Clinical uses of L-carnitine supplementation

Abstract

Carnitine, a quaternary amine (3-hidroxy-4-n-trimethylaminobutyrate) is synthesized in the body (liver, kidney and brain) from lysine and methionine, two essential amino acids, in the presence of iron, ascorbate, niacin and vitamin B6. Carnitine plays a central role in the cellular energy metabolism because it transports long-chain fatty acids from the cytosol to the mitochondria for oxidation and adenosine 5′-triphosphate generation. The organic concentration of carnitine is a result of several metabolic pathways such as ingestion, endogenous synthesis, transport and elimination, which may be altered by diseases leading to carnitine deficiency and impaired lipid metabolism. In addition, supplementation with carnitine can raise the muscle blood flow by vasodilatation and antioxidant effects, reducing some of the complications of ischaemic diseases, such as coronary artery disease and the consequences of diabetic neuropathy. Therefore, the purpose of this study was to describe the possible benefits of carnitine supplementation in subjects with special needs and susceptible to a carnitine deficit, such as renal diseases, diabetic neuropathy, Acquired Immunodeficiency Syndrome and cardiovascular diseases.