Improved endothelial function.:Chronic Fatigue syndrome-mitochondrial
dysfunction & Role of L – Carnitine
in our body - beta
oxidation -?
L- Carnitine is a naturally occurring fatty acid transporter that transports fatty acids into the mitochondrial matrix
for beta oxidation . It also helps in the removal of excess
acyl groups from the
body and in the modulation of intracellular coenzyme A homeostasis.
At the tissue
level 95% of L carnitine is stored in the heart and the skeletal muscles . L carnitine content is
about 70 fold higher in the
muscles than its blood plasma stores . L carnitine accumulates in
the muscles and hence
its supplementation is proposed to play a crucial role in
individuals who need muscle health.
Evidence suggests the presence of mitochondrial
dysfunction in patients with
chronic fatigue syndrome . The level
of carnitine required for some
metabolic reactions in the
mitochondria is decreased in
patients with CFS. Previous studies
have correlated the levels of carnitine with functional capacity. Mitochondrial
membranes are impermeable to CoA esters
and long chain fatty acids. L-
Carnitine shuttles long chain fatty acids inside the mitochondria and transports the complex of long chain acetylcarnitine ester into
the mitochondrial matrix where the fatty acids are broken down
through th process of beta
oxidation to generate energy in the form
of ATP .
How does L carnitine help recover from muscle
injury after exercise ?
L- carnitine
is known to alleviate muscle injury and attenuate muscle
soreness by reducing :
· Markers of cellular damage
· Free
radical formation
Muscle
injury frequently occurs during or immediately after exercise.
Exercise induced muscle damage
and pain not only reduce
the quality of life but also limit
further training activity. L- carnitine helps
with recovery after exercise.
Supplementation
with L- carnitine increases its
content in the serum and muscles. This improves
the blood flow and oxygen supply to the muscle tissues through improved endothelial
function.
Favorable effects of L- carnitine include
a reduction in exercise induced
hypoxia as well as subsequent
muscle damage and delayed onset muscle
soreness. Furthermore it is effective in lowering tissue disruption
an post exercise leakage of
cytosolic proteins.
Biosynthesis
of L- carnitine accounts for 25% of the daily needs and hence either
dietary or nutritional
supplementation of L Carnitine is required.
What is the
role of carnitine derivatives in chronic fatigue syndrome. ?
Patients with CFS have decreased levels of acylcarnitine and reduced
muscle function.
Carnitine
improves energetic metabolism in the
myocardial and musculoskeletal
tissues thereby reducing the presence
and severity of physical
fatigue in patients with CFS.
In the
management of patients with CFS
supplementation with carnitine
improves its levels and ultimately ensures the following
· Maintenance of key proteins and lipids within the mitochondria at adequate levels
· Proper membrane
orientation
· Maximum energy production
In a
preliminary open label study in 150 patients with CFS , 6 month treatment with oral k L0 carnitine resulted in a marked improvement in 69%
of the patients .
Plioplys et
al conducted a study of crossover design in 30 patients with CFS to compare the efficacy of L- carnitine
ans amantadine. Each patient received
both medicines alternately for 2 months with a 2 weeks washout period between the treatment regimens
Amantadine was poorly tolerated by the patients with CFS. No
statistically significant clinical
difference in any clinical parameter
was observed.
In contrast
, 8 week treatment with L- carnitine led
to a statistically significant
clinical improvement in 12 of the 18 studied parameters . The most considerable improvement was
observed between 4 and 8
weeks of L- carnitine treatment .
In
patients with CFS, L- carnitine
supplementation ;
· Effectively treats lethargy and fatigue
· Improves symptoms
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