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Category: Nutrition

Re-energize with Carnitine

As we age, it’s almost expected that we will experience greater levels of physical fatigue, mental fatigue, muscular wasting, and even cognitive impairment. So what can be done? No doubt there is clear merit to the recommendations to stay both mentally engaged and physically active, and there is excellent scientific research to support these recommendations.

Much research is carried out in the area of the nutritional supplementation as it relates to these factors of aging. Certainly one of the most attractive nutritional supplements is carnitine as it is fundamentally important in the transport of fatty acid fuels to the energy producing parts of the cell called the mitochondria. So for energy production in, for example, muscles and in the brain, carnitine is a fundamental player. The bottom line is, whatever can be done to enhance mitochondrial function may very well enhance various performance parameters as we age.

In a study published in the American Journal of Clinical Nutrition, researchers needed to identify individuals who were likely to be suffering from the effects of aging, including those issues described above. So they decided to look at a group of 66 individuals who were at least 100 years of age. The study, which was placebo-controlled and double blinded, had a control group receiving a placebo pill while the treatment group received carnitine, a nutritional supplement, 2 g daily.

This study looked at such things as muscle mass, performance on a cognitive assessment, as well as physical endurance as assessed by walking. The subjects were all evaluated at the beginning of the study and then reassessed six months later.

The results of the study were profound. In the group receiving carnitine, muscle mass increased by an astounding 8.4 pounds. In addition, the carnitine group lost close to 4 pounds of body fat. Significant differences were also noted in physical fatigue in the group receiving carnitine whereas no change was seen in the placebo group. Mental fatigue also improved quite dramatically in the carnitine group while slight worsening was seen in the group receiving the placebo. Generalized fatigue dropped remarkably in the carnitine group while it actually worsened to a small degree in the group not receiving this supplement.

Perhaps most impressive was the improvement of the mini mental status examination (MMSE) score, a standardized test of cognitive function commonly used by neurologists. No changes were observed the group receiving the placebo whereas the score increased by an astounding 4.1 points on this 30 point scale, in the group taking the carnitine supplement.

So much depends upon mitochondrial function in terms of brain and body function. Carnitine plays a central role in how our cells, including brain cells, utilize fuel to create energy, and well designed research demonstrates significant improvements in a variety of energy dependent issues like muscle function, heart function, and as we see here, brain function as well.

While we don’t yet have anything pharmaceutical approach that can achieve this goal, it’s nice to know that there is such high-level scientific validation of a non-pharmaceutical nutritional supplement.

For more information, order your copy of Grain Brain today and join Dr. Perlmutter’s email list.

  • Matt L

    Fascinating. Any thoughts of the impact on (aging) endurance athletes of carnitine, or indeed the grain brain diet? Do we, middle aged, long distance cyclists just take plenty of healthy fat fuel with us on our 3+ hour rides and eschew the packaged ‘energy’ bars which supposedly deliver the energy we need to keep going? Your thoughts?

  • Curious-in-MI

    Advice for people with MTHFR gene anomaly?

  • Colby

    Is this is certain foods, vegetables, or anything?

    • David Perlmutter

      As the name would imply (carne means meat) good sources are grass fed meats

    • David Perlmutter

      As the name would imply (carne means meat) good sources are grass fed meats.

  • Jack

    You mention that they used 2g daily. The supplement that you have available on your site is only 340mg. What is the actual recommended dosage?

    • David Perlmutter

      I think 600-700 mg daily is adequate.

  • David Perlmutter

    I think 600-700 mg daily is adequate.

  • Inspiredoc

    Any concern about carnitine interfering with peripheral conversion of T4 to T3? seeing this in clinical practice with > 500mg carnitine. thanks.

  • Patrick

    Those results are amazing! Is it recommended to take carnitine with food or without?

    • David Perlmutter

      You’ll want to take it between meals.

  • Jo

    I read that carnitine might decrease the effectiveness of thyroid hormones. I had a total thyroidectomy due to cancer and I take levothyroxine 112 mcg/day. This dosage has finally been working for me. Will carnitine interfere with my med. I am 68 and would very much like to take this amino acid.

  • Kirk Gately

    Acetyl or L

    • Jo


  • Lee

    I am 57 and suffer from bipolar depression and fibromyalgia. I do eat regular servings of quality beef and other wild-caught or free-range protein. Would this be something that could potentially benefit or would it be redundant with my diet?

  • Glenda

    Does this help those with autoimmune disorders, such as Sjogrens, RA, etc?

  • HLB

    Dr. Oz on his blog of May 2013 stated that carnitine is converted by a stomach bacteria into TMA which is dangerous for the heart. He warns against supplementation and red meat. What’s the true picture?

  • mmgnaples

    I know Jo mentioned that L-Carnitine is what you recommend, but I’d rather have that confirmed by you, Dr. Perlmutter. Is that correct?

    • David Perlmutter

      That’s correct, L-Carnitine. Happy to confirm.

  • Wellness123

    I understand from my reading of Jon Barron of Baseline for health, that although carnosine is a great anti aging factor it does act to increase rhe production of lipofuscin in the brain, which is an unwanted side effect. He suggets taking it with other supplements to avoid this.
    I have heard of people saying that they felt a bit less clarity of thinking when taking carnosine in powder form on its own.
    Do you have any advice on this please?

    • superfats


      “Res. Right on the lipofuscin. In my treatise I say “Several of the antioxidants already mentioned function so as to reduce levels of lipofuscin accumulation in brain and other cells, including alpha-lipoic acid, CoQ10 and curcumin. Piracetam, another firewall component, appears to significantly decrease the formation of lipofuscin in neurons. I take two supplements which have a capability to pump lipofuscin out of cells. One is meclofenoxate (centrophenoxine) a ‘smart drug” used in Europe to treat symptoms of senile dementia and Alzheimer’s disease. The other is acetyl-l-carnitine, a pluripotent antioxidant also useful for mitochondrial health.”

  • Patty Hennessy Hughes

    Dr. Perlmutter — I am wondering if you might consider responding to the questions regarding this supplement and the thyroid? I am on low-dose synthroid and wondering

  • Art Lynch

    Dr. Perlmutter,
    The study mentioned in your article said that the dosage for those receiving carnitine was 2 grams per day. How was it administered – previous to a meal or on an empty stomach… – previous to a workout or, in the case of these 100-year-olds, previous to any suitable exercise… – one 2 gram dose or spread over a day… – and finally is there a difference between L carnitine tartrate and acetyl L carnitine?

    • Darlene

      I’m looking forward to hearing Dr. Perlmutter’s answers to your great questions.

  • miriambuges90

    I’m interesting to know about L-carnitine and the problem with the thyroid. I am hypo

  • Liz

    I, too, would like to see a response to the questions regarding L-carnitine and hypothyroidism. thank you.

  • Trudi Trahan-upchan

    My mom was starving to death while eating extremely healthy meals 4xday. She was losing 3 lbs overnight, having lost 20 in just a few months, she was just skin & bone.. and was dying right before my eyes. Frantic no doctors here would help taking the view it is just old age, blah blah. Well, I was going to be damned if I did nothing. I begged for help over the internet & American compassion responding was incredible. I discovered research by Dr. Wayne Pickering that metabolic breakdown can be halted with a diet separating all food groups. i.e.: am fruit lunch noon carbohydrates, supper & evening protein. It worked mom’s weight was halted at 105 but not gaining. I came across research claiming that all muscle wasting & extreme fat loss is a hormone imbalance, and any doctor can test for it & prescribe medication for it. Well not in Canada. I put her on multiple ‘essential’ whey protein etc and still no gain no loss. Finally, a friend in a health food shop suggested & gave me enzymes. In just a week she gained weight. She gained back over a 2 week period 5 lbs to 110 lbs. All research cautioned that to rebuild muscle you must exercise, protein by itself won’t work. Mom is doing stand up push ups on the kitchen counter 10 before lunch & supper. Too soon to tell. as I can’t get any doctor to bother testing her hormone imbalance. But practically over night mom went from death to dancing. I am considering adding Carnitine to her diet as recommended in a study Dr. Perlmutter has but am concerned in the research that was done, the group gained muscle but lost fat. My mom has no fat left, her bum is flat, her fat loss is very extensive & am frighted to try Carnitine. Any suggestions?

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