in the kidney following ischemia-reperfusion insult. Based on promising animal data, this study evaluated the possible protective effect of L-carnitine against DGF. This study is a pilot, randomized, double-blind, placebo-controlled clinical trial that was conducted on kidney transplantation patients in kidney transplant ward of Imam Khomeini hospital complex affiliated to Tehran University of Medical Sciences, Tehran, Iran. Patients older than 14years old undergoing their first kidney transplantation from a deceased donor were evaluated for eligibility to take part in this study. Fifty-six patients were randomly assigned to L-carnitine or placebo groups. During this trial, 3g of oral L-carnitine or placebo was administered in 3 divided doses each day for 4 consecutive days starting the day before kidney transplantation (i.e., days -1, 0, 1, and 2). The need for dialysis within the first week after transplantation, serum creatinine and urine output were assessed daily. After hospital discharge, patients were followed for 3months regarding organ function. DGF incidence did not differ between the L-carnitine and placebo groups (18.51% vs. 23.8%, respectively; P=.68). Total allograft failure within 3months after kidney transplantation happened in 6 patients in the placebo and 1 patient in the L-carnitine group (P=.05). This study showed no protective effects of oral L-carnitine supplementation against DGF occurrence recipients; however, 3-month graft loss was lower in the L-carnitine supplemented group.

EFFECT OF ACUTE L-CARNITINE SUPPLEMENTATION ON BLOOD LACTATE, GLUCOSE, AEROBIC AND ANAEROBIC PERFORMANCE IN ELITE MALE ARTISTIC GYMNASTS

Background. Probably L-Carnitine can induce the increase of Pyruvate dehydrogenase activity, decrease of lactic acid production and performance improvements due to the reinforcement of long chain fatty acid oxidation and stabilize of coASH to free COA. Based on this, the aim of our study was to investigate the effects of acute L-Carnitine supplementation on blood lactate, glucose, VO 2 max and anaerobic power in elite male artistic gymnasts. Methods. Eighteen male artistic gymnasts were randomly assigned to supplementation (n = 9) or placebo (n = 9) groups. In a double blind design, subjects participated in two tests with a break of one week between them. Subjects ingested 3 grams of L-Carnitine or placebo (maltodextrin) 90 minutes before aerobic and anaerobic exercise protocols. We used a 20 m shuttle run as an aerobic exercise protocol and running based anaerobic sprint test (RAST) as an anaerobic exercise protocol. Blood samples were collected 5 minutes pre and 4 minutes post-tests for the analysis of lactate and glucose. Results. L-Carnitine group had significantly lower lactate concentration than placebo group after tests (p &lt; .05). L-Carnitine group had significantly higher blood glucose (p &lt; .05) compared with placebo group, too. Also VO 2 max as well as mean and maximum power in L-Carnitine group were significantly higher than those in placebo group (p &lt; .05). Conclusions. These findings indicated that acute oral supplementation of L-Carnitine can probably induce fatigue decrease and improvement of aerobic and anaerobic performance in elite male artistic gymnasts.