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L-Carnitine Effective for Attention Deficit-Hyperactivity Disorder

By Alan R. Gaby, MD

Healthnotes Newswire (December 19, 2002)—Supplementation with L-carnitine decreases attention problems and aggressive behavior in boys with attention deficit-hyperactivity disorder (ADHD), according to a report in Prostaglandins Leukotrienes and Essential Fatty Acids (2002;67:33–8). L-carnitine may therefore represent a safer alternative to the stimulant drug methylphenidate (Ritalin®), the most common treatment for ADHD.

In the new study, 24 boys between the ages of 6 and 13 years received L-carnitine and a placebo, in random order, during two separate eight-week periods. The amount of L-carnitine used was 100 mg per kg (2.2 pounds) of body weight per day, with a maximum of 4 grams per day. Changes in the boys’ behavior were assessed by two commonly used rating scales, one completed by the parents and the other by the teachers. According to the parents’ ratings, 54% of the children showed significant improvement in their behavior while taking L-carnitine, whereas only 13% improved during the placebo period. The teachers’ ratings showed a similar, though slightly less pronounced, advantage of L-carnitine over placebo.

No serious side effects were seen, although one boy experienced an unpleasant body odor while taking L-carnitine. The authors of the study have found that this occasional side effect can be prevented by taking riboflavin along with the L-carnitine.

ADHD affects an estimated 3 to 5% of school-aged children in the United States. It is characterized by impulsiveness, inability to concentrate, excessive physical activity, and learning difficulties. The amphetamine-like drug methylphenidate, which acts as a stimulant for most people, has a paradoxical calming effect in children with ADHD. Methylphenidate has a long list of potential side effects, however, and there are concerns that long-term use of the drug could stunt the growth of children.

L-carnitine is a naturally occurring vitamin-like compound that plays a role in normal energy production in the body. It has been used successfully by doctors to treat heart disease, elevated cholesterol, and some cases of infertility. It is not known how L-carnitine improves behavior in children with ADHD, although blood levels of L-carnitine have been found to be low in some of these children.

Other natural treatments that have been reported to be effective for ADHD include avoiding refined sugar, removing synthetic and naturally occurring salicylates from the diet, identifying and avoiding allergenic foods, and supplementing with B vitamins. Preliminary research suggests that exposure to the radiation from television sets or from fluorescent bulbs may also promote hyperactive behavior.

L-carnitine is a relatively expensive nutritional supplement; the amount used in the new study would cost up to $6 per day. Additional research should focus on whether combining L-carnitine with dietary modification and other nutritional supplements would allow lower amounts of L-carnitine to be effective.

Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.

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