Acetyl-L-Carnitine and Peripheral Neuropathy

One of the most studied nutritional supplements for managing peripheral neuropathy is acetyl-l-carnitine (ALC).

And at the risk of telling you the end of the story first, most of the studies have shown it to be of value, at least in a portion of neuropathy sufferers. More about this later.

First, A Little Background…
Carnitine is an amino acid, and like all amino acids is a building block of protein. All amino acids have an ammonia molecule at one end of a chain of varying number of carbon and oxygen and hydrogen atoms.

When amino acids form, they can be develop in 2 different ways, each one a mirror image of the other. One of these is called the D-amino acid and the other is the L-amino acid (the “D” stands for dextero, which is Latin for “right” and the “L” for “levo”, Latin for “left”)

This turns out to be important. Think of each one being like one of your hands. Well, just as your right hand can’t fit into a left handed glove, the D-amino acid can’t easily fit into receptors built for L-amino acids.
Our bodies predominantly are set up to work with L-amino acids and have a harder time dealing with D-amino acids.

Okay so why is this important? Well, when amino acids are manufactured for supplements, both forms are made. Cheaper manufacturers may not bother to separate out the relatively active L-amino acids from the relatively inactive D- forms. So you could be purchasing a supplement that says it has 500 mg of an amino acid, when in reality it only has 250mg of the active form.

This means you may not get the benefit you’re looking for, and worse, you could tell other people who may otherwise be helped by that amino acid that it doesn’t work.

Back to Acetyl-L-carnitine.
ALC is an activated form of carnitine that has been shown to be protective of the energy production centers of the cells.

As I mentioned above, ALC has been shown to be helpful in at least some types of neuropathies, most notably diabetic and chemotherapy drug-induced neuropathies that are of relatively recent origin and are primarily characterized by pain.

Now this doesn’t mean that painless, longstanding neuropathy can’t be helped by ALC, but the studies to date have only lasted at most a year and it may be that nerve repair in longstanding conditions simply takes longer. Nonetheless, at the very least, if you do decide to try this and you don’t have neuropathy less than 5 years old and is painful, temper your expectations.

The general recommendations based on a recent study (Diabetes Care, Vol 28(1), January 2005) of over 1000 patients is 1000mg of ALC taken 3 times a day.

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You can buy ALC at your local market or pharmacy or online, where you can generally find better prices. You can buy it by itself, but it also is commonly combined with alpha-lipoic acid, another nutrient that has shown some promise in helping neuropathic pain.

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