L-carnitine and Women’s Health: Adding L-carnitine and Acetyl L-carnitine to support healthy ovulation and pregnancy*

// Tori Hudson, ND

L-carnitine and Women’s Health: Adding L-carnitine and Acetyl L-carnitine to support healthy ovulation and pregnancy*

Many practitioners of alternative and integrative medicine are familiar with the essential roles L-carnitine plays in energy production, oxidative stress, and glucose metabolism.1 L-carnitine has been shown in animal models to stabilize mitochondrial membranes, increase energy delivered to organelles, and protect against cellular apoptotic death.2 Acetyl L-carnitine is thought to provide additional clinical applications. It may support mitochondrial function, memory, and antioxidant status.*3,4,5 It may also have a structural role in peripheral and central nervous tissue.*Perhaps less familiar, is that L- carnitine supplementation has been used to support glucose metabolism* and some research has shown that L-carnitine insufficiency is even a contributing factor to related health status. 
L-carnitine diagramOne study showed that a subset of women seeking hormone balance had lower levels of serum L-carnitine and that decrease was correlated to changes in sex hormones and insulin.Even more specifically, a double-blind, placebo-controlled, parallel-group study, conducted in Egypt assessed the effectiveness of L-carnitine on the occurrence of ovulation and pregnancy in women seeking healthy fertility.*9 Women were randomly assigned to one of two groups. Group A (n=85) received 250 mg of a conventional agent intended for ovulation from day 3 until day 7 of the menstrual cycle, plus L-carnitine 3 grams per day. Group B (n=85) received 250 mg of the same conventional agent with placebo. 

The combination of L-carnitine and the conventional agent significantly improved both the ovulation rates (64.4% with L-carnitine vs 17.4% with placebo) and the cumulative pregnancy rates (51.5% vs 5.8%).* In addition, there was a significantly higher level of serum progesterone in the luteal phase among the L-carnitine and conventional agent group (Group A) compared with the control group (Group B). * There were also additional metabolic benefits in the women in Group A after 12 weeks.* 

Pregnancy rates are the name of the game in women taking the common conventional agent used in this study and the results in this study were compelling in this regard. Explanations for this can include:
1) an increase in luteal phase progesterone
2) greater endometrial thickness (Group A =10.1 mm vs Group B =6.8 mm)
3) The free radical scavenging effect of L-carnitine and subsequent effects on the endometrial blood flow ultimately supporting healthy endometrial receptivity in the peri-implantation phase.* 

Tori Hudson, ND

Dr. Tori Hudson is a naturopathic physician, graduating from the National College of Natural Medicine (NCNM) in 1984. Dr. Hudson has been in clinical practice since 1984 and is currently the Medical Director of her clinic, "A Woman's Time" in Portland, Oregon.

Dr. Hudson is the Director of Product Research and Education for VITANICA, and the Founder and Director of the Institute of Women's Health and Integrative Medicine. She is also the Founder and Co-Director of the Naturopathic Education and Research Consortium (NERC); in addition, she was a Site Director of the 2012 STAIR Integrative Residency Program.

She is a nationally recognized author (book: Women's Encyclopedia of Natural Medicine second edition, McGraw Hill 2008), speaker, educator, researcher, and clinician. Dr. Hudson serves on several editorial boards, advisory panels, and as a consultant to the natural products industry.
1 Vanella A, Russo A, Acquaviva R, et al.  L-propionyl-carnitine as superoxide scavenger, antioxidant, and DNA cleavage protector.  Cell Biol Toxicol 2000;16:99-104.
2 Pillich R, Scarsella G, Risuleo G.  Reduction of apoptosis through the mitochondrial pathway by the administration of acetyl-L-carnitine to mouse fibroblasts in culture.  Exp Cell Res 2005;306:1-8.
 Montgomery SA, Thal LJ, Amrein R. Int Clin Psychopharmacol. 2003;18(2):61-71.
 Malaguarnera M, Vacante M, Motta M, et al. Metab Brain Dis. 2011;26(4):281-9.
 Pettegrew JW, Klunk WE, et al. Neurobiol Aging. 1995 Jan-Feb;16(1):1–4.
6 Vivoli E, Di Cesare Mannelli L, Salvicchi A, et al. Neuroscience. 2010 Jun 2;167(4):1168-74.
7 Ringseis R, Eder K, Keller J.  Role of carnitine in the regulation of glucose homeostasis and insulin sensitivity: evidence from in vivo and in vitro studies with carnitine supplementation and carnitine deficiency.  Eur J Nutr 2012;51(1):1-18.
8 Fenkci S, Fenkci V, Oztekin O, et al.  Serum total-L-carnitine levels in non-obese women with polycystic ovary syndrome.  Hum Reprod 2008;23 (7):1602-6.
9 Ismail A, Hamed A, Saso S, Thabet H.  Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate.  A randomized clinical trial.  European J Obstetrics and Gynecology and Reproductive Biology. 2014; 180: 148-52.

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