Why L-Carnitine?

doc_ahof_group4_cropped_small_145By Duane Graveline MD, MPH

Statins and Mitochondrial Damage Part 7 of 11
Although CoQ10 usually gets top billing as the key player in mtochondrial energy production, it should interest you to learn that some 70% of mitochondrial energy is derived from the metabolism of fatty acids and therefore completely dependent upon L-carnitine (31). 

While you may think that you eat to satisfy your hunger, in reality you eat to fuel up the energy needs of your body.  Most of us think that a bit of glucose and a whiff of oxygen is all there is to it. We seem to recall primarily that oxygen and glucose are the key ingredients but that is only a small part of the story.

The truth is that 70% of our fuel comes from the degradation of fats, not glucose.  Three different mechanisms work together to make energy: the glycolytic pathway that converts glucose (or glycogen) into pyruvate, the Krebs cycle of Beta oxidation and the electron transport process, known as oxidative phosphorylation.  Fatty acids are the preferred food for these last two processes. 

Fatty acids are metabolized in our mitochondria and whereas glycolysis contributes 30% to our energy equation, beta oxidation and electron transport contributes the remaining 70% and all of this is dependent upon L-carnitine. 

L-carnitine is our only carrier for fat metabolism and without L-carnitine all energy potentially derived from fat would be lost.  Many people are born with a defect in L-carnitine synthesis and suffer varying forms of energy deficiency ranging in severity from occasional muscle pain with exercise (excessive build-up of lactic acid) to a very early demise from energy failure.

Georgirenne Vladutiu PhD of the Genetics Laboratory in Buffalo reports a very high incidence of disease and carrier state for this condition especially with the widespread use of statin drugs, which unmasks this often silent condition.

Coenzyme Q10 works closely with L-carnitine in the process of moving energy substrates into the mitochondria.  CoA binds with fatty acids and pyruvate to make them more reactive and lines these molecules up for transfer across the inner mitochondrial membrane.  Only L-carnitine can make the actual transfer across the membrane, as it is normally impermeable. 

These final metabolic products that CoA makes ready for L-carnitine transfer are called acyl-CoAs.  CoQ10 provides the spark to these acyl groups but it is L-carnitine that brings them across the inner membrane in bulk for final "burning".  As we progress through this discussion it will become easier to anticipate which supplements are "ripe" for inclusion into our mitochondrial maintenance recipe.

31. Lang T and others. EMBO J.: 2202-2213, 2001

Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor

11. Statins and Mitochondrial Damage - Conclusion
Updated September 2013

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