Clinical Information

Carnitine, a water-soluble compound, is a collective for a number of compunds that include L-carnitine, acetyl-L-carnitine, and propionyl L-carnitine^1,2. It can be ingested from food and endogenously synthesized². It is conditionally essential³.

Carnitine is critical for energy production by transporting long-chain fatty acids (LCFA) into the mitochondria for oxidation. It also helps in the prevention of the accumulation of toxic compounds in the cell organelles¹.

Signs and Symptoms of Deficiency or Toxicity

Deficiency is typically associated with reduced carnitine absorption or increased excretion, certain disorders such as chronic renal failure, or a genetic disorder¹.

Primary carnitine deficiency typically manifests at 5 years of age with symptoms of cardiomyopathy, skeletal-muscle weakness, and hypoglycemia ¹.

Adverse effects have been observed with intakes approximately 3 g/day. Too much carnitine can lead to nausea, vomiting, abdominal cramps, diarrhea, and a “fishy body odor”¹.

Biomarker and Methods of Analysis

TOTAL CARNITINE IN SERUM.

Serum total carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency either primary or secondary which are the commonly diagnosed carnitine deficiency⁴.

Supplementation Guide

No established guidelines for prophylaxis for general nutrition³.

No upper limit established.

Treatment with anticonvulsants like valproic acid, phenobarbital, phenytoin, or carbamazepine can significantly reduce blood levels of carnitine¹.