[Fwd: CARNITINE FOR ENERGY CARNITINE - WHAT IS IT?]

[Guest guest]

Since the carnitine yes or no discussion has reopened, I'm resending

this archived message from March.

On 30 Mar 2008, momresearch wrote:

Here's another great website on Carnitine...it also addresses the

question of how the body handles excessive consumption of carnitine

(i.e. carnitine " overdose " ): when you take more than you need it expels

itself via diarrhea.

*Archive message from 02 Feb 2005/deverelementary*

Yes, I have there are I believe 3 or 4 types of carnitine deficiency,

genetic, disease induced, and the ever famous of unknown etiology.

Carnitine in a transproter of energy, fats etc. Here is a page I

copied, it is kind of a general overview, not too helpful, but maybe

a starting point for you. Yes blocked pathways, another caveat we are

dealing with our kids. Hmmmm. Sound familiar?

CARNITINE FOR ENERGY CARNITINE - WHAT IS IT?

*http://www.upnaway.com/~poliowa/Carn%20for%20Energy.html*

Many people, (and many doctors) have never heard of carnitine. Yet

we are all familiar with it, although we may not know it. It is part

of the food we know as meat; is particularly found in red meat and

gives us sustaining energy.

The word carnitine is a derivative of the Latin root " carnis " - as in

carnivore or meat-eater.

Carnitine is an essential part of releasing energy from protein

foods. Carnitine is not an energy source itself. It is a catalyst.

It allows protein food particles to pass into the muscle cell by

linking up, carrying it through and returning it to its original form

on the other side. Without this process we are down on a lot of

energy, more likely to feel tired, have no get-up-and-go.

Carnitine is an amino acid ie part of the structure of protein. The

best sources of protein are animal foods like meat. Meat has many

things we need including iron, B vitamins, a special meat vitamin C,

Vitamin A, minerals, many amino acids, including carnitine and

taurine, protein building blocks for cell repair and growth, and

fatty acids as a source of fuel for muscle action. In fact it

contains many of the things needed to maintain and sustain, our

normal body function.

CARNITINE HISTORY

1905 - Carnitine was isolated from meat.

1927 - The chemical structure was identified.

1952 - Urwin Fritz discovered that carnitine was involved in the

oxidation of long chain fatty acids. It was Fritz who found that it

was important as a growth factor for meal worms.

1973 - The role of carnitine in human disease was recognised in 1973

when Engel and Angelini first described a young woman who had limb

weakness and lipid storage myopathy (fat globules abnormally present

in muscle tissue).

1985 - Carnitine was added to soy baby formulae to prevent " floppy

baby syndrome " as it was realised that carnitine is present in breast

and cow's milk but not other milk substitutes.

Over the last 20 years a lot more research has been done on carnitine

insufficiency syndromes, although recognition of the role of

carnitine in health is still relatively new and your doctor may never

have heard of it.

Fritz's work in 1952 showed that for meal worms, carnitine is a

vitamin as for them it is essential for life. They need to get it

all from their diet. They cannot make carnitine. Without it they

grow fat and die. In humans, provided we have the necessary

ingredients from other foods we can produce some of our daily needs

within the body. Body synthesis supplies 25% of our body's needs,

primarily in the liver and kidneys. (So people with liver or kidney

problems will have problems getting enough carnitine.) The remaining

75% that our body needs, we must get from our diet, primarily in our

red meats. The amounts in chicken and milk are negligible compared

to that available in red meat. The chart below shows the carnitine

value of some common foods.

FOOD SOURCES of CARNITINE

FOOD mg/100g of food

avocado ?? 100.0?? 1.25

mutton 210.0

lamb 78.0

beef 64.0

pork 30.0

chicken 7.5

lamb's fry 2.6

milk (cow) 2.0

fish 1.3

cheese 0.5

bread (wholemeal) 0.2

eggs 0.01

For people having to take supplemental carnitine to get enough to

resolve problems like fatigue and muscle pain, doses are in

combinations of 250mg capsules or the equivalent in powder form.

We have worked out that to get the equivalent of a 250mg capsule you

would need to eat

1/3 kilo of lamb (120g mutton)

nearly 1/2 kilo of beef

nearly a whole kilo of pork

3 1/3 kilos of chicken

12 1/2 litres of milk

or......(suspected but not confirmed) a medium sized (250g) whole

avocado

What if I need 4 - 10 capsules a day? Can we really get this amount

from our diet?

The essential ingredients to produce our own carnitine are the amino

acids;- lysine, (also from meat proteins) methionine (from plant as

well animal proteins) and Vitamins C, B3 and B6.

CARNITINE INSUFFICIENCY INDICATORS

We suspect the following physical characteristics may be indicators

of insufficient carnitine availability.

* Stooped/rounded shoulders

* Inability to hold self erect

* Slumped posture

* Postural back muscle ache

* " hitting the wall " feeling

* " flag out " after lunch - catnaps

* Restoration of energy after rest or short sleep

* " heavy feeling " in muscles

* Effort to lift arms and/or legs

Two types of carnitine problems are now known. Primary ie of genetic

origin where no other systemic illness is present to account for

reduced carnitine plasma and/or tissue levels, and secondary, which

includes genetic metabolic errors, acquired medical conditions or

iatrogenic disease (resulting from medical treatment eg valproate

given for epilepsy).

We are seeing a third group now emerging. Self-inflicted carnitine

deficiency. People who are deliberately not eating red meat because

either they have an aversion to eating animals and feel this is

cruel, or people who for health reasons, like high cholesterol or

fear of meat contributing to cancer and heart disease, think they are

doing the right thing.

We can add another category here too, people who have lost their

taste for meat because their zinc levels are too low. When zinc is

low you lose your sense of taste and smell. Also zinc is needed for

hydrochloric acid production in the stomach so your ability to digest

meat will diminish. People who are stressed or are on the Pill or

HRT, are often low on zinc because adrenaline and sex hormone

production uses more zinc (amongst other things).

Research we have undertaken in conjunction with SOMA Health WA, (a

consumer health organisation looking at orthomolecular medicine),

shows that depending on your blood group, you are programmed for the

foods available in the environment in which your blood group

developed.

So if you are an O or an A2 blood group you are programmed to eat a

lot of meat whereas an A1 can almost be vegetarian. This also has a

bearing on how much and how often red meat is part of our diet. If

you are O or A2 blood group and eating little meat per week, this

will be a contributing factor to fatigue and tiredness. It is not

just low iron levels or low B12 levels.

Certain disease groups are also showing signs of insufficient

carnitine. eg Post polio, chronic fatigue, muscular dystrophy,

heart disease, renal dialysis and AIDS patients. In pregnancy the

growing baby uses half of mum's carnitine.

A new development discovered in WA as part of the research in post

polio, is that children and grandchildren of polio survivors are

developing low carnitine levels too. Can this happen to others who

have reduced their red meat intake before and during pregnancy, and

thus affect their children and successive generations too?

We have not been aware of the effects of low carnitine levels long

enough to know all the subsequent dangers yet.

The following symptoms, a number of which may collectively be

present, are now recognised as indicative of reduced carnitine

capacity. These symptoms will vary from individual to individual.

SYMPTOMS EXHIBITED by CARNITINE DEFICIENCY

(common complaints by polio survivors = P)

Fatigue

P

Poor muscle tone P

Muscle pain P

Exercise intolerance P

Increased serum creatinine kinase P

(indicates muscle break down)

Apnea (temporary cessation of breathing) P

Gastro-oesophageal reflux (indigestion) P

Acidosis (characterised by sweet smelling urine) P

Hypoglycaemia (low blood sugar)

Fasting intolerance

Heart irregularities

Non specific abdominal pain

Recurrent vomiting

Pyloric stenosis (projectile vomiting)

Kidney abnormalities

IN INFANTS

'Floppy baby' Syndrome

Failure to thrive

Pyloric stenosis

Developmental delay

Cardiomyopathy (disease of heart muscle)

Unexplained sudden death

GETTING ENERGY FROM FOOD

Most people do not need to take supplemental carnitine. Unless we

have one of the secondary causes listed on the back page (eg post

polio, chronic fatigue, muscular dystrophy, heart failure, diabetes,

coeliac disease, liver disease) we should be able to get enough

carnitine from our diet and make the remaining 25% in the liver. If

the kidneys are working well, most carnitine will be reabsorbed and

reused.

97% percent of body carnitine is found and stored in skeletal

muscle. So in people with diseases of muscle, storage capacity can

be affected. This may be why in post polio, a top up is needed first

thing in the morning. The heart, liver and brain share equal amounts

of the remaining 3%, with low levels in the kidneys and lowest

amounts circulating in the blood.

Dietry carnitine has better absorption from the gut than supplemental

carnitine, so we should attempt to get as much from our diet as

possible.

Energy from the food we eat, comes from the complexity of the

structure of the food. The more complex the food, the more time is

taken in the breakdown process, so the longer the energy will last.

Look at this table below.

If I eat a lolly I get instant energy in the form of glucose. But it

doesn't take much breaking down so is all gone very quickly, in about

10 mins. A piece of steak however will fill me up, give me energy

and I won't be hungry for 3 - 4 hours. Our bodies need different

things from different foods. We need a mix of protein, carbohydrate,

fats and essential fatty acids, every day, to get our daily

requirements for our bodies to function well.

The Internet Web page of Dr D'Adamo, author of " Eat Right for

Your Type " has the proportions of carbohydrate, protein and fat

required in the diet, depending on your blood group. Traditionally

we are told the food pyramid allows for about 10% fat, 30% protein

and 60% carbohydrate. To the right is the scale according to

D'Adamo, with A2 added by us, because D'Adamo's work had not included

A2, although he acknowledges he will start to include A2 in his

research now. This is important because this probably reflects

roughly, the proportions of type 1 & 2 muscles in the body, depending

on your blood group, which correlates with the amount of red meat

available in indigenous diets of our ancestors. Type 1 muscles need

carnitine, so to get it we need to eat more red meat in our diet.

CARNITINE and DIGESTION

The breakdown of meat starts in the mouth with chewing of our food

and saliva. In the stomach, hydrochloric acid provides a major

dismantling of protein structure. The next step is the small

intestine where bile from the liver via the gall bladder has further

action in digestion of meat. Pancreatic enzymes are also released

here, with action on all classes of foods. When food hits the

stomach, the message goes out to mobilise insulin too. Insulin

prepares the cells to receive glucose. The messenger doesn't know

how much is coming so whether we are having a snack or a roast

dinner, the body prepares for a big meal. Carnitine is absorbed

before fatty foods so supplements need to be taken on an empty

stomach.

TAURINE

Taurine is another amino acid found in meat. Taurine is used to turn

cholesterol into bile. Bile is needed to digest meat (ie carnitine,

fatty acids etc in meat). Without carnitine and taurine, fats cannot

be metabolised properly, so accumulate in liver and muscle tissue.

Taking extra taurine helps to clear fatty build up from the liver and

assists bile production so better absorption. With the liver working

better, there is room to make and store more carnitine. (As well as

other functions of the liver improving, like Vitamin A storage and

conversion, B6, magnesium etc.) We have found that taking 500mg of

taurine over a 12 month period reduces the amount of supplemental

carnitine needed. Taurine improves eyesight as well. For hepatitis

or gall bladder problems take 1000mg taurine and carnitine to avoid

surgery.

GLUTAMINE

Glutamine is another amino acid but this one is found mainly in

grains with gluten. Glutamine is the main neurotransmitter for the

brain. So people who have problems thinking clearly or are under

stress will be down on glutamine. Glutamine changes readily between

glutamic acid, glutathionine and GABA. They are all different forms

of glutamine that have a specific function in some part of the body.

We have found that when carnitine is low then glutamine often is

too. Glutamine has a function in the muscle too. It mops up toxic

lactic acid caused by inappropriate energy production due to lack of

carnitine leading to greater dependence on carbohydrate fuels. If

carbohydrate fuel and carnitine is running low, the body can convert

glutamine into glucose to fuel the muscles. If this is occurring the

glutamine cannot be recycled again for brain function so runs low as

a neurotransmitter and transformer of toxic ammonia in the brain.

The result is brain fog.

So you can see that other areas of the body depend on carnitine

working properly so that they can too. Choline and Vit B12 help to

stop excretion of carnitine in urine. Low levels of Vit C increase

urinary excretion of carnitine. So does antibiotics especially

ampicillins and poor kidney function. We have found that without

reasonable available carnitine, B6 and magnesium can't function

well. Many other vitamins, minerals and amino acids are interlinked

to adequate carnitine too so a cascade effect of ill health results

from poor carnitine levels. Insulin function in the body can be

effected, leading eventually to late onset diabetes as well.

HOW DOES CARNITINE WORK

Carnitine is essentially a transporter. It picks up at one end and

delivers to the other side. If we use the story below - carnitine

arrives on the meat bus with a lot of other visitors all coming to a

number of parties in lots of places. (ie all the other things we get

from meat that help our bodies to work, as mentioned before, like

iron, B6, B12, taurine etc.) One of the breakdowns of meat through

digestion is fatty acids. Acyl means fat. So we'll call our

hero " fatty acyl " .

" Fatty acyl " walks for a way, then finds a horse called " CoA " and

hitches a ride to get to his destination. On the way they find a

deep, swift flowing river that must be crossed to get to the party.

There is a tree on either side (the carnitine enzymes) and strung

between them is a rope called carnitine. (the carnitine rope may

have come on the bus too and someone else has thrown it across, tying

it to the 2 trees.) " Fatty acyl " can hang onto the rope and pull

himself across. CoA, the horse, has to swim across. On the other

side, " fatty acyl " climbs back on his horse to go to the party,

leaving the carnitine rope in place, ready for the return trip after

the party.

Now here's the same story in medical terms.

Carnitine transports long chain fatty acids from the metabolism of

protein foods, across the mitochondrial membrane in the muscle cell

with the aid of carnitine enzymes to enable further oxidation via the

Krebs cycle, to produce energy in the form of ATP. Short chain fatty

acid by-products of this process, can recombine with carnitine to

exit the cell for excretion via urine.

So, this diagram is not really so difficult is it?

If this process does not occur, fatty acids accumulate in muscle and

liver tissue, unable to be used and getting in the way. Finally, the

small amounts of carnitine that are there, have to partner the fatty

acids to try and get them out of the way and out of the body. So

carnitine is used on the mop-up process instead of transportation to

create energy. The end result is fatigue and muscle pain, lack of

endurance and muscle weakness.

BLOOD LEVELS of CARNITINE

Serum carnitine levels can be done at some children's hospitals.

This is the case in WA and in other Australian states. Your doctor

can order free and total carnitine levels to be done.

These are covered by Medicare if he feels you have possible symptoms

of low carnitine.

INTERPRETING YOUR RESULTS

Normal levels are generally taken to be

Free carnitine 30 - 60 umol/L

Total carnitine 35 - 65 umol/L

Acyl/Total % 10% - 25%

The research being done at the Polio Clinic in WA, shows that polio

survivors often have free serum carnitine levels in the lower half of

the normal range or even below normal range. For resolution of

symptoms of fatigue and muscle pain, levels need to be in the high

levels of normal. So for POLIO the free carnitine levels:

for female polios need to be above 45 umol/L

for male polios need to be above 50 umol/L

ACYL/TOTAL PERCENTAGE

The other factor is working out the usage of available carnitine in

the body. If you subtract the free from the total reading, it gives

the acylcarnitine level. Multiply the acyl reading by 100 then

divide by the total reading. This will give the acyl/free

percentage. Normal usage will give a percentage of 10% - 25%. If

the percent is low, then you are not using available carnitine well

for some reason. If the percent is high, then a lot of mopping up of

unused fatty acids is occurring. A percentage above 40% is certainly

cause for alarm. We have found that increasing available carnitine

by supplementation usually resolves these abnormalities.

RESULTS

Your results may look like this:

Date 10/8/99 18/9/99 (Normal)

Time 9.30am 10.15am (levels)

Free carn 29 55 (30-60)

Total carn 49 66 (35-65)

Acyl carn 20 11

Acyl/Total % 41% 17% (10%-25%)

The first reading taken before starting carnitine shows a free level

well below 45 needed for polio female and 41% is too high. The

second reading, taken after being on carnitine for a month, shows

that the free level is in the high levels of normal, the percentage

is midrange at 17% and hey! - you are feeling a lot better.

Here is a graph showing some changes in readings

See how the first set of readings are low and the second set for each

person are above the 45 dotted line needed to alleviate fatigue in

female post polios. Percentages have also come up or down to a more

normal level.

CARNITINE OVERDOSE

Carnitine is self limiting. If you take more than your body needs,

it will simply come out the other end in a hurry, ie diarrhoea. So

it is easy to tell if you have taken too much. Some people may get

some tummy discomfit with this. It simply means you have overdone

the dose and your body is rectifying the situation. If you are very

allergic or super sensitive to other medications or supple-ments, go

cautiously with increasing your dose.

INDIVIDUAL DOSE NEEDS

To work out how much supplemental carnitine you may need, we advise

that you start with 250mg and increase by 250mg every 3 days until

you get diarrhoea then reduce by the last 250mg to get your right

dose. Often, below that dose you will still be tired. We have found

it best to take your whole dose, first thing in the morning as soon

as you get up. Do not take it at night. It is likely to keep you

awake. If you are running out of energy later in the day and still

have to go out at night, take another 250mg then. If you are going

to have a more energetic day than normal, eg shopping, gym, golf,

physio, mowing the lawn, digging the garden etc, do take another

250mg just before you undertake this extra activity. (if you take

extra too early you will get diarrhoea.) Make it work for what you

need or want to do.

CARNITINE AVAILABILITY

Carnitine can be obtained in capsule or powder form. There is some

available in health food shops but we have found that most

commercial carnitine is crystalline instead of the proper powder and

this doesn't work as well. It may be okay for healthy sports people

who take large quantities, but we have found that for post polio,

chronic fatigue etc we need the really good stuff. We have

established a source of good quality powder through a professor at

Monash Uni who can assure us of the quality.

People in Australia can order through the WA Clinic and supplies can

be sent straight to you from our suppliers. They do not have the

time for taking individual orders or counselling so would prefer

orders to be directed through the WA Polio Clinic so that you can get

advice and we can monitor results. Contact Tessa at Post Polio WA

(08) 9383 9050 to have it mailed out.

PRICES - (for after GST 1/7/00)

Powders - 50Gm - $50 or 100Gm - $86

Capsules (100) $45

CARNITINE and DISEASE

Secondary carnitine deficiency can be associated with a number of

diseases. The work of the WA Polio Clinic is showing low levels in

many polio survivors and their descendants. Other research on autism

is showing that at least 50% of autistic children have a carnitine

problem. Carnitine is part of the picture in chronic fatigue.

Muscular dystrophy is showing poor carnitine levels. Malabsorption

syndromes can lead to low carnitine as can pregnancy. People with

liver, kidney and thyroid disease, cystic fibrosis and diabetes can

be low in carnitine. Epileptic drugs and antibiotics can lower

carnitine levels.

CARDIAC

As much as 80% of heart muscle is fuelled by fatty acids and

carnitine. Heart disease can result from poor carnitine levels.

Carnitine lowers cholesterol by allowing utilisation of fats, lowers

blood pressure, reduces irregular heart beats, angina and strengthens

heart muscle

DIABETES

Diabetic levels are known to stabilise with carnitine

supplementation. If we look at the way fuel is provided to the

muscle we can see that insulin is the major catalyst in Type 2

muscles and carnitine in Type 1 muscle. If the carnitine cycle is

functioning poorly, this puts more strain on the insulin-carbohydrate

cycle to fuel Type 1 muscles as well as Type 2. But the amount of

energy required is a lot greater (129 ATP for Type 1 compared to 36

ATP via glucose in the Krebbs for Type 2). So that the insulin cycle

has to work at more than 4 times the rate it was designed to and

there is a greater craving for carbohydrate foods to keep up the

energy supply. Eventually this breaks down too and we call it

diabetes. Fixing the carnitine cycle may have prevented this

happening.

POST POLIO

In post polio there is a documented increase in Type 1 muscles,

changed from Type 2 in the recovery process after polio due to nerve

sprouting. This increases the amount of carnitine needed to run

these extra Type 1 muscles. These muscles are larger and less

efficient so carnitine storage can be depleted too. We have been

researching carnitine in post polio in WA since 1994. Many of our

members have resolved fatigue and pain issues with a daily carnitine

supplement. Some have returned to work, having previously taken a

Disability pension because of fatigue and pain. Most say this has

given them a new lease on life.

____________________________________________________________

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