In our earlier article we have discussed with the roles of Conenzyne Q10 in energy generation and in protection of Heart or cardiovascular disease. Conenzyne Q10 helps cell powerhouse mitochondria in generating energy from carbohydrates and fatty acids. Conenzyne Q10 not only support the energy generation process like a spark but also additionally acts as a powerful antioxidant in mitochondrial membranes.(1,2)On the other hand L-carnitine a naturally occurring amino acid derivative involves in transporting fatty acid to mitochondria. So do they work in synergy? Does combination of L Carnitine and COQ10 work better for mitochondrial energy and heart health?
Also read Conenzyne Q10 deficiency risk, causes and symptoms.
L-Carnitine and CoQ10 combination for mitochondrial energy and heart health
What is L-Carnitine?
L-Carnitine is a naturally occurring amino acid derivative is found in nearly all cells of the body. The name carnitine is derived from the Latin carnus or flesh. (3)Food sources include animal and milk products.
The main role of L-Carnitine involves as mitochondrial function and energy generation. It helps in transporting fats (long-chained fatty acids) to mitochondria to use as energy.(4) L-Carnitine may help in improving mitochondrial function and thus prevents diseases as well as promote healthy aging.(5)
L-carnitine in heart function and cardiovascular health
Several studies examined the effectiveness of L. Carnitine in management of blood flow including heart tissue. L. Carnitine levels were low in heart failing muscle. L. Carnitine reduces risk of heart attack by counteracting the toxic effect of high levels of free fatty acids and by improving carbohydrate metabolism. (3,6)
L-carnitine in heart function and ability to perform exercise
Study showed people who took L-carnitine after suffering heart attack had significant lower mortality rate than controlled. They found 1.2 percent mortality rate in L-carnitine taker compared to 12.5 percent in the control group. (7) One randomised placebo controlled study on people with heart failure found people taking 2 g of L-carnitine had 3 years higher survival rate than placebo.(8)L-carnitine also improves ability to perform exercise in people with angina or chest pain without pain. (9,10)
L-carnitine as antioxidant defense and improvement of endothelial function
Oxidation of lipid promotes narrowing of blood vessel as well as development of atherosclerosis is recognized as major risk factor of heart disease. Increased oxidative stress is associated with all cardiovascular risk factors. Oxidative stress plays an important role in platelet activation and endothelial or inner line of blood vessel dysfunction.
Study showed Carnitines incubation significantly increased HO-1 as well as endothelial nitric oxide gene and protein expression. As HO-1 and nitric oxide are known as antioxidant, antiproliferative and anti-inflammatory, their increased expression would be expected to protect from oxidative stress. (11) Release of nitric oxide in endothelial or inner line of blood vessel keeps moisten lining of blood vessel which improves health of blood vessels and circulation. And therefore release of nitric oxide improves endothelial function as well as prevent plaque formation or atherosclerosis. Vitro and animal studies as well as some human studies favor the preventive effects of L-carnitine and its derivatives on endothelial dysfunction and platelet aggregation. (12)
In human clinical studies apart from favorable results in lipid profiles L-carnitine supplementation significantly reduced oxidative stress as well as increased antioxidant enzymes activities in people with heart disease.(13,14) L-carnitine also significantly decreased inflammatory response C reactive protein of CRP in meta analysis.(15)
A 2013 meta analysis of controlled trials published in Mayo Clinic Proceedings concluded that L-carnitine reduces 27% in all-cause mortality, a 65% in abnormal heartbeats, and a 40% reduction in chest pain in peoples experiencing an acute heart attack.(16)
L-Carnitine and CoQ10 combination for mitochondrial energy and heart health
Your heart is an organ with most metabolically active tissues that works constantly without any rest for your whole life. That’s why your heart tissues need proper energy as well as other supports. Apart from other roles both Coenzyme Q10 and L-carnitine preserves mitochondrial function as well as involves in mitochondrial energy generation.(17)
In animal study CoenzymeQ10 and L-carnitine supplementation has beneficial effect on cholesterol lowering drug stain induced pancreatic mitochondrial toxicity.(18) Researchers indicates the combination of L- carnitine and Coenzyme Q10 has shown more beneficial effect in mitochondrial disorder than using separately. (19,20) In a Mini Review and Clinical Trial CoQ10, L-Carnitine and other cocktail antioxidants like vitamin C, B, E and zinc and selenium had increased total serum antioxidant status in people with HIV. (21)
In most lifestyle intervention program increasing antioxidant intake seems to improve quality of life. Studies demonstrated being potent antioxidant both CoenzymeQ10 and L-carnitine improves quality of life in people with heart failure, cardiovascular and also kidney disease. Research published in the Journal of Cardiovascular and Thoracic Research indicates that supplementation with coenzyme Q 10 and L-carnitine improved the well-being of patients with heart disease. They found supplementing CoQ10 150 mg/d and L-carnitine 1200 mg/d for three months showed a significant improvement in both physical and emotional quality of life. The researchers suggested that the coenzyme Q 10 and L-carnitine may have positive effect in muscle as well as red blood cells (22, 23)
Apart from that the combination also showed beneficial effects in migraine pain in clinical study. (24)
Related articles to heart health:
Heart disease is multi factorial. So what you should know to prevent heart disease
Foods that lower high cholesterol naturally
Best foods to lower high blood pressure
Arterial calcium deposition is a major risk factor in development of heart disease. Know how crucial vitamin K2 improves your cardiovascular health by preventing calcium deposition in blood vessels and placing calcium in bones.
How coenzyme Q10 helps mitochondrial energy generation as well as improve heart health
Tocotrienols form of vitamin E have very powerful presence in management of cholesterol.
What should you know in choosing right cooking oil for your kitchen
Roles of omega 3 fatty acids for not only for your heart health also for over all health
Role of pantethine metabolically active derivative of vitamin B5 in reducing lip oxidation and management.
Daily dose of coenzyme Q10
Typical dose of CoQ10 ranges 90–200 mg per day depending upon varying health condition. Side effects appears as rare and mild like diarrhea, nausea, and heartburn in some cases. Pregnant, lactating as well as individual under medication should consult with healthcare provider first.
Daily dose of L-Carnitine
Safe daily dose of L-carnitine ranges up to 2 g per day with two to three divided dose. (25) But higher dose may be risky. Similarly pregnant, lactating as well as individual with specific health condition should consult with healthcare provider before application.
Disclaimer: Information provided here are generalized information for educational purpose only, not intended to provide one to one health consultation or replace practice of a qualified practitioner. Different people may have different health condition and may have different reaction to the same food. Hence it has been advised to consult with health care provider before application of any of above guidelines. 1. Lenaz G, Fato R, Castelluccio C, Cavazzoni M, Estornell E, Huertas JF, Pallotti F, Parenti Castelli G, Rauchova H., An updating of the biochemical function of coenzyme Q in mitochondria, Mol Aspects Med. 1994;15 Suppl:s29-36 2. Crane FL., Biochemical functions of coenzyme Q10, J Am Coll Nutr. 2001 Dec;20(6):591-8. 3.https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/ 4.Kent Sahlin,Boosting fat burning with carnitine: an old friend comes out from the shadow, J Physiol. 2011 Apr 1; 589(Pt 7): 1509–1510 5. Geier DA, Geier MR.,L-carnitine exposure and mitochondrial function in human neuronal cells, Neurochem Res. 2013 Nov;38(11):2336-41 6.Ferrari R, Merli E, Cicchitelli G, Mele D, Fucili A, Ceconi C, Therapeutic effects of L-carnitine and propionyl-L-carnitine on cardiovascular diseases: a review, Ann N Y Acad Sci. 2004 Nov;1033:79-91. 7. Davini P, Bigalli A, Lamanna F, Boem A., Controlled study on L-carnitine therapeutic efficacy in post-infarction, Drugs Exp Clin Res. 1992;18(8):355-65 8. Rizos I, Three-year survival of patients with heart failure caused by dilated cardiomyopathy and L-carnitine administration, Am Heart J. 2000 Feb;139(2 Pt 3):S120-3. 9. Cacciatore L, Cerio R, Ciarimboli M, Cocozza M, Coto V, D'Alessandro A, D'Alessandro L, Grattarola G, Imparato L, Lingetti M, et al., The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: a controlled study, Drugs Exp Clin Res. 1991;17(4):225-35 10.G.Louis Bartels,Willem J. Remme, Willem J. Remme, Mike Pillay, Dirk H.W. Schönfeld,Dick A.C.M. Kruijssen,Effects of L-propionylcarnitine on ischemia-induced myocardial dysfunction in men with angina pectoris, American Journal of Cardiology, July 15, 1994, Volume 74, Issue2, Pages 125–130 11.Calò LA, Pagnin E, Davis PA, Semplicini A, Nicolai R, Calvani M, Pessina AC., Antioxidant effect of L-carnitine and its short chain esters: relevance for the protection from oxidative stress related cardiovascular damage, Int J Cardiol. 2006 Feb 8;107(1):54-60 12. Mohammadi M, Hajhossein Talasaz A, Alidoosti M, Preventive effect of l- carnitine and its derivatives on endothelial dysfunction and platelet aggregation, Clin Nutr ESPEN. 2016 Oct;15:1-10. 13. H Mohammadi, M Djalali, M Daneshpazhooh, N M Honarvar, C Chams‐ Davatchi, F Sepandar, Z Fakhri, E Yaghubi, M Zarei & M H Javanbakht,Effects of L-carnitine supplementation on biomarkers of oxidative stress, antioxidant capacity and lipid profile, in patients with pemphigus vulgaris: a randomized, double-blind, placebo-controlled trial, European Journal of Clinical Nutrition volume 72, pages 99–104 (2018) 14.Bor-Jen Lee, Jun-Shuo Lin, Yi-Chin Lin, and Ping-Ting Lin, Effects of L-carnitine supplementation on oxidative stress and antioxidant enzymes activities in patients with coronary artery disease: a randomized, placebo-controlled trial, Nutr J. 2014; 13: 79 15. Yizhi Chen, Manuela Abbate, Li Tang, Guangyan Cai, Zhixiang Gong, Ribao Wei, Jianhui Zhou, Xiangmei Chen, l-Carnitine supplementation for adults with end-stage kidney disease requiring maintenance hemodialysis: a systematic review and meta-analysis, The American Journal of Clinical Nutrition, Volume 99, Issue 2, February 2014, Pages 408–422 16.DiNicolantonio JJ, Lavie CJ, Fares H, Menezes AR, O'Keefe JH., L-carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis, Mayo Clin Proc. 2013 Jun;88(6):544-51 17. Crestanello JA, Doliba NM, Doliba NM, Babsky AM, Niborii K, Osbakken MD, Whitman GJ.,Effect of coenzyme Q10 supplementation on mitochondrial function after myocardial ischemia reperfusion, J Surg Res. 2002 Feb;102(2):221-8 18. Melina Sadighara, Jalal Pourahamad Joktaji, Valiollah Hajhashemi, and Mohsen Minaiyan,Protective effects of coenzyme Q10 and L-carnitine against statin-induced pancreatic mitochondrial toxicity in rats, Res Pharm Sci. 2017 Dec; 12(6): 434–443 19.Bertelli A, Ronca F, Ronca G, Palmieri L, Zucchi R., L-carnitine and coenzyme Q10 protective action against ischaemia and reperfusion of working rat heart, Drugs Exp Clin Res. 1992;18(10):431-6 20.Kalman Filanovsky, Michal Haran, Vita Mirkin, Andrei Braester, Olga Shvetz, Anfisa Stanevsky, Erica Sigler, Ekaterina Votinov, Yehudit Zaltsman-Amir, Atan Gross and Lev Shvidel, Clinical Benefit and Improvement of Mitochondrial Function in Low Risk Myelodysplastic Syndrome Treated By Combination Ultra Coenzyme Q10 and L-Carnitine, Blood 2017 130:1704 21. M Sauka, G Selga, A Skesters, A Silova, T Westermarck, A Latvus and F Atroshi (May 28th 2014). Impact of CoQ10, L-Carnitine and Cocktail Antioxidants on Oxidative Stress Markers in HIV Patients — Mini Review and Clinical Trial, Pharmacology and Nutritional Intervention in the Treatment of Disease, Faik Atroshi, IntechOpen, DOI: 10.5772/58415. Available from: https://www.intechopen.com/books/pharmacology-and-nutritional-intervention- in-the-treatment-of-disease/impact-of-coq10-l-carnitine-and-cocktail- antioxidants-on-oxidative-stress-markers-in-hiv-patients-mi 22.Gholipur-Shahraki T, Feizi A, Mortazavi M, Badri S, Effects of Carnitine on Nutritional Parameters in Patients with Chronic Kidney Disease: An Updated Systematic Review and Meta-Analysis, J Res Pharm Pract. 2018 Apr- Jun;7(2):57-68. 23. Mohammad Hossein Sharifi, Mohammad Hassan Eftekhari, Mohammad Ali Ostovan, and Abbas Rezaianazadeh, Effects of a therapeutic lifestyle change diet and supplementation with Q10 plus L-carnitine on quality of life in patients with myocardial infarction: A randomized clinical trial, J Cardiovasc Thorac Res. 2017; 9(1): 21–28 24.Hajihashemi P, Askari G, Khorvash F, Reza Maracy M, Nourian M, The effects of concurrent Coenzyme Q10, L-carnitine supplementation in migraine prophylaxis: A randomized, placebo-controlled, double-blind trial, Cephalalgia. 2019 Apr;39(5):648-654 25. Bain MA, Milne RW, Evans AM., Disposition and metabolite kinetics of oral L-carnitine in humans, J Clin Pharmacol. 2006 Oct;46(10):1163-70
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