Pregnancy Use

Insufficient reliable information is available. However, animal studies have revealed no evidence of decreased fertility or harm to the fetus (Hendler & Rorvik 2001). In fact, some research suggests a role for carnitine.

Requirements for carnitine may increase during pregnancy and a small trial found a positive effect in women diagnosed with placental insufficiency taking 1 g l-carnitine twice daily (Genger et al 1988). Due to the role of l-carnitine in the synthesis of surfactant, trials have also been conducted using l-carnitine in combination with low-dose betamethasone in women with imminent premature delivery, with an improvement in respiratory distress syndrome and mortality rates (Kurzetal 1993).

PRACTICE POINTS/PATIENT COUNSELLING

• Carnitine is an amino acid that is ingested through the diet and also synthesised from lysine and methionine in the body.

• It is involved in numerous biochemical processes and is essential for energy production in the mitochondria of every cell.

• Vegetarians, and preterm infants or those on a carnitine-free formula, are at risk of deficiency. Secondary risk factors include genetic defects of metabolism, liver and renal disease, dialysis, certain medicines and hypopituitarism.

• l-Carnitine 2 g/day for 3 months has been shown to improve exercise tolerance and recovery, especially in people with cardiovascular disorders such as chronic stable angina and cardiac insufficiency. Preliminary evidence also suggests a possible role in hyperthyroidism, male infertility and peripheral vascular diseases such as intermittent claudication.

• Carnitine supplements are also used to promote weight loss and as an ergogenic aid, although large controlled studies are unavailable to assess effectiveness.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What will this supplement do for me?

l-Carnitine supplements improve clinical outcomes in people with cardiovascular disorders by reducing the frequency of angina attacks, and improving outcomes Carnitine 192

after heart attack, cardiogenic shock and in cardiomyopathy. It may also reduce

symptoms in hyperthyroidism, increase male fertility, increase walking distance in people with peripheral vascular disease and reduce the side-effects of some medicines.

When will it start to work?

People with cardiovascular disorders such as chronic stable angina and cardiac insufficiency should experience benefits within 1-3 months. Are there any safety issues?

Carnitine is well tolerated, but people with chronic liver disease or epilepsy should use it with caution.

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