Written by Greg Arnold, DC, CSCS. A study with 74 patients with Nonalcoholic liver disease was conducted with 2 grams of L-carnitine per day for 24 weeks. Patients receiving L-carnitne showed “significant improvement” compared to the placebo group. Researchers suggest that L-carnitine help detoxify the liver. 

Nonalcoholic steatohepatitis is the most common cause of chronic liver disease in the western countries (up to 24% of all patients with liver disease), with 75% of those with NASH being classified as obese (1). While the exact mechanisms leading to NASH are still unclear, the prevalence of obese patients diagnosed with NASH strongly suggests lack of blood sugar control, insulin resistance, and blood lipid problems may play a significant role (2).

Because 20% of those with NASH progress to end-stage liver disease (3), ways to help maintain liver health in those with NASH is a priority. Now a new study (4) suggests that L-carnitine, an amino acid more commonly association with weight loss (5), may also help with liver health.

In the study, 74 patients between the ages of 43 and 53 diagnosed with NASH received either 2 grams of L-carnitine per day (1 gram tablet after breakfast and one after dinner = 36 patients) or placebo (38 patients) for 24 weeks. The patients followed the diet recommended by the National Cholesterol Education Program Adult Treatment Panel III (6). They also provided blood samples before and after the study to measure their liver function.

At the end of the study, patients in the L-Carnitine group showed “significant improvements” in numerous measures of liver health, including:

  • A 56% and 53% decrease in the liver enzymes AST and ALT, respectively, compared to 38% and 34% in the placebo group (p < 0.001).
  • A 22% decrease in total cholesterol compared to 3% in the placebo group (p < 0.001).
  • A 31% decrease in LDL cholesterol compared to 5% in the placebo group (p < 0.001).
  • A 43% decrease in the inflammatory protein, C-Reactive Protein compared to 15% in the placebo group (p < 0.001).
  • A 25% decrease in the inflammatory protein TNF-alpha compared to 6% in the placebo group (p < 0.001).

The levels of each liver health measurement before and after the study for each group are shown in the table below:

-Carnitine Group (Before/After) Placebo Group (Before/After)
AST (IU/L) 128.1/56.4 124.2/78.1
ALT (IU/L)  110.2/51.8 112.8/75.4
Total Cholesterol (mmol/L) 6.09/4.78 6.04/5.88
LDL Cholesterol (mmol/L)  4.52/3.15 4.45/4.24
C-Reactive Protein (mg/dl) 9.1/5.2 8.7/7.4
TNF-alpha (pg/dl) 1.44/1.08 1.38/1.30

For the researchers, “patients with NASH who were treated with L -carnitine compared with patients who were treated with placebo have (a greater) improvement in (the markers for liver health)” and suggest that L-Carnitine exerts its health effects by helping detoxify the liver.

Source: Malaguarnera, Mariano, et al. “L-carnitine supplementation to diet: a new tool in treatment of nonalcoholic steatohepatitis—a randomized and controlled clinical trial.” The American journal of gastroenterology 105.6 (2010): 1338-1345.

© 2010 The American College of Gastroenterology

Posted June 25, 2012.

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.

References:

  1. Clark JM , Diehl AM . Nonalcoholic fatty liver disease: an underrecognized cause of cryptogenic cirrhosis . JAMA 2003 ; 289 : 3000 – 4.
  2. Malaguarnera L , Rosa MD , Zambito AM et al. Potential role of chitotriosidase gene in nonalcoholic fatty liver disease evolution . Am J Gastroenterol 2006 ; 101 : 2060 – 9.
  3. Adams LA. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology 2005 Jul;129(1):113-21.
  4. Malaguarnera L. L -Carnitine Supplementation to Diet: A New Tool in Treatment of Nonalcoholic Steatohepatitis — A Randomized and Controlled Clinical Trial. Amer Jou Gastroenterology 2010.
  5. “Herbal Remedies and Supplements for Weight Loss” – posted on the Medline Plus website.
  6. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults . Executive summary of the Th ird Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001 ; 285 : 2486 – 97.