Monday, April 15, 2013

Carnitine: Terrible Toxin? Or Necessary Nutrient? Inform Yourself With Facts and Avoid Bombastic BS! :-)

From our friends at Geronova Research :

Hello all,

By now many of you may have seen the article or heard the news regarding meat consumption and heart disease risk. It also discussed the substance carnitine, found in meat, and also in many nutritional supplement products. I have received many questions on this study, so thought it appropriate to send out an email with Dr. David Brady's official response.

From what I can conclude at this point, it is not carnitine that is the problem. It is the gut flora that produce TMAO and can potentially utilize carnitine and other substrates.

There are many questions to be answered. For example, what type of gut microbiota will produce TMAO from meat and other foods? By the way, carnitine is not just found in red meat, it is also found in chicken, fish, and dairy products. Carnitine has been studied extensively because it is so important to energy production and is a well-tolerated and generally safe therapeutic agent.

I certainly will not stop eating foods that contain carnitine and give up carnitine supplements based on this study...too many variables and questions unanswered. And there is much more research showing the benefits of carnitine!

"Calm Down About Meat and Carnitine Folks!
David M. Brady, ND, CCN, DACBN

By now many of you may have seen the article in the NY Times and elsewhere regarding meat consumption and heart disease risk. It also discussed the substance carnitine, found in meat, and also in many nutritional supplement products. This is very interesting research, but not in the least surprising. This is a matter of variable GI microbiota (the bugs that grow and live inside human’s intestines), and their subsequent metabalome (chemicals and substances produced by these microbes), in people chronically consuming different diets. The reality is that people who very commonly eat meat simply develop a different composition of the GI bacteria than those who eat vegan or vegetarian, for instance, or those who meat less frequently. While it has been well‐established statistically that those who consume red meat have a somewhat higher statistical incidence of cardiovascular events, it also does not seem logical in many ways that this is all
connected to the fats and cholesterol in the meat, or even the high‐levels of the pro‐inflammatory arachadonic acid in the meat due to corn feeding of the animals, although those are certainly contributory. The issue of specific microbes commonly present in the GI environment only in frequent meat eaters metabolizing this dietary substrate (meat) in a novel manner which liberates a problematic compound, in this case TMAO, is very plausible and I have no specific reason to doubt the specific findings of this latest research. That TMAO can also derive from the carnitine component of the meat is also certainly plausible.

However, we need to be very careful how we interpret such narrowly focused research in the greater context. How the media draws conclusions and spins the take‐away message from such research is very deceiving and can misinform and unnecessarily scare the public and consumers all for the sake of a good story, or simply due to a lack of understanding of the limitations of making such broad conclusions based on such narrow research. For instance, if you study something and find out that it has 50 beneficial properties, and then study the same compound in a different way and find something that under the right circumstances may be negative, is the substance being studied then immediately something “bad”? And if you just finished reading the one negative study, and may have had no exposure to the positive ones, you would likely come away with the impression that the substance in question is “bad”. However, in reality, virtually everything can be somewhat “good” and somewhat “bad” under certain circumstances. For instance, if you search the medical literature you will find studies of people dying from drinking water under certain circumstances, such as over‐hydration during exercise diluting blood electrolytes and causing heart failure. Do you have any plans to immediately stop drinking water? If you look at any of these issues and research paper press releases in a very narrow, reductionist and myopic manner you will OFTEN draw very reactionary and incorrect conclusions.

The facts: Carnitine is a substance manufactured in the body from the amino acids lysine and methionine, which you derive whenever you eat any proteins containing these amino acids, not just meat! In living cells, it is required for the transport of fatty acids located in the body’s cells into the mitochondria during the breakdown of lipids (fats) for the generation of energy. There are reams of quality scientific literature supporting its safe use for maintaining optimal body composition and weight loss, to support those with fatigue or energy deficiency syndromes, and even for use in patients with various kidney and cardiac diseases. That does not sound like really bad stuff to me, and if it was why would your own body make it? Perhaps the issue of carnitine is more complex than the sound bites from this recent research study press release?

See more about carnitine at:

If carnitine, or meat for that matter, is the main culprit in cardiovascular mortality how do you explain
the following?‐of‐death/coronary‐heart‐disease/by‐country/

and this:

Note that the highest meat consumption (thus carnitine consumption) are in countries like the US [120.2](80.5), Canada [94.3](66.2), Australia [115.5](60.3), Argentina [98.3](70.6), Spain [97](43.5), and New Zealand [106.4](76.5). Low meat consumption countries are India [4.4](165.8), Indonesia [11.6](150.8), Pakistan [14.7](222.9), and Bangladesh [4](203.7).

In parenthesis are the death rates per 100k from heart disease. In brackets is annual meat consumption per capita.

Clearly there is something going on much more significant than the production of a byproduct in the gut from consumption of meat/carnitine. For instance, research shows that choline consumption produces similar levels of the harmful chemical in question in this latest study (TMAO) by these bacteria. Choline is present in many vegetable products and is especially high in nuts, seeds, and grains. Will you stop eating vegetable, nuts and seeds now too?

I wonder why these researchers, and the media, chose to focus on carnitine, and thus shine a negative light on red meat and carnitine? Is there some kind of agenda or are there unknown market forces at work here, or perhaps just a good alarming story for the media to sell papers, magazines and generate web site hits? I am not sure, but there is certainly not sound and rational science behind the conclusions drawn by the media, and sadly, many of the other scientists quoted in reaction to this latest paper in Nature Medicine.

When these kinds of studies generate popular media press releases and stories that scare you about something new every other day it seems please pause and take a nice deep breath and remember that it is the preponderance of the evidence that really counts and that the story behind complex metabolic issues is often much more elaborate than any one study is able to evaluate."