L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women. Carnitine does not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted, low-fat diet. L-Carnitine-supplementation in advanced pancreatic cancer (CARPAN) - a randomized multicentre trial Effects of Oral L-Carnitine Supplementation on Leptin and Adiponectin Levels and Body Weight of Hemodialysis Patients: a Randomized Clinical Trial. Effect of L-carnitine supplementation in comparison with moderate aerobic training on serum inflammatory parameters in healthy obese women. Weight loss associated with reduced intake of carbohydrate reduces the atherogenicity of LDL in premenopausal women. Influence of A Thermogenic Dietary Supplement on Safety Markers, Body Composition, Energy Expenditure, Muscular Performance and Hormone Concentrations: A Randomized, Placebo-Controlled, Double-Blind Trial. Lack of Effect of L-Carnitine Supplementation on Weight Gain in Very Preterm Infants L-carnitine treatment in incident hemodialysis patients: the multicenter, randomized, double-blinded, placebo-controlled CARNIDIAL trial. Effect of lysine, vitamin B(6), and carnitine supplementation on the lipid profile of male patients with hypertriglyceridemia: a 12-week, open-label, randomized, placebo-controlled trial. Safety, tolerability and symptom outcomes associated with L-carnitine supplementation in patients with cancer, fatigue, and carnitine deficiency: a phase I/II study. Randomised controlled trial of L-carnitine as a nutritional supplement in preterm infants Nutritional effects of carnitine supplementation in hemodialysis patients. Results of a single blind, randomized, placebo-controlled clinical trial to study the effect of intravenous L-carnitine supplementation on health-related quality of life in Indian patients on maintenance hemodialysis. Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial Role of L-carnitine in apnea of prematurity: a randomized, controlled trial. The Effects of L‐Carnitine L‐Tartrate Supplementation on Hormonal Responses to Resistance Exercise and Recovery Effects of carnitine supplementation on flow-mediated dilation and vascular inflammatory responses to a high-fat meal in healthy young adults. Phase II Open Label Study of Valproic Acid in Spinal Muscular Atrophy Potential inhibitory effects of L-carnitine supplementation on tissue advanced glycation end products in patients with hemodialysis. Effects of high carnitine supplementation on substrate utilization in low-birth-weight infants receiving total parenteral nutrition. Clinical effects of L-carnitine supplementation on apnea and growth in very low birth weight infants. Conjugated linoleic acid improves glycemic response, lipid profile, and oxidative stress in obese patients with non-alcoholic fatty liver disease: a randomized controlled clinical trial
L-Carnitine ( L-C ) transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement . In a double-blind investigation to test the weight loss efficacy of L-C , 36 moderately overweight premenopausal women were pair matched on Body Mass Index ( BMI ) and r and omly assigned to two groups ( N = 18 ) . For 8 weeks the L-C group ingested 2 g twice daily of L-C , while the placebo ( P ) group ingested the same amount of lactose . All subjects walked for 30 min ( 60 - 70 % maximum heart rate ) 4 days/week . Body composition , resting energy expenditure ( REE ) and substrate utilization were estimated before and after treatment . For the subjects who completed the study ( 15 P , 13 L-C ) , no significant changes in mean total body mass ( TBM ) , fat mass FM , and resting lipid utilization occurred over time , nor were there any significant differences between groups for any variable . Conversely REE increased significantly for all subjects , but no between group differences existed . Five of the L-C group experienced nausea or diarrhea and consequently did not complete the study . Eight weeks of L-C ingestion and walking did not significantly alter the TBM or FM of overweight women , thereby casting doubt on the efficacy of L-C supplementation for weight loss OBJECTIVES Carnitine deficiency impairs fatty acid beta-oxidation and may partly explain weight gain in valproate-treated patients . The aim of this study was to determine whether l-carnitine supplementation improves weight loss outcomes in bipolar patients taking sodium valproate .  METHODS Sixty bipolar patients with clinical ly significant weight gain thought to be related to sodium valproate , who had been taking sodium valproate for > or=6 months , were r and omized to l-carnitine ( 15 mg/kg/day ) or placebo for 26 weeks , in conjunction with a moderately energy-restricted , low-fat diet . The primary outcome measure was weight change . RESULTS l-carnitine had no effect on mean weight loss compared with placebo ( -1.9 kg versus - 0.9 kg ) ( F = 0.778 , df = 1,58 , p = 0.381 ) . The number of people in each group able to lose any weight was identical ( = 0 , p = 1.0 ) ; more patients in the carnitine group ( nine versus five ) achieved a clinical ly significant weight loss ( > or=5 % ) but this was not statistically significant ( p = 1.0 , Fisher 's exact test ) . CONCLUSIONS At the dose prescribed in this study carnitine supplementation did not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted , low-fat diet Background Cachexia , a > 10 % loss of body-weight , is one factor determining the poor prognosis of pancreatic cancer . Deficiency of L-Carnitine has been proposed to cause cancer cachexia . Findings We screened 152 and enrolled 72 patients suffering from advanced pancreatic cancer in a prospect i ve , multi-centre , placebo-controlled , r and omized and double-blinded trial to receive oral L-Carnitine ( 4 g ) or placebo for 12 weeks . At entry patients reported a mean weight loss of 12 ± 2,5 ( SEM ) kg . During treatment body-mass-index increased by 3,4 ± 1,4 % under L-Carnitine and decreased ( −1,5 ± 1,4 % ) in controls ( p < 0,05 ) . Moreover , nutritional status ( body cell mass , body fat ) and quality -of-life parameters improved under L-Carnitine . There was a trend towards an increased overall survival in the L-Carnitine group ( median 519 ± 50 d versus 399 ± 43 d , not significant ) and towards a reduced hospital-stay ( 36 ± 4d versus 41 ± 9d , n.s . ) . Conclusion While these data are preliminary and need confirmation they indicate that patients with pancreatic cancer may have a clinical ly relevant benefit from the inexpensive and well tolerated oral supplementation of L-Carnitine INTRODUCTION Carnitine supplementation may improve the general health and quality of life of hemodialysis patients by improving adipokines levels . The aim of the study was to investigate the effects of L-carnitine supplementation on leptin levels , adiponectin levels , and body weight of hemodialysis patients . MATERIAL S AND METHODS Fifty hemodialysis patients were r and omly divided into the carnitine group , who received oral L-carnitine , 1 g/L for 3 months , and the control group . Anthropometric measurements and serum levels of adipokines were measured at baseline and at the end of the intervention . RESULTS Forty-two participants completed the study . Serum leptin concentrations decreased after 12 weeks of the intervention in both groups , but these changes were not significant . The mean change of leptin concentration were , -1.7 ± 19.0 µg/mL and -7.1 ± 20.0 µg/mL in the carnitine group and the control group , respectively ( P = .39 ) . The mean adiponectin levels at baseline and after the intervention were 8.6 ± 11.19 µg/mL and 9.8 ± 4.1 µg/mL in the carnitine group ( P = .67 ) and 5.0 ± 2.5 µg/mL and 11.2 ± 5.4 µg/mL in the control group , respectively ( P < .001 ) . Serum adiponectin levels increased significantly in the control group only . The decrease in body mass index was not significant . CONCLUSIONS This study showed that a daily supplementation of 1000 mg oral syrup of L-carnitine for 12 weeks did not affect leptin and adiponectin levels or the body weight or body mass index of hemodialysis patients AIM Obesity is an important worldwide public health problem and considered a disease of chronic low- grade inflammation . The aim of this study was to evaluate the effect of L-carnitine supplementation in comparison with moderate aerobic exercise training on serum inflammatory parameters in healthy obese women . METHODS In this double-blind r and omized controlled clinical trial , 44 obese women were r and omly assigned to 4 groups ( N.=11 ) as follows : 1 : L-carnitine supplementation ( 2 g/day ) ( CAR ) , 2 : aerobic training + placebo ( EXR+PLA ) , 3 : L-carnitine supplementation + aerobic training ( CAR+EXR ) and 4 : placebo ( PLA ) . All intervention periods were eight weeks and subjects of aerobic training groups underwent 8-week aerobic training protocol ( 3 sessions a week [ 24 sessions ] ) . Body Mass Index , daily dietary intake and serum free L-carnitine , IL-6 , high-sensitivity C-reactive protein ( Hs-CRP ) and IL-10 levels of subjects were measured before and after interventions . RESULTS Interventions had no significant effects on body weight , BMI , daily dietary intake and serum IL-10 levels of subjects in all groups . Serum free L-carnitine concentration increased significantly after interventions in CAR and CAR+EXR groups . Significant decreases of IL-6 were observed in EXR+PLA and CAR+EXR groups compared with placebo group . L-carnitine supplementation plus aerobic training led to significant decrease of serum Hs-CRP levels in CAR+EXR group compared with baseline values . CONCLUSION L-carnitine supplementation did not affect serum IL-6 , Hs-CRP and IL-10 levels in obese women .  Aerobic training alone or in combination with L-carnitine had favorable effect on serum Il-6 and Hs-CRP levels as markers of inflammation in studied subjects The effect of a 3-tier intervention including dietary modifications ( ie , moderate energy restriction , decreased carbohydrate , increased protein ) , increased physical activity , and the use of carnitine as a dietary supplement was evaluated on plasma lipids and the atherogenicity of low-density lipoprotein ( LDL ) particles in a population of overweight and obese premenopausal ( aged 20 - 45 years ) women .  Carnitine or a placebo ( cellulose ) was r and omly assigned to the participants using a double-blind design . Carnitine supplementation was postulated to enhance fat oxidation result ing in lower concentrations of plasma triglycerides . Seventy women completed the 10-week protocol , which followed a reduction in their energy intake by 15 % and a macronutrient energy distribution of 30 % protein , 30 % fat , and 40 % carbohydrate . In addition , subjects increased the number of steps taken per day by 4500 . As no differences were observed between the carnitine and placebo groups in all the measured parameters , all subjects were pooled together for statistical analysis . Participants decreased ( P<.01 ) their caloric intake ( between 4132.8 and 7770 kJ ) and followed prescribed dietary modifications as assessed by dietary records . The average number of steps increased from 8950+/-3432 to 12764+/-4642 ( P<.001 ) . Body weight , plasma total cholesterol , LDL cholesterol , and triglyceride were decreased by 4.5 % , 8.0 % , 12.3 % , and 19.2 % ( P<.0001 ) , respectively , after the intervention . Likewise , apolipoproteins B and E decreased by 4.5 % and 15 % ( P<.05 ) after 10 weeks . The LDL mean particle size was increased from 26.74 to 26.86 nm ( P<.01 ) , and the percent of the smaller LDL subfraction ( P<.05 ) was decreased by 26.5 % ( P<.05 ) after 10 weeks . In addition , LDL lag time increased by 9.3 % ( P<.01 ) , and LDL conjugated diene formation decreased by 23 % ( P<.01 ) , indicating that the susceptibility of LDL to oxidation was decreased after the intervention . This study suggests that moderate weight loss ( < 5 % of body weight ) associated with reduced caloric intake , lower dietary carbohydrate , and increased physical activity impacts the atherogenicity of LDL Dietary supplementation is commonly employed by individuals seeking to improve body composition and exercise performance . The purpose of the present study was to examine the safety and effectiveness of a commercially available dietary supplement design ed to promote thermogenesis and fat loss . In a r and omized double-blind trial , participants were assigned to consume placebo or a multi-ingredient supplement containing caffeine , green tea extract , l-carnitine , evodiamine and other ingredients that purportedly enhance thermogenesis . The study included acute baseline testing , a 6-week progressive resistance training and supplementation intervention , and post-intervention testing . Laboratory assessment s included resting energy expenditure responses to acute supplement ingestion , evaluation of body composition and muscular performance , and analysis of blood variables ( metabolic panel , testosterone , estrogen and cortisol ) . Dependent variables were analyzed using ANOVA with repeated measures . No unfavorable effects of supplementation were reported , and the supplement did not adversely affect safety markers . However , the supplement did not reduce fat mass or increase lean mass relative to placebo . In the supplement group , lower body maximal strength was increased relative to placebo ( + 18 % , d=1.1 vs. + 10 % , d=0.5 ) , and cortisol concentrations were decreased relative to placebo ( -16 % ; d=-0.4 vs. + 15 % , d=.75 ) . However , no differences were observed for upper body maximal strength or muscular endurance . REE increased in response to both supplement and placebo ingestion ( placebo : + 5 % ; supplement : + 11.5 % ) , but the difference between conditions was not statistically significant . Overall , some select parameters may have been beneficially modified by supplementation , but this did not result in superior weight or fat loss over 6 weeks of supplementation and resistance training OBJECTIVE Carnitine transfer across the placenta occurs predominantly during the third trimester . Unless L-carnitine is provided , very preterm infants develop carnitine deficiency . Although breast milk and infant formulas contain L-carnitine , parenteral nutrition solutions do not routinely provide L-carnitine . We hypothesized that prolonged L-carnitine supplementation in very preterm infants would improve weight gain and shorten length of stay in the hospital . STUDY DESIGN The study was a double-blind parallel placebo-controlled  r and omized clinical trial . Eligible patients were < 29 weeks of gestation , < 72 hours of age , and did not have a potentially life-threatening congenital malformation or hereditary metabolic disorder . Patients were stratified by gestational age ( 23 to 256/7 and 26 to 286/7 weeks ) , and r and omized to receive , either L-carnitine at a dose of 50 μmol/kg/day , or placebo . Carnitine was provided intravenously until the infants tolerated 16 ml/day of feeds . The sample size was calculated to have 80 % power to detect a 10 % increase in weight gain from birth until 36 weeks of postmenstrual age or discharge from the hospital . Secondary outcome variables included food efficiency ( defined as weight gain divided by caloric intake ) , weight gain at 4 weeks of age , time to regain birth weight and length of stay . RESULTS Among the 63 infants enrolled in the trial , 32 were r and omized to L-carnitine and 31 to placebo . L-Carnitine supplementation did not significantly affect average daily weight gain from birth until 36 weeks or hospital discharge , or any of the secondary outcome variables . CONCLUSION Prolonged supplementation of L-carnitine did not improve long-term weight gain in very preterm infants BACKGROUND L-carnitine levels decrease rapidly and steadily with duration of hemodialysis , and carnitine depletion can impair response to recombinant human erythropoietin ( rHuEPO ) . The study hypothesis was that L-carnitine supplementation during the first year of hemodialysis would improve this response . DESIGN , SETTING , PARTICIPANTS , & MEASUREMENTS From October 2006 through March 2010 , this multicenter , r and omized , double-blinded study assigned 92 incident hemodialysis patients to receive placebo or 1 g of intravenous L-carnitine after each dialysis session for 1 year . The primary outcome measure compared the groups for  rHuEPO resistance index ( EPO-RI ) , defined as weekly rHuEPO doses ( IU/kg body weight divided by hemoglobin level ) ( g/dl ) . RESULTS In the L-carnitine group , carnitine concentration increased from a mean ± SD of 79 ± 51 µmol/L to 258 ± 137 µmol/L ; in the placebo group , it declined from 68 ± 25 µmol/L to 53 ± 24 µmol/L ( interaction group × time , P<0.001 ) . Carnitine deficiency affected about 30 % of the patients in the placebo group during the study period . EPO-RI varied from 15.8 ± 11.3 to 9.5 ± 5.8 IU/kg per g/dl in the placebo group and from 20.6 ± 12.8 to 15.6 ± 15.9 IU/kg per g/dl in the L-carnitine group , for a mean variation of -3.94 ± 12.5 IU/kg per g/dl and -2.98 ± 15.5 IU/kg per g/dl , respectively ( P=0.7 ) . After adjustment for baseline characteristics , the EPO-RI course was similar in each group ( difference between groups , P=0.10 ; interaction group × time , P=0.9 ) . CONCLUSIONS Carnitine levels decrease by about 11 % ± 33 % during the first year of hemodialysis . Treatment of incident hemodialysis patients with L-carnitine does not improve their response to rHuEPO BACKGROUND Fat metabolism is known to be altered in hypertriglyceridemia . Fat oxidation requires carnitine , which can be obtained either from the diet ( animal or dairy products ) or through synthesis in the body using both lysine and vitamin B(6 ) . OBJECTIVE The goal of this study was to investigate the effect of lysine , vitamin B(6 ) , and carnitine supplementation on both glycemia and the lipid profiles , specifically triglyceride ( TG ) levels , in men with hypertriglyceridemia . METHODS This 12-week , r and omized , placebo-controlled clinical trial was conducted at a Lebanese medical center . A total of 85 hypertriglyceridemic ( TG > 150 mg/dL ) male patients were r and omized to 1 of 5 groups and given supplements of lysine ( 1 g/d ) , vitamin B(6 ) ( 50 mg/d ) , lysine ( 1 g/d ) + vitamin B(6 ) ( 50 mg/d ) , carnitine ( 1 g/d ) , or placebo for 12 weeks . The lipid profile ( TG , total cholesterol , LDL-C , and HDL-C ) and fasting plasma glucose levels were assessed at baseline and at 6 and 12 weeks . RESULTS Adults ( ∼50 years ) Lebanese males from a low socioeconomic status in Beirut were given the appropriate supplements . Vitamin B(6 ) supplementation was associated with a significant reduction in total cholesterol and HDL-C of ∼10 % . In addition , plasma TG was reduced by 36.6 mg/dL at 6 weeks , whereas levels in the placebo group increased by 18 mg/dL ; this difference failed to reach statistical significance . No major changes in the lipid profile were observed in the lysine and carnitine groups or when lysine was added to vitamin B(6 ) . CONCLUSION Vitamin B(6 ) supplementation in these male patients with hypertriglyceridemia reduced plasma total cholesterol and HDL-C concentrations Carnitine deficiency is among the many metabolic disturbances that may contribute to fatigue in patients with cancer . Administration of exogenous L-carnitine may hold promise as a treatment for this common symptom . Little is known about L-carnitine  safety , tolerability , and dose-response in patients with cancer . We conducted a Phase I/II open-label trial to assess the safety and tolerability of exogenous L-carnitine and clarify the safe dose range associated with symptom effects for future controlled trials . Adult patients with advanced cancer , carnitine deficiency ( free carnitine < 35 for males or < 25 microM/L for females , or acyl/free carnitine ratio > 0.4 ) , moderate to severe fatigue , and a Karnofsky Performance Status ( KPS ) score > or = 50 were entered by groups of at least three into a st and ard maximum tolerated dose design . Each successive group received a higher dose of L-carnitine ( 250 , 750 , 1250 , 1750 , 2250 , 2750 , 3000 mg/day , respectively ) , administered in two daily doses for 7 days . To compare symptom outcomes before and after supplementation , patients completed vali date d measures of fatigue ( Brief Fatigue Inventory [ BFI ] ) , depressed mood ( Center for Epidemiologic Studies Depression Scale [ CES-D ] ) , quality of sleep ( Epworth Sleeplessness Scale [ ESS ] ) , and KPS at baseline and 1 week later . Of the 38 patients screened for carnitine levels , 29 were deficient ( 76 % ) . Twenty-seven patients participated ( " intention to treat , ITT " ) ( 17 males , 10 females ) , and 21 completed the study ( " completers " ) ; 17 of these patients ( " responders , " mean+/-[SD ] age=57.9+/-15 ) had increased carnitine levels at the end of the supplementation period . The highest dose achieved was 3000 mg/day . No patient experienced significant side effects and no toxicities were noted . Analysis of all the patients accrued ( ITT , n=27 ) showed a total carnitine increase from 32.8+/-10 to 54.3+/-23 microM/L ( P<0.001 ) and free carnitine increase from 26.8+/-8 to 44.1+/-17 microM/L ( P<0.001 ) . BFI decreased significantly , from 66+/-12 to 39.7+/-26 ( P<0.001 ) ; ESS decreased from 12.9+/-12 to 9+/-6 ( P=0.001 ) ; and CES-D decreased from 29.2+/-12 to 19+/-12 ( P<0.001 ) . A separate analysis of the 17 " responders " showed a dose-response relationship for total- ( r=0.54 , P=0.03 ) , free-carnitine ( r=0.56 , P=0.02 ) levels , and fatigue ( BFI ) scores ( r=-0.61 , P=0.01 ) . These findings suggest that l-carnitine may be safely administered at doses up to 3000 mg/day and that positive effects may be more likely at relatively higher doses in this range . This study provides the basis for the design of future placebo-controlled studies of l-carnitine supplementation for cancer-related fatigue AIMS To evaluate the effect of L-carnitine supplementation ( 25 mg/kg/d ) on the growth and incidence of hypoglycaemia in preterm infants . METHODS A double blind , placebo controlled r and omised trial , stratified for gestational age , was conducted of 86 preterm infants between 28 and 34 gestational weeks . The median gestational ages in the carnitine group and placebo groups were 30.7 weeks ( range 28.0 to 33.6 ) and 31.4 weeks ( range 28.0 to 33.9 ) , respectively . The median birthweights were 1.557 kg ( range 0.944 to 2.275 ) and 1.645 kg ( range 0.885 to 2.545 ) , respectively . RESULTS Mean plasma free carnitine concentrations were below values for normal term infants in both groups on day 1 ( carnitine group 44.8 μmol/l , placebo group 25.5 μmol/l ) in the placebo group on day 7 ( 50.7 μmol/l ) , but in neither group on days 14 and 28 . Total , free , and acylcarnitine concentrations were significantly increased in both urine and blood in the L-carnitine group . There was no significant difference between the placebo and carnitine supplemented groups in growth rate , as assessed by weight , length , skinfold thickness and head circumference measurements , or in the incidence of episodes of hypoglycaemia . CONCLUSION The addition of carnitine as a nutritional supplement at a dose of 25mg/kg/day did not improve growth in our group of preterm infants nor protect them from episodes of hypoglycaemia AIMS Carnitine is involved in fatty acid metabolism and it is cleared by dialysis . As it plays a role in energy utilization and because malnutrition is a frequent complication of HD treatment , we studied the effects of carnitine supplementation on several nutritional parameters in HD patients . MATERIAL AND METHODS The main selection criterion was a body mass index ( BMI ; body weight/(height)2 ) < 22 kg/m2 . Fifty-three patients were enrolled to participate in this open and r and omized study . For 6 months , 28 patients received 15 mg/kg of intravenous L-carnitine at the end of each  hemodialysis ( HD ) treatment  ( Group A ) , the remaining 25 patients were controls ( Group B ) . The measured parameters were the post-dialysis body weight , serum albumin concentration ( nephelemetry ) , food intake assessed by a 3-day food question naire , nPNA ( normalized protein equivalent of nitrogen appearance ) , creatinine generation , and anthropometry . RESULTS Forty-five patients completed the study ( Group A : 14 F/9 M , 66.7 years old ; Group B : 11 F/11 M , 65.2 years old ) . At the beginning of the study , there were no differences between the groups for age , gender , HD duration , BMI , diabetes prevalence , plasma carnitine levels and measured nutritional parameters . 65.2 % and 77.3 % in each group were carnitine-deficient ( plasma total carnitine level < 35 micromol/l ) . After 6 months of L-carnitine supplementation , none of the nutritional parameters had changed in either group , except that serum albumin concentration decreased in both groups . Dividing each group according to their respective median serum albumin concentrations , daily energy and protein intakes , creatinine generation or triceps skinfold thickness did not show any difference in the various nutritional parameters with or without carnitine supplementation . CONCLUSION Carnitine supplementation , despite normalization of plasma carnitine levels , has no effect on the nutritional status of HD patients BACKGROUND Carnitine insufficiency is responsible for various co-morbid conditions in maintenance hemodialysis ( MHD ) patients .  L-carnitine supplementation is expected to improve the quality of life ( QoL ) of patients on MHD . AIMS To study the effect of L-carnitine supplementation on QoL of Indian patients on MHD . SETTING AND DESIGN This was a single ( patient ) blind , r and omized , placebo-controlled clinical trial conducted on patients on MHD attending hemodialysis unit of the study center . MATERIAL S AND METHODS Twenty patients on MHD suffering from hemodialysis-related symptoms were r and omly assigned to receive intravenous L-carnitine 20 mg/kg or placebo after every dialysis session for 8 weeks . SF36 ( Short Form with 36 questions ) score for QoL , laboratory investigations and dialysis related symptoms were recorded at baseline and after 8 weeks . Improvement in QoL , laboratory parameters and dialysis related symptoms in the two groups after 8 weeks was compared . STATISTICAL ANALYSIS USED Depending on normality of data , unpaired T test or Mann Whitney U test was used for comparison of change ( 8 weeks-baseline ) in SF36 scores and laboratory parameters observed in the two groups . RESULTS L-carnitine supplementation increased total SF36 score by 18.29 + /- 12.71 ( 95 % CI : 10.41 to 26 ) while placebo result ed in reduction in total SF36 score by 6.4 + /- 16.39 ( 95 % CI : -16.59 to 3.73 ) . L-carnitine also result ed in significant increase in hemoglobin and serum albumin and decrease in serum creatinine as compared to placebo . More patients were relieved of dialysis related symptoms in L-carnitine group . CONCLUSION Intravenous L-carnitine supplementation improves QoL in patients on MHD Background Frailty is a biological syndrome of decreased reserve and resistance to stressors due to decline in multiple physiological systems . Amino acid deficiency , including L-carnitine , has been proposed to be associated with its pathophysiology . Nevertheless , the efficacy of L-carnitine supplementation on frailty status has not been documented . Thus , this study aim ed to determine the effect of 10-week L-carnitine supplement ( 1.5 g/day ) on frailty status and its biomarkers and also physical function , cognition , and nutritional status among prefrail older adults in Klang Valley , Malaysia . Methodology This study is a r and omized , double-blind , placebo-controlled clinical trial conducted among 50 prefrail subjects r and omized into two groups ( 26 in L-carnitine group and 24 in placebo group ) . Outcome measures include frailty status using Fried criteria and Frailty Index accumulation of deficit , selected frailty biomarkers ( interleukin-6 , tumor necrosis factor-alpha , and insulin-like growth factor-1 ) , physical function , cognitive function , nutritional status and biochemical profile . Results The results indicated that the mean scores of Frailty Index score and h and grip test were significantly improved in subjects supplemented with L-carnitine ( P<0.05 for both parameters ) as compared to no change in the placebo group . Based on Fried criteria , four subjects ( three from the L-carnitine group and one from the control group ) transited from prefrail status to robust after the intervention . Conclusion L-carnitine supplementation has a favorable effect on the functional status and fatigue in prefrail older adults OBJECTIVE Carnitine is thought to be a conditionally essential biological cofactor for premature infants . A preliminary study suggested that carnitine could significantly reduce  apnea of prematurity .  The objective of this study was to evaluate critically the role of carnitine in idiopathic apnea of prematurity and to determine whether the use of carnitine would facilitate discontinuation of mechanical ventilatory support , shorten the duration of ventilatory support , and reduce the amount of time that such infants are exposed to both mechanical ventilation and oxygen . We also wanted to determine the effects of supplemental carnitine on weight gain , time to regain birth weight , time to achieve full enteral feedings , and length of hospital stay . METHODS A prospect i ve , r and omized , blinded trial was conducted on 44 preterm infants who were from the same neonatal intensive care unit and who were < or = 32 weeks ' gestational age with a postnatal age < 48 hours and a birth weight < 1500 g and required total parenteral nutrition ( TPN ) . Infants were r and omized to receive carnitine supplementation or placebo without crossover . Carnitine-supplemented infants received 30 mg/kg/d carnitine in their TPN until the they were tolerating 120 mL/kg/d enteral feedings , and then they received 30 mg/kg/d oral carnitine . The placebo group received TPN without supplemental carnitine ; when they tolerated 120 mL/kg/d enteral feedings , they received an oral placebo . The 2 groups continued on their respective supplemental carnitine or placebo until 34 weeks ' adjusted age , at which time the study period was completed . Twelve-hour cardiorespiratorygrams to record heart rate , respiratory impedance , and oxygen saturation , and a nasal thermistor to detect expiratory airflow were performed every 4 days on 3 occasions and at 30 and 34 weeks ' adjusted age . Plasma carnitine levels were measured at day 14 . RESULTS There were no significant differences between the 2 groups in the occurrence of apnea as detected by cardiorespiratorygram or nursing observation . There were no significant differences between the groups in regard to total days on ventilator , days of nasal continuous positive airway pressure , time to regain birth weight , time to reach enteral feedings of 120 mL/kg/d , discharge weight , adjusted age at discharge , need for oxygen at 28 days ' and 36 weeks ' adjusted age , or length of stay . The plasma carnitine level was a median of 15.5 micromol/L ( range : 7.6 - 30.5 ) for the placebo infants compared with a median of 195.3 micromol/L ( range : 71.7 - 343.6 ) for the carnitine infants . CONCLUSIONS In this blinded , r and omized , placebo-controlled study , we found that infants who received supplemental carnitine did not demonstrate any reduction in apnea of prematurity , ventilator or nasal continuous positive airway pressure days , or the need for supplemental oxygen therapy . Although carnitine may be of significant nutritional benefit for very low birth weight infants , our study does not support its use to reduce apnea of prematurity or decrease dependence on mechanical ventilation The purpose of this investigation was to examine the influence of L-carnitine L-tartrate ( LCLT ) supplementation using a balanced , cross-over , placebo-controlled research design on the anabolic hormone response ( i.e. , testosterone [ T ] , insulin-like growth factor-I , insulin-like growth factor-binding pro-tein-3 [ IGFBP-3 ] , and immunofunctional and immunoreac-tive growth hormone [ GHif and GHir ] ) to acute resistance exercise . Ten healthy , recreationally weight-trained men ( mean ± SD age 23.7 ± 2.3 years , weight 78.7 ± 8.5 kg , and height 179.2 ± 4.6 cm ) volunteered and were matched , and after 3 weeks of supplementation ( 2 g LCLT per day ) , fasting morning blood sample s were obtained on six consecutive days ( D1-D6 ) . Subjects performed a squat protocol ( 5 sets of 15–20 repetitions ) on D2 . During the squat protocol , blood sample s were obtained before exercise and 0 , 15 , 30 , 120 , and 180 minutes postexercise . After a 1-week washout period , subjects consumed the other supplement for a 3-week period , and the same experimental protocol was repeated using the exact same procedures . Expected exercise-induced increases in all of the hormones were observed for GHir , GHif , IGFBP-3 , and T. Over the recovery period , LCLT reduced the amount of exercise-induced muscle tissue damage , which was assessed via magnetic resonance imaging scans of the thigh . LCLT supplementation significantly ( p < 0.05 ) increased IGFBP-3 concentrations prior to and at 30 , 120 , and 180 minutes after acute exercise . No other direct effects of LCLT supplementation were observed on the absolute concentrations of the hormones examined , but with more undamaged tissue , a greater number of intact receptors would be available for hormonal interactions . These data support the use of LCLT as a recovery supplement for hypoxic exercise and lend further insights into the hormonal mechanisms that may help to mediate quicker recovery Because carnitine has been shown to decrease oxidative stress and improve endothelial cell functioning , we examined the effects of carnitine supplementation on postpr and ial flow-mediated dilation ( FMD ) and circulating biomarkers of inflammation and oxidative stress after a high-fat meal . A r and omized , double-blind , placebo-controlled , crossover study design was used . Thirty men and women ( age 30 + /- 8 year , body mass 72.9 + /- 17.1 kg , body fat 13.0 + /- 6.4 % ) participated in 2 vascular testing days , each preceded by 3 weeks of supplementation with either 2 g/day of L-Carnitine ( L-Carnitine L-Tartrate ) or placebo with a 3- to 5-week washout period between trials . Brachial artery FMD in response to 5 minutes of upper arm occlusion and circulating markers of oxidative stress and inflammation were measured in the fasting state and after a st and ardized high-fat meal . After 3 weeks of supplementation , peak FMD in the fasting state was similar between the carnitine and placebo trials , averaging 6.6 % . Peak FMD during the postpr and ial period decreased to 5.8 % at 1.5 hours during placebo and increased to 7.7 % during the carnitine trial ( n = 30 : p = 0.043 for supplement by time interaction effect ) . This improvement in postpr and ial vascular function was most dramatic in subjects who showed a decrease in peak FMD in response to the meal ( n = 15 : p = 0.003 for supplement by time interaction effect ) . There was a significant increase in postpr and ial lipemia and plasma interleukin-6 but no effect of supplementation . There were no significant postpr and ial changes or supplement effects for plasma tumor necrosis factor-alpha and malondialdehyde . In conclusion , consistent with other work showing a beneficial effect of carnitine on vascular function , these findings indicate that carnitine supplementation in healthy individuals improves postpr and ial FMD after a high-fat meal Preliminary in vitro and in vivo studies with valproic acid ( VPA ) in cell lines and patients with spinal muscular atrophy ( SMA ) demonstrate increased expression of SMN , supporting the possibility of therapeutic benefit . We performed an open label trial of VPA in 42 subjects with SMA to assess safety and explore potential outcome measures to help guide design of future controlled clinical trials . Subjects included 2 SMA type I ages 2–3 years , 29 SMA type II ages 2–14 years and 11 type III ages 2–31 years , recruited from a natural history study .  VPA was well-tolerated and without evident hepatotoxicity . Carnitine depletion was frequent and temporally associated with increased weakness in two subjects . Exploratory outcome measures included assessment of gross motor function via the modified Hammersmith Functional Motor Scale ( MHFMS ) , electrophysiologic measures of innervation including maximum ulnar compound muscle action potential ( CMAP ) amplitudes and motor unit number estimation ( MUNE ) , body composition and bone density via dual-energy X-ray absorptiometry ( DEXA ) , and quantitative blood SMN mRNA levels . Clear decline in motor function occurred in several subjects in association with weight gain ; mean fat mass increased without a corresponding increase in lean mass . We observed an increased mean score on the MHFMS scale in 27 subjects with SMA type II ( p≤0.001 ) ; however , significant improvement was almost entirely restricted to participants < 5 years of age . Full length SMN levels were unchanged and Δ7SMN levels were significantly reduced for 2 of 3 treatment visits . In contrast , bone mineral density ( p≤0.0036 ) and maximum ulnar CMAP scores ( p≤0.0001 ) increased significantly . Conclusions While VPA appears safe and well-tolerated in this initial pilot trial , these data suggest that weight gain and carnitine depletion are likely to be significant confounding factors in clinical trials . This study highlights potential strengths and limitations of various c and i date outcome measures and underscores the need for additional controlled clinical trials with VPA targeting more restricted cohorts of subjects . Trial Registration Clinical BACKGROUND AND AIMS Advanced glycation end products ( AGEs ) contribute to cardiovascular disease in patients with hemodialysis ( HD ) . We have recently found that carnitine levels are inversely associated with skin AGE levels in HD patients . We examined whether L-carnitine supplementation reduced skin AGE levels in HD patients with carnitine deficiency . METHODS This was a single-center study . One hundred and two HD patients ( total carnitine levels < 50 μmol/L ) were enrolled and r and omized to either oral administration of L-carnitine ( 900 mg/day ) ( n=51 ) or control ( n=51 ) . After 6 months , metabolic and inflammatory variables , including serum levels of carnitine , were measured . Skin AGE levels were determined by evaluating skin auto-fluorescence with an AGE-reader . RESULTS There were no significant differences of clinical variables at baseline between the  control and L-carnitine therapy group . Thirty-two patients did not complete the assessment or treatment of the study .  Oral L-carnitine supplementation for 6 months significantly increased low-density lipoprotein cholesterol ( LDL-C ) , triglycerides , total , free , and acyl carnitine levels , while it decreased alanine transaminase , acyl/free carnitine ratio , β₂-microglobulin , and skin AGE values . Change in total carnitine values from baseline ( Δtotal carnitine ) and Δfree carnitine were inversely associated with Δskin AGE levels  in L-carnitine-treated patients ( p=0.036 and p=0.016 , respectively ) . In multiple regression analysis , Δfree carnitine was a sole independent determinant of Δskin AGEs ( R²=0.178 ) . CONCLUSIONS The present study demonstrated that oral L-carnitine supplementation significantly decreased skin AGE levels in HD patients with carnitine deficiency . These observations suggest that supplementation of L-carnitine might be a novel therapeutic strategy for preventing the accumulation of tissue AGEs in carnitine-deficient patients with HD Parenterally fed preterm neonates are known to be at risk for carnitine deficiency . We studied substrate utilization in low-birth-weight infants receiving total parenteral nutrition ( TPN ) with ( A ) and without ( B ) supplementation of 48 mg carnitine.kg-1.d-1 on days 4 - 7 ( birth weights 1334 + /- 282 vs 1318 + /- 248 g , gestational age 32 + /- 2 vs 32 + /- 2 wk , A vs B , respectively ) . TPN consisted of 11 g glucose.kg-1.d-1 and 2.4 g.kg-1.d-1 of both protein and fat . Plasma carnitine concentrations at day 7 were for free carnitine 11.8 + /- 5.0 vs 164 + /- 56 mumol/L and for acyl carnitine 3.8 + /- 2.0 vs 33.9 + /- 15.4 mumol/L , respectively . Indirect calorimetry at day 7 showed a higher fat oxidation ( 0.21 , -0.31 to + 0.60 vs 1.18 , 0.70 to 1.95 g. kg-1.d-1 , respectively , P less than 0.02 , median and interquartile range ) in group B and a higher protein oxidation ( 0.37 , 0.30 - 0.43 vs 0.63 , 0.53 - 0.88 g.kg-1.d-1 , P less than 0.001 ) . The time to regain birth weight was also higher in group B ( 7 , 5.5 - 9 vs 9 , 7 - 14 d , P less than 0.05 ) . Carnitine supplementation and calorie intake were the best explanatory variables for metabolic rate ( R2 = 0.45 , P less than 0.002 ) . We conclude that carnitine supplementation of TPN in this dosage does not seem advisable OBJECTIVE Systemic carnitine deficiency may present with apnea , hypotonia , and  poor growth . Premature infants often manifest these symptoms and are at risk of developing carnitine deficiency because of immaturity of the biosynthetic pathway , lack of sufficient predelivery transplacental transport , and lack of sufficient exogenous supplementation . This study was undertaken to examine the effect of carnitine supplementation in premature infants . METHODS Eighty preterm infants < 1500 g were enrolled in a prospect i ve , double-blind , placebo-controlled study of carnitine supplementation within 96 hours of delivery . Growth , length of hospital stay , and frequency and severity of apnea were the primary outcome measures . RESULTS Weight gain and change in length , fronto-occipital head circumference , mid arm circumference , and triceps skinfold thickness were similar between the carnitine-supplemented and placebo groups . The amount and severity of apnea and the overall length of hospitalization were also similar between the 2 groups . The carnitine levels in the supplemented group were significantly higher than in the placebo group at 4 and 8 weeks after study entry . CONCLUSION Although preterm infants < 1500 g have low carnitine levels , routine supplementation with carnitine has no demonstrable effect on growth , apnea , or length of hospitalization and thus seems to be unnecessary Aim To investigate if conjugated linoleic acid supplementation ( CLA ) affects metabolic factors and oxidative stress in non-alcoholic fatty liver disease ( NAFLD ) . Methods The study was a r and omized , controlled clinical trial conducted in specialized and subspecialized clinics of Tabriz University of Medical Sciences from January 2014 to March 2015 . 38 obese NAFLD patients were r and omly allocated into either the intervention group , receiving three 1000 mg softgel of CLA with a weight loss diet and 400 IU vitamin E , or into the control group , receiving only weight loss diet and 400 IU vitamin E for eight weeks . Dietary data and physical activity , as well as anthropometric , body composition , metabolic factors , and oxidative stress were assessed at baseline and at the end of the study . Results Weight , body composition , and serum oxidative stress , insulin , and lipid profile significantly improved in both groups , while hemoglobin A1c ( HbA1c ) levels ( P = 0.004 ) , total cholesterol to high density lipoprotein ratio ( P = 0.008 ) , low density lipoprotein to high density lipoprotein ratio ( LDL/HDL ) ( P = 0.002 ) , and alanine aminotransferase to aspartate aminotransferase ( ALT/AST ) ratio ( P = 0.025 ) significantly decreased in the intervention group . At the end of the study , fat mass ( P = 0.001 ) , muscle mass ( P = 0.023 ) , total body water ( P = 0.004 ) , HbA1c ( P < 0.001 ) , triglycerides ( P = 0.006 ) , LDL/HDL ratio ( P = 0.027 ) , and ALT/AST ratio ( P = 0.046 ) were significantly better in the CLA group than in the control group . Conclusion CLA improved insulin resistance , lipid disturbances , oxidative stress , and liver function in NAFLD . Therefore , it could be considered as an effective complementary treatment in NAFLD . Registration number : I RCT 2014020516491N1
No significant effect was seen for waist circumference ( WC ) and body fat percent .
A non-linear dose-response association was seen between l-carnitine supplementation and body weight reduction ( P < 0.001 ) suggesting that ingestion of 2000 mg l-carnitine per day provides the maximum effect in adults .
This association was not seen for BMI , WC and body fat percent .
CONCLUSIONS l-carnitine supplementation provides a modest reducing effect on body weight , BMI and fat mass , especially among adults with overweight/obesity
BACKGROUND AND AIM Clinical evidence which investigated the effects of l-carnitine , a vitamin-like substance , on weight loss had led to inconsistent results .
This study therefore aim ed to examine the effect of l-carnitine supplementation on body weight and composition by including the maximum number of r and omized controlled trials ( RCTs ) and to conduct a dose-response analysis , for the first time .