Do Vegans Need Carnitine?

at a glance

– Carnitine helps us use fat as a fuel, and is therefore involved in many systems in the body

– Recent studies indicate vegans can have 40% less carnitine¹ than omnivores as it is only found in animal products.

– Studies show Acetyl-L-Carnitine supplements have neurological benefits², where as L-Carnitine supplements have more effects on physical fitness.³

What does carnitine do and do vegans get enough

Carnitine plays a key role in bringing long chain fatty acids into mitochondria, where they can then be used as fuel. Dietary sources are only found in animal products, however it can be made in the body.

Omnivores obtain about 75% of their carnitine from their diet. Vegans adapt by excreting less carnitine, and producing more internally, however recent studies have indicated they can have significantly less free carnitine in the plasma; around 40% reductions where shown in this study¹ below, with over half vegans having levels indicative of ”hypocarnitinemia” – not enough carnitine for optimal health.

In rare cases, genetic differences mean some people cannot synthesise carnitine at all in their body and will get extremely ill on a vegan diet without supplementation.⁴

What are the benefits of Carnitine Supplementation

Carnitine has been studied for over 100 years, and there is an extensive list of potential benefits you can read about on an impartial site like examine.com. The Acetly-L-Carnitine variety has more neurological effects, ranging from increased attention², protection from alcoholism⁵, and reductions of symptoms of Autism⁶.

L-Carnitine tends to have more physical benefits like enhanced anaerobic exercise^3,7, antioxidant properties⁸, enhanced sperm motility and erectile function⁹, increased nitric oxide, increases in lean mass and fat reduction (at least in eldery populations). Improved blood flow, reduced blood pressure, and reductions in fatigue.¹⁰

Athletes recorded higher peak sprint performance (measured on a bicycle), lower levels of lactic acid build up, and higher levels of IGF-BP3 which enhances skeletal muscle growth and reduces muscular damage. ^3,7

Now to be clear, most of non exercise related benefits where seen in people with some impediment or reduced carnitine levels. But as some studies suggest vegans have a lower level of carnitine than the standard population, supplementation could be wise, especially for very active vegans as exercise can diminish carnitine levels, and carnitine helps us recover from muscle damage during exercise.

The TMAO debate

There is some controversy around carnitine which lies in the fact that it can be converted into a compound called TMAO in the gut, which is correlated with atherosclerosis. Which is strange as meta-analysis have shown carnitine is effective in treating heart disease.¹¹

However, there is a lot of controversy around TMAO toxicity. Many of the big papers including the often cited (Koeth et al, 2013) paper, and (Ling Ding et al, 2018), reported experimenters fed their mice amounts of TMAO or precursors that are 100x or more than what would be given in a supplement. Koeth et al stated they fed their mice a 1.3% carnitine diet, (Steak is 0.01% carnitine), and Ling Ding et al stated they fed mice 2.6g/kg compared to a human supplemental dose of carnitine, around 0.007g/kg, of which maybe only a fraction would be converted in TMAO.

Infact, recent studies suggest a chronic low dose of TMAO may actually be heart protective.¹²

Other studies have now shown high levels of TMAO are associated with high levels of creatinine, low levels of HDL, type 2 diabetes and kidney disease¹³. People with kidney disease are more likely to have issues with atherosclerosis, and this may explain why people with high levels of TMAO are more likely to have atherosclerosis. Some argue that it is not the TMAO itself, it is just a marker of another condition. And this point is relevant as TMAO is excreted by the kidneys, and so damaged kidneys cannot excrete TMAO effectively. The question remains could the TMAO be damaging the kidneys in the first place or is it just a sign of kidney damage.

One interesting point to note is that fish has high TMAO levels, but fish consumption tends to be thought of as heart protective in humans. Studies in mice, however, have shown that adding fish to their diet does increased atherosclerosis in mice¹⁴ although other factors could be at play as fish is not a regular part of the murine diet.

Another interesting point from the (Koeth et al, 2013) paper, they found that vegans did not convert carnitine into TMAO, and they realised that the breakdown of carnitine to TMAO was mediated by gut bacteria that vegans didnt have. However long term carnitine supplementation could change that.

How TMAO production can be attenuated

With all this information out there, many vegans have chosen not to supplement carnitine for fear of the TMAO factor, despite all the possible benefits and risks of carnitine deficiency. There is good news however. Resveratrol, a compound known for its anti-aging benefits, has been shown to stop the breakdown of carnitine to TMAO in the gut ¹⁵, so we can now offer you a solution to this concern by including carnitine and resveratrol together.

Vegan powah hence provides you with a unique carnitine solution. We combine the benefits of Acetyl-L-Carnitine and L-Carnitine with Resveratrol to bring you all the benefits of these carnitnutrients without having to worry about TMAO and furthermore enjoying the antioxidant and anti-aging effects of Resveratrol.

(1) https://pubmed.ncbi.nlm.nih.gov/11043928/

(2) https://pubmed.ncbi.nlm.nih.gov/18286595/

(3) https://pubmed.ncbi.nlm.nih.gov/19341458/

(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1628441/

(5) https://pubmed.ncbi.nlm.nih.gov/20595193/

(6) https://pubmed.ncbi.nlm.nih.gov/21629200/

(7) https://pubmed.ncbi.nlm.nih.gov/12930169/

(8) https://pubmed.ncbi.nlm.nih.gov/20216464/

(9) https://pubmed.ncbi.nlm.nih.gov/21966881/

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2243251/

(11) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406747/

(12) https://pubmed.ncbi.nlm.nih.gov/30265149/