Watch BEFORE Taking Carnitine Supplements | The Benefits and Side Effects of Carnitine

Carnitine is not 100%, but primarily found in animal products. So if somebody is a strict vegan and they're having no animal products, they may or may not be getting enough carnitine. Another thing though that I've seen in people eating animal products is we're just trying to restore their energy, and maybe because of other demands, chronic illness, they've used their carnitine up. That's another time we would use it. Hey, it's Dr. A. Welcome to my YouTube channel. I've been researching and teaching in the integrative and naturopathic medical communities for 30 years now plus, and I've been seeing patients for a long time in the cancer and chronic illness sphere. I use this channel to answer your questions, and this particular question that came in was about a supplement, a nutrient. And the question essentially was, is there a difference between the forms of supplement L-carnitine or carnitine, the amino acid or amino-like acid, and is it dangerous? in any way. So let's get into this for today. The first thing is different types of supplements. So carnitine is an amino structure that is used to primarily help shuttle fatty acids into the mitochondria so they can undergo what's called beta oxidation and be burned in the mitochondria for fuel. Carnitine runs a portion of what's called the carnitine shuttle to help get the fats on the inside of mitochondria. Fats are a very high-density energy source. So if we are low in carnitine, we have trouble producing energy, mitochondria don't run as well, et cetera. Carnitine can be taken in a couple of forms orally. One is L-carnitine, which is very common. The other is acetyl-L-carnitine or ALC. And the difference essentially is both will be helpful to you as far as carnitine levels in your body, but acetyl-L-carnitine will be absorbed more efficiently. And there's, far as I know, Not a lot of specific research about, well, there's this much difference between L-carnitine and acetyl-L-carnitine. But essentially, if we're working out, you know, somebody's been taking 2,000 milligrams of L-carnitine a day to try and help their energy, et cetera, we're going to do about 1/3 of that in acetyl-L-carnitine unless there's a real specific indication. Sometimes in neuropathies, nerve damage, acetyl-L-carnitine, you might dose it a little bit differently. So the big difference between the 2 forms that you're commonly see as supplements is just one absorbs more efficiently. So the dose is usually lower and that lower dose is usually in the acetyl-L-carnitine. Now we've already talked about the difference in the dose forms. We talked about the fact that it primarily helps you with energy, cell energy through mitochondria and the fat shuttling in to burn the fats. Danger or potential issues, et cetera. The first one is if you take a lot of carnitine, you can slow your thyroid down. And that is a well-known factor. Now, if you're just going to take a lot of carnitine for a couple of weeks, that's probably not going to happen. But there is a dose-dependent relationship between big doses of carnitine and the thyroid slowing down. And what I have seen clinically is in the world of L-carnitine, that's usually 3,000 milligrams, 3 grams or higher for long periods of time, meaning 1, 2, 3, 4 months or longer, okay, before your thyroid really slows down. Now, if you convert that over to acetyl-L-carnitine, that's going to be 1,000 milligrams or higher over time. So remember about a 3:1 ratio there. Normally, if we're using carnitine, we'll talk about why you might use it to boost up energy. But if we're using it at higher doses, we might use a high-dose short period, meaning a few weeks to a month, and then we'll taper the dose down so we don't engender, you know, any thyroid issues that go on. But the thyroid issues of slowing the thyroid down are very dose-dependent. And in my Clinical experience, it's usually at three plus grams, three thousand plus milligrams. Quick plug here: If you're a healthcare practitioner working with patients with these issues, I have a CE website and I do webinars on this topic and others. So we're going to put a link in the description below to the CE website link and the particular webinar of interest. Thank you. The other issue, which has gotten a lot more press in the last ten years, is increases in a chemical in the blood called TMAO. Which is a really long word. You can look up TMAO, and carnitine given orally does increase that. Now, TMAO is a metabolite that is associated with cardiac inflammation and other stuff, so obviously we don't want to be jacking that up, right? But it turns out, if you read most of the research about TMAO and carnitine, that it's not just that the carnitine automatically does that. It's when the carnitine goes into a digestive tract— because you're taking these pills orally— goes into a digestive tract that has an imbalance of good flora, so the microbiome is off, you have a much higher level of carnitine creating TMAO formation. If we have really good balance of microbial flora in the GI tract, we don't make that much TMAO or none. And there was some research that came out a few years ago that showed that if you take the herbal extract berberine, which we see used a lot for some infections and diabetes and all sorts of other stuff, but if you take berberine, it actually shuts down the formation of TMAO from carnitine. So, if we're going to have somebody on it a long time and we're worried about their gut flora, we'll usually do a combo of carnitine or acetyl-L-carnitine, berberine, and then at night, we'll have them take some extra human microflora strains, some probiotics that are going to be helpful. So, that's the other one. It's a relative thing that, yes, if you just go willy-nilly and give everybody a bunch of carnitine, you can raise TMAO levels and inflammation, stuff like that. But, you can head it off at the pass By increasing good flora, giving berberine alongside, and then adjusting the dose over time as well. Now, some people will have some nausea, digestive upset with it. If that happens, we usually have them take it with a bit of food, and that's going to be fine as far as absorption. Some people will get kind of— if you're taking a lot, you might smell kind of fishy or fishy body odor. Those are the main sort of side effects that people get. So, Why would we give people carnitine? Well, carnitine is primarily, not 100%, but primarily found in animal products. So if somebody is a strict vegan and they're having no animal products, they may or may not be getting enough carnitine. So if we have an energy issue, that might be one thing. Another thing though that I've seen in people eating animal products is we're just trying to restore their energy. And maybe because of other demands, chronic illness, they've used their carnitine up. Obviously we still have some carnitine, but not enough to run the energy system. That's another time we would use it. Another time, and specifically most of the research is around acetyl carnitine, is in neurological issues. And if you think about it, the nervous system, whether it's peripheral or central nervous system, uses a lot of energy, uses a lot of mitochondria. So feeding the mitochondria would be a good thing, which carnitine helps with. So when we're thinking about carnitine in that sense for neurological issues, most of the time it's acetyl carnitine. Cardiovascular issues, Acetyl-L-carnitine. And again, we're not going to dose that as high as we would L-carnitine because of the differential in absorption. What's another thing to think about with carnitine supplementation? In the world where people are doing very low carbohydrate diets, like a ketogenic diet or something like that, sometimes people— there's a term called the keto flu where you're on keto for a while and you start to feel kind of yucky. A lot of that is a decrease in energy because you've increased the amount of Protein and fat, decrease the carbohydrates. And so you're putting more fatty acids in for the mitochondria to burn, which is fine, but you use the system at a higher rate when you have more fat. And so the keto flu often is that I've used up the carnitine transport system. Usually carnitine's the water-soluble intermediate part. And so maybe I've made myself have a transient depletion of carnitine or a lowering of carnitine, really. So often we'll give those people, you know, acetyl-L-carnitine, carnitine to increase the energy so that they can get out of the keto flu. That's another sort of specific reason it's used. All right, well, I'm Dr. A. I hope this has answered those questions about carnitine, acetyl-L-carnitine, TMAO, all of the other stuff. That's what we do on this channel is answer questions. I want to thank all of the subscribers, both previous and new. Channel's growing all the time. Please do like, share, and subscribe. That really does help us, helps us get out there in the algorithm. Do the notifications so that you know when we post new stuff. And a lot of the ideas that we get for our next videos do come from your comments. So like, share, subscribe, and do comment. Thank you very much. See you on the next one.