Updated Review
Published: September 21, 2024
As of September 21, 2024 we found one new paper showing that acetyl-L-carnitine treatment lowered serum markers of oxidative stress in a small sample of people living with ALS https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604350/. Since our TOE Mechanisms grade was already an A, this did not result in any grade changes.
Updated Review
Published: June 17, 2024
Since our review, we found a new published retrospective case control study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576701/. This shows that treatment with acetyl-l-carnitine at 1.5g/d (but not 3g/d) was associated with significant survival benefits. We thus change our TOE Cases grade from C to A. We continue to watch for a phase 3 trial of acetyl-l-carnitine to verify the benefits seen in the previous small phase 2 trial and this new case control study.
Key Information
Click on any letter grade below for more info:
Mechanism Grade: A
Preclinical Trials Grade: D
Cases Grade: A
Trials Grade: D
Risks Grade: B
Published: Jul 2020
There are good theoretical mechanisms for carnitines, some pre-clinical evidence for LC and ALCAR, and a single clinical trial that suggested ALCAR could slow disease progression in PALS. All three carnitines appear to be well-tolerated, generally safe, and inexpensive. We believe that there is a need for future clinical trials of carnitines in PALS to further elucidate their efficacy. Until there is further data, we cannot endorse any of these supplements as a definite way to slow ALS progression; however, oral ALCAR at 1000mg three times daily (3000 mg total daily dose) appears to be a theoretically promising supplement available for PALS whom would like to self-experiment.