Top 5 Powerful Carnitine Benefits for Energy and Fatigue

So there's 5 big areas and a whole bunch of others in the research where carnitine is helpful. But if we remember that it's there to help bring extra energy into the body through burning of fats, these will probably make some sense. Hey, I'm Dr. A. On this channel, we talk about all things medicine, highly focused on complex chronic illness and oncology. Today, I'm going to answer a question that I got about the amino acid carnitine and how it relates to health, energy, fatigue, et cetera. Let's break that down. So the first thing is, what is carnitine? Carnitine, usually in the body as L-carnitine, although there's a couple of other forms, is an amino structure. So it's considered an amino acid usually, and it is involved in very particular biochemical processes. And because of the processes that carnitine is involved with, it is associated with the use of energy, the burning of fat, which Leads to energy potentials for affecting fatigue and a number of other processes in the body. So you could imagine that a water-soluble substance like carnitine would be critically important to be getting from the diet so that we have enough in the body to fuel all of these processes that it's involved with. Now, generally speaking, people will often be recommended or prescribed carnitine, or as a supplement, maybe acetyl-L-carnitine, which is a little more highly absorbed, but they're both going to give you carnitine one way or the other, and they will be given it and they might be told, well, this is to help your fatigue or to help your, you know, overall energy or your metabolism or something like that. One of the primary ways— now there's a bunch of secondary ways that carnitine works in the body through secondary mechanisms, but one of the primary ways that carnitine works, which is really critical to your body's function, is when we get inside the cell. Most of us realize we have the cell membrane, and that's the limits of the cell. And inside of that, we have the water-soluble matrix called the cytosol, which has enzymes and a whole bunch of organelles, little things that help the cell do its business. And then inside, we have a number of little organisms called the mitochondria. These are an organelle, but it's an organelle that was believed to have evolved on its own and eventually merged with cells to create energy. Inside the mitochondria, we have a matrix that creates energy through ATP production, but the mitochondria Kind of like the cell proper, has a double mitochondrial membrane. The mitochondrial membrane then works like the other membranes where it just doesn't let any old thing in. And so if we are burning carbohydrate, for example, we break carbohydrate down through glycolysis and we get down to a 2-carbon unit, and that 2-carbon unit can go in as a water-soluble substrate. And go right in and help to kick off the energy production of making ATP. On the other hand, if we have a fatty acid, so fat metabolism, you might know or have heard in a class, fats have much higher amount of energy that they provide than carbohydrate. And so if we look at that, we have a fat that is multiple carbons long, often 16 or longer, but multiple carbons long. And fats, those big chunks of carbons, don't naturally go in to be burned up as a fuel source. But if you can imagine, the energy I get from a 2-carbon unit from glycolysis and carbohydrate breakdown is decent. What would I get out of a 16-carbon or 18 or 20-carbon, etc.? I'm going to get a lot more energy, but I have to break it down through a process called beta oxidation, and I need to get that fat into the mitochondria so it can be beta oxidized and burned up. This is where the metabolism and fat burning, quote unquote, come from. It's because we have to get the fat in to burn them, but we have one limitation, and that is they don't naturally go in like carbohydrate-derived 2-carbon substrates do. So who is there to help get the fat from the cytosol into the mitochondria? It is carnitine, the amino, and a little process called the carnitine transport system, sometimes known as the carnitine shuttle. So there is a set of enzymes called CPT1 on the outer membrane and CPT2 on the inner membrane, which are carnitine palmitoyltransferases. Meaning carnitine fat transfer. So you can think of it as on the outside we have a fat that goes down and it's not going to go in on its own, but we can attach it to CPT1. And then in the middle of CPT1 and 2 is carnitine acyltransferase. So as soon as I attach to number 1, carnitine joins the fat. And what that does then is it pulls the fat towards carnitine acyltransferase and is sucking it into the mitochondria. And then at the CAT enzyme, the carnitine is released to be recycled and Fat is held onto and shoved over to CPT2 and forced into the mitochondria for beta oxidation, and the fat can't get out then. So if carnitine levels drop, this carnitine shuttle slows down. We can only do with what we have for carnitine. Now, carnitine is water soluble. It's an amino substance, and that means it comes from amino acids, which come from proteins. A lot of chronically ill people will maybe not be protein deficient. They might be, but maybe not fully deficient, but because they're trying to burn energy and all this, they may be lower in carnitine than we might believe from the outside. At the moment, testing carnitine is a little bit tricky, so it's not like you can go and get a carnitine level and say for sure you're low or you're high or whatever. There's a lot of subtlety to carnitine testing, but usually in chronically ill people, we will empirically give them acetyl carnitine or L-carnitine. I prefer acetyl carnitine because it's More highly absorbed orally as a supplement, and we will give them that as a trial. Now, if I give you acetyl carnitine and you start taking it today, you're not going to suddenly think, "Oh wow, I've got all this energy." It's a slow process because you have to replete the carnitine that's in your body. Sometimes when we give carnitine intravenously because it goes right into your system, people will feel that a little bit of an energy boost. But of course, you can only get so many intravenous things. So you know, orally is usually the way you have to go with it. There are benefits though in that we number one, we want to have fat. being burned because it gives us more energy. Also, it takes away the excess fats that we may have to try to metabolize around in the cells. There are other states where people maybe have been fasting or really sick for a long time, and so they'll go into a functional ketosis. And what will go on is that they're burning more, or they need to burn more ketones, and there will be more fatty acids floating around. And so the process of that being in ketosis, et cetera, will burn up more carnitine. So a lot of times people have experienced Maybe they do like a keto diet or something. They get the quote unquote keto flu. Well, a lot of that is a fatiguing situation and it's a depletion of carnitine. So we often give people carnitine for that. But let's say you're not trying to do the keto diet or something, but you've just been sick for a long time. You can also get into ketosis doing that or just being depleted. So there's 5 big areas and a whole bunch of others in the research where carnitine is helpful. But if we remember that it's there to help bring extra energy into the body through burning of fats, these will probably make some sense. The first one is it is terrifically useful in cardiac conditions. So any type of cardiac condition, but again, if it works in the mitochondria, the heart is one of the highest mitochondrial density tissues that we have in the body. So that would make sense. Peripheral artery disease, believe it or not, that can be related to low carnitine levels. And one of the things that we want to keep in mind is in the peripheral arteries, we have a lot of Peripheral arterial muscular activity, so there's smooth muscle that runs in and around the arterial system, and those are also very dense in their energy demands. They have a lot of mitochondria, so it would make sense they may start to burn it up too if we get into PAD. Kidney disease again high demand area, so carnitine is implicated in some kidney diseases. Neurological conditions: your brain, like your heart, has tons of mitochondria per cell, so that would make complete sense. And then infertility. And you think, why would that be? Well, if we go back to the idea biologically that carnitine works by increasing energy production in the mitochondria, the reproductive organs are like the brain and the heart, some of the most dense mitochondria numbers per cell. And so if the energy in the mitochondrial activity in the reproductive organs goes down, the fertility will go down as well. All right. Well, I hope that answers the question. Thank you everyone who's joined our community. Please do subscribe, like, share, do all this stuff. Take a look at some of the other content we have on the main YouTube channel, and I'll see you guys on the next video.