Acetyl-L-Carnitine: Hope for Brain-Injured Patients

In my nutrition practice I have seen countless patients with brain injuries. These injuries can be a result of car, motorcycle, bicycle or skiing/ snowboarding accidents, or even from domestic or crime-related violence. Brain injuries are reaching epidemic proportions in America. Sadly, most patients with brain injuries do not realize that optimal nutrition can often make a difference in their recovery. They are even told often by well-meaning physicians that there is nothing they can do to improve their brain function. Not so.

Brain nutrients for head trauma patients is one of the most exciting applications of optimal nutrition I have seen in my 15 years of practice. But let me make one thing very clear: optimal nutrition is not going to cure anyone from a brain injury. However, in a time of trauma, or even years after the trauma, it only makes sense to feed the brain as optimally as possible. The results will vary from mild to striking improvement in mental function.

Of all of the nutrients needed to optimize brain recovery from physical injury--and there are many--the most important and best studied is acetyl-L-carnitine.

Why Acetyl-L-Carnitine?
Acetyl-L-carnitine is a special form of carnitine that has the particular ability to optimize brain function. Acetyl-L-carnitine is able to cross into the brain more effectively than regular carnitine. It therefore enhances brain cell function much better than regular carnitine. As we age, acetyl-L-carnitine levels in our brains go down and for optimal brain function, supplements of acetyl-L-carnitine become mandatory. Particularly for those over 40, acetyl-L-carnitine is the preferred form of carnitine.

The research on acetyl-L-carnitine shows it to be nothing short of extraordinary. Acetyl-L-carnitine prevents the deterioration of the brain during stress and it helps the aging brain function better. Acetyl-L-carnitine also helps prevent damage that can occur to nerve cells when there is a lack of oxygen in the brain. It is therefore of no surprise that acetyl-L-carnitine is very helpful for stroke victims, who have been found to recover better on 1500 mg of acetyl-L-carnitine per day.

Acetyl-L-carnitine acts in many ways to prevent the deterioration of brain cells that normally happens with age. It does this in many ways. It acts as a powerful antioxidant, provides the brain with healing energy and increases levels of a very important messenger molecule called acetylcholine. It is acetylcholine which becomes deficient in the brains of Alzheimer's patients and that is why these patients have such poor memory function. So by increasing levels of acetylcholine, acetyl-L-carnitine helps the memory work better and may help prevent Alzheimer's as well.

Animal studies have shown that acetyl-L-carnitine can greatly improve the body's ability to recover and repair nerves after physical trauma. Acetyl-L-carnitine is an exciting nutrient for application in any kind of nerve damage because it is a real "Renaissance nutrient" when it comes to healing nerves. The many roles acetyl-L-carnitine plays in promoting nerve healing include:

promoting the growth and health of nerve cells in many ways
accelerating the maturation of nerve cells
protecting nerve cells from free radicals
activating nerve growth factor, an important nerve cell healing compound made by the body
speeding the healing of damaged nerves in peripheral neuropathies
Helping Kim, who was in a car accident
A woman we'll call Kim came to see me a year after a car accident. She had been rear-ended by a teenager looking at his girlfriend instead of the road. She had her head severely jerked forward and then back. A year after the accident she could not remember more than two states out of the union, though she studied a map of the U.S. often. She spoke slowly and haltingly. She was taking a few supplements and wanted to know if a more aggressive nutritional regimen could help--especially since it had already been a year since her accident.

I said maybe, and at the worst it would do no harm except to her pocket book. (These brain supplements are expensive.) She was taking B complex, some vitamin C and an antioxidant formula. A nice start. But with brain damage of any kind, you need to get very aggressive with your nutrition.

The sooner you can optimize nutrition for brain injuries, the better. The goal with such optimized nutrition is twofold: you want to help stop any further damage to the brain that may be progressing since the accident and you want to help encourage the brain to heal. While some nerve cells are lost and may not be repairable, others may be encouraged to function better and pick up the slack. Making the brain cells you have work better can make an enormous difference. Optimizing nutrition for the brain also helps neurons set up new networks that can bypass damaged areas.

You also want to protect the brain from further damage that can be caused by an accident. One study showed that nearly a third of those with Alzheimer's had had a head injury. Head injuries can set off a cascade of events that optimal nutrition can prevent. Wearing bike helmets and headgear during all sports is important for all of us as well. What was remarkable was that Kim responded to the regimen, even though she began it a full year after the accident, when one might think nutrition would no longer have a therapeutic effect--but it did. Here is what I put her on:

Acetyl-L-Carnitine 1,000-2,000 mg
Phosphatidyl Serine 500 mg
NADH 5 mg
CoQ10 100 mg
N-Acetyl-Cysteine 1200 mg
Vicamin C 2,000-5,000 mg
Vicamin E 1,000 IUs
Tocotrienols 100 mg
Magnesium 400 mg
Zinc 15 mg
Selenium 400 mg
Lipoic Acid 100-200 mg
Ocracosanol 20 mg
Milk Thistle Extract 150 mg
Grape Seed Extract 100 mg
Ginkgo Biloba Extract 240 mg
After six months on this regimen, Kim was talking more clearly and her memory was much improved. After a year she sounded better still as she talked to me over the phone and told me of plans she had to open her own business. She also told me that when she stopped the supplements for a month, she found that her brain function and memory were regressing.

Helping Rosa with chronic fatigue
A woman we'll call Rosa is a good friend of mine. She had chronic fatigue since being in a car accident 10 years ago. She is an intelligent woman and would cry a lot because she could not perform well on her job or in life due to her fatigue. She had seen a host of alternative medicine practitioners and with little results.

I was so busy when Rosa called that I could not fit her into my practice. I simply put her on 1000 mg of acetyl-L-carnitine and 300 mg of phosphatidyl serine and asked her to call me if she felt any better. That was on a Wednesday. On Saturday I got a message on my machine that for the first time in years she felt energized. She even said she was sleeping better. For her this was a huge breakthrough.

From the striking results Rosa had, I believe that she was probably deficient in both acetyl-L-carnitine and phosphatidyl serine. This is not surprising, since there are virtually no food sources for these nutrients and since the body has a difficult time making them as we age. I saw Rosa recently at the health food store and she is still doing great: she just finished a huge project at work that she is very proud of.

Helping Tom, who was robbed
Violent crime in America touches many of us and brain injuries are often the result. A man we will call Tom was struck in the back of the head with a tire iron by a man who attempted to rob him. The result was that this once intelligent man could barely remember anything. He had great difficulty getting a job.

Tom was put on 1500 mg of acetyl-L-carnitine and 300 mg of phosphatidyl serine. His improvement was slow but after three months his memory was working better. He was able to get a job and e-mailed me his phone number and address--from memory. For Tom these were huge breakthroughs. He is far from his former self, unfortunately, but thanks to two powerful brain nutrients, he is able to support himself and is doing the best that can be hoped under the circumstances.

The best thing about acetyl-L-carnitine is that it is completely natural. Became of this it is completely non-toxic. And acetyl-L-carnitine, like all natural compounds, works through many pathways to help keep the body well. When the body weakens, it does so at many points, not just at one particular area. That is why acetyl-L-carnitine and the natural medicine of which it is a part is so superior for disease prevention. No drug will ever work as well as acetyl-L-carnitine at slowing brain aging or promoting brain health, because no drug can match its breadth of influence on brain function.

So don't let anyone keep you from progressing because of their limited understanding of how the brain can heal. There are many stories like these and everyone I have ever dealt with who has had a brain injury has found optimal nutrition to be a positive experience. No one has fully recovered because of nutrition but all have been helped. Brain cells always want to heal and have maximal function. Just give them an optimal supply of nutrients and they will show you just how much they want to heal.

The Research on Acetyl-L-Carnitine
Acetyl-L-carnitine maintains our ability to learn and interact positively with others as we age. In other words, it allows us to teach old dogs new tricks and make them happier throughout the process. It probably does this through its overall beneficial effects on brain function. Older adults given acetyl-L-carnitine saw their directional and word memory improve in a matter of weeks. Many studies have confirmed these beneficial effects on memory in older adults and the dose used in the studies is usually 2000 mg (2 g) per day. Even alcoholics with cognitive impairment have benefited from acetyl-L-carnitine.

Acetyl-L-Carnitine Benefits the Entire Body
Acetyl-L-carnitine has been found to be an important nutrient for sperm health. It may also be important for the health of the offspring, because acetyl-L-carnitine protects the valuable genetic material in sperm from free radical damage.

Acetyl-L-carnitine has also been found useful in the treatment of diabetic neuropathy. There is mounting evidence that acetyl-L-carnitine plays a key role in immune defense. This is because immune cells require acetyl-L-carnitine to remain energetic when they defend the body and fight off pathogens. Acetyl-L-carnitine helps our immune cells stay healthy and strong. It has been found useful in the treatment of depression. This again is through its role in helping brain cells communicate more effectively. A social brain--one where nerve cells can communicate effectively--is a happy one. I have found the acetyl-L-carnitine, along with phosphatidyl serine, B complex and EPA/DNA, can virtually eliminate winter depression (seasonal affective disorder), especially when combined with a healthy diet.

Common Questions Asked About Acetyl-L-Carnitine
Q: When should someone start taking acetyl-L-carnitine?

A: As early in adulthood as possible. College age is a good time. While I believe it is an essential supplement for everyone over 40 who wants optimal brain health and longevity, the damage to the brain from stress begins earlier, for many in the college years. So for those who can afford it, I recommend taking acetyl-L-carnitine during stressful times (studying, exam times), throughout one's 20s and 30s, and regularly after age 40. Brain aging starts young. If we are going to slow it down, we have to start optimizing nutrition and lifestyle as soon as possible. Only then can we get the best handle on preventing the loss of brain function later in life.

Q: How much does acetyl-L-carnitine cost?

A: Acetyl-L-carnitine is somewhat expensive and I hope to see prices come down soon so that it will become more affordable. This may be the main limiting factor for many who want to take it. When you compare the cost of a dose of acetyl-L-carnitine (500 mg) to the price of a cup of coffee, however, you realize that it costs less, energizes the brain in a much more beneficial way and has none of the downside of coffee. A lifetime of taking acetyl-L-carnitine will leave you with a much healthier brain and body than a lifetime of caffeine.

Q: Is there anyone who should not take acetyl-L-carnitine?

A: I do not recommend that acetyl-L-carnitine be taken without supervision in someone with epilepsy or someone who is a manic depressive (bipolar). Such people do not always need more energy in their brain cells. However, epileptics taking medications such as Valproate--which induces carnitine deficiency--should take supplemental acetyl or regular L-carnitine at a dose of 500 mg per day.

Q: Are there any side effects to taking acetyl-L-carnitine?

A: One of the side effects of taking acetyl-L-carnitine regularly is more vivid dreams at night. Some enjoy this while others do not. Adjust your dose of acetyl-L-carnitine to correspond with how much you like to dream.

Q: What about older folks who have the beginnings of dementia--how much should they take?

A: They should take 500 mg to 2500 mg of acetyl-L-carnitine per day. Ideally they should also be given vitamin B12 shots and plenty of B vitamins orally--these are all often deficient in those over 60. Phosphatidyl choline, 2000 mg per day, is also very helpful. This is all best done with the guidance of one's healthcare practitioner.

Q: Are there nutrients that help acetyl-L-carnitine work more effectively?

A: Yes, B vitamins, magnesium, phosphatidyl choline and EPA/DHA (fish oils) all increase the effectiveness of acetyl-L-carnitine.

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By Robert Crayhon, M.S.

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