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L-Carnitine

L-Carnitine and its many forms are useful in liver diseases, as well depression, metabolic health, and potentially many other things. L-Carnitine is often used for fat loss, but its usefulness is questionable.

Our evidence-based analysis on l-carnitine features 355 unique references to scientific papers.

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Summary of L-Carnitine

Primary information, health benefits, side effects, usage, and other important details

Note: The last update for this page was a partial update. We haven't yet added most studies for dementia, growth, neuropathy, and several other areas. We also haven't added most studies in hemodialysis and cardiovascular disease treatment, as these studies are largely only relevant to medical professionals and, for now, our efforts could be directed towards more directly applicable endeavors.

What is L-carnitine?

L-Carnitine is a compound produced by the body from lysine and methionine. It can be acetylated to produce acetyl-L-carnitine (ALCAR), which is similar but crosses the blood-brain barrier more efficiently. L-Carnitine is best known for its involvement in the mitochondrial oxidation of long-chain fatty acids.

It's found in food and is most prevalent in meat, and beef in particular.

What are L-carnitine's benefits?

It seems to have high utility in liver diseases where it reduces ammonia levels, the symptoms of hepatic encephalopathy, and various markers of poor liver function. An improvement in sperm quality has been found with supplementation of high doses, and improvements in male fertility have been noted in a small number of studies. It seems to help women with polycystic ovary syndrome by reducing some of the symptoms, and one study found an increase in fertility, but more research is needed.

Acetyl-L-carnitine (and possibly L-carnitine too, but studies only use ALCAR) shows efficacy in depression, though more research is needed to determine how useful it is. It seems to reduce fatigue in older adults with low muscular endurance, but its effects on athletes during physical activity aren't particularly consistent, though research supports small improvements. L-Carnitine may slightly limit muscle damage during resistance exercise.

It seems to have minor beneficial effects on blood pressure, blood glucose, insulin sensitivity, lipid profile, oxidative stress, and inflammation. Overall, it seems useful in metabolic syndrome but not a first choice.

When it comes to fat-burning, studies in isolation do not show very good results. Some studies have found minor fat loss, which is typically attributed to increased physical activity due to increased energy levels.

What are L-carnitine's side effects and downsides?

A few studies have noted a benign adverse effect of 'odd smell', which is said to be due to the formation of trimethylamines; it has occurred at a frequency of 4%.

Does L-carnitine help with weight loss?

Probably only if it helps to reduce fatigue and that leads to an increase in physical activity. It's possible that very low carnitine levels could lead to impaired fatty acid oxidation, but for most people, there isn't a notable increase in resting fatty acid oxidation when taking carnitine.

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How to Take

Recommended dosage, active amounts, other details

The standard dose for L-carnitine is between 500-2,000mg.

There are various forms of carnitine supplementation available. Acetyl-L-Carnitine (ALCAR) is used for cognitive enhancement. L-Carnitine L-Tartrate (LCLT) is typically used for physical performance and power output. Glycine Propionyl L-Carnitine (GPLC) is used to alleviate intermittent claudication and blood flow issues.

L-carnitine is supplemented daily.

The equivalent dosage range for other forms of L-carnitine are as follows: 630-2,500mg (ALCAR), 1,000-4,000mg (LCLT) and 1,000-4,000mg (GPLC).

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Human Effect Matrix

Unlocked for Examine members

The Human Effect Matrix summarizes human studies to tell you what effects L-Carnitine has on your body, how much evidence there is, and how strong these effects are.

Full details are available to Examine members.
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a Notable Very High See all 11 studies
A decrease in ammonia has been noted, and appears to influence both hepatic encephalopathy as well as persons with no significant liver damage.
grade-a Notable Very High See all 12 studies
The reduction is fairly notable and consistent overall. Longer studies and doses lower than 2000 mg per day were more effective, and the effect doesn't seem to be as strong for females, though more evidence is needed.
grade-a Minor Very High See all 25 studies
The decrease is generally small and not particularly consistent, though it does appear to be present. The reduction is particularly apparent for those with type 2 diabetes and liver diseases, as well as in studies where participants took less than 1000 mg per day, as opposed to more (more is not better).
grade-a Minor - See all 13 studies
A modest improvement, in general, has been found. It seems to be more potent for those who are 45 years old or older, though it's not clear if anything else influences its effects.
grade-a Minor Low See all 25 studies
Overall, there appears to be a small increase in HDL, which is more effective in those with obesity and healthy participants as opposed to those with diabetes and kidney disease. There seems to be a greater effect for females but this is only based on a handful of studies.
grade-a Minor Very High See all 24 studies
A small reduction has been noted overall. It may be more effective for those who have overweight and obese, and in those who are healthy and with hepatic disorders as opposed to those with diabetes or on hemodialysis, but more research is needed.
grade-a Minor Moderate See all 30 studies
A small reduction has been found overall. There is a greater effect of doses 2 g or more than lower doses, and healthy participants seem to benefit more than those with diabetes or on hemodialysis, while those who are overweight but not obese saw the greatest reduction.
grade-a Minor High See all 25 studies
A small reduction has been found overall. It seems to be more potential for those who are overweight but not obese, and those who are obese than for healthy participants,
grade-a Minor Very High See all 6 studies
There seems to be a small but potentially notable slimming effect of carnitine supplementation for those with metabolic syndrome.
grade-b Strong Very High See all 3 studies
It shows strong effects in the case of oligoasthenoteratozoospermia for males and polycystic ovary syndrome for females. However, the effect for females is based on only one study and more research is needed.
grade-b Notable High See all 10 studies
There seems to be a notable and reliable benefit for infertile people, The most common dose is 2 g per day, and is probably the most reliable dose, though lower doses may have benefits as well.
grade-b Notable Very High See all 4 studies
Symptoms of intermittent claudation are notably reduced with L-Carnitine supplementation (the rate of improvement over time, as assessed by walking distance, seems to be doubled; ie. from 40% to 60% or 60% to 90%) and associated with the Propinyl-L-Carnitine form (found in the supplement GPLC). The role of propinoic acid cannot be ruled out at this time, and studies have not used basic L-carnitine or ALCAR
grade-b Minor Very High See all 8 studies
There's a fairly notable reduction in blood pressure for those with metabolic syndrome, though this isn't based on many studies. Other studies suggest smaller effects.
grade-b Minor Very High See all 5 studies
A decrease in the exercise-induced increase in MDA levels is seen with carnitine supplementation, possibly secondary to reducing damage to muscle tissue. The degree of MDA reduction is not overly remarkable
grade-b Minor High See all 10 studies
It appears to be somewhat effective for general over day fatigue in a variety of health conditions.
grade-b Minor Very High See all 15 studies
There's a small but potentially meaningful reduction overall. Those with worse diabetes are likely to see the greatest benefits.
grade-b Minor Very High See all 12 studies
A reduction has been found for those with chronic metabolic diseases and liver disease, though not for healthy participants.
grade-b Minor Very High See all 3 studies
More evidence is needed but there's a small reduction in general.
grade-b Minor Very High See all 8 studies
An increase in lean mass has been noted in elderly persons and other cases, though more research is needed to determine its effects, particularly in conjunction with exercise.
grade-b Minor Very High See all 8 studies
Both a reduction during exercise and in metabolic syndrome have been consistently found.
grade-b Minor Very High See all 12 studies
Reductions in the case of liver diseases have been found, with a particularly large effect for NAFLD, though more research is needed on NAFLD in particular.
grade-b Minor Low See all 4 studies
Unreliable and mixed effects, but some studies do note that muscular carnitine levels can be increased with carnitine supplements.
grade-b Minor Very High See all 4 studies
Biomarkers of muscle damage including creatine kinase and muscle soreness are both fairly reliably reduced following ingestion of carnitine and pairing with exercise.
grade-b Minor Very High See all 6 studies
An improvement in the case of oligoasthenoteratozoospermia has been found, based on a handful of trials. More research is needed, as the effect isn't statistically significant when pooled.
grade-b Minor Very High See all 6 studies
There appears to be a benefit in oligoasthenoteratozoospermia, however, it's based on only a handful of studies and not statistically significant in the available meta-analysis.
grade-b Minor Very High See all 7 studies
The cognitive side effects of hepatic encepalopathy are alleviated with carnitine supplementation, notably fatigue and cognitive performance.
grade-b Minor Very High See all 10 studies
A fairly modest effect has been found overall. This is generally seen with high doses (2 g or more per day), though more research to determine the optimal dose is needed,
grade-b Minor Very High See all 21 studies
It's far from certain, and probably doesn't make very much difference, but a small reduction has been found for those who are overweight and obese.
grade-b - Moderate See all 5 studies
More evidence than not suggest no significant influence on low intensity and high duration cardiovascular exercise
grade-b - Very High See all 9 studies
Very mixed evidence, averaging out to no meaningful effect overall.
grade-b - Very High See all 10 studies
Very mixed evidence, averaging out to no meaningful effect.
grade-b - Moderate See all 16 studies
Reductions are sometimes found, but they're inconsistent and it's not clear when it's effective.
grade-b - - See all 9 studies
Studies that measure the effects of carnitine on body fat specifically are far rarer than those that measure weight, and it's best to refer to weight as a proxy for body fat.
grade-b - High See all 4 studies
Studies have mostly not found an effect.
grade-b - Very High See all 3 studies
No apparent effect on average.
grade-b - Very High See all 3 studies
No apparent effect.
grade-b - Moderate See all 8 studies
Highly mixed effects on power output, with mostly no significant influence but a possible increase in mean power output occurring in short-term anaerobic endurance exercise secondary to reducing the rate of perceived exertion
grade-b - Very High See all 3 studies
No apparent effect
grade-c Strong Very High See all 7 studies
Increases are generally seen with supplementation.
grade-c Notable Very High See all 7 studies
Acetyl-L-carnitine seems to have a fairly notable benefit in a variety of circumstances where participants have heightened depression.
grade-c Notable - See study
High dose carnitine (50mg per kilogram) appears to reduce some symptoms of autism as assessed by rating scales; notable due to the rarity of a supplement towards this goal
grade-c Minor Very High See all 4 studies
A few studies have found a reduction in children, though one study didn't, and more research is needed.
grade-c Minor Very High See all 3 studies
An increase in adiponectin has been noted in a handful of studies.
grade-c Minor - See study
Secondary to reducing symptoms of ADHD, L-carnitine may reduce aggression in children.
grade-c Minor - See study
A reduced rate of relapse and alcohol cravings was noted with ALCAR ingestion relative to placebo
grade-c Minor Very High See 2 studies
An increase in anaerobic cardiovascular exercise has been noted with carnitine ingestion
grade-c Minor - See study
At least one study has noted an increase in androgen receptor density in skeletal muscle tissue
grade-c Minor Very High See 2 studies
An increase in all three main enzymes (SOD, glutathione peroxidase, catalase) has been detected following ingestion of carnitine
grade-c Minor Very High See all 3 studies
Reductions have been found in depression and encephalopathy, but to migraines, though many more studies are needed to determine its efficacy in various anxiety disorders.
grade-c Minor Moderate See all 5 studies
An increase in attention has been noted to be secondary to reductions in the symptoms of chronic fatigue
grade-c Minor Very High See all 3 studies
Reductions have been found in the case of liver diseases, but not healthy participants. More studies in general are needed to determine its effects.
grade-c Minor Very High See all 3 studies
Increases in blood flow appear to occur following carnitine supplementation, which may be related to the increases in nitrate
grade-c Minor Very High See all 3 studies
Improvements in general cognitive capacity has been noted in elderly persons and in disease models (hepatic encepalopathy); lack of literature on otherwise healthy youth
grade-c Minor Very High See all 4 studies
Several studies have found an improvement in the case of erectile dysfunction, but more research is needed to confirm its effects.
grade-c Minor Moderate See all 3 studies
A decrease in heart rate has been noted during exercise, though it isn't completely consistent.
grade-c Minor Very High See 2 studies
An increase in IGF binding protein (3) has been noted following carnitine supplementation in otherwise healthy youth
grade-c Minor Moderate See all 6 studies
There's potentially a small reduction overall but the evidence is quite mixed, and it's not clear when it has effects and when it doesn't.
grade-c Minor - See study
A decrease in muscle oxygenation has been noted during occlusion, but not during squat exercise; practical significance of these results unknown
grade-c Minor Very High See all 4 studies
The decrease in muscle soreness appears to correlate with the reduced muscle damage
grade-c Minor Very High See 2 studies
An increase in nitric oxide has been noted, thought to be secondary to increases in plasma nitrate
grade-c Minor Very High See 2 studies
Plasma nitrate appears to be increased following carnitine ingestion, although not to the same degree as nitrate supplementation itself
grade-c Minor Very High See all 3 studies
Mixed evidence. One study did found a reduction during running.
grade-c Minor - See all 5 studies
General improvements have been noted in cases where participants have affective disorders.
grade-c Minor - See study
Fibromyalgic symptoms are reduced with carnitine ingestion in one study.
grade-c Minor Very High See 2 studies
Some symptoms of hyperthyroidism are reduced following carnitine supplementation
grade-c Minor - See study
Some symptoms associated with multiple sclerosis are noted to be reduced with carnitine ingestion.
grade-c Minor - See 2 studies
An increase has been found in elderly male participants but not in the case of resistance training. More evidence is needed.
grade-c Minor Very High See all 5 studies
General increases have been found overall, but more research is needed to bolster the level of evidence.
grade-c Minor Very High See 2 studies
A benefit has been found in liver disease but not healthy participants, which is consistent with its general efficacy for liver diseases. More evidence is needed to be confident in this finding, however.
grade-c Minor Very High See all 3 studies
A decrease in uric acid has been noted
grade-c - Moderate See all 4 studies
The evidence is mixed and unclear.
grade-c - Very High See 2 studies
No significant changes in IGF-1 seen with carnitine supplementation; IGF-2 also appears unaffected
grade-c - High See all 4 studies
One study found an improvement in children with moderate asthma, while the others didn't find an effect in conjunction with exercise.
grade-c - Very High See all 3 studies
No significant influence on metabolic rate noted with carnitine supplementation
grade-c - Very High See all 5 studies
Most studies didn't find an effect during exercise.
grade-c - Moderate See all 5 studies
Mixed evidence, without enough research to be able to discern the reason for the inconsistency.
grade-c - Very High See all 6 studies
No detectable influence on VO2 max associated with carnitine supplementation
grade-c - Moderate See all 4 studies
Inconsistent effects in those with peripheral artery disease.
grade-d Strong - See study
A considerable reduction in overall migraine index score was found in one study.
grade-d Strong - See study
One study found an increase.
grade-d Notable - See study
One study found a notable decrease when carnitine was added to a statin drug, compared with just using the statin drug. Much more research is needed to confirm.
grade-d Notable - See study
One study found an effect of 4 g of intravenous carnitine in participants with metabolic syndrome. Much more research is needed.
grade-d Notable Very High See 2 studies
In two studies, it led to less of an increase than placebo during resistance exercise.
grade-d Notable - See study
A decrease was found in one study on women with polycystic ovary syndrome.
grade-d Notable - See study
One study found an increase for women with PCOS.
grade-d Notable - See study
An increase in estradiol was found for women with PCOS in one study.
grade-d Notable - See study
A reduction was found in one study on knee osteoarthritis.
grade-d Notable - See study
One study found a reduction.
grade-d Notable - See study
A notable increase was seen in one trial on polycystic ovary syndrome.
grade-d Minor - See study
A modest reduction in hospitalizations and an improvement in lung function have been found in one study that used 350 mg 3 times daily on children. Much more research is needed.
grade-d
Minor
- See 2 studies
On the one hand, one study found a reduction in carotid intima-medial thickness over the course of 12 weeks, and another found no effect on total plaque volume after 6 months, but did find a notable increase in stenosis when taking carnitine, though most of the study isn't available. Much more research is needed to discern what can be expected from long-term carnitine supplementation.
grade-d Minor - See study
One study found an increase in hepatectomized patients when taking 2 weeks before liver resection.
grade-d Minor - See study
An increase during rest, during exercise, and during recovery was found in one study
grade-d Minor - See study
One study in hyperthyroidism found an increase, likely secondary to a reduction in hyperthyroidism.
grade-d Minor High See all 3 studies
Evidence is mixed, but two studies have found an increase when taken acutely.
grade-d Minor - See study
One study found a decrease in participants with major depression.
grade-d Minor - See study
One uncontrolled trial found a reduction in cramps for participants with cirrhosis.
grade-d Minor Very High See 2 studies
Two studies found modest reductions.
grade-d Minor - See study
One study found an improvement.
grade-d Minor - See study
A reduction was found in one study in hyperthyroidism, secondary to reducing hyperthyroidism.
grade-d Minor Very High See all 3 studies
Reduction in general oxidation seems to be secondary to antioxidant enzyme induction
grade-d Minor - See study
One study found an effect in polycystic ovary syndrome.
grade-d Minor - See study
One study found a reduction in those with peripheral vascular disease.
grade-d Minor - See study
Both 1 and 2 g of l-carnitine produced significantly lower hypoxanthine levels immediately after and 5, 10, 20, and 30 minutes post-exercise. There was no difference between 1 and 2 g.
grade-d Minor - See study
A reduction in children with asthma was found in one study.
grade-d Minor - See study
A reduction was found in one study on knee osteoarthritis.
grade-d Minor - See study
One retrospective observational study found an improvement.
grade-d Minor - See study
In one study of knee osteoarthritis, the placebo group saw an increase while the carnitine group didn't.
grade-d Minor - See study
A reduction was found in one study on knee osteoarthritis.
grade-d Minor Moderate See 2 studies
An improvement was found in one study on chronic alcoholism but not in another study under normal conditions, though the negative study only lasted for 3 days.
grade-d Minor Moderate See 2 studies
Mixed evidence but the positive study found a quite notable effect.
grade-d Minor Moderate See 2 studies
Mixed evidence, slightly favoring a benefit. Much more research is needed.
grade-d Minor - See study
A reduction has been noted in one study.
grade-d Minor - See study
One study found a reduction. More research is needed.
grade-d Minor - See study
One study found a reduction from 1 or 2 g.
grade-d
Minor
- See all 3 studies
One study on hepatectomized patients saw a reduction but two on healthy participants didn't.
grade-d Minor - See study
One study found an increase in participants with hyperthyroidism.
grade-d Minor - See study
One study found a reduction in participants with diabetes.
grade-d Minor Very High See 2 studies
A reduction has been found in 2 studies on osteoarthritis.
grade-d Minor - See study
Reduction in one study on peripheral vascular disease.
grade-d Minor - See study
One study found an increase in participants with PCOS.
grade-d Minor - See study
One study found a reduction in reaction time.
grade-d
Minor
- See all 3 studies
Mixed evidence, though reductions were found during exercise an increase was found during a glucose disposal test.
grade-d Minor - See study
One study found an increase.
grade-d Minor - See study
One study found a reduction in chronic stable angina.
grade-d Minor - See study
One study found a reduction in participants with hyperthyroidism.
grade-d Minor Very High See 2 studies
Two studies found improvements, one in aging participants and one in combination with sildenafil after bilateral nerve-sparing radical retropubic prostatectomy.
grade-d Minor - See study
One study found an increase.
grade-d Minor - See study
One study found an improvement.
grade-d Minor Very High See all 3 studies
Three studies have found some benefit at doses of 750 mg per day of L-carnitine tartrate and L-carntine.
grade-d Minor Very High See 2 studies
Two studies have found benefits at 500 mg and 200 mg of L-carnitine, and at 600 mg of 600 mg of L-propionylcarnitine.
grade-d Minor - See study
One study found an increase.
grade-d - Minor - See study
One study found a decrease.
grade-d Minor - See study
One study found a benefit.
grade-d Minor - See study
One study found a reduction with 100mg/kg
grade-d Minor - See study
One study found an improvement.
grade-d Minor - See study
One study found a reduction.
grade-d Minor - See 2 studies
No apparent effect.
grade-d Minor - See study
One study found an improvement in type 2 diabetes patients.
grade-d Minor - See study
One study found a reduction during an acute dose of 1 and 2 g.
grade-d Minor Very High See 2 studies
Two studies found reductions in polycystic ovary syndrome and cystic acne for those taking isotretinoin (Accutane).
grade-d - - See study
No apparent effect in one study on healthy participants.
grade-d - Moderate See 2 studies
Inconsistent results from two studies. More research is needed.
grade-d - - See study
No apparent effect in one study during exercise.
grade-d - - See study
No apparent effect in one study in traumatic brain injury.
grade-d - Very High See 2 studies
No apparent effect in two studies.
grade-d - Very High See 2 studies
No apparent effect in two studies.
grade-d - Moderate See 2 studies
Mixed evidence but likely not a big effect. More research is needed.
grade-d - Moderate See 2 studies
No apparent effect in mitochondrial myopathy in one study.
grade-d - Moderate See 2 studies
No apparent effect overall.
grade-d - - See study
No apparent effect in one study on type 2 diabetes.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in one study.
grade-d - Moderate See 2 studies
Mixed evidence. One study didn't find a change but another found an increase in a small trial.
grade-d - Very High See 2 studies
No apparent effect in two studies.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in one study on aging males.
grade-d - Very High See 2 studies
No apparent effect in two studies.
grade-d - - See study
No apparent effect in one study.
grade-d - Very High See 2 studies
No apparent effect in two studies.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in one study.
grade-d - - See study
No apparent effect in participants with peripheral artery disease.
grade-d - - See study
No apparent effect.
grade-d - Very High See all 3 studies
No apparent effect.
grade-d - - See study
No apparent effect.
grade-d - - See study
No apparent effect.
grade-d - Very High See all 3 studies
No apparent effect.
grade-d - - See study
No apparent effect.

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Frequently Asked Questions and Articles on L-Carnitine

What beneficial compounds are primarily found in animal products?

Things to Note

Is a Form Of

Primary Function:

Also Known As

Acetyl-L-Carnitine, ALCAR, Acetylcarnitine, L-Carnitine-L-Tartrate, LCLT, Glycine Propionyl-L-Carnitine, GPLC, Levocarnitine, Levacecarnine, L-3-hydroxytrimethylamminobutanoate, carnitine

Do Not Confuse With

Carnosine (the product of beta-alanine)

Goes Well With

  • L-Carnitine, in the form of ALCAR, is anecdotally reported as a stimulant, but effects are less than of other known stimulants (such as caffeine). It is currently not known why these effects occur

  • There are four common forms of carnitine supplements: L-Carnitine, Acetyl-L-carnitine (ALCAR), L-Carnitine L-Tartrate (LCLT) and Propionyl-L-Carnitine (usually bound to Glycine and called GPLC)

  • At least one study has noted, in regards to nitric oxide increases, there to be non-responders to carnitine supplementation.[1]

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