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L-Carnitine

L-carnitine is an endogenous compound; human studies show mixed to favorable results depending on the form, population and route of administration.

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We evaluated 316 human studies on L-Carnitine, including 144 randomised controlled trials and 80 meta-analyses or systematic reviews; the controlled studies include 9,025 participants in total. As of 10 October 2026.

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1. What Is L-Carnitine? Occurrence, Origin and Forms

L-carnitine is a compound the body produces itself and also takes up from food. It takes part in the use of long-chain fatty acids in the cell's power plants, which is why it is found mainly in skeletal and heart muscle. In human studies, L-carnitine is examined above all in sport, in the cardiovascular field, in fertility and in kidney disease.

In the body, L-carnitine is found mainly in skeletal and heart muscle as well as in liver and kidney. Through food it is taken up predominantly with meat, dairy products and other animal foods, while plant foods contain little of it.

For dietary supplements, L-carnitine is produced by fermentation or synthesis. Studies examine different forms, such as free L-carnitine (levocarnitine), acetyl-L-carnitine, L-carnitine L-tartrate and propionyl-L-carnitine. It is given orally or as an infusion, for example in the care of dialysis patients.

Forms and Preparations Studied

  • Free L-carnitine (levocarnitine)
  • Acetyl-L-carnitine
  • L-carnitine L-tartrate
  • Propionyl-L-carnitine
  • Glycine propionyl-L-carnitine, a combination of propionyl-L-carnitine and glycine

Not covered on this page:

  • D-carnitine, the mirror-image form, which does not count as L-carnitine
  • Meldonium, a drug with a similar name but a different structure
  • Carnosine, a different endogenous peptide with a similar-sounding name

2. What Does L-Carnitine Do? Results by Area

AreaResult in controlled studiesStrength of evidenceStudiesParticipants
Metabolism and Blood Lipidsmixedhigh31 meta-analyses · 37 controlled · 14 other1,446
Heart and Circulationmostly no differencehigh12 meta-analyses · 17 controlled · 7 other955
Dialysis and Kidney Diseasemixedhigh7 meta-analyses · 18 controlled · 4 other610
Cognition and Nervous Systemmixedhigh3 meta-analyses · 6 controlled · 19 other636
Fertilitymixedmoderate5 meta-analyses · 5 controlled · 11 other669
Tolerability and Safetyworsenedunclear0 meta-analyses · 1 controlled · 31 other409
Other investigationsmixedhigh27 meta-analyses · 64 controlled · 48 other3,895

How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.

3. What the Studies Show in Detail

L-Carnitine, Metabolism and Blood Lipids: Human Studies

Meta-analyses found lower values for fasting glucose, HbA1c, HOMA-IR, triglycerides and LDL cholesterol under L-carnitine, especially in diabetes, impaired glucose tolerance and overweight 56104451. In women with polycystic ovary syndrome, fasting glucose and blood lipids decreased 21. By contrast, in metabolic syndrome, total and LDL cholesterol as well as narrowing of the carotid artery increased more strongly under L-carnitine than under placebo 85, and in hemodialysis patients, LDL cholesterol and triglycerides increased under oral levocarnitine 182. The findings apply to oral free L-carnitine (levocarnitine), acetyl-L-carnitine and L-carnitine L-tartrate. In women with polycystic ovary syndrome, insulin and HOMA-IR improved under metformin and pioglitazone with and without additional acetyl-L-carnitine, regular cycles were more frequent with acetyl-L-carnitine 88. With combination products of L-carnitine and chromium picolinate 135 as well as of L-carnitine, epigallocatechin gallate, capsaicin and piperine 100, the effect cannot be attributed to L-carnitine alone. It remains open how strongly the participants' baseline state, the dose and the route of administration determine the results.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
1 Hamedi-Kalajahi et al. 2025meta-analysis · 16,352 participantsL-carnitine supplementation; 150 to 4000 mg/day; 8 to 30 weeks; vs. Placebo or controlWeight reduction: improved (ES = -1.11; 95% CI: -1.90, -0.33, p = 0.005); BMI reduction: improved (ES = -0.33; 95% CI: -0.61, -0.04, p = 0.026); Waist circumference reduction: improved (ES = -1.34; 95% CI: -1.83, -0.85, p < 0.001)
5 Gheysari et al. 2024meta-analysis · 2,900 participantsL-carnitine supplementation; vs. PlaceboTriglycerides: improved (WMD = - 13.50 mg/dl, p = 0.039); LDL cholesterol: improved (WMD = - 12.66 mg/dl, p < 0.001); Fasting blood glucose: improved (WMD = - 6.24 mg/dl, p = 0.001)
6 Zamani et al. 2022meta-analysis · 2,900 participantsoral L-carnitine supplements; intervention dose ≥2 g/day in subgroup analyses; at least seven days; subgroups ≥12 weeks; vs. control groupfasting blood glucose (FBG): improved (WMD = -3.22 mg/dl; 95% CI, -5.21 to -1.23; p = 0.002); hemoglobin A1c (HbA1c): improved (WMD = -0.27%; 95% CI, -0.47 to -0.07; p = 0.007); HOMA-IR: improved (WMD = -0.73; 95% CI, -1.21 to -0.25; p = 0.003)
8 Hu et al. 2023meta-analysis · 2,362 participantsCarnitine as a nutritional supplement; vs. Placebo and other nutritional supplementsBody weight: improved (SUCRAs: 96.04%); Body mass index (BMI): improved (SUCRAs: 97.73%)
9 Talenezhad et al. 2020meta-analysis · 2,292 participantsL-carnitine supplementation; 2000 mg per day (maximum effect); vs. Placebo or controlBody weight: improved (WMD = -1.21 kg, 95% CI: -1.73, -0.68; P < 0.001); Body mass index: improved (WMD = -0.24 kg/m2, 95% CI: -0.37, -0.10; P = 0.001); Fat mass: improved (WMD = -2.08 kg, 95% CI: -3.44, -0.72; P = 0.003)
10 Mirrafiei et al. 2024meta-analysis · 2,041 participantsL-carnitine supplementation; 1 g/d; dose-response up to 4 g/d; vs. Control groups of included RCTsBody mass index: improved (MD: -0.37 kg/m2, 95% CI: -0.59, -0.15); HbA1c: improved (MD: -0.16%, 95% CI: -0.32, -0.01); Serum triglycerides: improved (MD: 0.07 mmol/L)
12 Chen et al. 2014meta-analysis · 1,734 participantsL-carnitine; vs. Placebo or controlSerum LDL: improved (-5.82 mg/dL; 95% CI: -11.61, -0.04 mg/dL); C-reactive protein: improved (-3.65 mg/L; -6.19, -1.12 mg/L); Triglycerides: no difference (-0.89 mg/dL; -29.32, 27.53 mg/dL)
14 Karimi et al. 2024meta-analysis · 1,340 participantsL-carnitine; vs. Placebo or controlTriglycerides: no difference (SMD: -0.006; 95% CI, -0.272 to 0.259; P = 0.95); Total cholesterol: no difference (SMD: -0.086; 95% CI, -0.253 to -0.079; P = 0.29); HDL cholesterol: no difference (SMD: 0.060; 95% CI, -0.057 to 0.177; P = 0.29)

Further studies in this area: 15 17 21 29 34 35 40 42 44 48 50 51 55 56 58 60 64 66 68 69 70 74 77 85 88 95 98 107 110 111 118 122 123 133 137 140 142 147 148 150 153 155 156 157 159 161 163 168 174 176 177 181 182 183 186 187 188 192 194 196 198 199 200 202 214 219 228 232 236 241 247 262 269 273

L-Carnitine, Heart and Circulation: Human Studies

Meta-analyses found a higher ejection fraction and less frequent atrial fibrillation with L-carnitine after heart surgery 26, and a higher ejection fraction in hemodialysis patients 33; after bypass surgery, a small randomized study showed no advantage over the control 152. In coronary heart disease, inflammatory and oxidative stress markers decreased more with L-carnitine than with placebo 112, and meta-analyses found lower CRP values 576. Before bypass surgery, intravenous L-carnitine briefly lowered the neutrophil-to-lymphocyte ratio 127. The strength of evidence is high, but in the controlled individual studies no difference from the control predominates; the findings apply to the respective form studied. A combination product of acetyl-L-carnitine and caffeine slightly raised diastolic blood pressure shortly after intake, and the values remained within the normal range 144; this cannot be attributed to L-carnitine alone. It remains open whether the results from intravenous administration in dialysis patients can be transferred to oral intake in other population groups.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
4 Shang et al. 2014meta-analysis · 3,108 participantsoral L-carnitine; 2 g, 3 g, 4 g, 6 g daily; vs. different oral maintenance dosesall-cause mortality: no difference (RR = 0.77, 95% CI [0.57-1.03], P = 0.08); heart failure: no difference (RR = 0.53, 95% CI [0.25-1.13], P = 0.10); unstable angina: no difference (RR = 0.90, 95% CI [0.51-1.58], P = 0.71)
5 Gheysari et al. 2024meta-analysis · 2,900 participantsL-carnitine supplementation; vs. PlaceboCRP: improved (WMD = - 0.07 mg/dl, P = 0.037); TNF-α: improved (WMD = - 1.39 pg/ml, p = 0.033)
10 Mirrafiei et al. 2024meta-analysis · 2,041 participantsL-carnitine supplementation; 1 g/d; dose-response up to 4 g/d; vs. Control groups of included RCTsLow-density lipoprotein cholesterol: improved (MD: -0.11 mmol/L, 95% CI: -0.16, -0.05)
13 Anaraki et al. 2024meta-analysis · 1,412 participantsOral L-carnitine supplements; vs. Placebo or controlSystolic blood pressure: no difference (WMD = -1.22 mm Hg, 95% CI: -3.79, 1.35; P = 0.352); Diastolic blood pressure: no difference (WMD = -0.50 mm Hg, 95% CI: -1.49, 0.48; P = 0.318); Diastolic blood pressure in BMI >30: improved (WMD = -1.59 mm Hg; 95% CI: -3.11, -0.06; P = 0.041)
14 Karimi et al. 2024meta-analysis · 1,340 participantsL-carnitine; vs. Placebo or controlSystolic blood pressure: no difference (SMD: 0.055; 95% CI, -0.110 to 0.220; P = 0.43); Diastolic blood pressure: no difference (SMD: -0.028; 95% CI, 0.156 to 0.099; P = 0.56)
26 Shalabi et al. 2025meta-analysis · 786 participantsL-carnitine (form not specified); preoperative administration, short-term; vs. control/placebocardiac index (CI): improved (MD: 0.14; 95% CI: 0.07, 0.20; P < 0.01); left ventricular stroke work index (LVSWI): improved (MD: 0.42; 95% CI: 0.06, 0.78; P = 0.02); left ventricular ejection fraction (LVEF): improved (MD: 7.88; 95% CI: 6.67, 9.09; P < 0.01)
29 Vajdi et al. 2026meta-analysis · 699 participantsoral L-carnitine supplementation; subgroups: ≥1000 mg/day or <1000 mg/day; subgroup: >12 weeks or ≤12 weeks; vs. control/placebo in included trialssystolic blood pressure (dose <1000 mg/day): improved; diastolic blood pressure (duration >12 weeks): improved
33 Nabi et al. 2025meta-analysis · 426 participantsL-carnitine supplementation; vs. Control (placebo or standard care)Left ventricular ejection fraction (LVEF): improved (MD = 1.64, 95% CI 0.10-3.17, p = 0.04); Left ventricular mass index (LVMI): no difference (MD = -3.19, p = 0.60); E/A ratio: no difference (MD = -0.13, p = 0.47)

Further studies in this area: 41 42 60 65 76 83 85 110 112 123 127 129 141 143 145 152 155 160 164 176 190 191 197 203 230 243 248 269

L-Carnitine, Dialysis and Kidney Disease: Human Studies

In hemodialysis patients, the carnitine level increased under intravenous as well as oral levocarnitine 99163164; in carnitine deficiency, muscle mass and handgrip strength were maintained under intravenous administration, while they declined without treatment 102. Findings on the response to erythropoietin are inconsistent: a meta-analysis 18 and a placebo-controlled pilot study with intravenous administration 170 found a better response, a randomized study in new dialysis patients 99 and another meta-analysis 12 found no difference. The findings come predominantly from intravenous administration of levocarnitine in hemodialysis patients and cannot be readily transferred to oral intake in other population groups; the studies are mostly small and short, and the participants' baseline state influences the interpretation.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
12 Chen et al. 2014meta-analysis · 1,734 participantsL-carnitine; vs. Placebo or controlHemoglobin: no difference (0.68 g/dL; 0.14, 1.50 g/dL); Hematocrit: no difference (2.04%; -1.39, 5.48%); Albumin: no difference (1.65 g/L; -0.22, 3.51 g/L)
18 Zhu et al. 2021meta-analysis · 1,090 participantsL-carnitine; vs. Control (placebo/standard care)Erythropoietin responsiveness index: improved (MD: -2.72, 95% CI -3.20 to -2.24; P < 0.00001); Required ESA dose: improved (MD: -1.70, 95% CI -2.04 to -1.36; P < 0.00001); Hemoglobin level: no difference (MD: 0.18, 95% CI -0.20 to 0.55; P = 0.35)
29 Vajdi et al. 2026meta-analysis · 699 participantsoral L-carnitine supplementation; subgroups: ≥1000 mg/day or <1000 mg/day; subgroup: >12 weeks or ≤12 weeks; vs. control/placebo in included trialsalbumin: no difference (P = 0.820); hemoglobin: no difference (P = 0.322)
38 Chewcharat et al. 2022meta-analysis · 224 participantsLevocarnitine (L-carnitine); > 4,200 mg/week; at least 12 weeks; vs. Control groupIncidence of dialysis-related hypotension: improved (pooled OR = 0.26, 95% CI [0.10-0.72], p = 0.01); Incidence of muscle cramps: improved (pooled OR = 0.22, 95% CI [0.06-0.81], p = 0.02)
39 Lynch et al. 2008meta-analysis · 193 participantsL-carnitine supplementation (oral route not specified); at least 8 weeks; vs. PlaceboPooled odds ratio for intradialytic cramping: no difference (0.30 (95% confidence interval, 0.09 to 1.00; P = 0.05)); Pooled odds ratio for intradialytic hypotension: no difference (0.28 (95% confidence interval, 0.04 to 2.23; P = 0.2))
55 Askarpour et al. 2020meta-analysisl-carnitine supplementation; vs. control groups in 43 randomized controlled trialsanthropometric indexes in hemodialysis patients: no difference
64 Askarpour et al. 2019meta-analysisl-carnitine supplementation; doses above 2 g/day effective; lower doses no effect; vs. placebo or control in randomized trialstotal cholesterol, LDL-C and triglycerides in hemodialysis patients: no difference
99 Mercadal et al. 2012randomised controlled · 92 participantsintravenous L-carnitine; 1 g after each dialysis session; 1 year; vs. placeboEPO resistance index: no difference (P=0.7)

Further studies in this area: 102 103 105 132 134 145 150 155 163 165 170 171 176 182 183 188 193 209 215 274 276

L-Carnitine, Cognition and Nervous System: Human Studies

In diabetic neuropathy, a combination product of acetyl-L-carnitine, superoxide dismutase, alpha-lipoic acid and vitamin B12 improved symptoms and nerve conduction values 101, and in breast cancer patients receiving paclitaxel, oral acetyl-L-carnitine reduced neuropathic complaints 149. In hepatic encephalopathy, oral acetyl-L-carnitine improved ammonia levels and the number connection test in a meta-analysis 30, and in prefrail older adults the MMSE score increased more than with placebo 98. In contrast, a systematic review found no effects of L-carnitine on reaction time, vigilance and memory performance in cognitively healthy young adults after short-term intake 73. In diabetic neuropathy, acetyl-L-carnitine acted similarly to methylcobalamin 82. The findings apply predominantly to oral acetyl-L-carnitine in ill or older persons; with the combination product 101, the effect cannot be attributed to acetyl-L-carnitine alone.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
25 Veronese et al. 2018meta-analysis · 791 participantsAcetyl-L-carnitine, mostly monotherapy; vs. Placebo/no intervention or antidepressantsDepressive symptoms (ALC vs placebo/no intervention): improved (SMD = -1.10, 95% CI = -1.65 to -0.56); Depressive symptoms (ALC vs antidepressants): no difference (SMD = 0.06, 95% CI = -0.22 to 0.34)
30 Jiang et al. 2013meta-analysis · 660 participantsOral acetyl-L-carnitine; vs. PlaceboNumber connection test completion time: improved (weighted mean difference 16.62, 95% confidence intervals 9.88 to 23.36, P < 0.05)
49 Rodrigues et al. 2023systematic reviewAcetyl-L-carnitine (named as trigger)Manic/hypomanic episodes
73 Chen et al. 2017systematic reviewL-carnitine or acetyl-/propionyl-L-carnitine; any dose, not reported; 3 days of treatment; vs. placebo or no treatmentreaction time: no difference; vigilance: no difference; immediate memory: no difference
86 Yoon et al. 2022randomised controlled · 150 participantsL-carnitine; 2 g/day; 24 weeks; vs. PlaceboPHES score: unclear (p = 0.007); Stroop test: unclear (r = 0.3; r = 0.4; r = 0.5; r = 0.3)
88 Tauqir et al. 2021randomised controlled · 147 participantsAcetyl-L-carnitine plus metformin and pioglitazone; ALC 1500 mg, metformin 500 mg, pioglitazone 15 mg twice daily; 12 weeks; vs. Metformin plus pioglitazone plus placeboPSS scores: improved (p < 0.001)
92 Parnetti et al. 1993randomised controlled · 126 participantsST200 (acetyl-L-carnitine); vs. l-alpha-glycerylphosphorylcholine (alpha GPC)neuropsychological parameters: unclear
98 Malaguarnera et al. 2022randomised controlled · 92 participantsOral acetyl-L-carnitine; 1.5 g twice daily; 3 months treatment, 3 months follow-up; vs. Placebo, double-blind randomizedMMSE score: improved (p < 0.0001); MMSE score (group comparison): improved (p < 0.001)

Further studies in this area: 120 131 201 216 222 224 227 236 237 240 242 244 247 255 256 258 261 265 268 270

L-Carnitine and Fertility: Human Studies

In men with impaired fertility, meta-analyses found better sperm motility under L-carnitine or acetyl-L-carnitine 114559. In a study with several treatment arms, motility improved in all groups, normal sperm morphology only with L-carnitine 80; a combination product of L-carnitine, acetyl-L-carnitine and further micronutrients improved concentration and motility compared with placebo 96. In women with polycystic ovary syndrome, higher pregnancy and ovulation rates as well as more favorable follicle and endometrium findings were found under levocarnitine 19, and in IVF patients with previous treatment failure, oral levocarnitine was associated with more oocyte maturation, blastocyst formation and live births 189. This contrasts with a placebo-controlled study in women with polycystic ovary syndrome undergoing assisted reproduction, in which oocyte maturation, embryo quality and pregnancy rates did not differ 95.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
11 Su et al. 2022meta-analysis · 1,790 participantsCarnitine (form not specified); vs. Placebo and other antioxidantsSperm motility: improved (MD = 12.43; 95% CI: 4.07, 20.26); Sperm concentration: no difference; Sperm morphology: no difference
19 Abu-Zaid et al. 2025meta-analysis · 1,046 participantsL-carnitine (LC) supplementation; vs. untreated groupschemical pregnancy rate: improved; clinical pregnancy rate: improved; ovulation rate: improved
45 Ma et al. 2025meta-analysisOral L-carnitine monotherapy; vs. PlaceboSperm concentration: improved (p < 0.001); Normal morphology: improved (p = 0.03); Sperm motility: improved (p = 0.02)
46 Niu et al. 2025meta-analysisOral carnitine and coenzyme Q10 antioxidants; vs. PlaceboSperm concentration: improved (SMD 2.98 [95% CI: 1.13 to 7.87]); Progressive sperm motility: improved (SMD 4.19 [95% CI: 1.60 to 10.95]); Morphologically normal sperm: improved
59 Khaw et al. 2020meta-analysisL-carnitine and L-acetylcarnitine; vs. Placebo or controlTotal sperm motility: improved (significantly improve); Progressive sperm motility: improved (significantly improve); Sperm morphology: improved (significantly improve)
62 Buhling et al. 2019meta-analysisL-carnitine + acetyl-L-carnitine; 2 g/day L-carnitine + 1 g/day acetyl-L-carnitine; vs. PlaceboSemen parameters (asthenozoospermia): improved (SMD 0.57)
80 Lee et al. 2024randomised controlled · 350 participantsL-carnitine 2 g/day alone or with tadalafil and/or S. repens; 2 g daily; 3 months post-therapy; vs. tadalafil 5 mg, S. repens 320 mg, combinations, 7 groupstotal sperm motility: unclear (significantly improved in all groups); normal morphology: unclear; leukocytospermia: unclear
88 Tauqir et al. 2021randomised controlled · 147 participantsAcetyl-L-carnitine plus metformin and pioglitazone; ALC 1500 mg, metformin 500 mg, pioglitazone 15 mg twice daily; 12 weeks; vs. Metformin plus pioglitazone plus placeboTestosterone, FSH, LH: improved; LH: improved (p = 0.013); Regular menstrual cycles: improved (97.2%)

Further studies in this area: 95 122 169 189 207 229 238 246 249 263 264 267 275

L-Carnitine, Tolerability and Safety: Human Studies

Regarding the tolerability of L-carnitine and acetyl-L-carnitine, several controlled studies found no differences in adverse events 328182176; in hepatic encephalopathy they were rare and minor 30. A meta-analysis in hemodialysis patients 12 and a placebo-controlled study in pemphigus vulgaris 141 reported no side effects. Less frequent vomiting occurred in a controlled study with oral acetyl-L-carnitine in breast cancer patients 149. This contrasts with a large placebo-controlled study in women receiving taxane chemotherapy, in which acetyl-L-carnitine did not prevent nerve damage: at the later measurement, nerve complaints were more severe and severe neurotoxicity was more frequent than with placebo 79. The findings come predominantly from oral administration of acetyl-L-carnitine and free levocarnitine in different patient groups. A combination product of L-carnitine, acetyl-L-carnitine, L-arginine, glutathione, coenzyme Q10, zinc, selenium and B vitamins was as tolerable as placebo 104. Overall, the evidence is low, the studies are small and heterogeneous; long-term studies on safety in healthy individuals are still pending.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
12 Chen et al. 2014meta-analysis · 1,734 participantsL-carnitine; vs. Placebo or controlAdverse effects (No adverse effects were reported)
24 Kumar et al. 2026meta-analysis · 809 participantsAcetyl-L-carnitine; vs. Placebo and standard antidepressantsAdverse effects (fewer adverse effects)
25 Veronese et al. 2018meta-analysis · 791 participantsAcetyl-L-carnitine, mostly monotherapy; vs. Placebo/no intervention or antidepressantsIncidence of adverse effects
30 Jiang et al. 2013meta-analysis · 660 participantsOral acetyl-L-carnitine; vs. PlaceboAdverse events (reported infrequently and were minor)
32 Li et al. 2015meta-analysis · 523 participantsAcetyl-L-carnitine; vs. Placebo or other active medicationsTotal adverse event rate
34 Martí-Carvajal et al. 2019systematic review · 398 participantsAcetyl-L-carnitine plus standard care; vs. Placebo plus standard careNon-serious adverse events (RR 2.51)
67 Di et al. 2019systematic reviewAcetyl-L-carnitine (ALC); vs. PlaceboSafety profile
71 Liu et al. 2018systematic reviewOral dietary supplements, including L-carnitine; Short term, medium term, long term; vs. PlaceboSafety outcomes

Further studies in this area: 73 79 81 82 87 92 119 131 141 149 160 162 172 176 179 192 194 219 232 240 243 247 255 270

L-Carnitine: Further Outcomes in Studies

Meta-analyses and several placebo-controlled studies found lower inflammatory markers with L-carnitine 3546398113117125 and more favorable values for oxidative stress 354117119; after exercise, the muscles recovered better with L-carnitine L-tartrate than with placebo 108. Systematic reviews on poisoning 41 and on skin treatment 43 also include combinations, for example with N-acetylcysteine or licochalcone A, which do not allow conclusions about L-carnitine alone. The overall strength of evidence is high, but the heterogeneity of forms, doses and populations limits generalization.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
3 Rastgoo et al. 2023meta-analysis · 3,255 participantsL-carnitine supplementation; Subgroups: ≥ 2 g/day; Subgroups: ≥ 12 weeks; vs. Placebo groupC-reactive protein (CRP): improved (p < 0.001); Interleukin-6 (IL-6): improved (p = 0.001); Tumor necrosis factor-α (TNF-α): improved (p = 0.002)
7 Zeng et al. 2025meta-analysis · 2,481 participantsL-carnitine (nutritional supplement); vs. other nutritional supplements and controls6-minute walk distance: improved (MD=53, 95% CI (24, 82))
16 Oh et al. 2022meta-analysis · 1,217 participantsl-carnitine or carnitine-orotate (complex); vs. Control without carnitineProportion with ALT normalization (carnitine-orotate): improved (OR 4.61 (1.48-14.39)); Proportion with ALT normalization (carnitine-orotate complex): improved (OR 18.88 (7.70-46.27)); Serum ALT reduction: improved (-11.99 (-22.48 to -1.49))
20 Askarpour et al. 2020meta-analysis · 1,025 participantsL-carnitine supplementation; vs. Control group (placebo or no supplementation)Alanine aminotransferase (ALT): improved (WMD: -10.729 IU/L, 95% CI: -13.787, -7.672, p <0.001); Aspartate aminotransferase (AST): improved (WMD: -7.149 IU/L, 95% CI: -9.202, -5.096, p <0.001); Gamma-glutamyl transferase (GGT): improved (WMD: -7.395: IU/L, 95% CI: -9.171, -5.619, p <0.001)
22 Rolim et al. 2019systematic review · 907 participantsAcetyl-L-carnitine (ALC); 1500 mg/day, 2000 mg/day, or 3000 mg/day; up to 12 months; vs. Placebo, methylcobalamin 1.5 mg/day, or no interventionPain on visual analogue scale (0-100 mm): improved (MD -9.16, 95% CI -16.76 to -1.57); Pain on VAS at dose ≤1500 mg/day: no difference (MD -0.05, 95% CI -10.00 to 9.89); Pain on VAS at dose >1500 mg/day: improved (MD -14.93, 95% CI -19.16 to -10.70)
23 Cai et al. 2018meta-analysis · 826 participantsAcetyl-L-carnitine (ALC); vs. placebo, lactulose, probiotics, rifaximin, L-ornithine L-aspartateserum ammonia: improved; serum albumin: improved; SUCRA ranking for serum ammonia: improved (87.2%)
24 Kumar et al. 2026meta-analysis · 809 participantsAcetyl-L-carnitine; vs. Placebo and standard antidepressantsDepressive symptoms: improved (significantly reduces depressive symptoms compared to placebo); Efficacy versus standard antidepressants: no difference (comparable efficacy to standard antidepressants)
27 Abbasnezhad et al. 2019meta-analysis · 779 participantsL-carnitine supplementation; less or higher than 4000 mg/day; short and long duration of supplementation; vs. Control group in randomized clinical trialsBlood ammonia: improved; Blood bilirubin: improved; Blood AST: improved

Further studies in this area: 28 30 31 32 34 36 37 41 43 47 48 52 53 54 57 61 63 67 71 72 75 77 78 79 80 81 82 86 87 88 97 98 106 108 109 111 113 114 115 116 117 118 119 120 121 124 125 126 128 130 131 133 134 136 138 139 140 141 146 149 150 151 153 154 155 157 158 160 161 162 166 167 172 173 174 175 177 178 180 181 183 184 185 187 191 195 196 200 204 205 206 208 209 210 211 212 213 214 215 216 217 218 220 221 223 225 226 228 231 233 234 235 236 237 239 245 247 248 250 251 252 253 254 257 259 260 266 268 270 271 272

4. How Is L-Carnitine Dosed? Preparation, Dose and Duration in Studies

The studies predominantly used oral free L-carnitine (levocarnitine), acetyl-L-carnitine and L-carnitine L-tartrate. In hemodialysis patients, levocarnitine was given partly intravenously after dialysis, partly orally. Individual investigations tested combination products with other substances, from which no single-substance effect can be derived.

Preparation or formDoseDurationStudy
Acetyl-L-carnitine3,000 mg per day24 weeks79
L-carnitine 2 g/day alone or with tadalafil and/or S. repens2 g daily3 months post-therapy80
oral acetyl-L-carnitine3 g/day8 weeks81
oral acetyl-L-carnitine vs. methylcobalaminALC 500 mg t.i.d.; MC 0.5 mg t.i.d.24 weeks82
oral L-carnitine (levocarnitine)20 mg/kg/day12 months83
L-carnitine fumarate + acetyl-L-carnitine + vitamin/mineral complex + clomiphene citrateL-carnitine fumarate 1 g, acetyl-L-carnitine 0.5 g twice daily; CC 25 mg twice daily3-4 months treatment, follow-up at 6 months84
L-carnitine (L-C)2 g daily6 months85
L-carnitine2 g/day24 weeks86
acetyl-L-carnitine (ALC) versus placebo, plus sagopilone 16 mg/m² i.v.1,000 mg ALC every 3 daysup to 6 cycles of sagopilone every 3 weeks87
Acetyl-L-carnitine plus metformin and pioglitazoneALC 1500 mg, metformin 500 mg, pioglitazone 15 mg twice daily12 weeks88
Crisugabalin plus acetyl-L-carnitine vs. alpha-lipoic acid plus acetyl-L-carnitine—16 weeks89
G-Series medium with three antioxidants (A3)—culture to day 5/690
Acetyl-L-Carnitine plus alpha-lipoic acid, resveratrol, cholecalciferol1000 mg acetyl-L-carnitine daily30 days91
Liquid nutraceutical with collagen peptides, vitamins, L-carnitine—90 days93
Donepezil plus acetyl-L-carnitine (DA group)—24 weeks94

5. Is L-Carnitine Safe? Side Effects in Studies

Several controlled studies found no differences in adverse events compared with the comparison group 328182176; further work reported rare and minor or no side effects 1230141. A large placebo-controlled study in women undergoing taxane chemotherapy found stronger nerve complaints at the later measurement and more frequent severe neurotoxicity under acetyl-L-carnitine than under placebo 79. The evidence on tolerability is overall low, the studies are small and heterogeneous.

StudyReported side effects
2 Zhou et al. 2024Safety ranked by SUCRA; acetyl-L-carnitine not among top three safest
12 Chen et al. 2014No adverse effects reported
24 Kumar et al. 2026fewer adverse effects than standard antidepressants
25 Veronese et al. 2018Adverse effects less frequent with ALC than antidepressants
28 Yang et al. 2017All drugs except pemoline relatively safe
30 Jiang et al. 2013infrequent and minor
32 Li et al. 2015No severe adverse events; pain, headache, paraesthesia, hyperesthesia, retching, biliary colic, gastrointestinal disorders; rates similar to control
33 Nabi et al. 2025Safety assessed, no specific details
34 Martí-Carvajal et al. 2019Non-serious adverse events: 8/126 vs 3/120; RR 2.51
38 Chewcharat et al. 2022Muscle cramps
41 Rezaee et al. 2026LC/ALC was generally well tolerated
43 Chow et al. 2026TMAO-related cardiovascular risks mentioned

6. What Remains Open: Limits of the Evidence

  • It remains open how strongly the participants' baseline state determines the results.
  • The optimal dose and route of administration (oral vs. intravenous) is not clarified.
  • Results from intravenous administration in dialysis patients cannot be readily transferred to oral intake in other population groups.
  • With combination products, the effect cannot be attributed to the single substance.
  • Long-term studies on safety in healthy individuals are still pending.

7. Bottom Line: What Is Established About L-Carnitine

L-carnitine is investigated in numerous human studies, especially in sports, cardiovascular diseases, fertility disorders, kidney diseases and cognitive disorders. The results are mixed depending on the field and population: meta-analyses show improvements especially in sperm motility, in blood glucose and blood lipids, and under acetyl-L-carnitine in hepatic encephalopathy; in hemodialysis patients, the findings are inconsistent depending on the measured parameter. Individual studies, by contrast, found an increase in LDL cholesterol, and in metabolic syndrome also greater narrowing of the carotid artery. The findings apply in each case to the form and preparation investigated, mostly oral levocarnitine or acetyl-L-carnitine; with combination products, no single-substance effect can be derived. Tolerability was comparable to the control group in several controlled studies, but the evidence for this is low, and one randomized controlled study reported more neurotoxicity under acetyl-L-carnitine during taxane chemotherapy.

Frequently Asked Questions

How well has L-Carnitine been studied in humans?

We evaluated 316 human studies on L-Carnitine, including 144 randomised controlled trials and 80 meta-analyses or systematic reviews; the controlled studies include 9,025 participants in total. As of 10 October 2026.

Does L-Carnitine help with metabolism and Blood Lipids? What the studies show

We evaluated 31 meta-analyses or systematic reviews, 37 controlled studies and 14 further studies; the controlled studies include 1,446 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: high. Sources: 1568

Does L-Carnitine help with heart and Circulation? What the studies show

We evaluated 12 meta-analyses or systematic reviews, 17 controlled studies and 7 further studies; the controlled studies include 955 participants in total. Result of the controlled studies: mostly no difference. Strength of evidence under our published rules: high. Sources: 451013

Does L-Carnitine help with dialysis and Kidney Disease? What the studies show

We evaluated 7 meta-analyses or systematic reviews, 18 controlled studies and 4 further studies; the controlled studies include 610 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: high. Sources: 12182938

Does L-Carnitine help with cognition and Nervous System? What the studies show

We evaluated 3 meta-analyses or systematic reviews, 6 controlled studies and 19 further studies; the controlled studies include 636 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: high. Sources: 25304973

Does L-Carnitine help with fertility? What the studies show

We evaluated 5 meta-analyses or systematic reviews, 5 controlled studies and 11 further studies; the controlled studies include 669 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: moderate. Sources: 11194546

Does L-Carnitine help with tolerability and Safety? What the studies show

We evaluated one controlled study and 31 further studies; the controlled studies include 409 participants in total. Result of the controlled studies: worsened. Strength of evidence under our published rules: unclear. Sources: 12242530

What is L-carnitine and what is it investigated for in studies?

L-carnitine is an endogenous compound that is involved in the utilization of long-chain fatty acids. Human studies investigate it especially in sports, cardiovascular diseases, fertility disorders, kidney diseases and cognitive disorders.

Which forms of L-carnitine were used in the studies?

The studies predominantly used oral free L-carnitine (levocarnitine), acetyl-L-carnitine and L-carnitine L-tartrate. In hemodialysis patients, levocarnitine was given partly intravenously after dialysis, partly orally. Individual investigations tested combination products with other substances.

Do the human studies show an effect on fertility?

In men with impaired fertility, meta-analyses found better sperm motility under L-carnitine or acetyl-L-carnitine 114559. In women with polycystic ovary syndrome, higher pregnancy and ovulation rates were found 19. In women with polycystic ovary syndrome undergoing assisted reproduction, by contrast, L-carnitine did not improve oocyte maturation, embryo quality and pregnancy rates 95.

How tolerable is L-carnitine?

Several controlled studies found no differences in adverse events compared with the comparison group 328182176; further work reported rare and minor or no side effects 1230141. A large placebo-controlled study in women undergoing taxane chemotherapy found stronger nerve complaints at the later measurement and more frequent severe neurotoxicity under acetyl-L-carnitine than under placebo 79. The evidence on tolerability is overall low.

What should be considered when interpreting the study results?

The results apply in each case to the form and preparation investigated. With combination products, the effect cannot be attributed to the single substance. Results from intravenous administration in dialysis patients cannot be readily transferred to oral intake in other population groups. The participants' baseline state influences the interpretation.

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Every statement on this page carries its evidence tier — proven, plausible or hypothesis — and leads to the original work. The decision in the individual case rests with the practitioner; we provide the connections.

International Health Research · https://ih-research.com/en/knowledge/l-carnitine/ · Last updated: 2026-10-15