Evidence supporting the use of: Acetyl L-carnitine
For the health condition: Wasting

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Acetyl L-carnitine (ALCAR) is an acetylated form of L-carnitine, a compound involved in mitochondrial energy metabolism. Its use in the context of wasting—which generally refers to the loss of muscle and fat mass, as seen in conditions like cancer cachexia, HIV/AIDS, or chronic illness—has some scientific basis, though the evidence is not robust or universally accepted. Several small clinical trials and animal studies have explored ALCAR as a supportive therapy for wasting syndromes.

The rationale for its use is that L-carnitine plays a crucial role in the transport of long-chain fatty acids into mitochondria for energy production. In various wasting conditions, carnitine deficiency has been observed, which might contribute to fatigue, muscle weakness, and loss of lean body mass. Some studies, particularly in HIV/AIDS patients and those with cancer-related cachexia, have shown that carnitine supplementation (including ALCAR) may improve fatigue, appetite, and sometimes even lean body mass.

However, the overall quality of evidence is limited by small sample sizes, heterogeneity in patient populations, and inconsistent results. Meta-analyses generally conclude that while there is a potential benefit, larger and more rigorous studies are needed to make firm recommendations. Therefore, the use of ALCAR for wasting is supported by some scientific data, but the strength of evidence is modest (rated 2/5).

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