L-Carnitine and its short chain derivative, Propionyl-L-Carnitine, are

naturally occurring compounds that are synthesized endogenously as well as

obtained from dietary sources. L-Carnitine is synthesized in the kidney by the
enzyme Acetyl-L-Carnitine-Transferase that facilitates the uptake of Acetyl Co-A
into the mitochondrial for fatty acid oxidation (Hashemi, 2011). This small
molecule is freely filtered by the glomerular membrane and reabsorbed by the
proximal tubule via organic cation carnitine transporter 2 receptors, with a renal
clearance of about 13 ml/min. However, endogenous synthesis is altered by the
dialysis of cofactors of carnitine synthesis, including vitamin B6, niacin, vitamin
C, lysine, and methionine, and by protein malnutrition (Mercadal, 2012).
The liver also represents one of the main sources of endogenous carnitine
synthesis from lysine, methionine and ascorbate, niacin, pyridoxine, and Fe
2+
.
Carnitine is captured and stored by the muscle because there is no carnitine
synthesis in muscle (Hurot, 2002). Leads one to presume that depletion of
carnitine from the liver would be partly compensated by carnitine released from
muscles (Hashemi, 2011). L-Carnitine serves as acetyl buffer in muscle cells
during anaerobic motor activations (Citil, 2009).

Xia, Yunqiu et al. 2011. L-Carnitine Ameliorated Fatty Liver in High-Calorie
Diet/STZ-Induced Type 2 Diabetic Mice by Improving Mitochondrial
Function. (http://www.dmsjournal.com/content/pdf/1758-5996-3-31.pdf).
[pdf]. Accessed on 2 December 2012 at 6.47 pm.
Citil, Mehmet, et al. 2009. Effect of orally administered l-carnitine on
selected biochemical indicators of lactating Tuj-
ewes._______________________. Accessed on 2 December 2012 at
6.55 pm.
Hurot, Jean-Marc, et al. 2002. Effects of L-Carnitine Supplementation in
Maintenance Hemodialysis Patients: A Systematic Review

Hashemi, et al. 2011. Efficacy of L-carnitine on liver function in childrens
under chemotherapy with acute lymphoblastic
leukemia._________________________________. Accessed on 3 December
2012 at 7.55 pm.

Mercadal, Lucile et al. 2012. L-Carnitine Treatment in Incident Hemodialysis
Patients: The Multicenter, Randomized, Double-Blinded, Placebo-
Controlled CARNIDIAL trial. _____________________________.
Accessed on 4 December 2012 at 6.56 pm.