Carnitine (L-carnitine)

Carnitine (also known as L-carnitine) is a natural substance found in foods and made by the body. It works with the mitochondria to process fats and produce energy for the cells. It does this mainly by supplying the building blocks needed by the mitochondria to make an energy molecule called ATP, the basic fuel for cells. Most of the research suggests that carnitine has a protective effect on the central and peripheral nervous systems and the heart, probably because of its role in mitochondrial function. It may be helpful in the treatment of peripheral neuropathy (numbness, tingling or burning in the feet and sometimes hands), dementia and mitochondrial toxicity. Over-the-counter supplements may contain a version of carnitine called acetyl-l-carnitine, but beware that some have very little L-carnitine in them; be sure to buy from a reliable source. In Canada, L-carnitine is available by prescription and is called Carnitor. 

Prescription L-carnitine is very expensive and usually not covered by insurance plans for any of these indications. Check with your private insurer or provincial provider for more details. The therapeutic dose for L-carnitine is somewhere between 500 and 3,000 mg daily. The dosage is not defined because it has not been studied enough or approved for these applications. Some people with HIV who have mitochondrial toxicity and/or peripheral neuropathy appear to benefit from 1,500 mg of acetyl-l-carnitine once or twice daily for many months. Carnitine supplements should be spread out over 3 daily doses to prevent side effects, most commonly diarrhea.

Coenzyme Q10 (CoQ10) is a substance that plays a role as an antioxidant as well as a cofactor in mitochondrial energy production. It has been used to treat congestive heart failure and gum disease (gingivitis) and may help protect the heart and nerves. Statins, a class of cholesterol lowering drugs, reduce CoQ10 levels. The usual CoQ10 dosage range is 60 to 240 mg daily.

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