Abstracts
Ischemic Myocardium Condition
Ischemic myocardium condition
L-carnitine supplementation significantly improves the recovery of ischemic myocardium in diabetic and euglycemic rats. The effect of acute L-carnitine supplementation on rat hearts from diabetic and euglycemic animals was examined in a clinical trial. An hour after hearts taken from diabetic and euglycemic groups were administered L-carnitine, their left ventricular pressure in the hearts was significantly improved. Left ventricular end-diastolic pressure was also significantly reduced in the hearts from the diabetic L-carnitine supplementation group. L-carnitine may be beneficial among diabetic patients with ischemic myocardial dysfunction.
Keller VA; Toporoff B; Raziano RM; Pigott JD; Mills NL: Carnitine supplementation improves myocardial function in hearts from ischemic diabetic and euglycemic rats, Ann-Thorac-Surg. 1998 Nov; 66(5): 1600-3
Peripheral Arterial Disease
Peripheral arterial disease
The effects of carnitine supplementation during exercise in healthy individuals and those with special needs were examined. Clinical data have not been sufficient to demonstrate benefits of carnitine supplementation in healthy individuals. Carnitine or propionylcarnitine may improve muscle function and exercise capacity among patients suffering from peripheral arterial disease (PAD), and end stage renal disease. Peripheral arterial disease is associated with an abnormal metabolism in skeletal muscles. End stage renal disease requires long-term nutritional changes and dialysis therapy that may lower skeletal muscle carnitine. Clinical observations indicated that nutritional changes and dialysis therapy might also reduce skeletal muscle carnitine content among patients. Further research is necessary to determine the benefits of carnitine and acylcarnitine as therapy to improve exercise performance in patients with disease as well as in health individuals.
Brass EP; Hiatt WR: The role of carnitine and carnitine supplementation during exercise in man and in individuals with special needs, J-Am-Coll-Nutr. 1998 Jun; 17(3): 207-15
Cardiac Function
Cardiac function
Carnitine supplementation may not ameliorate cardiac function among children with carnitine deficiencies due to hemodialysis. In a clinical trial, total carnitine and free carnitine plasma levels were measured before and after 3 months of intravenous carnitine supplementation A significant increase in blood carnitine levels was found at the end of the 3-month period. . However, it was not associated with an improved cardiac function. A moderate but insignificant increase in mean Hematocrit (Hct) and Hb levels was seen. Plasma triglycerides, total cholesterol or lipoprotein levels remained the same. Overall, carnitine supplementation may not be sufficient to benefit children undergoing hemodialysis.
Topaloglu, R; Celiker, A; Saatci U; Kilinc, K; Bakkaloglu, A; Besbas, N; Sezaozen, Tokel K: Effect of carnitine supplementation on cardiac function in hemodialyzed children, Acta-Paediatr-Jpn. 1998 Feb; 40(1): 26-9 1998
Muscle Symptoms
Muscle symptoms
Low-dose L-carnitine treatment may improve muscle condition by restoring carnitine tissue.
Carnitine deficiency may cause muscle symptoms in patients on maintenance hemodialysis. The effect of low-dose L-carnitine treatment on muscle symptoms was investigated. L-carnitine treatment resulted in some improvement in muscular symptoms among two-thirds of the patients. Carnitine fractions were normal or slightly above normal, and lipid profiles were seemingly unaffected. A correlation between carnitine deficiency and months on dialysis was indicated. Long-term L-carnitine treatment may alleviate muscle symptoms during dialysis by replenishing the muscle tissue with carnitine and washing out acyl moieties.
Sakurauchi, Y; Matsumoto, Y; Shinzato, T; Takai, I; Nakamura, Y; Sato, M; Nakai, S; Miwa, M Morita, H; Miwa, T; Amano, I; Maeda, K: Effects of L-carnitine supplementation on muscular symptoms in hemodialyzed patients, Am-J-Kidney-Dis. 1998 Aug; 32(2): 258-64 1998 0272-6386
Hemodialysis Patients
Quality of life among hemodialysis patients
Health-related qulaity of life may directly influence a hemodialysis patient's compliance with medical treatments and therapies. L-carnitine supplementation may enhance muscle strength and vitality, therefore improving patient perception of health-related quality of life. In this study, oral administration of L-carnitine or placebo was given to hemodialysis patients for 6 months. During the early stage of the trial, patients taking oral L-carnitine supplementation seemed to have improved general health and physical function. However, the positive side effects were not sustained throughout the entire 6 months. L-carnitine may improve patients' overall health and perception of health for a short period of time. Serum albumin concentration was positively correlated with patient perception of quality of life.
Sloan, RS; Kastan, B; Rice, SI; Sallee, CW; Yuenger, NJ; Smith, B; Ward, RA; Brier, ME; Golper, TA: Quality of life during and between hemodialysis treatments: role of L-carnitine supplementation, Am-J-Kidney-Dis. 1998 Aug; 32(2): 265-72
Malabsorption & Carnitine
Malabsorption
The intravenous administration of carnitine (CAR) may improve carnitine levels among patients with severe malabsorption. This agent is essential in the metabolism of fatty acids. In a trial, a 3-year-old boy with a short bowel syndrome was administered total parenteral nutrition and also received oral carnitine. Oral L-CAR was not enough to provide sufficient carnitine levels in the patient. Thus, intravenous administration of carnitine may be necessary to provide sufficient amounts of carnitine to patients with severe malabsorption.
Hirose, S; Hirata, M; Azuma, N ;Shirai, Z ;Mitudome, A; Oda, T: Carnitine depletion during total parenteral nutrition despite oral L-carnitine supplementation, Acta-Paediatr-Jpn. 1997 Apr; 39(2): 194-200
Valproate Overdose
Valproate overdose
Carnitine useful for treating valproate overdose patients with coma. In an observation, urinary valproate (VPA) metabolites and carnitine concentrations were evaluated in child who overdosed on valproate, an anti-seizure medicine. After L-carnitine supplementation, VPA metabolism returned to normal.
Murakami, K; Sugimoto, T; Woo, M; Nishida, N; Muro, H: Effect of L-carnitine supplementation on acute valproate intoxication, Epilepsia.1996 Jul; 37(7): 687-9
Vaproate-induced Hyperammonaemia
Vaproate-induced hyperammonaemia
Carnitine supplementation may normalize elevated plasma ammonia concentrations. This study investigated the effect of carnitine supplementation among patients with valproic acid-induced increased plasma ammonia concentrations. Carnitine was administered to fourteen hyperammonaemic patients and one with normal ammonia levels. Plasma ammonia concentrations decreased in all 15 patients. Plasma free carnitine concentrations were increased. Thus, carnitine may reduce ammonia concentrations among patients taking valproic acid. However, it is inconclusive whether risk of developing VPA-induced Reye's-like syndrome is lowered.
Bohles, H; Sewell, AC; Wenzel, D: The effect of carnitine supplementation in valproate-induced hyperammonaemia, Acta-Paediatr. 1996 Apr; 85(4): 446-9
Skeletal Muscle Metabolism & Carnitine
Skeletal muscle metabolism
Asparagine and aspartate, both oxaloacetate precursors, and carnitine supplementation may improve muscle metabolism and endurance during prolonged and moderate exercise. Diet supplementation increased muscle capacity to utilize FFA as opposed to glycogen. The experimental supplementation group had a time to exhaustion that was 40% longer than that of the control group. The implication is that oxaloacetate may affect time to exhaustion during exercise.
Lancha, AH Jr; Recco, MB; Abdalla, DS; Curi, R: Effect of aspartate, asparagine, and carnitine supplementation in the diet on metabolism of skeletal muscle during a moderate exercise, Physiol-Behav. 1995 Feb; 57(2): 367-71
Nephropathic Cystinosis
Nephropathic cystinosis
Oral L-carnitine supplements may normalize muscle carnitine concentrations among children with nephropathic cystinosis. The renal tubular Fanconi syndrome in these children cause depletion of plasma and muscle carnitine. Six children receiving carnitine every 6 hours for an average of 62 months had muscle-free carnitine values of 16.0 to 28.0nmol/mg and a total body carnitine concentration of 3.4mg. Children without carnitine supplementation had muscle-free carnitine values of 3.0 to 11.4nmol/mg and a total body carnitine concentration of 2.3mg. Total muscle carnitine values were also normalized through carnitine supplementation. No dangerous side effects were observed. Oral L-carnitine treatment can be used to normalize muscle as well as plasma carnitine levels in children with cystinosis.
Gahl , WA; Bernardini, IM; Dalakas, MC; Markello, TC; Krasnewich, DM; Charnas, LR: Muscle carnitine repletion by long-term carnitine supplementation in nephropathic cystinosis, Pediatr-Res. 1993 Aug; 34(2): 115-9
Diphtheria
Diphtheria
Carnitine supplementation can be beneficial in treating diphtheria. The effect of carnitine supplementation on patients with diphtheria was studied. Over 600 children were treated with carnitine or placebo. Those receiving carnitine had reduced incidences of myocarditis. Those with myocarditis who received carnitine therapy showed a significant reduction in mortality compared to the placebo group. All patients with diphtheria are advised to receive carnitine supplementation.
Ramos, AC; Barrucand, L; Elias, PR; Pimentel, AM; Pires, VR: Carnitine supplementation in diphtheria, Indian-Pediatr. 1992 Dec; 29(12): 1501-5
Low Birth-Weight Infants
Low birth-weight premature infants
Oral L-carnitine supplementation can be beneficial for low birth-weight, premature infants. The effects of oral L-carnitine supplementation on fat and protein metabolism were examined. In this trial, infants were fed with pasteurized human milk containing carnitine supplement for a week. During the trial, daily urinary excretion of total carnitine increased until it leveled off, indicating that part of the supplement was retained by the body. Total and free carnitine levels were significantly increased in the plasma at the end of the trial. The increased levels of acylcarnitines in plasma and urine meant that carnitine was absorbed by the tissues and metabolized. An enhanced fat utilization and reduced amino acid and protein catabolism were indicated by a decrease in plasma triglyceride level and a decrease in urea and total N excretion.
Melegh, B; Kerner, J; Sandor, A; Vinceller, M; Kispal, G: Effects of oral L-carnitine supplementation in low-birth-weight premature infants maintained on human milk, Biol-Neonate. 1987; 51(4): 185-93
Childhood Epilepsy
Childhood epilepsy
A panel of pediatric neurologists agreed that intravenous L-carnitine supplementation is clearly indicated for valproate-induced hepatotoxicity, overdose, and other metabolic crises related to carnitine deficiency. Oral supplementation is strongly suggested for patients with secondary carnitine-deficiency syndromes, symptomatic VPA-associated hyperammonemia, multiple risk factors for VPA hepatotoxicity, renal associated syndromes, infants and young children on VPA, hypocarnitinemia, dialysis, and premature infants receiving total parenteral nutrition. A recommended dosage of 100 mg/kg/day up to a maximum of 2 g/day was given. Intravenous supplementation for emergency situations can exceed the recommended dosage.
De Vivo, DC; Bohan, TP; Coulter, DL; Dreifuss, FE; Greenwood, RS; Nordli, DR Jr; Shields, WD; Stafstrom, CE; Tein, I: L-carnitine supplementation in childhood epilepsy: current perspectives, Epilepsia. 1998 Nov; 39(11): 1216-25
Male Infertility & Carnitine
Male Infertility
According to this study conducted on 101 men, low levels of L-carnitine may be associated with low sperm quality. Seminal plasma from 101 men was examined for sperm quality and L-carnitine levels. Men with normal sperm quality exhibited an average L-carnitine level of 478.4, while men with reduced numbers of sperm or immotile sperm had an average L-carnitine level of 100.58, suggesting that L-carnitine may be related to sperm health.
Matalliotakis I, et al: L-carnitine levels in the seminal plasma of fertile and infertile men: correlation with sperm quality, Int J Fertil Womens Med 2000 May-Jun;45(3):236-40
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