Life Extension Update
L-carnitine reduces physical and mental fatigue, improves cognitive function in centenarians
A report published in the December, 2007 issue of the American Journal of Clinical Nutrition described the results of a study conducted by Italian researchers which found a positive effect for L-carnitine (levo-carnitine) on energy levels and cognitive function in individuals 100 years of age and older. The age-related decline in L-carnitine, which plays a role in cellular energy metabolism, could be involved in the fatigue experienced by many older individuals.
Twenty-four men and forty-six women aged 100 to 106 who reported experiencing fatigue after even slight physical activity were randomized to receive 2 grams L-carnitine per day or a placebo for six months. Physical examinations at the beginning and end of the treatment period determined the participants’ body mass index, total fat mass and muscle mass. Blood samples were drawn monthly and analyzed for cholesterol, carnitine levels and other factors. Mental and physical fatigue was scored, and cognitive function was evaluated before and after the treatment period. Physical activity was assessed each week with a six minute walking test.
There were three deaths among the group that received L-carnitine and five in the placebo group over the course of the study. The group that received L-carnitine experienced an increase in plasma carnitine concentrations. They also experienced lower total cholesterol, significant reduction of fat mass, gains in total muscle mass, a reduction in physical and mental fatigue and fatigue severity, and better cognitive function scores compared with those received a placebo. Additionally, walking capacity improved in the carnitine group.
Because L-carnitine is necessary for mitochondrial long-chain fatty acid oxidation, an elevation in carnitine levels could increase the fatty acid oxidation rate, thereby lowering glucose utilization, preserving muscle glycogen, and ensuring optimal production rates of oxidative adenosine triphosphate (ATP, which releases energy in the cell). “Our study indicates that oral administration of levo-carnitine produces a reduction of total fat mass, increases total muscular mass, and facilitates an increased capacity for physical and cognitive activity by reducing fatigue and improving cognitive functions,” the authors conclude.
It is estimated that up to one third of adults will experience a gradual decline in cognitive function known as mild cognitive impairment as they age (Low LF et al 2004; Busse A et al 2003). Less severe than dementia, mild cognitive impairment is defined as cognitive defects that do not interfere with daily living. It may include slower thinking, a reduced ability to learn, and impaired memory. While many conventional physicians view these defects as an inevitable consequence of aging, newer research has uncovered possible reasons for mild cognitive impairment and has also identified potential therapies that may enable people to battle age-related mental decline more effectively than ever before. Minimizing cognitive defects will become even more important as the average life span continues to lengthen and hundreds of thousands of people head into their 80s and 90s, when the risk for cognitive decline is greatest.
Acetyl-L-carnitine has been studied extensively relative to the treatment of dementia. It is believed to be a precursor in the synthesis of acetylcholine and participates in cellular energy production as well as in the removal of toxic accumulation of fatty acids. In one study, 30 participants with mild dementia were treated with 2 g daily of acetyl-L-carnitine, and 30 were treated with placebo. The results after three months showed a significant improvement in the group receiving the acetyl-L-carnitine (Passeri M et al 1990). Several other studies also indicate that acetyl-L-carnitine may be helpful in improving cognitive function in patients and possibly slowing the progression of Alzheimer’s disease (Rai G et al 1990; Bonavita E 1986). Animal studies have shown that acetyl-L-carnitine reverses the age-related decline in the number of neuron membrane receptors (McDaniel MA et al 2003), and an analysis of 21 clinical trials of acetyl-L-carnitine in the treatment of mild cognitive impairment and mild Alzheimer’s disease in rats showed it has demonstrated significant efficacy versus placebo (Ames BN et al 2004).
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