L CARNITINE

L-carnitine is an amino acid (a building block for proteins) that is naturally produced in the body.

L-carnitine supplements are used to increase L-carnitine levels in people whose natural level of L-carnitine is too low because they have a genetic disorder, are taking certain drugs (valproic acid for seizures), or because they are undergoing a medical procedure (hemodialysis for kidney disease) that uses up the body’s L-carnitine. It is also used as a replacement supplement in strict vegetarians, dieters, and low-weight or premature infants.

L-carnitine is used for conditions of the heart and blood vessels including heart-related chest pain, congestive heart failure (CHF), heart complications of a disease called diphtheria, heart attack, leg pain caused by circulation problems (intermittent claudication), and high cholesterol.

Some people use L-carnitine for muscle disorders associated with certain AIDS medications, difficulty fathering a child (male infertility), a brain development disorder called Rett syndrome, anorexia, chronic fatigue syndrome, diabetes, overactive thyroid, attention deficit-hyperactivity disorder (ADHD), leg ulcers, Lyme disease, and to improve athletic performance and endurance.

The body can convert L-carnitine to other amino acids called acetyl-L-carnitine and propionyl-L-carnitine. But, no one knows whether the benefits of carnitines are interchangeable. Until more is known, don’t substitute one form of carnitine for another.

How does it work?

L-carnitine helps the body produce energy. It is important for heart and brain function, muscle movement, and many other body processes.

L-carnitine is LIKELY SAFE for most people when taken by mouth. It is also safe when used as an injection, with the approval of a healthcare provider. It can cause side effects such as nausea, vomiting, stomach upset, heartburn, diarrhea, and seizures. It can also cause the urine, breath, and sweat to have a “fishy” odor.

L-carnitine is POSSIBLY SAFE when used appropriately, short-term in children.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Not enough is known about safety of using L-carnitine during pregnancy. Stay on the safe side and avoid use.

Taking L-carnitine is POSSIBLY SAFE in breast-feeding women when taken in the amounts recommended. Small amounts of L-carnitine have been given to infants in breast milk and formula with no reported side effects. The effects of large amounts taken by a breast-feeding mother are unknown.
Under-active thyroid (hypothyroidism): Taking L-carnitine might make symptoms of hypothyroidism worse.
Seizures: L-carnitine seems to make seizures more likely in people who have had seizures before. If you have had a seizure, don’t use L-carnitine.

Moderate Interaction Be cautious with this combination

• Acenocoumarol (Sintrom) interacts with L-CARNITINEAcenocoumarol (Sintrom) is used to slow blood clotting. L-carnitine might increase the effectiveness of acenocoumarol (Sintrom). Increasing the effectiveness of acenocoumarol (Sintrom) might slow blood clotting too much. The dose of your acenocoumarol (Sintrom) might need to be changed.
• Thyroid hormone interacts with L-CARNITINEL-carnitine seems to decrease how well thyroid hormone works in the body. Taking L-carnitine with thyroid hormone might decrease the effectiveness of the thyroid hormone.
• Warfarin (Coumadin) interacts with L-CARNITINEWarfarin (Coumadin) is used to slow blood clotting. L-carnitine might increase the effects of warfarin (Coumadin) and increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

GLUTATHIONE

Glutathione

"Glutathione is a very interesting, very small molecule that's [produced by the body and] found in every cell," says Gustavo Bounous, MD, director of research and development at Immunotec and a retired professor of surgery at McGill University in Montreal, Canada. "It's the [body's] most important antioxidant because it's within the cell."

Antioxidants -- the most well known of which are vitamins C and E -- are important for good health because they neutralize free radicals, which can build up in cells and cause damage. Because glutathione exists within the cells, it is in a prime position to neutralize free radicals. It also has potentially widespread health benefits because it can be found in all types of cells, including the cells of the immune system, whose job is to fight disease.

Glutathione occurs naturally in many foods, and people who eat well probably have enough in their diets, says Dean Jones, PhD, professor of biochemistry and director of nutritional health sciences at Emory University in Atlanta. Those with diets high in fresh fruits and vegetables and freshly prepared meats are most likely just fine. On the other hand, those with poor diets may get too little. 

What Does Glutathione Do?

The strong antioxidant effect of glutathione helps keep cells running smoothly. Bounous and another glutathione expert, Jeremy Appleton, ND, say it also helps the liver remove chemicals that are foreign to the body, such as drugs and pollutants.

Appleton is chairman of the department of nutrition at the National College of Naturopathic Medicine in Portland, Ore., and senior science editor for Healthnotes, a database on complementary and alternative medicine available at newspaper stands and health food stores.

Evidence for the important role that glutathione plays in health comes from studies in people who are severely ill.

"If you look in a hospital situation at people who have cancer, AIDS, or other very serious disease, almost invariably they are depleted in glutathione," says Appleton. "The reasons for this are not completely understood, but we do know that glutathione is extremely important for maintaining intracellular health." 

How Should Glutathione Be Taken?

Glutathione is probably not well absorbed into the body when taken by mouth. One way to get around that is to take it by vein. A more practical solution is to take the precursors -- that is, the molecules the body needs to make glutathione -- rather than glutathione itself. While there is no solid proof this works, the consensus among experts is that that doing so will increase the amount of glutathione in the cells.

Bounous has developed a glutathione-enhancing product called Immunocal, which is made up of glutathione precursors, mainly the amino acid cysteine.

Who Does Glutathione Help?

Animal and laboratory studies have demonstrated that glutathione has the potential to fight almost any disease, particularly those associated with aging, since free radical damage is the cause of many of the diseases of old age.

"Theoretically, there are many very strong arguments in favor of a therapeutic use of glutathione," says Appleton. "But when people have actually tried to use glutathione as an oral supplement, nasal spray, or intravenously, the results have been more of a preliminary nature. The amount of research on glutathione as a supplement ... is very limited."

Nevertheless, people have tried glutathione for the treatment of a whole host of conditions, including cancer, high blood pressure, Parkinson's disease, Alzheimer's disease, cataracts, and male infertility.

The best studies have been conducted in cancer. One study involved women with ovarian cancer who were being treated with chemotherapy. Some of the women were also treated with intravenous glutathione. Those given the glutathione not only had fewer side effects from the chemotherapy but also had better overall survival rates.

Myriam Abalain of Montreal, Canada, is one of the many people who have taken Bounous's Immunocal to combat cancer. In 1996, at age 33, a routine PAP smear revealed she had precancerous cells on her cervix, which is one step away from having cervical cancer. The three specialists she visited all told her that a hysterectomy was her only option, but she hesitated to have such major, life-altering surgery.

Instead, she waited. For more than two years, her condition remained stable. Then a friend suggested she try Immunocal. After eight months of taking the supplement, her physician could no longer detect any precancerous cells. Does this mean Immunocal cured her? It's hard to say based on just one case like hers. It is possible her body went into remission naturally.

Even Bounous acknowledges there's no real proof his product cured her cancer, but he's working on conducting good clinical research, comparing individuals with cancer taking glutathione to those who are not.

What Are the Risks?

Overall, taking glutathione or its precursors in reasonable amounts appears to be quite safe, although it should be avoided in people with milk protein allergies and in those who have received an organ transplant. There is also some concern, however, about the safety of taking glutathione for the one condition for which there is the greatest evidence of its usefulness: cancer.

"People don't get concerned about these health-promoting [supplements] until they're in their 50s and 60s," says Emory's Dean Jones. At that point, they may already have the initial precancerous [cells]. Therefore, the supplements, just like they promote health in normal tissues, might promote health in the precancerous tissue."

Appleton recognizes this possibility but says "there's no evidence that supplementing with glutathione, even intravenously, is in any way going to make any cancer worse. In fact, the evidence we have suggests the opposite. It suggests that glutathione and other antioxidants, far from interfering with the activity of chemotherapy, appear to reduce side effects without decreasing efficacy and may, in fact, improve the efficacy of the chemotherapy in fighting cancer."

Bounous says his research has demonstrated that taking Immunocal actually lowers glutathione in cancer cells while increasing it in normal cells. As a result, the cancer cells are more vulnerable to chemotherapy, and the normal cells are protected.

The upshot? The experts disagree on who should take glutathione or its precursors. Bounous says everyone should take it in order to optimize overall health. Appleton would reserve it for people with cancer. Jones says it might only prove beneficial for those who eat poorly and are thus unlikely to be getting much glutathione or its precursors in their diet.

They all acknowledge that people with severe diseases known to be associated with low glutathione levels, such as AIDS, may well benefit from the supplement, although there is no proof to this effect.

For her part, Myriam Abalain is still taking Immunocal and feeling fine. "I'm doing pretty good now," she says. "I'm in better shape than ever!"

ALPHA LIPOIC ACID

Alpha lipoic acid is a fatty acid found naturally inside every cell in the body. It's needed by the body to produce the energy for our body's normal functions. Alpha lipoic acid converts glucose (blood sugar) into energy. Other names for it include lipoic acid, thioctic acid, and ALA.

Alpha lipoic acid is also an antioxidant, a substance that neutralizes potentially harmful chemicals called free radicals. What makes alpha lipoic acid unique is that it functions in water and fat, unlike the more common antioxidants vitamin C and vitamin E ,and it appears to be able to recycle antioxidants such as vitamin C and glutathione after they have been used up. Glutathione is an important antioxidant that helps the body eliminate potentially harmful substances. Alpha lipoic acid increases the formation of glutathione.

 Health Benefits of Alpha Lipoic Acid:

1) Peripheral Neuropathy

Peripheral neuropathy can be caused by injury, nutritional deficiencies, chemotherapy or by conditions such as diabetes, Lyme disease, alcoholism, shingles, thyroid disease, and kidney failure. Symptoms can include pain, burning, numbness, tingling, weakness, and itching.

Alpha lipoic acid is thought to work as an antioxidant in both water and fatty tissue, enabling it to enter all parts of the nerve cell and protect it from damage.

Preliminary studies suggest that alpha lipoic acid may help. In one of the largest studies on the use of alpha lipoic acid, 181 people took 600 mg, 1200 mg or 1800 mg of alpha lipoic acid a day or a placebo. After 5 weeks, alpha lipoic acid improved symptoms. The dose that was best tolerated while still providing benefit was 600 mg once daily.

2) Brain Function

Alpha lipoic acid can cross the blood-brain barrier, a wall of tiny vessels and structural cells, and pass easily into the brain. It is thought to protect brain and nerve tissue by preventing free radical damage.

3) Age-Related Conditions

As an antioxidant, alpha lipoic acid can neutralize free radicals which can damage cells. Free radical damage is thought to contribute to aging and chronic illness.

Other Common Uses:

Alpha lipoic acid has also been suggested for cataracts, glaucoma, multiple sclerosis, burning mouth syndrome, Alzheimer's disease and stroke, but large, well-designed studies are needed to see if it's effective for these conditions.

Sources

Alpha lipoic acid is made by the body and can be found in very small amounts in foods such as spinach, broccoli, peas, Brewer's yeast, brussel sprouts, rice bran, and organ meats.

Side Effects

Side effects of alpha lipoic acid may include headache, tingling or a "pins and needles" sensation, skin rash, or muscle cramps.

There have been a few reports in Japan of a rare condition called insulin autoimmune syndrome in people using alpha lipoic acid. The condition causes hypoglycemia and antibodies directed against the body's own insulin without previous insulin therapy.

The safety of alpha lipoic acid in pregnant or nursing women, children, or people with kidney or liver disease is unknown.

Possible Drug Interactions

Alpha lipoic acid may improve blood sugar control, so people with diabetes who are taking medication to lower blood sugar, such as metformin (Glucophage), glyburide (DiaBeta, Glynase), should only take alpha lipoic acid under the supervision of a qualified health professional and have their blood sugar levels carefully monitored.

Animal studies indicate that alpha lipoic acid may alter thyroid hormone levels, so it could theoretically have the same effect in humans. People taking thyroid medications such as levothyroxine should be monitored by their healthcare provider.