On an earlier thread Dick wrote:

"The Awesome Foursome is worth noting, including as it does Mg (a member of the Terrific Trio of K, Mg, and taurine) and COQ10, which are so often mentioned here. I haven't seen as much here on carnitine so it might be worthwhile to discuss such things as dosages for various conditions and the differences between l-carnitine and acetyl-l-carnitine."


Hi again Dick -

To get a dialogue going, here are some excerpts from Chapter 5, 'L-Carnitine: The Energy Shuttle' in the book 'The Sinatra Solution - Metabolic Cardiology'. The chapter covers a lot of ground - 40 pages of text! - but the bottom line is that carnitine is absolutely essential for energy (ATP) synthesis, hence cardiac function, for life itself, and that many of us, if not most, are deficient, and that the supplement form doesn't seem to matter much, if at all. Chapter 8 has recommended L-carnitine supplement dosages for various conditions ranging from 350 to 3,000 mg per day. For afib it's 1,000 to 2,000 mg per day.

Erling

"Since Coenzyme Q10 and carnitine synthesis may diminish with age, relative deficiencies may develop over time. This is one reason why it may be important to get carnitine both in the diet and in supplement form."

"Carnitine is actually derived from two amino acids, lysine and methionine.... complemented with niacin, vitamin B6, vitamin C, and iron."

"Remember, the word carnitine comes from 'carnis', meaning flesh or meat. The greatest amounts are found in mutton from older sheep, followed by lamb, beef, other red meat, and pork. Although carnitine is found in many foods, the quantities in plants are exceedingly small. So, vegetarians are, in this regard, "behind the eight ball". Not only do pure vegetarians fail to get enough carnitine in their diets, they may also lack the methionine and lysine needed to synthesize it in their bodies."

"The principal function of carnitine is to facilitate the transfer of long-chain fatty acids across the inner mitochondrial membrane to begin the process of 'beta-oxidation' we learned about in Chapter 3 [ATP: The Miracle of Life]. In fact, carnitine is the only carrier that can do this, and its abundant presence in the cell is an absolute requirement for life." [Go to 'Mitochondrial DNA in Aging and Disease' for graphics showing mitochondrial structure, also how / where ATP is recycled from ADP in the 'respiratory chain', aka 'electron transport chain', within the inner membrane: [www.nslc.wustl.edu]]

"Without L-carnitine, fatty acids can't penetrate the inner mitochondrial barrier [membrane]. Therefor, the rates of beta-oxidation, oxidative phosphorylation and energy recycling [ADP -> ATP] are all dependent upon the amount of carnitinr in the tissue."

"... a certain form of carnitine, propionyl-L-carnitine (PLC), has been shown to be a powerful vasodilator. In this capacity carnitine helps to open blood vessels, increasing the blood supply to the heart ... So, the physiological roles of carnitine are quite diverse and offer many ways to enhance a multitude of metabolic functions of the body ... PLC is a carnitine derivative that, along with L-carnitine (base) and acetyl-L-carnitine, forms a component of the body's carnitine pool... "Much of the work has been focused on the eventual release of a prescription form of PLC. A dietary version of PLC, Glycine-Propionyl-L-Carnitine (GPLC) has been released three years ago [2003?] .... "Studies ... have shown GPLC to be well tolerated on actual doses of three grams (3,000 mg) daily". "Maximal blood levels of PLC are reached in approximately 3 1/2 hours, while with most L-carnitine forms approximarely 15 hours are required. But for GPLC, serum uptake results in 1 1/2 hours...."

"Because carnitine doesn't get fully absorbed when taken orally, ingesting it three times per day is the preferred method.... the oral bioavailability leaves much ti be desired" "Bioavailability refers to the amount of nutrient that actually gets delivered to the tissues, and surprisingly, it actually decreases as the dose increases."

"A third study, also in a rat model, is even more interesting .... After heart attacks were induced the hearts were treated with... L-carnitine, acetyl-L-carnirine, or propionyl-L-carnitine. All three carnitine derivatives were used to see if there were differences in their metabolic effect on the heart... All three of the carnitines markedly improved recovery of energy compounds in the tissue.... L-carnitine quickly increased energy levels... Acetyl-L-carnitine was even stronger in its early response bur did not keep the energy level as high as L-carnitine over the entire study period.... In the propionyl-L-carnitine group the very early recovery was not as strong as either the L-carnitine group or the acetyl -L-carnitine group, but by the end of the study the recovery was greater.... The study showed that treatment with any of the carnitines tested improves the energetic state of the heart ....."

Erling,

Thank you for bringing this topic to the forum's attention.

Is Dr. Sinatra's book intended for a lay audience?

Are there any concerns that 3,000 mgs/day of L-carnitine might represent a dangerous overdose for some adults?

Of the three forms of L-carnitine, which do you recommend?

Josiah

Erling,

Thanks for the sharing of this important information.

What is your take on Jarrow's ACETYL L-CARNITINE ARGINATE?
it contains 225ms of actyl L cartinine and 198ms arginine.

Is combining these two substances as effective as taking them separately?


Keep on posting!


Thanks,

Dennis

Erling - thanks for this important post. Carnitine is an important heart nutrient.

I'd just like to comment before everyone rushes out to stoke up on carnitine that it can be too stimulatory for some afibbers.

I was one; Hans was another. I was unable to take any form of carnitine until after my ablation. Now I can consume 3,000 mg easily with no problems; in fact, I find it beneficial.

Just be aware that like hawthorn for some, carnitine also can be a problem.

Jackie

Josiah B. wrote:

> Is Dr. Sinatra's book intended for a lay audience?
>
> Are there any concerns that 3,000 mgs/day of L-carnitine might
> represent a dangerous overdose for some adults?
>
> Of the three forms of L-carnitine, which do you recommend?

Josiah,

Sinatra's book, though it has a good deal of science, is certainly written for a lay audience. The cover shouts, "Revive, Rejuvenate, and Revitalize Your Heart"!

He recommends up to 3,500 mg a day of L-carnitine for folks with congestive heart failure, but 250-750 mg for an "age-managment program."

I don't know what Erling would say, but in my reading, Sinatra does not make a definite recommendation as to which form of L-carnitine he deems "best." However--after the disclaimer "you should always consult with your own personal M.D. or health care practioner"--he goes on to say: "I especially like GPLC because it has a very rapid half-life as it gets into the muscles quickly offering enormous positive benefits. I wish this form of carnitine was available . . . when I was wrestling in the Division I level in college" (p. 116, 2008 ed.).



--Lance

Hi, Josiah -

Adding to Lance's good answers I'd say be prepared for some fairly heavy going in the science chapters 3,5,6, and 7, but studying them carefully will give a good understanding of how ATP (energy) in the heart muscle cells is improved by supplementing with carnitine, CoQ10, ribose, magnesium (the Awesome Foursome), and specific vitamins, minerals, and amino acids -- important stuff for an afibber to know.

Please pay attention to Jackie's caution. Personally I never had any such difficulty with high dose carnitine, having taken 3,000 mg per day for a long time when I was struggling with afib, but that's just me.

Of the three canitines available as supplements, plain L-carnitine, acetyl L-carnitine, and glycine propionyl -L-carnitine (GPLC), I've only used basic L-carnitine, so have no way of judging differences. Sinatra writes about certain virtues of GPLC:

"I make my recommendation to those looking specifically for dietary blood vessel support to strongly consider GPLC"
"GPLC also has been shown as having a significant favorable effect on blood triglycerides"
"Maximal blood levels of PLC are reached in approximately 3 1/2 hours, while with most L-carnitine forms approximately 15 hours are required. But for GPLC, serum uptake results in 1 1/2 hours, showing how quickly it is taken up and utilized by muscle tissue."
"I especially like GPLC for people who have leg cramps when they walk, fibromyalgia and chronic fatigue."

The rapid absorption of GPLC makes it in this respect at least seem superior to the others. Since lately I've been getting leg pains when walking I'm considering using GPLC to see if it will help. Blockage in leg arteries is obvious cause for concern about the health of cardiac arteries. Price might be an issue. Hans' iHerb store is an excellent source for the various carnitines, and for doing a cost comparison.

Erling

Hi Dennis -

Hopefully someone with personal experience will be able to answer your question as to whether combining carnitine with arginine in one molecule is as effective (or more) as taking them separately. Having no experience with Jarrow's ALCA, or with any amino carnitines, I can only quote general information:


From 'The Sinatra Solution' (2008) on amino carnitines in general that might be helpful:

- The accumulated body of scientific literature shows that L-carnitine precursors such as glycine, arginine, taurine, and lysine are related to L-carnitine's metabolic performance.
- An entirely new library of distinct forms of L-carnitine that deliver L-carnitine along with a specific amino acid have been recently developed by a company called Sigme-tau HealthScience. Called AminoCarnitines, they deliver L-carnitine along with a specific amino acid in one distinct molecule.
- Unlike an intimate combination or blend (mixture) of the two nutrients, there is no disparity in content uniformity of the actives during blending, mixing, or tableting or within gelatin capsules.
- As dissociation of the specific AminoCarnitine occurs within the intestinal tract, molecule, by molecule, a specific amount of amino acid becomes simultaneously available alongside the L-carnitine for metered absorption within the body.
- Two such amino carnitines that have already generated widespread interest are acetyl L-catnitine arginate and acetyl L-catnitine taurinate.
- It is probable that as the clinical evidence continues to accumulate for GPLC as well as the other amino carnitines, the market may reflect a shift away entirely from the earlier forms...


From iHerb.com on Jarrow Formulas' ALCA 500, Acetyl L-Carnitine Arginate:

- Pharmaceutical Grade
- Amino Carnitine
- Dietary Supplement
- ALCA 500 contains Acetyl-L-Carnitine Arginate, a novel molecular combination of the amino acids Acetyl-L-Carnitine and L-Arginine. Acetyl-L-Carnitine is a more bioavailable form of L-carnitine, an amino acid found in high concentrations in human brain, nerve, heart, liver and sperm cells. Acetyl-L-Carnitine supports energy production, participating in metabolizing fatty acids to yield the energy molecule ATP in the mitochondria. As an antioxidant, Acetyl-L-Carnitine protects neurons from damage caused by the corrosive superoxide radical.
- L-Arginine is utilized to produce nitric oxide, an important compound involved in circulation and creatine, a compound needed to regenerate ATP stores.

Erling

I'm just throwing my 2 cents worth in here to help any Canadians avoid the problem I had a few years ago.

I ordered some carnitine from Iherb along with some other supplements. Customs stopped the shipment at the border and gave me two choices. Remove the offending substance and allow the rest through or have it sent back to the supplier and they remove it and re-ship it. I chose option two and ended up paying for the extra shipping costs.

Having said that I found out that my local health food store did indeed have some carnitine for sale but it was kind of a back room deal. So if you really want it, ask.

Adrian

Hey Adrian! - How are you these days! Miss your posts. Jackie

Erling,

I have read your post in the conference room #61 dated Dec 07. I found it very interesting and would like to ask questions of your diet and current protocol. May I know your email address?

Thank you,

Charle