L-CARNITINE: PHYSIOLOGICAL EFFECTS, REALITIES AND PROSPECTS FOR USE IN MEDICINE

The article presents a literature review of the positive effects of carnitine on the animal organism: energy-tropic, antioxidant, antihypoxic, detoxifying, hypolipidemic, membrane-stabilizing, antiapoptotic, anabolic and stabilizing mitochondria. The article discusses the effectiveness of carnitine and acetylcarnitine in compensating for polyneuropathies of various origins, various neurodegenerative disorders, hereditary muscular dystrophies, cardiomyopathy, cancer sarcopenia, for the purpose of hepatoprotection, alleviation of metabolic syndrome, peripheral atherosclerosis, age-related changes in mitochondria in skeletal and cardiac muscles, damage of skeletal muscles during physical exertion, manifestations of hyperammonemia.At the same time, most studies indicate that the beneficial effects of carnitine require a long period of administration – at least 12 weeks, and its clinically effective doses correspond to or are twice as high as the upper permissible level of consumption in specialized food products and dietary supplements (more than 2 g/a day). At the same time, some studies have found that food supplements with carnitine can significantly increase the level of atherogenic trimethylamine-N-oxide in the blood serum of both humans and rodents. In addition, it has been established that too high doses of exogenous carnitine during physical exertion against the background of circulatory insufficiency and, accordingly, tissue oxygenation, can cause a negative effect. In this regard, the advisability of long-term use of pharmacological doses of carnitine, especially when administered orally, requires careful justification.Despite the contradictory results of studies regarding the effectiveness of exogenously administered carnitine in animal models and conditionally healthy people, it may be very useful in certain pathologies, primarily those caused by primary or secondary carnitine deficiency, impaired metabolism and energy metabolism disorders, including mitochondrial dysfunctions, as well as in older patients who often develop secondary mitochondrial dysfunctions.