Tag Archives: carnitine

Carnitine Levels and Muscle Boosters | The Paleo Diet
When we follow a healthy, Paleo diet, we want to make sure we’re covering all bases, not only in terms of getting every last vitamin and mineral, but doing so in a balanced way. As such, entertaining the idea of taking supplements to meet recommended daily value (DV) requirements is natural. In fact, so many of us take supplements that we’re spending billions.

Sales of supplements in 2013 reached $13 billion, as more people turned to the supplements to boost their health and lose weight, despite an investigation that found most didn’t contain herbs listed on their labels, and in some cases, the supplements didn’t even identify potentially dangerous allergens.1

So, do we really need any of them? Doesn’t a real Paleo diet provide all we need? Yes, but there are a couple caveats worth considering including supplementation for:

VITAMIN D

Most westerners, particularly those living at northern latitudes, do not receive sufficient sunlight exposure required for our bodies to produce adequate blood concentrations of vitamin D.

FISH OIL

We could avoid supplementing if we were to eat the entire carcass of animals and fish (brains, liver, marrow, gonads) which are rich sources of EPA and DHA.2

In my experience, I’ve found on an individual basis, clients may need supplements of one kind or another, but rather than going to the nearest Whole Foods and dropping hundreds of dollars in self-diagnosed natural remedies, do yourself a favor and if you feel something is amiss, see your functional medicine doctor3 to get a full work up and determine what you actually need.

What’s the deal with some of the popular supplements that we see advertised all over the place? We already know how to address some of them. Our need for calcium, for example, is adequately met on a Paleo diet, even though we don’t eat dairy.

And, rather than turning to B12 supplements for energy, we can create a naturally balanced blood sugar levels simply by following the low-glycemic eating regime that is inherent to Paleo.

But what about some of the more confusing supplements, such as those designed to help with performance in sport? Carnitine is a perfect example.

L-carnitine is an amino acid that is naturally produced in the body.  Supplements are used to increase levels in people whose natural level of L-carnitine is too low because they have a genetic disorder, are taking certain drugs, or because they are undergoing a medical procedure that uses up the body’s L-carnitine. It is also used as a replacement supplement in strict vegetarians, dieters, and low-weight or premature infants.4

But can it also give us an edge in sport? Apparently so, according to a recent study published in Cell Metabolism.

“Supplementation with carnitine increases activity of metabolic pathways that helped mice run longer and further than those without supplementation”, said the US-based researchers who conducted a recent study focused on an enzyme, which uses carnitine to boost energy economy.5

Researchers moved to address ways routine activities like mowing the lawn or climbing stairs was becoming problematic due to exercise intolerance. The study concluded that carnitine supplementation did, in fact, work synergistically with the enzyme to optimize energy metabolism during exercise.

But what were the subjects eating? There’s no mention of the diet administered to the mice in the study, and aside from a brief mention that “nutritional and/ or pharmalogical strategies aimed at promoting enzymatic activity could prove useful for offsetting metabolic inertia,” we’re left with a fundamental piece of information, which seems to have been grossly overlooked.

Meat, poultry, and fish, staples of any Paleo diet, are all rich sources of L-carnitine where 63% – 75% is absorbed, whereas only 14% – 20% is absorbed in supplementation.6 Rather than heading straight to the vitamin shop and stocking up on carnitine, do yourself and your wallet a favor and make sure your diet is, in fact, a balanced Paleo approach. L-Cartinine supplementation may prove to be nothing more than the proverbial Band-Aid.

 

REFERENCES

[1] “Americans Are Ignoring the Science and Spending Billions on Dietary Supplements.” Washington Post. The Washington Post, 04 Feb. 2015. Web

[2] “Nutrient Deficiencies and Supplementation | The Paleo Diet.” The Paleo Diet. N.p., 23 Feb. 2015. Web

[3] “Institute for Functional Medicine What Is Functional Medicine?” Institute for Functional Medicine What Is Functional Medicine

[4] “L-carnitine: Uses, Side Effects, Interactions and Warnings – WebMD.” WebMD. WebMD, n.d. Web. 29 July 2015.

[5] Carnitine Supplementation Could Boost Muscle Stamina: Animal Data.” NutraIngredients.com. N.p., n.d. Web.

[6] Linus Pauling Institute. “L-Carnitine.” Micronutrient Information Center. Oregon State Univeristy, 2015. Web.

Carnitine Levels | The Paleo Diet

Hi Loren,

Here I go again with the question of the week. I love my job!

What do you think about carnitine found in high levels in red meat ( and in other products- other meats,  sports drinks, etc) and its potential association with the formation of coronary plaque?

I appreciate your response to my questions.  Feel free to answer when you have time.  No rush.

Thanks for your time and expertise.

— Pam

Dr. Cordain’s Response:

Hi Pam,

Good to hear from you. General practitioners such as yourself are responsible to your patients for giving them proper dietary advice, particularly whether or not they should avoid red meat to protect against heart disease.  The most recent commotion about red meat, carnitine and formation of coronary plaque (atherosclerosis) comes from the paper1 listed below from Stanley Hazen’s group at the Cleveland Clinic.

My colleague, Chris Masterjohn, has done a superb job of critiquing this paper and it’s scientific shortcomings in “Does Carnitine From Red Meat Contribute to Heart Disease Through Intestinal Bacterial Metabolism to TMAO?

I am in complete agreement with Chris’s conclusion that, “The bottom line here is that the popular interpretation of this study as an indictment of red meat makes no sense.” I have a few additional comments that corroborate Chris’s conclusion.

Although intriguing, Hazen’s model doesn’t fit well with the bigger picture of atherosclerosis etiology, particularly the two large meta analyses by Key’s group2, 3 showing cardiovascular disease (CVD) mortality in vegans and vegetarians to be no better than the general population.  Vegans/vegetarian data from India actually show high mortality from CVD and an earlier disease progression/mortality.4

Another point worth considering are the well studied polymorphisms disrupting FMO3 activity in trimethylaminuria patients causing inefficient conversion of TMA to TMAO.  Hence in these patients tissue concentrations of TMAO are severely reduced.  Given this metabolic scenario, one would expect that any of the polymorphisms disrupting the FMO3 gene would be highly protective for CVD (if the Hazen hypothesis is correct).  No CVD epidemiologic evidence supports this evidence.  In fact, a recent study5 shows that heterozygote genotypes (158Glu/Lys and 308Glu/Gly) increase the risk of stroke six times in hypertensives.

Cordially,

Loren Cordain, Ph.D., Professor Emeritus

References

1. Koeth RA, Wang Z, Levison BS, Buffa JA, Org E, Sheehy BT, Britt EB, Fu X, Wu Y, Li L, Smith JD, Didonato JA, Chen J, Li H, Wu GD, Lewis JD, Warrier M, Brown JM, Krauss RM, Tang WH, Bushman FD, Lusis AJ, Hazen SL. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med. 2013 May;19(5):576-85

2. Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, Mann J, McPherson K. Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr. 1999 Sep;70(3 Suppl):516S-524S.

3. Key TJ, Appleby PN, Spencer EA, Travis RC, Roddam AW, Allen NE. Mortality in British vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford).  Am J Clin Nutr. 2009 May;89(5):1613S-1619S

4. Kumar J, Garg G, Sundaramoorthy E, Prasad PV, Karthikeyan G, Ramakrishnan L, Ghosh S, Sengupta S. Vitamin B12 deficiency is associated with coronary artery disease in an Indian population. Clin Chem Lab Med. 2009;47(3):334-8.

5. Türkanoğlu Özçelik A, Can Demirdöğen B, Demirkaya S, Adalı O. Flavin containing monooxygenase 3 genetic polymorphisms Glu158Lys and Glu308Gly and their relation to ischemic stroke. Gene. 2013 Mar 17. pii: S0378-1119(13)00244-8. doi: 10.1016/j.gene.2013.03.010. [Epub ahead of print]

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