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Acetyl-L-Carnitine Supplements Review

Choose the Best Acetyl-L-Carnitine Supplement. Don't Overpay! CL Identifies Quality Acetyl-L-Carnitine Supplements at the Best Value.

Latest Update
Cardiovascular Concerns With L-Carnitine

Last Updated: 04/07/2022 Initially Posted: 07/06/2012

Update

Update:
Vitacost Acetyl-L-Carnitine HCl 500 mg (4/1/16, Updated 4/5/16): A CL member reported recently purchasing this product on Amazon.com
(where it is listed as "from Vitacost Brand") but, upon opening the sealed container, noticed, that "the capsules are two different colors. About
half are a solid light cream color. The other half have light tan spots all over the capsule." See Photo. Despite the odd appearance, a family
member used the product for four days. No adverse effects were reported. The product is marked Lot # 503872, Exp date - 4/18.

When ConsumerLab.com tested this product in 2012 for its Review (below), all capsules had a uniform whitish color -- none had spots. The
spots are not normal. It would appear that there is a problem with the production of this product. We speculate that some of the capsules
may have been exposed to conditions which oxidized certain components. If you have purchased a similar product, we suggest that you do
not use it.

We asked Vitacost for a response and received the following on 4/5/16: "A little background on the product: Carnitine is a very unstable
molecule, especially in its base form. Acetyl-L Carnitine is more stable, but it is very sensitive to moisture and temperature. If bottles are not

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closed tightly, they will easily oxidize, a process that may result in spots. It's important to note that although it may be unsightly, spotting does
not necessarily means that the product is bad or that it has lost its efficacy. We have checked multiple samples of lot you referenced and are
not seeing oxidation or any other color inconsistencies."

"Because items on Amazon are not being sold directly through us, we unfortunately cannot guarantee the product was stored properly in the
seller's possession. Vitacost distribution centers are temperature and moisture controlled and we recommend that your member purchase this
product from us directly in the future. Once you receive your Acetyl-L Carnitine, it should be stored in a cool, dry place (we don't recommend
storing it in a bathroom because of the heat and moisture) and kept tightly sealed. That being said, we stand behind all of our Vitacost brand
products, and our policy is that we'll buy it back if you're not satisfied for any reason - even if the bottle or bag is empty. If your member is a
customer of Vitacost we can offer them a full refund. If not, we are more than happy to send a replacement bottle at no charge!"

Since originally posting this update, another CL member notified us of the same problem with the same product bearing the same lot
number and expiration date, suppling us with photographic evidence and noting that some of the product had been used without harm. This
time, however, the product had been purchased directly from Vitacost (which has provided a full refund). We have asked Vitacost to
comment on this second report, particulary as the product was purchased from Vitacost and not a third party, and to explain why only some
of the capsules are spotted. We were told that a response will be provided this week, and we will post the response here. [No response was
received from Vitacost.]

Problems with products can be reported to ConsumerLab.com at www.ConsumerLab.com/SupplementProblemReport.asp.

What It Is:

Acetyl-L-carnitine is a particular form of carnitine, a non-essential amino acid that can be synthesized in the body from lysine and methionine and
is found in red meats and dairy products. It is believed that acetyl-L-carnitine plays a role in production of acetylcholine, an important
neurotransmitter.

What It Does:

Acetyl-L-carnitine is one of many dietary supplement ingredients that have been evaluated to help prevent or treat memory disorders. Other
ingredients tested and reviewed by ConsumerLab.com include ginkgo, huperzine A, ginseng, niacinamide, and fish/marine oils. While early
studies found evidence of modest benefit with acetyl-L-carnitine in Alzheimer's disease and other forms of dementia, later, larger studies failed to
find it effective (Hudson, Cochrane Database Syst Rev 2003). If there is any benefit at all, it may be limited to people with mild cognitive
impairment and early Alzheimer's disease (Montgomery, Int Clin Psychopharmacol, 2003).

Acetyl-L-carnitine seems to improve symptoms of diabetic neuropathy and neuropathy associated with antiretroviral drug therapy used by
people with HIV infection.

A study suggested that acetyl-L-carnitine does not significantly reduce pain intensity but may improve some mental health symptoms in people
with fibromyalgia. However, the lack of a placebo group in the study makes it impossible to know whether acetyl-L-carnitine was beneficial. In the
study, 51 people with fibromyalgia (average age 52) were given 500 mg of acetyl-L-carnitine three times daily or 30 to 60 mg of duloxetine (an
antidepressant) daily. Those given acetyl-L-carnitine did not experience an improvement in pain intensity or anxiety compared to baseline. While
they did show a 2.18-point improvement (on a 7-point scale) in overall severity of illness and a reduction in depression based on one scale, the
patients did not show an improvement in depression based on another scale. Those in the duloxetine group showed similar improvements in
depression and no improvement in anxiety, but those in the duloxetine group did show reduction in pain compared to baseline (Leombruni, Clin
Exp Rheumatol 2015).

Taking acetyl-L-carnitine in combination with propionyl-L-carnitine seems to help symptoms of androgen decline in older men, improving sexual
dysfunction, depression, and fatigue. It may also improve memory in chronic alcoholics and increase sperm motility in men with infertility.
Acetyl-L-carnitine may be helpful in an inflammatory condition of the penis called Peyronie's disease, where it has been shown to reduce pain and
slow progression of the disease (Biagiotti, BJU Int. 2001). Early research suggests that acetyl-L-carnitine might reduce hyperactivity in boys with
fragile X syndrome.

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Acetyl-L-carnitine (500 to 1,000 mg) taken twice daily for a period of months may modestly reduce systolic blood pressure in people with high
blood pressure, although it does not seem to lower diastolic blood pressure. One study found that taking 1 gram of acetyl-L-carnitine twice daily
for 6 months lowered systolic blood pressure by about 8 mm Hg compared to baseline, although this study did not have a comparison group so
the results are uncertain (Ruggenenti, Hypertension 2009). Another study in 36 people (average age 63) with coronary artery disease found that
taking 500 mg of acetyl-L-carnitine plus 200 mg of alpha-lipoic acid twice daily for 8 weeks lowered systolic blood pressure by 9 mm Hg in
people with coronary artery disease and high blood pressure, which was significant compared to placebo. The study was partially funded by the
maker of the supplement (Juvenon Cellular Health Supplement, Juvenon Inc.) (McMackin, J Clin Hypertens 2007). Although a study in 219 older
people with high blood pressure, high cholesterol and diabetes found that taking 1 gram of acetyl-L-carnitine twice daily for 6 months did not
lower systolic blood pressure compared to placebo, the people in this study were taking the cholesterol-lowering medicine simvastatin, which can
also lower blood pressure and may have overshadowed any effects of acetyl-L-carnitine (Parvanova, J Endocr Soc 2018).

Some studies with L-carnitine (not acetyl-L-carnitine) have evaluated its potential use in weight loss because L-carnitine is involved in the
transport of fatty acids into the mitochondria of cells for use as fuel. However, a weight loss benefit has not been demonstrated. A study in which
moderately obese women were given 2 grams daily of L-carnitine for eight weeks showed no effect on amounts of body fat or body weight
(Villani, Int J Sport Nutr Excerc Metab 2000).

Quality Concerns and Tests Performed:

Neither the U.S. government nor any other agency is responsible for routinely testing dietary supplements for their contents or quality. In order to
help consumers identify products of better quality, ConsumerLab.com purchased and tested acetyl-L-carnitine supplements for the quality of
their ingredients and other relevant parameters as described below. See Testing Method for more details.

Because carnitine is sold in different chemical forms that may have different effects, CL specifically tested for acetyl-l-carnitine, the form most
studied for memory enhancement. Any product in tablet form (excluding chewable and time-release tablets) was tested for its ability to properly
break apart (disintegrate) in solution — which is necessary for ingredients to be absorbed.

What CL Found:

All three of the acetyl-L-carnitine supplements selected for review by ConsumerLab.com passed testing (Bluebonnet, Doctor's Best, and Jarrow
Formulas) as did four other products (GNC, Twinlab, Vitacost (see Update), and Vitamin Shoppe) tested through CL's Voluntary Certification
Program.

As acetyl-L-carnitine supplements are among the more expensive supplements and the products essentially contain the same key ingredient in a
capsule, it pays to comparison shop for the lowest cost while factoring in other special requirements you may have, such as having a product that
is gluten free, kosher, etc. The cost to obtain a 1,500 mg dose of acetyl-L-carnitine from the reviewed products ranged from a low of 30 cents
from Vitacost (which is gluten-free) (see Update) to a high of $1.24 from Bluebonnet (which is gluten-free as well as vegetarian and kosher).

Test Results by Product:

Listed below are the test results for seven different acetyl-Lcarnitine supplements, listed alphabetically. ConsumerLab.com selected three
products. Three other products (each indicated with an asterisk) were tested at the request of their manufacturers/distributors through CL's
Voluntary Certification Program and are included for having passed testing.

Shown for each product is the claimed amount and form of the tested ingredient and the serving size recommended on the label. The full list of
ingredients is available for each product by clicking on the word "Ingredients" in the first column. Products listed as "Approved" met their label
claims and ConsumerLab.com's quality criteria (see Passing Score). Be aware that suggested serving sizes on labels may not reflect an
appropriate dosage for your intended use. Be sure to compare the "Suggested Daily Serving" in the second column to dose information provided
in What to Consider When Using. Cost comparisons are shown in the last column.

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CONSUMERLAB.COM RESULTS FOR ACETYL-L-CARNITINE SUPPLEMENTS
Click on beneath a product name to find a vendor that sells it.
To find retailers that sell some of the listed products click here.
Product Name, Unit Type, Amount of Acetyl-L-Carnitine Per --TEST RESULTS --
and Suggested Daily Suggested Daily Serving on Label
OVERALL Met Broke Cost for 1,500 mg Acetyl-L-
Serving
RESULTS: Claim Apart Carnitine1
Properly
(Click on "Ingredients" for Full
APPROVED Cost For Suggested Daily Serving
List and Special Designations)
(Passed)
or Additional Key Ingredients,
NOT Product Notes, and/or Special
APPROVED Designations2
(Failed)
Price Paid
Acetyl-L-Carnitine Supplements:
Bluebonnet Acetyl-L-Carnitine 500 mg APPROVED N/A $1.24
500 mg
(1 vegetarian capsule daily)
$0.41
Mfd. by Bluebonnet Nutrition
Corporation
Ingredients
Vegetarian, Gluten free and kosher

$24.76/60 vegetarian capsules

Doctor's Best® Best Acetyl-L- 500 to 2,000 mg APPROVED N/A $0.55

Carnitine
(1 to 4 capsules daily)
$0.18 - $0.73
Dist. by Doctor's Best, Inc.
Ingredients
$21.99/120 capsules

GNC Acetyl L-Carnitine 500 500 to 1,000 mg APPROVED N/A $0.87

(1 to 2 capsules daily)*

Dist. by General Nutrition

$0.29 - $0.58
Corporation
Ingredients
Gluten free

$34.99/120 capsules

Jarrow Formulas® Acetyl L- 500 to 1,000 mg APPROVED $0.52

Carnitine 500
(1 capsule, once or twice
daily)
$0.17 - $0.35
Dist. by Jarrow Formulas®
Ingredients
Vegan/Vegetarian and Gluten free

$20.99/120 vegetarian capsules

Twinlab® Acetyl-L-Carnitine 500 to 2,000 mg APPROVED N/A $0.75

(1 capsule, one to four times
daily)*
$0.25 - $1.00
Mfd. by ISI Brands, Inc.
Ingredients
$30.19/120 capsules

Vitacost® Acetyl-L-Carnitine 500 mg APPROVED N/A $0.30

HCl 500 mg
(1 capsule daily)* Lowest cost for acetyl-L-carnitine
(See Update)

Dist. by Vitacost® $0.10

Ingredients

Gluten free

$11.99/120 capsules

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Vitamin Shoppe® Acetyl-L- 500 mg APPROVED N/A $0.87
Carnitine 500 mg
(1 capsule daily)*
$0.29
Dist. by The Vitamin Shoppe®
Ingredients
$34.99/120 capsules

Not applicable: Only non-chewable, non-capsule, non-enteric coated, and non-time release formulations are tested for disintegration.
* Tested through CL's Voluntary Certification Program prior to, at time of, or after the posting of this Product Review.
** Product identical in formulation and manufacture to a product that has passed testing but sold under a different brand. For more information see CL's Multi-
Label Testing Program.

1
Amounts shown are for general comparison purposes and are calculated from the price paid by ConsumerLab.com (without tax or shipping) and amounts of
Acetyl-L-Carnitine shown on labels. Unit amounts of some products do not provide exactly 1,500 mg of Acetyl-L-Carnitine. Prices may vary by retailer and
number of pills per package.
2 Not tested but claimed on label.

Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review.
Manufacturers may change ingredients and label information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If
a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested.

The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it
believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its
officers or employees. CL cannot assure the accuracy of information.

Copyright ConsumerLab.com, LLC, 2012 All rights reserved. Not to be reproduced, excerpted, or cited in any fashion without the express written permission of
ConsumerLab.com LLC

Show the results table

ConsumerTips™:

What to Consider When Buying:

Different forms of carnitine are used for different purposes. Acetyl-L-carnitine is somewhat different from both L-carnitine and propionyl-L-
carnitine. Although the body can convert L-carnitine to acetyl-L-carnitine and vice versa, it is not known whether the benefits of acetyl-L-carnitine
are from the intact molecule, from its metabolites, or some other activated form, so it is advisable not to substitute one form of carnitine for
another. Another form of carnitine, D-carnitine, should not be used as it may compete with other forms of carnitine and cause symptoms of
carnitine deficiency.

What to Consider When Using:

Acetyl-L-carnitine is taken in fairly large doses - often measured in grams rather than milligrams (1,000 mg = 1 gram). In Alzheimer's disease, 1.5
to 4 grams daily has been used, usually divided into two or three doses during the day. In age-related memory impairment, 1.5 to 2 g daily has
been used. For depression in the elderly, 1.5 to 3 grams daily in divided doses has been used.

For diabetic neuropathy, 1.5 to 3 grams per day in divided doses has been used, with the higher dose apparently more effective for improving
vibratory sensations and reducing neuropathy-related pain. For neuropathy associated with antiretroviral drug therapy, the dose is 1 gram two
times daily. The dose for reducing fibromyalgia pain is 1.5 grams each day.

In infertile men, 3 to 4 grams daily has been used to improve sperm function, sometimes as a mixture of acetyl-L-carnitine and L-carnitine. For
Peyronie's disease, 2 grams divided into two doses during the day for 3 months has been used. For symptoms of age-related testosterone
deficiency, 2 grams of acetyl-L-carnitine plus 2 grams of propionyl-L-carnitine daily have been used. For boys with fragile X syndrome, the daily
dose to reduce hyperactivity is 20 to 50 mg/kg.

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Concerns and Cautions:

Alzheimer's disease and other types of severe age-related mental impairment are too serious to treat on your own and the symptoms of these
diseases could be confused with those of other serious conditions. It is advisable to see your doctor before self-medicating for severe memory or
cognitive problems. Acetyl-L-carnitine is believed to be quite safe, but may cause gastrointestinal side-effects and agitation. It can also cause the
urine, breath and sweat to have a fishy odor. Acetyl-L-carnitine should be used with caution in people taking blood-thinning medication, as it can
theoretically increase the anti-coagulant effect. People with low or borderline-low thyroid levels should not take acetyl-L-carnitine or other forms
of carnitine because it may impair thyroid hormone function. Low thyroid levels are particularly common among women over 60 years of age.
(Conversely, in cases of hyperthyroidism giving acetyl-L-carnitine or other forms of carnitine may be helpful.) (Benvenga, Ann NY Acad Sci 2004).

Individuals on dialysis should not take this without a physician's supervision when used orally and appropriately.

L-carnitine
Although acetyl-L-carnitine is not the same as L-carnitine, it contains (and provides) L-carnitine, so it is worth noting the following concerns with
L-carnitine:

Some research suggests that L-carnitine intake may contribute to cardiovascular disease in certain people. People who eat red meat (e.g., beef)
maintain organisms in their gut that digest carnitine to the compound TMA, a precursor to the compound TMAO, which appears to advance
atherosclerosis (hardening of the arteries) by reducing the normal clearing of cholesterol (Koeth, Nature Medicine 2013). Vegetarians and vegans
do not have this reaction when first exposed to carnitine. Supplementing with L-carnitine (and possibly acetyl-L-carnitine due to their chemical
similarity, i.e., both contain the TMA moiety) may potentially foster growth of these organisms, increase levels of TMAO, and have negative long-
term cardiovascular effects, although clinical evidence is mixed. One study among healthy, active older women found no significant increase in
blood-based markers thought to predict future cardiovascular events when they were given 1,020 mg of L-carnitine (from 1,500 mg of L-carnitine-
L-tartrate) for 24 weeks even though their blood levels of TMAO increased ten-fold (Samulak, Ann Nutr Metab 2018). On the other hand, a study in
Canada among 157 men and women (average age 66) with metabolic syndrome found that those who supplemented with 1,000 mg of L-
carnitine twice daily for six months had a 9.3% increase in the narrowing of the carotid arteries (a risk factor for stoke) compared to those who
took a placebo (among whom this narrowing slightly decreased), although L-carnitine did not increase the total volume of carotid artery plaque.
Those who supplemented with L-carnitine also had increases in bad "LDL" cholesterol (5% increase vs 7% decrease) and total cholesterol (10%
increase vs 6% decrease) compared to those who took placebo (Johri, Nutr Metab (Lond) 2022).

Also, L-carnitine may worsen chemotherapy-related nerve damage: A double-blind, placebo-controlled study among women receiving taxane-
based chemotherapy to treat breast cancer found that 3 grams of L-carnitine taken daily for 5 ½ months significantly worsened symptoms of
chemotherapy-induced peripheral neuropathy compared to placebo, and this difference was also seen after 2 years. The effect was unexpected,
although a similar problem has been observed with other antioxidants given during chemotherapy (Hershman, J Clin Oncol 2018). Based on this
evidence, the American Society of Clinical Oncology recommended in 2020 that clinicians discourage use of acetyl-L-carnitine for preventing
chemotherapy-related nerve damage (Loprinzi, J Clin Oncol 2020).

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor is it meant to substitute for the
advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating
a health problem or disease. Consumers should inform their healthcare providers of the dietary supplements they take.

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