Carnitine (Carnitor)

Carnitine is a naturally occurring amino acid. Chemical variations of carnitine include L-acetyl carnitine and acetyl L-carnitine (LAC) and L-carnitine.

L-carnitine suppresses the production of tumour necrosis factor, which is responsible for wasting in HIV-positive people. Patients taking L-carnitine have reported reduced fatigue and greater energy.1

A six-month study of carnitine supplementation also significantly reduced the frequency of CD4 and CD8 T-cell death and produced higher CD4 cell counts.2 3 There is substantial evidence from an Italian research group that L-carnitine inhibits HIV-related cell death by targeting the immune system rather than the virus itself.

A deficiency in L-acetyl carnitine may also play a role in neuropathy related to HIV treatment.4 Taking L-acetyl carnitine supplements may reverse the nerve damage caused by HIV treatment, accompanied by an improvement of pain in most patients.5 Similar studies have also shown improvements in pain with L-acetyl carnitine treatment, with one showing sustained benefit after more than four years.6 7 8 Although the mechanism of L-acetyl carnitine’s action is unknown, it may counteract neuropathy by acting as an anti-oxidant, preventing the damage to mitochondria. Preliminary evidence suggests that carnitine may also be effective in treating other symptoms of mitochondrial toxicity, including elevated lactic acid levels.9

Side-effects of carnitine include mild gastrointestinal upset and diarrhoea.

Carnitine, L-carnitine and LAC come in various oral and intravenous formulations. L-carnitine is sold under the trade name Carnitor for the treatment of people with carnitine or vitamin B7 deficiency.

References

  1. De Simone C et al. High dose L-carnitine improves immunologic and metabolic parameters in AIDS patients. Immunopharmacol Immunotoxicol 15: 1-12, 1993
  2. Moretti S et al. Effect of L-carnitine on human immunodeficiency virus-1 infection-associated apoptosis: a pilot study. Blood 91: 3817-3824, 1998
  3. Moretti S et al. L-carnitine reduces lymphocyte apoptosis and oxidant stress in HIV-1-infected subjects treated with zidovudine and didanosine. Antioxid Redox Signal 4: 391-403, 2002
  4. Famularo G et al. Acetyl-carnitine deficiency in AIDS patients with neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS 11: 185-190, 1997
  5. Hart AM et al. Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS 18: 1549-1560, 2004
  6. Scarpini E et al. Effect of acetyl-L-carnitine in the treatment of painful peripheral neuropathies in HIV+ patients. J Peripher Nerv Syst 2: 250-252, 1997
  7. Osio M et al. Acetyl-l-carnitine in the treatment of painful antiretroviral toxic neuropathy in human immunodeficiency virus patients: and open label study. J Peripher Nerv Syst 11: 72-76, 2006
  8. Herzmann C et al. Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy. HIV Clin Trials 6: 344-350, 2005
  9. Claessens YE et al. Detecting life-threatening lactic acidosis related to nucleoside-analog treatment of human immunodeficiency virus-infected patients, and treatment with L-carnitine. Crit Care Med 31: 1042-1047, 2003

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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.