Indications

l Carnitine Tartrate SAP may be used to help prevent stable angina.
l Carnitine Tartrate SAP may be used to help prevent pain associated with peripheral vascular disease (PVD).
l Carnitine Tartrate SAP may increase sperm count and mobility.
l Carnitine Tartrate SAP may help prevent cancer cachexia.
l Carnitine Tartrate SAP may improve recovery time for athletes.

Ingredients

Each capsule of l Carnitine Tartrate SAP contains:
l Carnitine tartrate 750 mg
Providing 500 mg of l carnitine.

Description

l Carnitine plays an important role in fatty acid metabolism and has important antioxidant and anti-inflammatory properties.(1) l Carnitine is a non-essential amino acid synthesized primarily in the liver and kidneys from the amino acids lysine and methionine. l Carnitine is stored in skeletal muscles, brain, heart, and sperm, and therefore plays a functional role in each of these tissues. Deficiency if in l carnitine may be associated with certain medications, angina, and vegan or vegetarian diets. Symptoms of deficiency may include fatigue, muscle weakness, and a decreased tolerance to metabolic stress.(1)

l-CARNITINE BIOCHEMISTRY
Carnitine is a cofactor that is required to metabolize free long-chain fatty acids into acylcarnitines, which
are then transported into mitochondria for betaoxidation.(2) This form of energy production is the
primary fuel source for both heart and skeletal muscle. Carnitine can be synthesized via methylated l lysine with S adenosyl methionine (SAM).(2) Cofactors important for this process include magnesium, ascorbic acid, iron, pyridoxal-5 phosphate, niacin, and methionine, as well as the cofactors necessary for the methylation pathway.(2) If patients are deficient in any of the cofactors, this may
result in a relative deficiency of carnitine, which may have an impact on proper functioning of skeletal muscle, heart, or sperm function.

ANGINA
l Carnitine may help improve duration of exercise and recovery time in patients with stable angina.(2) A sixmonth trial using 2 g/d l carnitine in patients with exercise-induced stable angina demonstrated a reduction in the number of premature ventricular contractions at rest, improved exercise tolerance, increased maximal systolic arterial blood pressure, and reduced ST-segment depression during maximal effort.(2) There was also a reduction in the number of cardioactive pharmaceuticals
needed in patients supplementing l carnitine.(2) In a separate randomized, placebo-controlled, crossover study investigating stable effort-induced angina, patients were given l carnitine or placebo.(2) Twenty-two percent of the patients in the l carnitine group reported being free of angina, compared to nine percent in the placebo group.(2) Results indicated a reduction in ECG indices of ischemia and improved exercise tolerance with l carnitine supplementation.(2)

INTERMITTENT CLAUDICATION
A review article exploring the use of supplementing l carnitine in patients with intermittent claudication
examined 17 articles that met their inclusion criteria.(3) Researchers found that of the 5 randomized control trials, 4 demonstrated significant improvements in walking performance following dosing of between 300–600 mg/d of oral l carnitine or propionyl-l carnitine (PLC).(3) Average improvements compared to placebo showed an improvement in pain-free walking distance as well as
for maximal walking distance by 23–132 m and 104 m, respectively, following carnitine intervention.(3)

MALE FERTILITY
l Carnitine plays an essential role in maintaining male fertility. In a study examining sperm motility, count, and morphology, researchers found that infertile subjects had a significantly lower amount of seminal free l carnitine compared to fertile controls, and that subjects in the azoospermic group had the lowest levels of l carnitine.(4) In another study, researchers found a significant positive
correlation between seminal plasma total carnitine concentration and total sperm count.(5) Researchers
concluded that seminal carnitine levels may be a useful test when evaluating male infertility.(5)

CANCER CACHEXIA
In patients with cancer, cachexia is a major concern and a likely determinate of longevity. In a review study, researchers presented evidence regarding the use of carnitine supplementation for treating cachexia in patients with cancer. Data showed that cancer patients had low serum carnitine levels, and that l carnitine supplementation resulted in improvement in fatigue aswell as quality of life.(1)

ATHLETES
l Carnitine can enhance vascular endothelial function, which may lead to improving blood flow to muscle tissue, resulting in a decrease in hypoxic stress.(6) In a direct assessment of muscle-tissue damage using an MRI, researchers found that l carnitine supplementation reduced muscle damage related to hypoxic stress.(6) Other aspects of l carnitine with regards to athletic
performance have had mixed results. There are some studies that have shown a positive impact on
VO2 max; however, others have not supported those findings.(2) There are also some studies that demonstrate using l carnitine during exercise may enhance fat metabolism, while others fail to observe a benefit in body-fat percentage reduction.(2) It appears likely that if an athlete is deficient in l carnitine, they may benefit from supplementation; however, athletes with sufficient l carnitine supplementation may have limited effect on VO2 max or fat metabolism.

Quantity

90 capsules

Dose

ADULT DOSAGE
Start with 1 capsule twice daily with food and gradually increase to 2 capsules twice daily with food or as directed by your health care practitioner. Take 2–4 hours prior to exercise. Consult a health care practitioner for use beyond 6 months.

Potential side effects/Safety

l carnitine is considered to be a safe supplement with rare side effects that may include nausea or gastric upset. l Carnitine does interact with some medications so if you are taking any of the medications below, please speak with your health care practitioner before taking l carnitine:

• Isotretinoin (Accutane) can cause side effects similar to those seen with carnitine deficiency, including muscle pain and weakness, high cholesterol, and liver concerns. Taking l carnitine with this medication may improve these side effects.

• Valproic acid (Depakote) – Taking l carnitine concurrently with this medication may prevent any deficiency and reduce the side effects of valproic acid.

• Doxorubicin – Concurrent use of l carnitine may help protect cardiac cells against the toxicity that can result from doxorubicin.

• Thyroid hormone – l Carnitine may reduce the amount of thyroid hormone that is able to get into cells.

PURITY, CLEANLINESS AND STABILITY:

Third-party testing is performed on finished product to ensure l Carnitine Tartrate SAP is free of heavy metals, solvents, pesticides, and other impurities.

References

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1. SilvÉrio, R., et al. “l Carnitine and cancer cachexia: Clinical and experimental aspects”. Journal of Cachexia, Sarcopenia and Muscle Vol. 2, No. 1 (2011): 37–44.
2. Kelly, G. “l Carnitine: Therapeutic applications of a conditionally essential amino acid”. Alternative Medicine Review Vol. 3, No. 5 (1998): 345–360.
3. Delaney, C.L., et al. “A systematic review to evaluate the effectiveness of carnitine supplementation in improving walking performance among individuals with intermittent claudication”. Atherosclerosis. 2013 doi: 10.1016/j.atherosclerosis.2013.03.004. [Epub ahead of print]
4. Ahmed, S.D., et al. “Role of l carnitine in male infertility”. Journal of the Pakistan Medical Association Vol. 61, No. 8 (2011): 732–736.
5. GÜrbÜz, B., et al. “Relationship between semen quality and seminal plasma total carnitine in infertile men”. Journal of Obstetrics and Gynaecology Vol. 23, No. 6 (2003): 653–656.
6. Huang, A. and K. Owen. “Role of supplementary l carnitine in exercise and exercise recovery”. Medicine and Sport Science Vol. 59 (2012): 135–142