L-Carnitine and Non-Alcoholic Fatty Liver
Non-Alcoholic Fatty Liver is an imbalance of removal of lipids (fats) from the liver and thus an accumulation of lipids in the liver. It is considered a metabolic disease. Overtime this can cause inflammation and scarring of the liver eventually leading to chronic liver disease, cirrhosis and/or liver cancer. Insulin resistance, mitochondrial dysfunction and thus oxidative stress and inflammation play a central role in NASH. Obesity and Type II Diabetes are contributing factors to the development of NASH.
One supplement used in treatment and prevention of NASH is L-Carnitine. L-carnitine is an amino acid found in animal products and diary products primarily in whey protein. People may be low in L-carnitine due to genetic disorders, certain medications, undergoing hemodialysis for kidney disease or in low weight or strict vegetarian/vegan diets. It is a well tolerated and therapeutically safe. Side effects occur at larger doses which include nausea, vomiting, stomach upset, heartburn, diarrhea, seizures and a fishy odor. It is taken orally or by IV. There are different forms of Carnitine. L Carnitine is the most biologically active form. Doses range for different conditions. For NASH, the general dose is 500- 1000mg twice a day.
L-Carnitine is synthesized by lysine and methoionine in the liver with Vit C, ferrous ions and niacin as co-factors. It transports long chain fatty acids into the mitochondria to be oxidized into energy. It has shown to regulate the lipid profile, improve glucose metabolism and decrease oxidative stress and inflammatory responses. Furthermore it has shown to reduce specific inflammatory markers (CRP, TNF-alpha), improve liver function, and restore some histological changes in NASH.
In one study double blind study, 78 people were either given L-Carnitine at 1g twice a day for 24 weeks or a placebo. All other variables were accounted for. Both groups were told to exercise and to follow a low calorie diet. At the end of the study, BMI reduction was similar. In the L-carnitine group there was a significant decrease in liver enzymes, inflammatory markers and there was an improvement in insulin resistance. The liver biopsies done before and after treatment showed histological improvements.
L-Carnitine has been well researched on its value for prevention and treatment of NASH. It is a good part of a holistic treatment plan for NASH including weight loss, exercise, dietary changes and individual treatment/supplement plans.
Please book an appointment to talk about what best would work for you.
References:
Gaby, Alan R. “Nonalcoholic Fatty Liver Disease.” Nutritional Medicine, by Alan R. Gaby, 2nd ed., Fritz Perlberg Publishing , 2017, pp. 518–526.
https://www.ncbi.nlm.nih.gov/pubmed/20068559
https://www.ncbi.nlm.nih.gov/pubmed/16406828
https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/#h3
https://www.nature.com/articles/s41598-017-02924-5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682907/
https://www.webmd.com/vitamins/ai/ingredientmono-1026/l-carnitine
https://www.healthline.com/nutrition/l-carnitine#bottom-line