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Background Despite extensive research, the effects of L-carnitine supplementation in treating obesity are still unclear and equivocal. L-carnitine transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement. The purpose of the present research is to investigate the efficacy of L-carnitine during concurrent training on the functional capacities and body composition in obese men. Methods Thirty nonactive, obese males (age = 37.2 ± 1.5 years; body mass index = 33.8 ± 2.5 kg/m 2) participated in this research. The participants were randomly divided into three groups: experimental group 1 (EXP1)—concurrent training with L-carnitine supplementation; experimental group 2 (EXP2)—L-carnitine supplementation without training; and control group—without training or L-carnitine supplementation. Concurrent training was performed for 8 weeks, three sessions per week, with a training intensity ranging from 60 to 75% of the maximum heart rate reserve and one-repetition maximum. Both experimental groups were supplemented with 35 mg L-carnitine supplement per kilogram body weight. Various functional and body composition variables were collected at three time points (pre-test, mid-test, and post-test). Results A number of variables were significantly improved in EXP1 after 4 and 8 weeks (systolic blood pressure, maximal oxygen consumption, weight, body mass index, and one-repetition maximum) and only after 8-weeks (diastolic blood pressure, resting heart rate, percentage of body fat, and fat-free mass). No significant changes were observed for EXP2 and the control group. Conclusion L-carnitine supplementation, in conjunction with concurrent training, emerges as a highly effective approach for enhancing body composition and boosting functional capacities in obese adult men. Therefore, it is recommended that overweight male individuals integrate concurrent training into their regimen while taking L-carnitine. [ABSTRACT FROM AUTHOR]

Background Infertility is one of the most stressful and complicated experiences in a couple's life. Objective The aim of this study was comparing the effects of Nettle and Alyssum with Q10 plus and L-Carnitine on improving the sperm parameters of infertile men in Iran. Materials and Methods This three-blind randomized clinical trial study conducted on 75 infertile men referred to Jahrom infertility clinic in 2022. The participants selected by simple random method and assigned to two intervention and control groups. The subjects of the intervention group took herbal drugs includes urtidine (Nettle) and Alyssum. The control group took routine treatment consists Q10 plus and l-carnitine for 12 weeks. Data collected through the standard checklist of semen analysis before and the end of the intervention for both groups. Data were analyzed by descriptive (frequency and percentage) and analytical (Fisher-exact, chisquare, independent t-test and Mann-Whitney U) tests. Results The results indicated that the positive effectiveness of Nettle and Alyssum on the improvement of some sperm parameters of infertile men, including volume, sperm shape and motility compared to Q10 plus and L-carnitine. In fact, after the intervention, a statistically significant difference observed in the parameters of sperm in in the intervention group compared to the control group (p<0/05). Conclusions: consumption of Nettle and Alyssum improves semen volume, sperm motility and morphology in infertile men. Considering the positive effect of herbal remedies on the spermogram of infertile men, the results of this research along with further studies can use in infertility clinics. [ABSTRACT FROM AUTHOR]

Background: Migraine is a severe neurological disorder that is recognized as one of the most common debilitating diseases worldwide. Although the exact cause of migraine is not known, research suggests that inflammation, oxidative stress, mitochondrial dysfunction, and insufficient nutrients may contribute to its development. Studies indicate that nutrition-based approaches are safer and more cost-effective strategies for managing migraine symptoms compared to medication. In this regard, the impact of nutrition, as a complementary medicine, is largely attributed to that of certain nutrients on inflammation and mitochondrial function. It is hypothesized that alpha-linolenic acid and L-carnitine, which possess anti-inflammatory and antioxidant properties, may be synergically beneficial for migraine patients. Therefore, this study will be conducted to assess the efficacy of alpha-linolenic acid and L-carnitine co-supplementation in patients with migraine., Methods: This is a parallel, randomized, triple-blind, placebo-controlled clinical trial, in which 80 women aged 20 to 50 years with migraine will be assigned to receive either intervention group (n = 40) receiving both 1000 mg/day flaxseed oil and 500 mg/day L-carnitine simultaneously for 12 weeks, or control group (n = 40) receiving both 1000 mg/day paraffin oil and 500 mg/day maltodextrin as the placebos for the same duration. The primary outcomes include changes in clinical symptoms of migraine, including frequency, severity, and duration of attacks, serum levels of C-reactive protein (CRP), total antioxidant capacity (TAC), nitric oxide (NO), malondialdehyde (MDA), and superoxide dismutase (SOD). Secondary outcomes include mental health, sleep quality, and quality of life (QOL)., Discussion: In this study, we aim to investigate the potential benefits of combining alpha-linolenic acid and L-carnitine as a treatment option for migraine sufferers. Migraine, characterized by recurrent severe headaches, affects a significant portion of the population and can significantly impact an individual's quality of life. By studying alternative therapies such as alpha-linolenic acid and L-carnitine, researchers hope to expand the range of treatment options available and potentially provide relief to migraine sufferers., Trial Registration: Iranian Registry of Clinical Trials ( www.irct.ir ) (ID: IRCT20121216011763N57). Registration date: 29 March 2023., Trial Status: The protocol is version 1.0 dated December 30, 2023. Recruitment began on July 10, 2023, and is expected to be completed by January 22, 2024., (© 2024. The Author(s).)

Background: Mitochondria are cellular organelles required for energy production, vital to reproduction, especially oocyte maturation and fertilization. It has been seen that oocyte cryopreservation (OC) can cause mitochondria damage, aggregation of lipid droplets near mitochondria and endoplasmic reticulum, and cryoinjury. In recent studies use of antioxidants such as L- carnitine can increase the number of active mitochondria and decrease intracellular ROS levels. The present study aimed to determine the beneficial effect of L --carnitine on oocyte mitochondrial activity after vitrification. Materials and Methods: In the present experimental study, 6-8 weeks of female NMRI mice were taken from the Royan Institute of Iran and stimulated with 7.5 IU Pregnant Mare Serum Gonadotrophin (PMSG) and 10 IU of human chorionic gonadotropin (HCG) after 48 hours was injected. After stimulation, oocytes were collected, and MII oocytes were selected. A two-step vitrification procedure was done, and 0.6mg/ml of L --carnitine was added to both ES and VS mediums. After two weeks, oocyte thawing was performed, intracellular GSH level was also measured mitochondrial membrane potential was measured. Captured images were analyzed by J software (Version 1.40; and obtained data were analyzed using SPSS Ver.20. Results: Average difference in intracytoplasmic GSH level in the study group was significantly higher than the control group (P<0.001). So, L --carnitine could successfully increase the oocyte intracytoplasmic GSH level. Also, it has been seen that the LC supplement could successfully grow oocyte mitochondrial function and subsequent mitochondrial membrane potentials(P<0.001). Conclusion: Adding LC to the cryopreservation media could increase mitochondrial activity, GSH level, and mitochondrial membrane potentials. Adding LC to the cryopreservation could enjoy the beneficial effect of L -- carnitine on oocyte mitochondrial activity after vitrification and minimize mitochondrial damage and boost oocyte quality which can lead to successful fertilization and embryo growth. [ABSTRACT FROM AUTHOR]

Background: Obesity, a multifactorial disorder with pandemic dimensions, is conceded a major culprit of morbidity and mortality worldwide, necessitating efficient therapeutic strategies. Nutraceuticals and functional foods are considered promising adjuvant/complementary approaches for weight management in individuals with obesity who have low adherence to conventional treatments. Current literature supports the weight-reducing efficacy of pro/pre/synbiotics or L-carnitine; however, the superiority of the nutraceutical joint supplementation approach over common single therapies to counter obesity and accompanying comorbidities is well documented. This study was designed to assess the effects of L-carnitine single therapy compared with L-carnitine and multistrain/multispecies synbiotic co-supplementation on anthropometric and cardiometabolic indicators in women with obesity., Methods: The current placebo-controlled double-blind randomized clinical trial was performed on 46 women with obesity, randomly allocated to either concomitant supplementation [L-carnitine tartrate (2 × 500 mg/day) + multistrain/multispecies synbiotic (1 capsule/day)] or monotherapy [L-carnitine tartrate (2 × 500 mg/day) + maltodextrin (1 capsule/day)] groups for 8 weeks. Participants in both groups received healthy eating dietary advice., Results: Anthropometric, lipid, and glycemic indices significantly improved in both intervention groups; however, L-carnitine + synbiotic co-administration elicited a greater reduction in the anthropometric measures including body mass index (BMI), body weight, and neck, waist, and hip circumferences ( p < 0.001, <0.001, <0.001, = 0.012, and =0.030, respectively) after adjusting for probable confounders. Moreover, L-carnitine + synbiotic joint supplementation resulted in a greater reduction in fasting blood sugar (FBS), insulin (though marginal), and homeostatic model assessment of insulin resistance (HOMA-IR) and more increment in quantitative insulin sensitivity check index (QUICKI; p = 0.014, 0.051, 0.024, and 0.019, respectively) compared with the L-carnitine + placebo monosupplementation. No significant intergroup changes were found for the lipid profile biomarkers, except for a greater increase in high-density lipoprotein-cholesterol concentrations (HDL-C) in the L-carnitine + synbiotic group ( p = 0.009)., Conclusion: L-carnitine + synbiotic co-supplementation was more beneficial in ameliorating anthropometric indices as well as some cardiometabolic parameters compared with L-carnitine single therapy, suggesting that it is a promising adjuvant approach to ameliorate obesity or associated metabolic complications through potential synergistic or complementary mechanisms. Further longer duration clinical trials in a three-group design are demanded to verify the complementary or synergistic mechanisms., Clinical Trial Registration: www.irct.ir, Iranian Registry of Clinical Trials IRCT20080904001197N13., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Fallah and Mahdavi.)

Background: Critically ill patients must be monitored constantly in intensive care units (ICUs). Among many laboratory variables, nutritional status indicators are a key role in the prognosis of diseases. We investigated the effects of L-carnitine adjunctive therapy on monitoring variables in critical illness., Method: A prospective, double-blind, randomized controlled trial was implemented in a medical ICU. Participants were 54 patients, aged > 18 years, with multiple conditions, randomly assigned to receive 3 g L-carnitine per day or placebo, along with enteral feeding, for 1 week. Primary outcomes included monitoring variables related to nutritional status., Result: Of 54 patients randomly assigned, 51 completed the trial. Serum albumin (Alb) (P-value: 0.001), total protein (P-value: 0.003), and calcium (Ca) (0.044) significantly increased in the intervention vs. control group. Alanine transaminase (ALT) (0.022), lactate (<0.001), creatinine (Cr) (0.005), and international normalized ratio (INR) (0.049) decreased meaningfully in the intervention vs. control group., Conclusion: L-Carnitine supplementation in critically ill patients can improve several parameters including INR, Cr, ALT, lactate, Ca, Alb, and total protein., Trial Registration: Iranian Registry of Clinical Trials IRCT 20151108024938N2. This trial was approved by the Research Ethics Committee of Mashhad University of Medical Sciences (registration code: IR.MUMS.fm.REC.1396.671) (available at https://en.irct.ir/trial/30748 , May 2018)., (© 2023. The Author(s).)

Background: Atherosclerosis is the leading cause of death in hemodialysis patients. These patients are also very prone to Lcarnitine deficiency due to kidney disease. In this clinical trial, we investigated the effect of oral L-carnitine on endothelial function of these patients. Materials ans Methods: We studied 31 adult chronic hemodialysis patients in our center and divided them into two groups. The first group (n = 20) received 1500 mg/dialysis interval (every other day) oral L-carnitine. The control group (n = 11) received placebo for one month. Ultrasonographic measurements of flow mediated dilation and carotid intima-media thickness were performed before and after one month of L-carnitine and placebo therapy. Results: This study showed that after one month of Lcarnitine or placebo therapy there was no significant improvement in flow mediated dilation (p = 0.80 and p = 0.59, respectively) or decrease in carotid intima-media thickness (p = 0.12 and p = 0.50, respectively). Conclusions: Our study revealed that one month of oral L-carnitine therapy did not improve endothelial function in hemodialysis patients. Long-term studies with large sample size using intravenous form and higher doses of the drug are required to clarify the questionable role of L-carnitine in hemodialysis patients. [ABSTRACT FROM AUTHOR]

Purpose: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women. Insulin resistance and dyslipidemia are linked to PCOS. L-Carnitine supplementation as a management strategy for women with PCOS has been proposed. The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin (SHBG) and lipid profile in overweight/obese women with PCOS was investigated., Methods: This randomized, double-blind, controlled clinical trial, was conducted on 62overweight/obese women with PCOS. Participants were randomly assigned into two groups to receive 1000 mg/day L-carnitine or placebo (1000 mg starch) for 12 weeks., Results: L-Carnitine supplementation compared to the placebo showed a significant improvement in insulin [- 0.7 (- 7.3 to 4.0) vs. 0.7 (- 3.0 to 5.2); P = 0.001], homeostatic model assessment for insulin resistance [- 0.4 (- 1.7 to 1.1) vs. 0.0 (- 0.7 to 1.3); P = 0.002], quantitative insulin sensitivity check index (+ 0.01 ± 0.02 vs. - 0.01 ± 0.01; P = 0.02) and a non-significant change toward improvement in SHBG (+ 11.5 ± 40.2 vs. - 3.2 ± 40.2; P = 0.2). However, there was no significant differences between the two groups in serum levels of fasting plasma glucose, total cholesterol, triglyceride, low density lipoprotein-cholesterol and high density lipoprotein cholesterol (P > 0.05)., Conclusion: 12-week L-carnitine supplementation in overweight or obese women with PCOS ameliorate insulin resistance, but has no effect on SHBG and lipid profile. Studies with higher dosages and duration of L-carnitine intake are required. The trial was registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1., Trial Registration: Registered on 30th December 2019 at Iranian Registry of Clinical Trials (IRCT20191016045131N1)., (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Sepsis is a common cause for admission to the intensive care unit (ICU), and its incidence has been increasing. It is associated with a significant increase in serum inflammatory biomarkers such as C-reactive protein (CRP) and cytokines such as interleukin 1 (IL-1), IL-6, and tumor necrosis factor (TNF). Sepsis is also associated with pathophysiological changes that include fluid accumulation in the lungs, eventually leading to acute respiratory distress syndrome (ARDS), tissue edema, hypotension, and acute kidney injury (AKI). Conventional therapies include antibiotics, but these may have important adverse effects, so novel therapeutic approaches are required. In animal studies, L-carnitine improves antioxidant status, and in some clinical trials, it has been shown to reduce inflammation. It has also been shown to improve respiratory distress and help maintain coenzyme A homeostasis, metabolic flexibility, promoting the normal function of the tricarboxylic acid (TCA) cycle, and oxidation of fatty acids by peroxisomes. We aim to determine the effects of very high doses of L-carnitine on inflammatory factors, oxidative stress, and clinical outcomes of patients with sepsis in ICU., Method and Design: In this double-blind, randomized controlled clinical trial, we will use block randomization of 60 patients with sepsis, aged between 20 and 65 years from Al-Zahra Hospital, Isfahan, Iran. The intervention group (n = 30) will receive three capsules of L-carnitine (each capsule contains 1000 mg L-carnitine; totally 3000 mg/day) for 7 days, and a control group (n = 30) will receive a placebo with the same dose and for the same duration in addition to usual care. At baseline, scores for clinical and nutritional status (Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Quick SOFA (qSOFA), and NUTRIC Score) will be assessed. At beginning and end point of the study, inflammatory markers (CRP, erythrocyte sedimentation rate (ESR)), oxidative stress status (total oxidative stress (TOS), total antioxidant capacity (TAC)), and clinical variables will be evaluated also. The mortality rate will be assessed within 28 days of the beginning of the intervention., Discussion: Because of the anti-inflammatory and antioxidant properties of L-carnitine, it is possible that using a high dose of 3000 mg daily of this nutritional supplement may reduce inflammation and oxidative stress and improve subsequent mortality of critically ill patients with sepsis., Trial Registration: Iranian Registry of Clinical Trials IRCT20201129049534N1 . Registered on 2 May 2021., (© 2022. The Author(s).)

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women, and is associated with cardiovascular diseases as well as non-alcoholic fatty liver disease. The recent evidence suggested the beneficial effects of l-carnitine in women with PCOS., Objective: The present study aimed to investigate the effect of l-carnitine supplementation on liver fat content and cardiometabolic outcomes in overweight/obese women with PCOS., Methods: The present study was designed as a 12-week double-blind, randomized controlled clinical trial. Sixty-two overweight/obese women with PCOS were assigned into the treatment (received 1000 mg/d l-carnitine capsule) and the control (received placebo capsule) groups. The outcomes included lipid accumulation product (LAP), atherogenic index of plasma (AIP), atherogenic coefficient (AC) and Castelli II indices., Results: At the end of the trial, there was no significant difference between the treatment and the control groups in terms of LAP (-1.1 vs. -4.0; P = 0.45), AIP (0.0 vs. -0.09; P = 0.14), AC (-0.2 vs. -0.8; P = 0.06) and Castelli II index (-0.2 vs. -0.6; P = 0.07) after controlling the mean change of waist circumference., Conclusion: l-carnitine supplementation for 12 weeks has no beneficial effect on liver fat content and cardiometabolic outcomes in overweight or obese women with PCOS., Trial Registration: Registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1., Competing Interests: Declaration of competing interest The authors have declared no competing interests., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Pemphigus vulgaris (PV) is a severe, bullous, autoimmune disease of the skin and mucous membranes. Corticosteroids are usually the main core treatment for controlling PV, which could lead to several side effects such as insulin resistance, osteoporosis, and cardiovascular disorders. The aim of this study is to evaluate the protective effects of l-carnitine (LC) supplementation in PV patients under corticosteroid treatment. In this randomized, double-blind, placebo-controlled clinical trial, 48 patients with PV were divided randomly into two groups to receive 2 g LC (n = 24) or a placebo (n = 24) for 8 weeks, respectively. Serum levels of osteopontin (OPN), bone morphogenic protein 4 (BMP4), cystatin C, systolic and diastolic blood pressure, 25 hydroxyvitamin D3, and LC were evaluated at the beginning and at the end of the study. LC supplementation demonstrated a significant increase in serum carnitine (p < .001). In addition, at the end of the trial, LC supplementation significantly decreased serum BMP4 (p = .003), OPN (p = .03), and cystatin C (p = .001) levels. There was no significant effect on blood pressure in comparison with the placebo. During study, no harmful side effects were reported by patients. These findings indicate that LC supplementation significantly leads to favorable changes in OPN, BMP4, and cystatin C in PV patients under corticosteroid therapy. However, further investigations are required to confirm these results., (© 2019 Wiley Periodicals, Inc.)