Acetyl L-Carnitine - How it Works

Along with Alpha Lipoic Acid (see yesterday's post), Acetyl L-Carnitine, is another anti-oxidant/amino acid that is widely used to help with neuropathy symptoms. Today's very honest extract from an article from howstuffworks.com (see link below) gives a detailed description of what it is and how it works. Whether it works as well as claimed for neuropathic problems is also debated here but it certainly has a theoretical, beneficial effect on the mitochondria. It provides them with the means of metabolising fatty acids and converting them to energy - thus maintining nerve health.
Just as with Alpha Lipoic Acid, it doesn't come cheap and with the recommended doses being very high, you may find it too expensive as an option. Probably best to discuss it with your HIV-specialist or neurologist first.

Acetyl-L Carnitine Overview
by Eleanor Duse

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Acetyl-L Carnitine at Work in Your Body

Without acetyl-L-carnitine, the mitochondria can't absorb and metabolize fatty acids. This process has led to the claim that acetyl-L-carnitine can aid in weight loss.

There is little actual proof to support that claim, or the claim that acetyl-L-carnitine can lead to a better fat-to-muscle ratio. The supplement may improve the endurance of patients with emphysema (also known as COPD, or chronic obstructive pulmonary disease), and relieve the fatigue associated with fibromyalgia and celiac disease [source: NAT]. If you're already adhering to a substantial exercise program, though, there's no proof that acetyl-L carnitine will make a difference in your results.

It is somewhat more promising as a treatment for certain neural disorders. Acetyl-L-carnitine contains an acetyl group that is essential for the production of a key neurotransmitter [source: UMHS]. The nervous system depends on fat metabolism. Fat is a major component of the myelin sheath that coats each nerve cell. The chemical composition of the myelin sheath is what allows impulses to jump across synapses (the spaces between nerve cells) and travel through the body to turn into actions, sensations, ideas or feelings. The breakdown of the myelin sheath can prevent the nervous system from being able to communicate effectively with itself. That's what happens in diseases such as multiple sclerosis. A myelin sheath with a high fat content performs more effectively, insulating the nerve and allowing the impulse to travel faster [source: Nagel].

Because of the way acetyl-L-carnitine seems to aid in fat metabolism, some doctors believe it shows promise as a treatment for certain nervous and cognitive disorders. Among these disorders are dysthymia (mild depression), attention deficit and hyperactivity disorder (ADHD) Alzheimer's disease, the neural degeneration associated with cirrhosis and obsessive-compulsive disorder (OCD) [sources: Arnold, NAT]. Acetyl-L-carnitine has been studied as a way to reduce the hyperactivity associated with fragile X syndrome, a serious genetic disorder, but results are inconclusive [source: NAT].

Some complications of diabetes also impair the nerves. Certain doctors consider acetyl-L-carnitine a promising candidate for repairing the damage wrought by diabetic neuropathy, a harrowing complication that erodes nervous function in the arms and legs -- and sometimes in the heart -- leading to pain and numbness. But clinical proof is lacking, and at least one study indicates that carnitine supplements might actually hurt diabetics by increasing blood triglyceride levels (the amount of fat in the circulatory system) [source: NAT].

Acetyl-L Carnitine Benefits

Although much more study is needed, and several existing studies have been significantly flawed, acetyl-L-carnitine does seem to have promise in enhancing quality of life for people with cognitive problems and nerve damage, especially when those problems are the side effects of disease or other drug therapies [source: UMHS].

For example, some AIDS and HIV treatments cause muscular wasting and impair nervous function. There's a possibility that acetyl-L-carnitine could restore some of that function.

Likewise, alcohol abuse can gradually impair nervous function, partly because the liver loses its ability to process fat. In severe cases, it leads to a condition called hepatic encephalopathy. Acetyl-L-carnitine might help restore the balance. However, severe, long-term alcoholism has many cognitive effects that go beyond fat metabolism.

In a study, the drug also seemed to help a group of seniors with mild Alzheimer's disease, the progressive (and irreversible) neurological disorder that gradually destroys a person's memory, independence, motor functions and sense of self. Some patients who took supplements of acetyl-L-carnitine had reduced symptoms of dementia [source: NAT]. Later studies, though, were unable to duplicate this success [source: Hudson].

Another group of seniors with mild depression saw significant improvement following regular acetyl-L-carnitine supplements [source: NAT]. Some cases of depression are related to chemical imbalances in the brain and nervous system, so it's hypothesized that acetyl-L-carnitine would treat depression by improving the overall chemical function of the nervous system.

Of course, happy senior citizens and recovering alcoholics are not nearly as alluring as the image of you with bodybuilder muscles and increased sexual function, so those tend to be the aspects of acetyl-L-carnitine that the pill industry touts. Ironically, these are the claims with the least scientific evidence to back them up [source: UMMC]. Acetyl-L-carnitine may aid in the treatment of Peyronie's disease, which can affect male sexual function [source: NAT]. But it's probably not going to become the new Viagra any time soon.

Acetyl-L Carnitine Side Effects

Acetyl-L-carnitine seems to be safe in general. Clinical trials have included children, with no marked side effects [source: Arnold].

There is some evidence that its usage may lead to mild symptoms. Some of them are not surprising, given that the supplement may affect metabolic processes. They include nausea or vomiting, diarrhea, skin rash, agitation, increased appetite and altered or unpleasant body odor [sources: UMMC, UMHS]

http://tlc.howstuffworks.com/family/acetyl-l-carnitine1.htm