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Senior Member
Midwest USA
I was reading about L-Carnitine again last night and found this article from a newsletter in 2000.

Has anyone ever tried Carnitor - injectable or oral - and had any success over the supplement version?

Has anyone ever tested Carnitine? The lab referenced doesn't seem to be around anymore and the Labcorp test seems to be from serum and not plasma. Would serum measurements work for this purpose or do they have to be plasma?

Is the acylcarnitines panel necessary as well?

Thanks! Ema

FDA OKs injectable form of kidney drug Carnitor®By Patti SchmidtIn December, the Food and Drug Administration (FDA) gave Sigma-Tau Pharmaceuticals approval to market the company’s injectable levocarnitine (Carnitor®) for prevention and treatment of carnitine deficiency in patients with end-stage renal disease. Some people with chronic fatigue and immune dysfunction syndrome (PWCs) also take Carnitor, which is the only prescription drug approved in the U.S. to treat carnitine deficiency.

Three independent research groups have found low levels of serum carnitine in CFS patients as well as abnormalities in carnitine metabolism. In addition, a there is a correlation between higher serum carnitine levels and better functional capacity.

The cause of the carnitine deficiency in CFS patients is not known. It is possible that carnitine may not be absorbed from food in sufficient amounts, or that carnitine synthesis in the liver may be insufficient.

"Carnitine is necessary for carrying fatty acids into the mitochondria of your cells for ATP production," says Justina Lambert, corporate affairs manager for Sigma-Tau. "It is also necessary to remove waste products from the mitochondria." Clincial symptoms of deficiency include abnormalities in the muscles, heart and brain as well as fatigue.

The usual dose of the oral tablets for CFS patients is 990 mgs two or three times per day. With the injectable form, the recommended dose is 50 mg/kg given as a slow 2-3 minute bolus injection or by infusion. The company recommends obtaining a plasma carnitine level before beginning therapy.

Injectable forms of drugs are always more "bioavailable," which means your body is better able to assimilate them. Carnitor’s injectable form is 100% bioavail-able; the oral form is only 5-15% bioavailable in healthy volunteers.

A study done by David S. Millington, PhD, of Duke Univer-sity showed that the L-carnitine available in health food stores may contain less than 60% of the advertised amount. PWCs may want to use the prescription form of the drug, which is covered by most insurance companies.

One note of caution--the Carnitor labeling indicates seizures have been reported in patients without pre-existing seizure activity receiving the drug. In patients with pre-existing seizure activity, an increase in seizure frequency and/or severity has been reported. If you are at risk for seizures, talk to your doctor before starting Carnitor therapy.

Getting tested
Should your insurance company demand it, carnitine testing is available through Neogen. The complete panel costs $50; if you mention The CFIDS Chronicle, Neogen will do the testing for $25. Call Brenda or Bethany at (412) 341-8658.

Neogen will send you a kit, which includes a filter paper that you take to your doctor for processing. Results will be released to your physician.

For further information about Carnitor, visit
www.sigmatau.com. For further information about Neogen, visit www.neogenscreening.com. You can also write to Sigma-Tau Pharmaceuticals at 800 South Frederick Avenue, Suite 300, Gaithersburg, MD 20877, or call 1-800-447-0169.
Some of the most popular carnitine supplement brands use Sigma-Tau's carnitine. I think there's at least two reputable sources that supplement makers can use and Sigma-Tau is one of them. It would say on the package somewhere if so. I can't remember the other one, it might have been BASF or from Japan.