Carnitine Derivatives: Clinical Usefulness
– Source: Current Opinion in Gastroenterology, Mar 2012
By M Malaguarnera
[Note: For more information relating to chronic fatigue syndrome and fibromyalgia, see also “Breaking Through the Mental Fog,” and “L-Carnitine: Typically Low in Fibromyalgia and ME/CFS; Promotes Healthy Mood & Energy”.]
Purpose of Review: Carnitine [L-Carnitine] and its derivatives are natural substances involved in both carbohydrate and lipid metabolism.
This review summarizes the recent progress in the field in relation to the molecular mechanisms.
Recent Findings: The pool of different carnitine derivatives is formed by acetyl-L-carnitine (ALC), propionyl-L-carnitine (PLC), and isovaleryl-carnitine.
Acetyl-L-carnitine may have a preferential effect on the brain tissue.
Acetyl-L-carnitine represents a compound of great interest for its wide clinical application in various neurological disorders: It may be of benefit in treating:
• Alzheimer’s dementia,
• Depression in the elderly,
• HIV infection,
• Chronic fatigue syndrome [ME/CFS],
• Peripheral neuropathies,
• Ischemia [reduced blood flow] and reperfusion of the brain,
• And cognitive impairment associated with various conditions.
Propionyl-L-carnitine (PLC) has been demonstrated to replenish the intermediates of the tricarboxylic acid cycle by the propionyl-CoA moiety, a greater affinity for the sarcolemmal carrier, peripheral vasodilator activity, a greater positive inotropism, and more rapid entry into myocytes. [Note: The complex tricarboxylic acid cycle – aka Krebs cycle or citric acid cycle – involves breakdown of fatty acids, carbs and proteins in the mitochondria to produce cellular energy (ATP).]
Most studies of the therapeutic use of PLC are focused on the prevention and treatment of:
• Ischemic heart disease [heart can’t pump enough blood to rest of body owing to narrowing of small blood vessels supplying the heart],
• Congestive heart failure [heart muscle weakened by narrowed arteries/reduced blood supply],
• Hypertrophilic heart disease [heart muscle thickening],
• And peripheral arterial disease [plaque buildup reduces blood flow to arms & legs].
Acetyl-L-carnitine and propionyl-L-carnitine are considered well tolerated without significant side-effects.
Summary: A number of therapeutic effects possibly come from the interaction of carnitine and its derivatives with the elements of cellular membranes.