Acetyl L-Carnitine

[slowandsteady]

You mean it might be the magnesium that is responsible for your improvement rather than the new form of carnitine?

Yep. I'm still a bit amazed by how many features of Peyronies Disease can be explained by magnesium deficiency, as I wrote here.

[Fred22]

S&S,

In what way did it "soothe" your symptoms?  Could you be more specific?  Thanks.

Fred

Just less discomfort during the day. Now that I think about it I have also started taking 800 mg/day in magnesium glycinate lately, which could have been confounding things.

You mean it might be the magnesium that is responsible for your improvement rather than the new form of carnitine?

[slowandsteady]

S&S,

In what way did it "soothe" your symptoms?  Could you be more specific?  Thanks.

Fred

Just less discomfort during the day. Now that I think about it I have also started taking 800 mg/day in magnesium glycinate lately, which could have been confounding things.

[Fred22]

There are other forms of carnitine besides acetyl-l-carnitine. One of the is carnitine fumarate. I've been on ALC for years without any great impact on my Peyronies Disease. After a couple of days at 1g/2x daily, I'm finding carnitine fumarate seems to sooth Peyronies Disease symptoms for me more than ALC. I'm gong to give it a try for a few weeks and see if there is anything noteworthy.

S&S,

In what way did it "soothe" your symptoms?  Could you be more specific?  Thanks.

Fred

[Fred22]

There are other forms of carnitine besides acetyl-l-carnitine. One of the is carnitine fumarate. I've been on ALC for years without any great impact on my Peyronies Disease. After a couple of days at 1g/2x daily, I'm finding carnitine fumarate seems to sooth Peyronies Disease symptoms for me more than ALC. I'm gong to give it a try for a few weeks and see if there is anything noteworthy.

Please disregard this post. I got your answer by PM. Thanks

Fred

[George999]

There are other forms of carnitine besides acetyl-l-carnitine. One of the is carnitine fumarate. I've been on ALC for years without any great impact on my Peyronies Disease. After a couple of days at 1g/2x daily, I'm finding carnitine fumarate seems to sooth Peyronies Disease symptoms for me more than ALC. I'm gong to give it a try for a few weeks and see if there is anything noteworthy.

Very interesting!  Keep us updated on this please.  - George

[slowandsteady]

There are other forms of carnitine besides acetyl-l-carnitine. One of the is carnitine fumarate. I've been on ALC for years without any great impact on my Peyronies Disease. After a couple of days at 1g/2x daily, I'm finding carnitine fumarate seems to sooth Peyronies Disease symptoms for me more than ALC. I'm gong to give it a try for a few weeks and see if there is anything noteworthy.

[BrooksBro]

Taking ALC has not produced these for me. 

When I first started on 50 mg topical testosterone, and oral quecertin, I remembered dreaming (a rare event for me).  I stopped taking the querecetin because it seemed to increase BPH.  Since then, a one-time trial of a double dose of testosterone resulted in dreams, and I even slept until my alarm went off.  My new prescription is for 100 mg per day, starting today.  I am curious to see if the dreams return. 

[ohno]

I have never remembered my dreams upon waking till I started with my whole regimen of peyronie's supplements. I'm sure all dreams are weird but now I remember them. Really strange stuff.

[Fred22]

Has anyone taking ALCAR noticed an increase in very vivid dreams?  I have had weird dreams since starting the ALCAR, but could just be a coincidence.

Fred

[Fred22]

Sounds like a good plan.  Please keep posting results and so will I. 

Fred

[BrooksBro]

With the recent suggestions, I am now trying ALC 1g twice daily.  First with my morning coffee, about 1 hour before breakfast.  Again in mid-afternoon, about 2-hours after lunch. 

This article was one of my sources:
http://www.lef.org/magazine/mag2005/oct2005_cover_arteries_02.htm

PLC and Male Sexual Dysfunction
In a study of male sexual dysfunction, testosterone supplementation was compared to supplementation with a combination of oral PLC and acetyl-L-carnitine. Both the carnitine combination and testosterone improved the following penile functions: peak systolic velocity, end-diastolic velocity, resistive index, nocturnal penile tumescence, and the International Index of Erectile Function score.

The combination of 2 grams each of PLC and acetyl-L-carnitine daily was more effective than testosterone at improving nocturnal penile tumescence and the International Index of Erectile Function score, an important measure of erectile and sexual function. PLC and acetyl-L-carnitine thus appear to be safe, effective agents for managing male sexual dysfunction.

Here is the study it references, comparing 2 g PLC plus 2 g ALC daily to testosterone, and a placebo control group:
http://www.ncbi.nlm.nih.gov/pubmed/15072869

RESULTS: Testosterone and carnitines significantly improved the peak systolic velocity, end-diastolic velocity, resistive index, nocturnal penile tumescence, International Index of Erectile Function score, Depression Melancholia Scale score, and fatigue scale score. Carnitines proved significantly more active than testosterone in improving nocturnal penile tumescence and International Index of Erectile Function score. Testosterone significantly increased the prostate volume and free and total testosterone levels and significantly lowered serum luteinizing hormone; carnitines did not. No drug significantly modified prostate-specific antigen or prolactin.


I cannot find the reference that encouraged me to take 2 g ALC and 800 mg ALA daily.  I just started with NSI brand ALA (200 mg) and ALC (500 mg) tablets.  It was the only tablet I found in the 500mg & 200mg ratio. 

I am unsure which supplement is the cause (I also resumed 250 mg slow release niacin 4x daily this week), but my heart rate was lower than normal during my Saturday morning run.  At my usual running pace on a common route, my heart rate was about 5% lower.  I will be happy if that is repeatable.

Otherwise, I have yet to notice any other effects, good or bad, from taking these supplements.

Although I cannot quantify it, this week I observed what I believe is some slight softening of my plaque.  Even lightly squeezing it in one direction used to result in pain, and now it does not.  That is encouraging.  I cannot yet tell if there is any observable reduction in curvature.





 

[Fred22]

I'm confused regarding the recommended dosage.  The study involving 48 men conducted at Swedish Medical Center says the dosage was 1g per day.  However, in another article which cites this study it stated that the dosage was 1g 2x per day.  This was the study which compared tomoxifen with ALCAR.  There is also an Italian study comparing ALCAR and tamoxifen in which the dosage was said to be 2g per day.  I've been taking 2, but if 1g is as effective then I prefer taking the smaller dose.  George says 2g is common but I just read Panic's post below and he says 4 to 6g per day. If I'm going to take this stuff I want to take it in the recommended amounts and at the proper time of day (between meals or with).  Does anyone have definitive info on this?  From what I've read the consensus seems to be 1g 2x per day between meals (I just checked with my pharmacist and she says "between meals" or "on an empty stomach" means 2 hours after a meal). BTW, where is everybody??

Fred

[Fred22]

I took the whole 2 grams about 1-hour before breakfast this morning.  By noon, my urine weakly smelled like after eating asparagus, and it was brighter yellow than normal.  When I am awake, I eat a small meal about every 3-hours, so the only time my stomach is empty is upon waking.

Most sources say to take in divided doses.  I wonder if it's just as effective to take the whole 2g at once.  I've been Googling "how long after meals is stomach empty" and although there are various opinions (as always on the internet) the general consensus is between 2 and 3 hours.  One dr. said if a med indicates to take on an empty stomach, 2 hours after a meal is fine.  I suppose that would depend on the size of the meal and what you had.  For example, a steak would take more time to digest that a bowl of cereal with fruit.  I finished breakfast today about 7:50 and plan to take my first dose ALC at 10:30, then lunch at 12 (finish about 12:30) and 2nd dose of ALC at 3 or 4.  I've read some articles that recommend not taking it after 3 PM as it could interfere with sleep, but I haven't noticed any stimulating effect.  I took my last dose a 3 PM yesterday, went to bed about 9:30 and slept pretty normally for me.  However, I do take Remeron, an antidepressant which has a sedative effect and 5 mg valium 30 min. to an hour before bedtime.  If anyone else has information regarding correct dosing method of ALC please post.

Fred

[BrooksBro]

I took the whole 2 grams about 1-hour before breakfast this morning.  By noon, my urine weakly smelled like after eating asparagus, and it was brighter yellow than normal.  When I am awake, I eat a small meal about every 3-hours, so the only time my stomach is empty is upon waking.

[Fred22]

OK...What are the obvious advantages of taking a supplement on an empty stomach? 

It's usually one of two things. In the case of some amino acids that compete against one another for absorption (like large neutral amino acids), you don't want your target amino being out-competed by other amino acids in food.

The other is when it is desirable to get a high peak plasma level of an item, which is best achieved on an empty stomach. When taken with food, the plasma curve over time is generally lower and more spread out. I'm guessing that this second case applies to ALC.

In "Kinetics, Pharmacokinetics, and Regulation of l-Carnitine and Acetyl-l-carnitine Metabolism" (link),

At normal circulating l-carnitine concentrations, renal l-carnitine reabsorption is highly efficient (90-99% of filtered load; clearance, 1-3 mL/min), but displays saturation kinetics. Thus, as circulating l-carnitine concentration increases (as after high-dose intravenous or oral administration of l-carnitine), efficiency of reabsorption decreases and clearance increases, resulting in rapid decline of circulating l-carnitine concentration to baseline. Elimination kinetics for acetyl-l-carnitine are similar to those for l-carnitine.

The fact that ALC is so rapidly cleared implies that a brief high peak plasma level is needed for best effect.

The Peyronies Disease study with ALC used 1g/2x daily. Its possible that taking a gram (or two, depending on body mass) dose more than twice a day spread out over time.

s&s

Is 2 to 2 1/2 hours after a meal enough time?

[slowandsteady]

OK...What are the obvious advantages of taking a supplement on an empty stomach? 

It's usually one of two things. In the case of some amino acids that compete against one another for absorption (like large neutral amino acids), you don't want your target amino being out-competed by other amino acids in food.

The other is when it is desirable to get a high peak plasma level of an item, which is best achieved on an empty stomach. When taken with food, the plasma curve over time is generally lower and more spread out. I'm guessing that this second case applies to ALC.

In "Kinetics, Pharmacokinetics, and Regulation of l-Carnitine and Acetyl-l-carnitine Metabolism" (link),

At normal circulating l-carnitine concentrations, renal l-carnitine reabsorption is highly efficient (90-99% of filtered load; clearance, 1-3 mL/min), but displays saturation kinetics. Thus, as circulating l-carnitine concentration increases (as after high-dose intravenous or oral administration of l-carnitine), efficiency of reabsorption decreases and clearance increases, resulting in rapid decline of circulating l-carnitine concentration to baseline. Elimination kinetics for acetyl-l-carnitine are similar to those for l-carnitine.

The fact that ALC is so rapidly cleared implies that a brief high peak plasma level is needed for best effect.

The Peyronies Disease study with ALC used 1g/2x daily. Its possible that taking a gram (or two, depending on body mass) dose more than twice a day spread out over time.

s&s

[Fred22]

S&S- Are you saying that taking with food is ineffective.  Mine says to take "preferably with a meal".

I don't know if I'd go that far. If you google "acetyl-l-carnitine empty stomach", you'll see lots of results recommending this kind of dosing. Maybe everyone is quoting everyone else.

OK...What are the obvious advantages of taking a supplement on an empty stomach?  I skipped my ALC at breakfast (7:30) and I'm getting ready to take one now (10 AM).  We'll see if I have ill effects (nausea, etc.)

Fred

[BrooksBro]

One recommendation I read was to take it 2 minutes before waking.  No doubt tongue in cheek.

[slowandsteady]

S&S- Are you saying that taking with food is ineffective.  Mine says to take "preferably with a meal".

I don't know if I'd go that far. If you google "acetyl-l-carnitine empty stomach", you'll see lots of results recommending this kind of dosing. Maybe everyone is quoting everyone else.

[Fred22]

Hey Fred22. Acetyl-l-carnitine is water soluble. I've heard consistently that it should be taken on an empty stomach. It is stimulating, so taking it upon waking is a good idea. PMID 11446848 used 1 g twice daily, and reported that

Acetyl-L-carnitine reduced penile curvature significantly, while tamoxifen did not; both drugs significantly reduced plaque size.

What I like about the 2g dosage is that it appears to be a good bet for general health as well, so I don't see any downsides.

s&s

S&S- Are you saying that taking with food is ineffective.  Mine says to take "preferably with a meal".

[slowandsteady]

Hey Fred22. Acetyl-l-carnitine is water soluble. I've heard consistently that it should be taken on an empty stomach. It is stimulating, so taking it upon waking is a good idea. PMID 11446848 used 1 g twice daily, and reported that

Acetyl-L-carnitine reduced penile curvature significantly, while tamoxifen did not; both drugs significantly reduced plaque size.

What I like about the 2g dosage is that it appears to be a good bet for general health as well, so I don't see any downsides.

s&s

[Fred22]

Just got mine from Puritan's Pride and the bottle recommends 1g per day preferably with meals.  However, most of the articles, etc. I've read online recommends 2g per day for Peyronie's.  One source said to take with a meal which contains "good" fats (omega 3).  It's also recommended to not take it too late in the day as some people have insomnia as a side effect.  So I'm taking 1 with breakfast along with my 1200 mg fish oil (the good fat), Vit. E and D3, then another with lunch along with another cap of fish oil.  I've been taking it for 3 days now and no nausea or other side effects.
Fred

[panic]

I take about 2g twice per day. I remember reading somewhere that the recommended dose is 4-6g per day. I also remember reading that it should be taken on an empty stomach. I also remember reading that if the dose is increased past a certain point, it can actually increase TGFbeta levels...

But I don't actually remember where I read these things, or who wrote them, so I could be terribly wrong.

[Fred22]

Is it ok to take ALCAR with food?

Fred

[George999]

S&S,  That is a really good link and a good discussion of the whole issue.  The whole Lipoic Acid scene is just so complex.  A lot of the lower tier vendors buy their LA from cheapo Chinese vendors and who knows what kind of contaminants they contain or what their true potency is.  The whole supplement industry is largely unregulated.  That is why it is a good idea for anyone using supplements to be a member of an organization like Consumer Labs so that they have access to independent testing.  Also, by going through these independent tests line by line, one quickly figures out who are the vendors who are dependable and who are the ones who are unreliable in terms of delivering a quality product.  There are brands that I just won't touch for that reason.  Their products are loaded with contaminants and contain less than the listed amount of active ingredients.

[slowandsteady]

@alexk: you might want to give this post a read.

[George999]

I would suggest that anyone afraid of supplement side effects simply not take supplements.  ALL supplements have side effects.  It has been demonstrated in recent research that Vitamin C can cause stomach cancer.  Fish oil is loaded with all sorts of noxious contaminants and yet studies have repeatedly shown that people who take fish oil benefit from it.  Everything assumes common sense.  Anyone concerned about the ALA/Biotin issue can just take some biotin along with the ALA.  In fact a lot of good quality ALA supplements include biotin.  I take lots of both, so I'm not the least bit worried about it.  I have also had all of my nutrient levels profiled via a blood test.  The reality is that the benefits of ALA far outweigh the risks.

[alexk]

And just what would THOSE unknowns be about?  As with ALCAR, everything I have ever read about ALA has been positive.

Lipoic Acid Reduces the Activities of Biotin-Dependent Carboxylases in Rat Liver
http://jn.nutrition.org/cgi/content/abstract/127/9/1776

http://www.jarrow.com/productProfile.php?newsId=8
"Anyone likely to be severely biotin-deficient should take supplemental biotin if alpha lipoic acid is used regularly. Since biotin and alpha lipoic acid are chemically similar and are transported into cells by the same mechanism, elevated dietary alpha lipoic acid can interfere with biotin absorption. Additionally, alpha lipoic acid may decrease the efficacy of biotin’s role in the function of certain enzymes."

Too much ALA will basically reduce or block the function of biotin, or vitamin B7, which plays important roles in cell growth, tissue regeneration, blood sugar control, the breakdown of protein into individual amino acids, and many other life-sustaining functions. Not something you want to mess around with unless you know your biotin status.

[Nemo]

ALCAR is just an abbreviation for Acetyl L Carnitine (ALC), and ALA is Alpha Lipoic Acid. 

[Fred22]

I guess I missed something in this discussion.  I know what ALC is, but what's ALCAR and ALA?

Fred

[slowandsteady]

And just what would THOSE unknowns be about?  As with ALCAR, everything I have ever read about ALA has been positive.  - George

I think I may have been a bit scared off by it earlier by the study discussed on this thread, but after reading more about it I'm less worried.

[George999]

My take is that it is better not to take so much ALCAR that oxidative stress is induced such that you need LA to deal with it, particularly in light of the unknowns surrounding lipoic acid.

And just what would THOSE unknowns be about?  As with ALCAR, everything I have ever read about ALA has been positive.  - George

[slowandsteady]

If you find ANYTHING that specifically states that ALC CAUSES oxidative stress, please, please, post the link. OK?  - George

It seems to be dose dependent. See this post, which links a PDF of an Ames lecture. Apparently the 1.5% (in water) acetyl-l-carnitine corresponds to 12 grams in a human, a huge amount.

It appears that the full text of the Ames study is online.

In that paper, we read:

For rats fed 1.5% (wt/vol) ALCAR, ascorbate levels in hepatocytes from both young and old rats were significantly lower than corresponding controls (not shown). Cosupplementation of LA with ALCAR negated both the age-related and ALCAR-induced decline in hepatocellular ascorbate concentrations.

and further on:

Thus, the combination of ALCAR with LA not only reverses the age-related increase in oxidants, but also the additional oxidants induced by high doses of ALCAR. These results suggest that ALCAR+LA supplementation not only improves metabolic rate and physiological activity, but does so without causing a concomitant increase in oxidants.

So increased oxidation due to ALCAR was reversed by LA (lipoic acid, and in particular R-alpha lipoic acid). My take is that it is better not to take so much ALCAR that oxidative stress is induced such that you need LA to deal with it, particularly in light of the unknowns surrounding lipoic acid.

I'm in my mid forties, and I take a gram of ALCAR when I wake up. I love the energy and mood boost.

s&s

Edit: the discussion section of the study is a nice read.

[Nemo]

George, that's what I found too. 

Nemo

[George999]

Despise,  Everything I am seeing on a quick glance is indicating that ALC actually protects against oxidative stress AND that when combined with ALA that effect is enhanced.  If you find ANYTHING that specifically states that ALC CAUSES oxidative stress, please, please, post the link. OK?  - George

[despise]

I've never heard that about ALC causing oxidative stress.  Having the skin/auto-immune disease vitiligo, that would be a bad thing.  Can you turn me onto where you read that?

Nemo

I can't find the exact website, but it is all over the net-just google it and You will find a lot of research on it.

[slowandsteady]

What is the recommended dosage for peyronies sufferers? I'm guessing that people here take more of it than normally is usual, but I was reading that it should be taken with Alpha Lipoic Acid to not cause increase of oxidative stress.

The latest thought on that at imminst.org is that it's not needed if the dose of ALCAR isn't that high. There is also some concern that ALA permanently might inhibit the benefits of caloric restriction on life extension.

[Nemo]

I've never heard that about ALC causing oxidative stress.  Having the skin/auto-immune disease vitiligo, that would be a bad thing.  Can you turn me onto where you read that?

Nemo

[George999]

2 Grams is common.

[despise]

What is the recommended dosage for peyronies sufferers? I'm guessing that people here take more of it than normally is usual, but I was reading that it should be taken with Alpha Lipoic Acid to not cause increase of oxidative stress.