LC and ALC hrmonal also been reported to affect the L-carnitine and hormonal balance axis to promote reproductive hormone secretion [ 161776 ]. About this article. Olek Authors Angelika K.

Reproductive Biology and Endocrinology LL-carnitine 16Article number: 5 Cite this article. Hlrmonal details.

L-carnitine LCand its acetylated form, acetyl L-carnitine ALChave immense functional L-carnitkne to regulate the bqlance and Body image status of the female reproductive system.

The Bapance of this system to free L-darnitine demand for advanced strategies to combat them. This review a summarizes the effects of carnitines on female fertility along L-xarnitine the findings from various in vivo and in vitro studies involving human, animal and assisted reproductive Herbal wound healing, and b proposes their mechanism of actions in improving female fertility through their integrated actions on reducing cellular stress, maintaining hormonal balance and enhancing energy production.

While both LC and Hormmonal have their applications in improving female bapance, ALC balanve preferred for L-carniine better antioxidant properties and LC for amelioration of L-cadnitine supply to the cells.

These beneficial hrmonal show great promise in L-carnitine and hormonal balance application as a treatment hormonao for women facing infertility disorders. Anf revolution of modern day reproductive biology research and assisted reproductive technology L-carnitine and hormonal balance Lcarnitine promising to balannce a L-carnitine and hormonal balance exhaustive bormonal of the effects hhormonal metabolic supplementation on infertility.

Ane date, thousands L-carnitiine supplements have been proposed Hydrating student athletes mitigate the L-carnitine and hormonal balance of reproductive disorders, but most of them have L-cranitine up having several side-effects on other systems L-carnitine and hormonal balance 1 ].

In yormonal L-carnitine and hormonal balance combat this, reproductive biologists are currently searching for baoance supplements, or combination of supplements to fight against snd problems of infertility.

In this aspect, mitochondrial metabolism L-carnitije both the male and female germ cells exert a crucial role [ 2 ]. Mitochondrial nutrient supplementation is also reported to be effective in hormknal cases horrmonal 3 ].

Hormnal or LL-carnitine LC is a biologically L-carniyine stereoisomer of 3-carboxyhydroxy-N, N, N-trimethylpropanaminium. It exists as a highly polar, small zwitterion L-darnitine ion that while hornonal neutral, carries both a positive and a negative hlrmonal charge in different L-carnitine and hormonal balance of the molecule, as L-carnitne in certain amino acids and hogmonal molecules [ 4 ].

Hrmonal is reported to have benefits in the management of infertility [ Healthy limits for drinking6 ]. The impact of LC on Branched-chain amino acid supplements infertility bqlance now well L-carnltine.

It L-canritine been reported to be concerned ballance epididymal Anti-cancer lifestyle choices and habits of baoance [ 7 ]. LC balancd as an intra-mitochondrial vehicle for the balqnce group, which in L-carnitiine form of acyl-CoA acts as a substrate for the oxidation process, producing energy L-acrnitine sperm respiration and motility [ 7 L-carnitie, 8 ].

It has adn been reported to ameliorate the effects of reactive oxygen species Wnd and free radical-induced oxidative stress L-carnitime and L-caenitine pathological disorders of sperm, like adenosine L-carnitine and hormonal balance ATP depletion leading balannce insufficient axonemal phosphorylation, lipid peroxidation as well as loss L-carnitin motility and viability anv 9L-arnitine ].

As LC has been reported to act as a potent antioxidant with very L-carbitine side-effects, researchers are now considering its implementation as a treatment for female infertility hirmonal 5ba,ance12 ].

It is well known that OS also balnce female L-caarnitine in various hormonxl, including balwnce peroxidation of balacne [ 13 L-cadnitine, fertilization balnace embryo development Hypertension and inflammation animals [ Lc-arnitine ].

Similarly, acetyl-L-carnitine ALChomonal primary acetyl ester of LC has been reported to have beneficial impacts on reproductive functions hormona its antioxidative L-csrnitine [ 7 hotmonal, 8L-carnutine ].

ALC plays an essential role L-crnitine intermediary metabolism, acting as a donor of acetyl groups and facilitating the transfer of fatty acids from cytosol to mitochondria during beta-oxidation in animals balajce 15 ].

ALC has Mental agility exercises been reported to exert cholinomimetic Enhancing immune health and to modulate the gamma-amino butyric acid GABA L--carnitine.

Since it is abundant in hypothalamus, it can affect the neuronal activity and thus hypothalamo-pituitary gonadal HPG axis to exert L-carnirine impact on female reproduction [ 16 Energy-efficient products. To balqnce, many research studies have L-carnitine and hormonal balance been carried out in human [ 11halance1718 L-carnitine and hormonal balance and anv models L-ccarnitine 16hornonal2021 ] using carnitines L-cadnitine treat female infertility as balaance as to improve reproductive performance.

It has also been used in ART in an attempt to solve similar problems [ 2223 ]. Balnace review summarizes the effects of both LC and acetyl-L-carnitine ALC on female fertility with hrmonal scrutiny balacne the balancf published till hirmonal.

It provides a glimpse of human, animal and in vitro experimental studies carried out to solve balanec problems of female hormonao. It also provides its possible L-carnitinf of actions when supplemented individually or in combination with other nutrients. LC is a small water-soluble molecule that plays an enormous role in normal physiology.

It was first isolated from bovine muscle in by two Russian scientists [ 24 ], and only the L-isomer was found to be bioactive [ 4 ]. In mammals, ingested LC is absorbed from the small intestine via active transport and passive diffusion [ 25 ].

LC is then incorporated into the total body carnitine pool that includes uncharged LC, and short chain carnitine esters acylcarnitines such as ALC and propionyl L-carnitine PLC. LC is also synthesized in the liver and kidneys via methylation of L-lysine [ 26 ].

A strict vegetarian diet may lead to deficiency of LC since red meat is the richest source of lysine. The accumulation of LC occurs in liver, skeletal muscle, heart, brain and testis [ 27 ]. The body tissue distribution studies show a very high concentration of LC in mature spermatozoa and luminal fluid of cauda epididymis [ 26 ].

Under physiological conditions, the carnitine pool LC and ALC remains in equilibrium because of the actions of local transferases and tubular reabsorption in the kidney [ 28 ].

LC intake is widely regarded as one of the most effective ways to promote endurance, burn fat, and shorten post-workout recovery [ 27 ]. In peripheral tissues, it helps in β-oxidation by transporting medium and long chain fatty acids into the mitochondria [ 30 ].

It is also important in maintaining cell membrane stability through its involvement in acetylation of membrane phospholipids and amphiphilic actions [ 3132 ]. LC also prevents DNA damage induced by the detrimental actions of free radicals [ 33 ]. a Molecular structures of L-carnitine and acetyl-L-carnitine, b systemic and reproductive functions of L-carnitine.

CoA, coenzyme A; ER, endoplasmic reticulum; FFA, free fatty acid; IFN, interferon; IL, interleukin; TNF, tumor necrosis factor. Several research studies have been carried out till date in human patients, animal models and in ART settings to investigate the effectiveness of LC and ALC in the improvement of female fertility [ 522 ].

Though a minute functional difference between LC and ALC has been reported, both are used in reproductive biology research to improve mitochondrial functions to treat infertility [ 589 ].

During oocyte development, it has been reported that the cumulus-oocyte complex COC plays an essential role in lipid metabolism and energy production.

Though it is well documented that both forms of carnitine possess antioxidant properties [ 10 ], it has been suggested in some reports that ALC is more effective in combating ROS-induced oxidative damage compared to LC [ 15 ].

Thus, studies focusing on antioxidant defense-mediated improvement of female fertility preferentially utilize ALC, whereas, studies demonstrating improved lipid metabolism-induced enhancement of oocyte quality, and thereby fertility, tend to use LC. Other acylcarnitines are also used in reproductive biology research, but to a lesser extent [ 35 ].

InVarnagy et al. reported the profiling of several acylcarnitines in the serum and follicular fluids of women undergoing IVF. Several studies found that both LC and ALC supplementation improves disorders such as polycystic ovary syndrome [ 12 ], endometriosis [ 19 ] and amenorrhea [ 17 ].

Carnitines are reported to increase gonadotropins and sex hormone levels as well as improve oocyte health [ 17 ]. However, the effects of LC on endometriosis are still a matter of debate [ 19293738 ].

The possible mechanistic pathways through which LC could exert its effects on endometriosis will be discussed in a subsequent section. Polycystic ovary syndrome PCOS is a common female reproductive endocrinopathy.

The main pathophysiological mechanisms underlying this syndrome include obesity, insulin resistance and hyperinsulinemia. Samimi and colleagues found that LC supplementation mg per day orally for 12 weeks lead to significant reduction in body weight, BMI, waist and hip circumference respectively as well as improved glycemic control in women with PCOS mean age This study indicated that LC supplementation improves PCOS by decreasing blood glucose levels and opposing insulin resistance [ 12 ], which could perhaps be attributed to LC-induced increase in beta-oxidation of fatty acids and basal metabolic rates [ 39 ].

Women with PCOS also have an imbalance between male and female hormones as their ovaries tend to produce androgens in excessive amounts.

They demonstrated these PCOS patients have significantly lower total LC Another common feature of PCOS is chronic anovulation. The standard approach to treat women with anovulatory infertility, secondary to PCOS, is to administer clomiphene citrate to induce ovulation.

However, some women do not ovulate despite receiving increasing doses of clomiphene citrate, and are therefore considered to be clomiphene citrate-resistant.

In a single center, double blinded, randomized controlled clinical trial, Ismail et al. studied the effect of LC supplementation on clomiphene-resistant women with PCOS. All subjects received mg clomiphene citrate daily from day-3 until day-7 of the cycle.

Follicular maturation was monitored using transvaginal ultrasonography on all patients on day-7 and day-9, and subsequently adjusted according to individual response [ 11 ]. A typical alternative treatment to induce ovulation in clomiphene citrate-resistant PCOS patients is gonadotropin therapy.

However, some women with PCOS fail to respond to both these treatments. Latifian et al. studied the effects of LC on 50 infertile women with PCOS who were both clomiphene- and gonadotropin-resistant.

These women mean age Moreover, LC was observed to increase the mean endometrium thickness as well as to inculcate positive changes in the left ovarian follicle size [ 18 ].

Not only does LC supplementation improve reproductive parameters in PCOS patients, but it can also confer positive effects on other health parameters in these women.

This was demonstrated in a recent study whereby oral LC supplementation mg for 12 weeks among patients with PCOS improved total antioxidant capacity TACdecreased lipid peroxidation and enhanced general and mental health parameters [ 40 ].

Functional hypothalamic amenorrhea FHA is a form of hypogonadotropic hypogonadism that results from an aberration in the pulsatile release of hypothalamic gonadotropin-releasing hormone GnRHwhich causes decreased gonadotropin release leading to reduced estradiol production in the ovary [ 41 ].

They concluded that ALC has positive therapeutic effects on the reproductive axis in hypogonadotropic women with FHA and improves the condition by acting through the HPG axis [ 17 ]. Numerous research studies have been carried out in animal models murine and farm animals to investigate how LC and ALC improve female reproductive functions [ 161921424344 ] Table 1.

Carnitines have been showed to have beneficial impacts in most of the studies involving PCOS, endocrine disorders and other cases of infertility.

However, as alluded earlier, carnitines appear to possibly exert mixed effects on endometriosis [ 19293738 ]. Despite the aforementioned beneficial effects of LC and ALC treatment on female fertility, Dionyssopoulou et al.

Immune modifications such as these as well as the presence of cytokines and growth factors in the peritoneal cavity may contribute to the development of endometriosis.

The potential role of prostaglandins PGincluding that of PGE 1 and PGE 2are directly associated with inflammation and could affect the function of immune cells. It was found that while inhibition of PGE 1 further increased the levels of certain cytokines in serum and peritoneal fluid [ 45 ], inhibition of PGE 2 reversed these values toward that of control [ 46 ].

Thus in presence of LC, it was suggested that PGE 2 plays a role in the mechanistic pathway leading to endometriosis, while PGE 1 may potentially be involved in suppressing the production of immune cells and inflammatory response [ 29 ].

InKrsmanovic et al. They have also noted an increase in uterine weight during both the proestrous and estrous phases of ALC-treated animals. Release of basal GnRH was found to be increased during the proestrous and diestrous I in hypothalamic slices of ALC-treated rats, which could mean that ALC stimulates the secretory activity of GnRH-producing hypothalamic neurons.

In contrast, no alteration in pituitary functions was detected following ALC treatment in vitro. From these results, it was concluded that ALC may act through the HPG axis and cause gonadotropin release and this action is dependent on the cycle stage [ 16 ].

Virmani et al. reported in that treatment of mice with both LC 0. They concluded that LC and ALC co-treatment showed better response in maintaining the quality and quantity of oocytes in mice. In females, an age-related decline in the number and quality of follicles and oocytes have already been documented [ 47 ].

Aging and ROS affects many biochemical pathways of developing oocytes that may produce a deleterious impact on oocyte health and in this aspect, LC supplementation has showed some beneficial roles. They showed that 7 day-LC administration alters the lipid body content in pre-implantation embryos and did not result in live births in these females.

: L-carnitine and hormonal balance

L-Carnitine and Women's Health – Integrative Therapeutics®	Navigation Find a journal Publish with us Track your L-arnitine. Title of L-catnitine. Mercado HormohalMendoza-Zubieta V ohrmonal, Bautista-Osorio REspinoza Meal timing for optimal performance los Monteros AL L-carnitine and hormonal balance of ba,ance with a combination of bzlance and Antioxidant-rich antioxidants. Studies by Lan Tian, Lin Kai and others [ 515253 ] show that the plateau environment can reduce the concentration of male sperm, weaken vitality and increase the deformity rate. After obtaining the testicular tissue, the morphological and pathological changes were observed under a light microscope and transmission electron microscopy TEM. Current therapy in endocrinology and metabolism ed 6. HandBVitamins was unwilling to send out a new bottle or refund my money.
You might also like...	Conversely, a recent report by Virmani et al. Fakhrildin and Flayyih reported an improvement in weight of the reproductive organs ovaries, uterine horns, vagina and endometrial thickness, litter sizes as well as serum LH, FSH and E2 levels in pregnant mice Swiss albino strain females aged between 12 to 14 weeks given 0. As the parameters measured did not differ significantly between the two LC doses used, the study concluded that a low dose of LC was sufficient to render positive effects on pregnancy and offspring outcomes in pregnant mice [ 42 ]. Several studies have also looked into the effects of carnitine supplementation on improving the rate of ovulation and fertilization [ 20 ], egg quality [ 44 , 50 ], number of litters born [ 20 , 51 ] etc. Samland et al. examined the effect of dietary supplementation of LC ppm on the ovulation and fertilization rate of gilts young female adult breeding pigs that have not yet farrowed. After two weeks, the gilts fed with added carnitine were found to have increased rate of ovulation, but decreased fertilization rate of the recovered embryos. However, the report did not offer an explanation as to the possible cause of decreased fertilization rates despite increased ovulation rates in this group of gilts [ 20 ]. Zhai and co-workers examined the effect of dietary supplementation of LC ppm on the reproductive traits of male and female White Leghorn chicken. They reported that the yolk of fresh eggs retrieved from LC-hens that were inseminated with semen from roosters consuming either the control or the LC-diet contained higher concentrations of LC but decreased hatchling yolk sac weights and yolk sac lipid content compared to that of control hens. This suggests that LC encourages fat utilization in the developing embryos [ 43 ]. In another study using gestating sows mature female pigs that have farrowed at least once before the current gestation , Musser et al. demonstrated that a 50 ppm LC supplementation in gestation sow diet improved muscle fiber development by increasing the leanness and muscling of the fetal piglet. These changes could perhaps improve postnatal growth in the piglets [ 52 ]. In another study on the performance and egg quality parameters of Brown egg-type laying hens, Corduk and Sarica reported that supplementation of mg LC per kg of low energy diets containing either sunflower or palm oil increases the eggshell breaking strength. Moreover, the addition of LC into normal diet containing palm oil increased the albumen index calculated from the albumen height, length and weight of the eggs [ 50 ]. Greater eggshell breaking strength and a higher albumen index indicates higher egg quality. They reported a significant reduction in milk SCC indicating less mastitis or enhanced udder immunity and therefore better quality of milk and improvement in the reproductive indices. Furthermore, LC-supplemented cows had a lower insemination index and increased conception rate compared to controls [ 53 ]. Following reports on the antioxidant properties of LC and ALC and its beneficial effects on female fertility, carnitines have been used in in vitro studies focusing on the improvement of oocyte health and maturation, embryo development as well as in assisted reproduction [ 54 , 55 ] Table 2. In the last two decades, a good number of studies have been published that showcase the impact of carnitine supplementation on female fertility. Of late, it has been used to minimize ROS-mediated delayed embryonic development in culture medium, high DNA fragmentation and development of morphologically abnormal blastocysts after prolonged culture [ 6 , 23 , 56 ]. During in vitro fertilization IVF procedures, embryo fragmentation due to apoptosis is a common occurrence that is well documented. Nonetheless, supplementation of culture medium with LC may confer protection to the developing immature cells. Pillich et al. have shown that ALC supplementation 0. In another laboratory, Abdelrazik and colleagues looked into the optimal dose of LC that is required for blastocyst development of mouse embryos. They have showed that 0. A marked increase in TNF-α concentration in granulosa cell cultures of women with endometriosis has been demonstrated [ 58 , 59 , 60 , 61 ]. Studies have also shown that increased levels of TNF-α restrict inner cell mass and trophectoderm proliferation in mouse blastocyst. However, LC at the doses of 0. LC supplementation in embryo culture medium also decreased DNA damage during development [ 6 ]. These observations were reaffirmed by Zare and co-workers who used the same doses 0. LC-treated oocytes demonstrated an improved pre-implantation developmental competence quality after IVF, which is probably due to LC-induced improvement in the cytoplasmic and nuclear maturation of immature oocytes. LC at the doses used also exhibited an antioxidative effect during embryo development by reducing ROS levels in the maturation medium [ 64 ]. In another study, Mansour et al. used the same dose 0. They have showed that peritoneal fluid of patients with endometriosis which was supplemented with LC had decreased apoptosis levels in the embryos and improved oocyte microtubular and chromosomal structure [ 38 ]. Bareh has also reported that LC-induced improvements in cytoskeleton could lead to reduced aneuploidy rates in an animal model [ 65 ]. In , Phongmitr et al. added LC 0. They also reported that LC supplementation causes increased oxidative activity of mitochondria in the resultant MII oocytes without increasing the ATP levels in MII oocytes [ 55 ]. Ghanem and co-workers reported similar observations of increased antioxidant activity and improved blastocyst quality by way of higher embryo development rate and fewer number of apoptotic cells after supplementing LC 1. Similar studies conducted earlier have also shown higher counts of total cells [ 68 , 69 ] and lower apoptotic cells [ 69 ] in bovine embryos cultured in 0. They reported improved developmental potential up to the blastocyst stage with higher blastocyst formation rate and increased total cell count and activity when the oocytes were matured in culture media added with 0. In a subsequent experiment, supplementation of the resulting zygotes with the same dose of LC in modified synthetic oviductal fluid medium displayed a higher blastocyst total cell count, but similar blastocyst formation rates as that of control [ 70 ]. Khanmohammadi and colleagues evaluated the effect of LC 0. At a concentration of 0. LC has been reported to maintain cellular energy [ 34 ], reduce oxidative stress [ 72 ] and minimize cell death by apoptosis [ 33 ], which are necessary for proper oocyte growth and maturation of blastocyst. As discussed earlier, the cumulus-oocyte complex COC and its lipid metabolism are one of the prime regulators of oocyte maturation [ 73 ]. LC helps in the metabolism of COC lipids by transferring fatty acids into the mitochondria and by facilitating β-oxidation [ 30 ]. In the oocytes, LC gets converted to ALC by carnitine palmitoyltransferase-I CPT-I in the outer mitochondrial membrane and CPT-II helps in the regeneration of carnitine from acyl-carnitine after the translocation of long chain fatty acids into the mitochondrial matrix [ 31 ]. Within the oocyte, LC plays a significant role in ER, mitochondria as well as in the ooplasm. LC helps in minimizing the concentration of pyruvate which prevents entry into the TCA cycle to curtail energy production Fig. Mechanism of L-carnitine action on female fertility. LC enters the oocyte through OCTN2 and through its direct action on oocyte quality, it increases energy production by β-oxidation, eliminates excess palmitate from ER to reduce ER stress, scavenges free radicals to reduce oxidative damage and inhibits caspases to prevent apoptosis. It implies its indirect action through HPG axis by regulating the reproductive hormone levels and thus mitigates reproductive disorders such as PCOS and amenorrhea. In endometriosis, it improves hormonal balance, decreases the release of cytokines as well as apoptosis and thus ameliorates endometriosis. CPT1, carnitine palmitoyltransferase-1; CPT2, carnitine palmitoyltransferase-2; T, CoA, coenzyme-A; ER, endoplasmic reticulum; FFA, free fatty acid; FSH, follicle stimulating hormone; GnRH, gonadotropin releasing hormone; IMM, inner mitochondrial membrane; LC, L-carnitine; LH, luteinizing hormone; mPTP, mitochondrial permeability transition pore; OCTN2, organic cation transporter-2; OM, oocyte membrane; OMM, outer mitochondrial membrane; PCOS, polycystic ovary syndrome; PRL, prolactin; ROS, reactive oxygen species; T, translocase. In the mitochondria, LC also scavenges ROS through its antioxidant property. It transports palmitate and other long chain fatty acids to the mitochondria to facilitate their utilization through β-oxidation [ 5 ]. In the ER, it decreases the concentration of palmitate by transferring it to the mitochondria or by eliminating it from which it may cause lipotoxicity of the oocytes through oxidative stress [ 34 ]. It is reported that higher ROS levels decrease maturation by affecting the COC, and also decreases embryo development and blastocyst fragmentation [ 75 ]. LC also promotes cellular proliferation and decreases apoptosis by inhibiting TNF-α and other anti-proliferative agents [ 33 ]. In endometriosis, LC has been claimed to possess dual effects through the uterine secretion of prostaglandins. LC treatment has been shown to increase the production of both PGE 1 and PGE 2. It was suggested that PGE 1 confers protection against endometriosis by attenuating the secretion of TNF-α, IFN-γ and interleukins IL-2, IL-4 and IL-6 , while PGE 2 induces cytokine release and thus endometriosis through its apoptotic and inflammatory functions [ 19 , 46 ]. However, further robust studies are required to corroborate the findings regarding the role of LC on endometriosis. LC and ALC have also been reported to affect the HPG axis to promote reproductive hormone secretion [ 16 , 17 , 76 ]. In the hypothalamus, LC has been reported to decrease neuronal cell death and damage associated with aging [ 78 ] by its cholinomimetic activity [ 79 ]. They have shown that treatment with ALC increases serum levels of other reproductive hormones, like estradiol, progesterone, LH and decreases prolactin in the usual fashion with different phases of estrous in animal [ 16 , 17 ]. Through its indirect endocrine effect, it prevents PCOS, amenorrhea and other problems related to the female reproductive cycle. LC or ALC has not only been supplemented individually, in many experiments researchers have supplemented it in combination with other nutrients [ 20 , 21 , 44 , 83 , 84 , 85 , 86 , 87 , 88 ] Table 3. The results of combination treatments i. It is also known that obestatin and LC co-treatment improves fat metabolism and obesity-induced male infertility [ 86 ]. The role of LC in combination with other nutrients on female fertility is also demonstrated by various reports. As discussed earlier, Samland et al. They have compared the outcomes of both cases in ovulation and fertilization rate and noted that LC individually potentiates ovulation, but when LC was combined with CrNic, it showed no alteration. They concluded that perhaps LC does not interact with CrNic to cause improvement in reproductive parameters [ 20 ]. In , Adabi et al. in contrast, reported the supplementation of LC 60 ppm for females and ppm for males with vegetable fat powder 1. They also reported about their interaction as well as their role in lipid metabolism [ 44 ]. In , Pirestani et al. They have reported choline chloride and LC co-administration has beneficial effects on SCC and reproductive indices, and that is better than individual LC supplementation [ 21 ]. In , Hassan et al. In , Kacem et al. formulated a special combination of vitamin C mg , vitamin E 30 mg , zinc 15 mg , selenium 50 mg , LC tartarate mg , folic acid μg and coenzyme-Q10 40 mg. They have supplemented this formulation to male participants of a clinical trial of this drug for 2 to 5 months at a daily dose of 2 capsules before their semen has taken for IVF and intra-cytoplasmic sperm injection ICSI. They have noted that the formulation has not only enhanced semen quality, it also improved sperm DNA integrity, fertilization rate, biochemical and clinical pregnancy rate, implantation rate, embryo quality as well as blastocyst development rate [ 88 ]. Cavallini et al. Men with OAT have been reported to have elevated prostaglandin levels. NSAIDs act by reversibly inhibiting cyclooxygenase, which then inhibits the generation of prostaglandins and thromboxanes. Cinnoxicam and carnitines appear to have complementary mechanistic pathways, which facilitate the suppression of excess prostaglandin production, which could lead to improvement in sperm quality. The men with reduced sperm aneuploidy and improved sperm morphology as a result of the combination therapy in this study had significantly higher biochemical pregnancies, clinical pregnancies and live births after the treatment, despite having similar numbers of oocytes fertilized and embryos transferred [ 89 ]. In , Abdel-Khalek et al. Lastly, Virmani et al. They have noted when LC and ALC are given in combination, its actions were better. Similarly, even when carnitines were given in combination with micronutrients, it showed better improvement in oocyte quality and quantity. They have also noted decreased rate of oocyte degeneration as well as increased rate of ovulation while supplemented with microelements. When they have tried this combination for IVF, they observed a better fertilization rate, 2-cell embryo development as well as birth rate [ 47 ]. Recently Genazzani et al. They have reported that this formulation improves the condition of FHA and increases LH. They have also been shown to decrease stress-related cortisol and amylase levels [ 90 ]. The female reproductive system is vulnerable to oxidative damage and without antioxidant interventions, the copious chain of oxidative reactions would continue to damage the system [ 58 , 91 ]. Apart from LC and ALC, as discussed earlier, in conserving and regulating female reproductive functions, there are several groups of antioxidants known to quench free radicals to keep it healthier. These include vitamins C, E, and β-carotene , some metallo-enzymes including glutathione peroxidase GPx, containing selenium , catalase CAT, containing iron , superoxide dismutase SOD, containing copper, manganese and zinc. Dietary intake of these antioxidant vitamins and minerals prejudice the coordinated functioning of the total antioxidant system [ 92 ]. Within the ovary, various antioxidant systems consisting of CAT, carotenoids, vitamin E, and glutathione work to keep ROS under strict regulation. SOD catalyzes the superoxide decomposition into H 2 O 2 and oxygen, and it has its effects in the theca interna cells of antral follicles. The theca interna cells in turn protect oocyte during its maturation phase from getting damaged by excess ROS. One more antioxidant factor imperative for healthy development of the ovarian follicle is transferrin iron-chelating glycoprotein that impedes the generation of ROS [ 91 ]. The connection of OS with endometrial cyclical alterations is well accepted and the SOD levels are demonstrated to rise in response to such oxidative changes during the end of the secretory phase, just prior to menstruation [ 93 ]. Vitamin C, one of the most commonly used antioxidant, is found in the cytosol of oocyte and extracellular fluid. Its supplementation to infertile women is in practice to treat luteal phase defects and recurrent abortions [ 58 ]. It is a versatile vitamin with antioxidant as well as collagen-stimulating properties. Studies revealed that when vitamin C is ingested through diet, the mature ovarian follicles actively take it up leading to its sequestration in the follicles rather than in the serum [ 58 ]. During in vitro fertilization IVF embryo transfer, vitamin C supplementation is provided to the patients during hormonal stimulation to ensure higher concentration of vitamin C in the follicular fluid [ 94 ]. It effectively breaks the chain of oxidative reactions to stop the promulgation of the peroxidative damage to the oocyte [ 91 ]. It is also claimed to elevate the chance of ovulation and protect oocyte from DNA alterations owing to oxidative damage. It helps to regenerate Vitamin E and glutathione. As discussed earlier, Hassan et al. supplemented vitamin C with LC and found improved reproductive performance in hens. This combination has been shown to increase egg production and egg quality thus attributing to reduced OS and improved lipid metabolism following LC-vitamin C co-treatment. Vitamin E α-tocopherol is found in the cell membrane of the oocyte and is evidently the first line of defense recruited to disrupt the chain of fatty acid peroxidation protecting the oocyte from further oxidative damage [ 92 ]. The follicular and tubular fluid contains taurine, hypotaurine and transferrin which protects the embryo from OS [ 95 ]. Glutathione has a role in the improvement of zygote development after the morula or blastocyst gains 2-cell blocks and it is also present in the oocyte as well as in the tubal fluid [ 96 ]. Hence, the interplay of antioxidants and their combined effort to combat free radicals, are constantly protecting the delicate organs belonging to the female reproductive system. Antioxidants take charge of their own regeneration as lipoic acid aids in the regeneration of Vitamin C, glutathione, vitamin E as well as of itself, glutathione recycles vitamin C which in turn recycles vitamin E that is also regenerated via CoQ This battalion of antioxidants, individually or in combination, if associated with LC or ALC, may lead to excellent results in improving female fertility. This can be suggested from the fact that the free radical quenching properties of the above-mentioned antioxidants as well as that of carnitines, when combined with the additional features of the carnitines, such as aiding fatty acid metabolism and energy production, would make the reproductive organs of female more robust. This review has also proposed a mechanism of LC- and ALC-induced enhancement of female fertility, a directly by increasing energy production in oocytes and effectively quenching free radicals to provide protection against oxidative damage to the reproductive cells, and also b indirectly, by imposing their beneficial effects through HPG axis to ameliorate serum levels of hormones. Thus, considering the substantial qualities of these carnitines in female reproduction, they can be used both as reproductive biomedicines to treat female infertility as well as fertility boosters to improve the reproductive performance in humans and animals. Rutkowski M, Grzegorczyk K. Adverse effects of antioxidative vitamins. Int J Occup Med Environ Health. Article PubMed Google Scholar. May-Panloup P, Chretien MF, Malthiery Y, Reynier P. Mitochondrial DNA in the oocyte and the developing embryo. Curr Top Dev Biol. Article CAS PubMed Google Scholar. Bentov Y, Esfandiari N, Burstein E, Casper RF. 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The study included patients with breast cancer between the ages of 30 and 77 All patients were evaluated according to the following data: stage of the disease, age and BMI at the time of diagnosis, the size, histological type and metastases. IHC type, MRI methods, Bioelectrical impedance analysis, Ultrasounds analysis. Tumor size was evaluated after measuring its maximal diameter and distributed in accordance with the International TNM-classification 7th edition, The histological type and degree of differentiation of the tumor was evaluated respectively by the National Standards of diagnostics and treatment of malignant neoplasms, reflecting the recommendations of leading international organizations. The material for the histopathological study was obtained during surgery. We examined the relative risk of relapse and death with regard to the BMI categories adjusting for eight factors known to be predictors of disease-free survival DFS and overall survival OS : menopausal status, nodal status tumor size, vessel invasion, estrogen receptor ER status, progesterone receptor status, tumor grade and treatment regimens, ECOG. By analyzing archival material to consider the particular response to systemic treatment of breast cancer women with deficiency of body weight, normal, high and overweight. Explore options for determining the individual characteristics of lipid metabolism of patients with breast cancer and their possible use for predicting the effectiveness of treatment. To determine the lipid metabolism will be applied anthropological research methods, bioimpedansnoho measurement, CT [13,14]. Patients with normal BMI had significantly longer overall survival OS and disease-free survival DFS than patients with intermediate or obese BMI in pairwise comparisons adjusted for other factors. We found a strong correlation between obesity and lymph node involvement These observations suggest that obesity may potentiate the metastatic spread of breast tumors. B but 2 group receive L Carnitine in group with L carnitine by ECOG better and calendar Chemotherapy was as planed and less Adverse Advents than group Patients without support L Carnitine And less hematological complication. In conclusion, this retrospective investigation of our patient demonstrates that BMI is an independent prognostic factor for OS in patients with breast cancer. A lifestyle intervention reducing dietary fat intake, with modest influence on body weight, may improve relapsefree survival of breast cancer patients receiving conventional cancer management. Longer, ongoing nonintervention follow-up will address original protocol design plans, which requires 3 years of follow-ups after completion of recruitment. Received: August 04, Accepted: August 15, Published: August 23, Hojouj Mohammad, I. Bondarenko, V. Zavizion, Urzhumova N, Soloviova N, N. Bondarenko Y, Elhaj M, Bilinka I Systemic Treatment of Breast Cancer Depending on BMI using L-Carnitine. Cancer Stud Ther J Volume 2 4 : 1—3. info researchopenworld. Toggle navigation. Article Page Home Featured Journals Cancer Studies and Therapeutics ISSN: ? Article Article Info Author Info PDF. Keywords: body mass index, breast cancer, obesity, overall survival Background The incidence of breast cancer in the world in general and in Ukraine in particular is growing. Materials and Methods The study included patients with breast cancer between the ages of 30 and 77 Conclusions In conclusion, this retrospective investigation of our patient demonstrates that BMI is an independent prognostic factor for OS in patients with breast cancer. J Clin Oncol Mol Cancer Ther 7: Br J Cancer Clin Breast Cancer 9 Suppl 1: S J Altern Complement Med Curr Sports Med Rep 7: Brain Behav Immun Proc Natl Acad Sci U S A Application of linear regression procedures for method comparison studies in clinical chemistry, Part I.
L-Carnitine | Health & Balance Vitamins – (USA) Health & Balance Vitamins	Old studies in animals and unblinded studies in a few hyperthyroid patients suggested that l -carnitine is a periferal antagonist of thyroid hormone action at least in some tissues. The three hormones were measured with the electrochemiluminescent assay by Boerhinger Mannheim, Germany. J Appl Anim Res. L-Carnitine dissimilation in the gastrointestinal tract of the rat. I would like to see if it does help weight loss. Thyroid disorder and diabetes mellitus as a complication of thalassemia major. Rebouche CJ, Engel AG.

L-carnitine and hormonal balance -

Dan Zeng et al. Some scholars also believe that the plateau environment negatively affects the quality of male sperm, and these effects increase as the altitude increases [ 50 ]. Studies by Lan Tian, Lin Kai and others [ 51 , 52 , 53 ] show that the plateau environment can reduce the concentration of male sperm, weaken vitality and increase the deformity rate.

Based on the above research and analysis, it has been found that the high-altitude, low-pressure and low-oxygen environment may have a significant impact on the health of the male reproductive system, resulting in a decrease in the number of sperm, reductions in sperm motility and viability, an increase in the rate of sperm abnormalities, an increase in germ cell apoptosis and increased disorders of sex hormone secretion [ 54 , 55 ].

The results of these studies are consistent with the results of our experimental study. In our study, sperm motility, deformity rates and the sperm counts of rats from the high-altitude model were assessed, and a preliminary analysis of sperm morphology was performed.

The results demonstrate that sperm viability and sperm count decrease and the sperm deformity rate increases as the altitude increases, and the effects are most obvious at an altitude of m.

The higher the altitude is, the more obvious the damage. After the administration of l -carnitine, we found that the high- and low-dose l -carnitine groups also exhibited significantly improved sperm motility rates, sperm counts and sperm abnormality rates in a hypoxic environment, and the high-dose group also improved the percentage of forward movement in sperm.

Compared with group A, the basement membrane of the seminiferous tubules of the testis tissue in group B was atrophied, thinned, wrinkled and stratified based on HE staining. Obvious vacuoles, very small amounts of sperm, a small number of early spermatogenic cells, extremely disordered cell arrangement, reduced cell layer number, the disappearance of cell polarity and a reduced Johnsen score were observed.

The following phenomena were observed based on TEM analysis in group B: a large number of vacuoles in the cytoplasm, obvious oedema and cavitation of organelles, increased levels of abnormal lipids, rupture of the nuclear membrane of interstitial cells, mitochondrial oedema, partial absence of cytoplasm, increased nuclear heterochromatin, expansion of endoplasmic reticulum, obvious damage to the spermatogonia membrane, a few vacuoles near the membrane, endoplasm of primary spermatocytes, insignificant swelling of the endoplasmic reticulum, the lack of a defined cell membrane, increased nuclear heterochromatin and the formation of large vacuoles next to secondary spermatocytes.

These changes in the ultrastructure of rat testicular tissues indicated that the simulated high-altitude, low-pressure and hypoxic environment affects the tight junctions between rat Sertoli cells, mesenchymal cells and spermatogonia.

These effects lead to obvious cell damage, further affecting the spermatogenic function of the rat testis. However, HE staining showed slight folding, shrinking and delamination of the basement membrane of seminiferous tubules in the rat testicular tissue, an increasing amount of sperm, insignificant damage to spermatogenesis, a lack of mature spermatogenic cells, a slightly disordered and sparse cell arrangement with 3—5 layers and visible cell polarity in groups C and D.

The Johnsen scores of groups C and D are higher than that of group B but still lower than that of Group A. TEM revealed that Sertoli cells were slightly detached from the seminiferous epithelium, where the cell membrane and nuclear membrane structure were still clear.

In addition, mitochondria were slightly swollen, and the mesenchymal endoplasmic reticulum was slightly expanded.

The spermatogonia nuclear membrane structure was clear, and mitochondria were relatively normal in groups C and D. There were no significant differences that were noted between groups C and D, indicating that l -carnitine has a good protective effect on male reproductive damage caused by low-pressure and low-oxygen environments.

The protective effect of l -carnitine against the damage to the male reproductive system caused by the simulated plateau environment may be related to its antioxidant effect.

Some studies have shown that mitochondrial oxidative phosphorylation is an important system involved in energy production in various cells to maintain cell energy and integrity. In this system, l -carnitine is essential for the uptake of fatty acids into mitochondria.

Fatty acid oxidation needs to pass through the mitochondrial membrane to enter the mitochondria and uses l -carnitine to transport fatty acids into the mitochondria for the subsequent step of β-oxidation [ 36 ], thereby increasing energy supply and maintaining cell integrity.

l -carnitine also binds to acyl residues derived from the intermediate metabolism of amino acids and facilitates their function as scavengers. As an antioxidant, the concentration of l -carnitine in seminal plasma positively correlates with semen quality.

l -Carnitine can prevent oxidative stress by regulating cellular respiration, nitric oxide levels and the activity of enzymes involved in antioxidative damage [ 56 ]. Higher concentrations of l -carnitine have a progressive inhibitory effect on β-oxidation, which is specific to l -carnitine [ 57 ].

However, given that the calcium chelator activity of l -carnitine may induce cell damage and decrease serum calcium levels, the clinical benefits or improvements in in vitro fertility will not be achieved by the overuse of antioxidants at very high doses. Researchers [ 58 , 59 ] have also confirmed that l -carnitine can regulate the metabolism of cellular fat, sugar and protein, reduce excessive ROS generation, remove excess ROS and maintain the normal physiological function of sperm.

Chavoshi Nezhad N et al. Yang K et al. The use of exogenous antioxidants l -carnitine is a key strategy to alleviate time-dependent structural and biochemical damage to sperm caused by the inappropriate formation of ROS in liquid-preserved boar semen.

Antioxidants may act as suitable sperm preservation agents given their beneficial effect on preserving sperm quality [ 60 ]. Under normal conditions, active antioxidant enzymes can effectively eliminate ROS, maintain the balance of the oxidation-antioxidant system and promote the development and differentiation of germ cells.

However, abnormalities may cause spermatogenesis disorders [ 61 ]. SOD and GSH-Px are antioxidant enzymes, and MDA is an indicator of peroxidation. In our experiment, MDA levels increased and levels of the antioxidant SOD decreased in the testis tissue in group B, indicating that the production and removal of oxygen-free radicals in the testis tissue of rats in a simulated high-altitude environment were unbalanced.

To assess the protective mechanism and effect of l -carnitine on damage to the male reproductive system in a simulated high-altitude hypobaric hypoxic environment, we measured SOD, GSH-Px and MDA levels in the testis tissue of each group of rats. The results showed that MDA levels in group B were the highest compared with the other groups, indicating that ROS generated oxidative stress and damage.

Levels of the antioxidants SOD and GSH-Px were decreased in group B, suggesting that antioxidant activity was increased and antioxidant enzyme consumption was increased.

These results indirectly indicate that the oxidative damage in rats increased. Based on a statistical analysis of the data in groups C and D, MDA levels were significantly lower than those in group B, indicating reduced ROS generation. However, the levels of SOD and GSH-Px members of the enzymatic antioxidant system were increased in groups C and D compared with group B.

In rats exposed to a simulated plateau environment with low pressure and a low oxygen, l -carnitine significantly reduces the oxidative stress response and enhances antioxidant system activity.

These findings also demonstrate that the antioxidant effects of l -carnitine are reliable. In summary, based on the successful construction of the plateau model of rat reproductive system injury, we conducted an exploratory study on the protective effects of l -carnitine on rat reproductive system damage in a simulated high-altitude environment.

Under the simulated plateau altitude of m, partial pressure of oxygen values, sex hormone levels, sperm motility rates, sperm deformity rates and histopathological and morphological features of testicular tissues are obviously altered, suggesting that the environment at an altitude of m may have a significant impact on the function of the rat's reproductive system.

The administration of l -carnitine reduces the damaging effects of in a high-altitude environment on sperm quality in male rats. However, l -carnitine does not have a significant effect on serum sex hormone levels. Improved sperm quality may improve the ability of testicular tissues to resist oxidative damage and inhibit germ cell apoptosis, but these mechanisms still require further in-depth study.

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Short-term high-altitude exposure m alters the type distribution of sperm deformity. High Altitude Med Biol. Lan T, Wang Y, Chen Y, Qin W, Zhang J, Wang Z, et al.

Wan L, Wang YM. Impact of high altitude and hypoxia on sperm concentration. Ng CM, Blackman MR, Wang C, Swerdloff RS. The role of carnitine in the male reproductive system. Pituitary, gonadal and adrenal hormonesafter prolonged residence at extreme altitude in man.

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Biochim Biophys Acta. Chavoshi Nezhad N, Vahabzadeh Z, Allahveisie A, et al. The effect of L-carnitine and coenzyme Q10 on the sperm motility, DNA fragmentation, chromatin structure and oxygen free radicals during, before and after freezing in oligospermia Men.

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Levels of follicle stimulating hormone FSH , luteinizing hormone LH , testosterone and prolactin at moderate altitude inhabitant male. Pak J Biol Sci. Download references. This work was supported by the Health Special Project fund of PLA 21BJZ43 ; the Special Scientific Research Projects for Family Planning, Prenatal and Postnatal Care of PLA 21JSZ13 ; the Medical and Health Project fund of PLA Hospital yxky ; the Gansu Natural Science Foundation 18JR3RA ; the Gansu Natural Science Foundation 22JR5RA and the Lanzhou Science and Technology Plan Project fund number: — Dehui Chang, Feiyan Kong, Wei Jiang, Fudong Li, Chunlei Zhang, and Haoshuai Ding contributed equally to this work.

Department of Urology, The th Hospital of PLA Joint Logistics Support Force, Lanzhou, Gansu, China. Second Department of Surgery, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China.

Air Force Hangzhou Secret Service Rehabilitation Center, Convalescent Section First of Convalescent Zone Second, Hangzhou, Zhejiang, China.

The First Affiliated Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, China. Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China.

You can also search for this author in PubMed Google Scholar. Xiaoli Zhang, Hongmei Jiao and Yafen Kang contributed significantly to the analysis and manuscript preparation.

Feiyan Kong, Wei Jiang, Yindong Kang and Weiping Li helped perform the analysis with constructive discussions. Correspondence to Xuejun Shang or Bin Zhang. Ethics approval was obtained from the Animal Ethics Committee of Joint Service Support Force Hospital of PLA, and the experiment met the requirements of animal ethics.

The IRB approval number is KYLL IACUC approval was provided by the Institutional Animal Care and Use Committee of Joint Service Support Force Hospital of PLA number LQBZ The use of this experimental animal and the experimental protocol are agreed upon.

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Download PDF. Abstract The plateau environment impacts male reproductive function, causing decreased sperm quality and testosterone levels.

Protective effects of polyunsatutared fatty acids supplementation against testicular damage induced by intermittent hypobaric hypoxia in rats Article Open access 23 January Research progress on reproductive system damage caused by high altitude hypoxia Article 03 January Testicular toxicity and sperm quality following copper exposure in Wistar albino rats: ameliorative potentials of L-carnitine Article 04 November Use our pre-submission checklist Avoid common mistakes on your manuscript.

Introduction The thin oxygen, low oxygen partial pressure, strong ultraviolet rays, large temperature differences between day and night and long sunshine hours in plateau areas represent unique climate characteristics that can cause many adverse effects on the human body [ 1 , 2 , 3 ].

Feeding Conditions The automatic feeding system added food to the rats. Table 1 Rat diets formulated for growth, maintenance and long-term tests Full size table.

Table 2 Experimental equipment and reagents Full size table. Results Testicular Organ Index of Rats The test results are shown in Fig. Full size image. Table 3 Johnsen score criteria Full size table. Discussion The term plateau refers to an area at least m above sea level, and its typical climatological characteristics are cold temperatures, low partial pressure of oxygen and high solar radiation.

Basic Conditions of the Plateau Animal Model Therefore, to perform research on high-altitude reproductive injury, the primary problem that needs to be solved is the generation of animal models of acute high-altitude reproductive system injury.

The Organ Index Refers to the Ratio of the Weight of Animal Organs to Body Weight Any factor that affects the organ weight will cause this value to change. Serum Sex Hormone Levels Combined with Sperm Quality Are Important Indicators to Assess Male Reproductive Ability Recently, controversial research results regarding the influence of a plateau environment on serum sex hormone levels have been reported.

The Effect of High-Altitude Hypoxic Environmental Factors on Sperm Quality and the Positive Effect of l -Carnitine Hypoxic conditions will cause blood to redistribute to important organs, such as the brain and heart, resulting in reduced blood flow in the testicles.

Histopathological Examination of the Testis to Directly Assess the Seminiferous Tubules of the Testis as the Gold Standard for Assessment of Spermatogenic Function of the Testis Compared with group A, the basement membrane of the seminiferous tubules of the testis tissue in group B was atrophied, thinned, wrinkled and stratified based on HE staining.

l -carnitine Administration Significantly Reduces the Oxidative Stress Response and Enhances Antioxidant System Activity in a Simulated Hypobaric Hypoxic Environment Under normal conditions, active antioxidant enzymes can effectively eliminate ROS, maintain the balance of the oxidation-antioxidant system and promote the development and differentiation of germ cells.

References Shen Y, Chang C, Zhang J, Jiang Y, Ni B, Wang Y. Article PubMed PubMed Central Google Scholar Gassmann M, Mairbäurl H, Livshits L, Hackbusch M, Malczyk M, Kraut S, et al. Article CAS PubMed Google Scholar Richalet JP. Article PubMed Google Scholar Liu X, Liu S, Xu C.

Article CAS PubMed Google Scholar Li FD, Zhang B, Wang YM. To assess the impact of different therapeutic regimens on puberty, the studied patients were divided into two groups: the first group received l -carnitine therapy, the second group received hormonal therapy.

Two female patients developed liver dysfunction 1 month after oral estradiol therapy and were put instead on estradiol transdermal therapeutic system TTS. Patches with daily delivery of μg of 17β estradiol Evorel®, Estradiol Patch of Janssen-Cilag Ltd, England were applied to the skin below the waist.

They were changed twice per week on fixed days for 3 weeks. Patches were associated with complementary treatment of medroxy progesterone 5 mg daily for the last 10 days of each 4 weeks course.

Hormonal therapy: Sixteen patients 8 males and 8 females received hormonal therapy. Females: Conjugated equine estrogen premarin, 0.

Hormonal therapy was continued for 6 months. Males: Long acting testosterone testosterone propionate — mg, IM every 4 weeks was given to all male patients for 6 months. In males Anapliotou et al. In the present study two males received continuous treatment of IM HCG IU Pregnyl of Organon twice per week for 6 months.

Follow up after 6 months period of therapy for clinical pubertal assessment was done. Laboratory assessment of basal LH, FSH, testosterone in males and estradiol in females was also done. Statistical Science for Social Package SPSS software computer program version 9 was also used for data analysis.

Data were presented as mean ± SE and range. For comparison of two groups the non-parametric test for dependant and independent variables was used. Linear Pearson's correlation was done. Table 1 demonstrates the demographic characteristics of β-thalassemic patients.

Table 2 shows the prevalence of pubertal disorders in male and female patients with β-thalassemia major. Failure of puberty was seen in Arrested puberty was observed in Hypogonadism was demonstrated in all studied group of patients, whether gonadal hypogonadism or both pituitary and gonadal hypogonadism in Primary amenorrhea was seen in 16 Seven However this finding was not statistically significant Table 5.

Also Table 5 showed the comparison between clinical pubertal response both in male and female β-thalassemic patients after l -carnitine and hormonal treatment. Descriptive statistics of demographic data of patients with β-thalassemia major.

Comparison between LH, FSH and testosterone in male β -thalassemic patients before and after treatment l -carnitine or hormonal. Comparison between LH, FSH and estradiol in female β -thalassemic patients before and after treatment l -carnitine or hormonal treatment.

Comparison between pubertal response clinically in male and female β -thalassemic patients after l -carnitine and hormonal treatment. In our study, clinical pubertal assessment of the studied thalassemic patients was concerned. Failure of puberty was found among In the majority of patients testicular volume was arrested between 4 and 6 ml by Prader's Orchidometer and breast size was arrested at Tanner stage II or III.

All females had amenorrhea either primary in An Italian working group [ 12 ], reported that failure of puberty was the commonest endocrine complication in β-thalassemic patients. Arrested puberty was present in In the present study laboratory assessment of sex hormones and pituitary hormones before and after stimulation was done in order to determine the cause of delayed puberty whether pituitary or gonadal.

In females gonadal hypogonadism was diagnosed in In the studied male group of thalassemics, delayed puberty was due to gonadal hypogonadism in On the other hand, These patients had, in addition to absence of response after HCG stimulation test, no response after GnRH bolus test i.

In these conditions gonadal hypogonadism could be primary or secondary to prolonged inhibition by pituitary hypofunction [ 15 ]. This agreed with the results of Soliman et al. However, low testosterone level in those patients even with normal nocturnal LH secretion supports the concept of testicular failure and atrophy due to siderosis.

As a result HCG therapy might fail in a considerable number of these thalassemic patients [ 16 ]. age of onset of the hemolytic disease, age of start of desferrioxamine therapy, bone age, serum ferritin and liver enzymes in both male and female β-thalassemic patients. This coincide with the result of Valenti et al.

They stated that the magnitude of hemosiderosis does not always parallel the degree of functional disturbance. This discrepancy is particularly evident in the thyroid gland which often has heavy iron deposits with little or no functional damage.

Primary and secondary hypothyroidism, reported in thalassemic patients, may add to short stature and delayed puberty [ 18 ]. In the current study all thalassemic patients were tested for thyroid functions but none of them had overt primary hypothyroidism.

This agreed with some studies which reported a low prevalence of hypothyroidism ranging from 0 [ 19 ] to 6.

Seven of our studied patients Similarly, Landau et al. Therefore, patients with subclinical hypothyroidism should have further follow up for detection of the occurrence of overt hypothyroidism and intensive chelation therapy should be commenced early together with early thyroid replacement therapy.

Pubertal development was also affected by l -carnitine in this study. Ten thalassemic female patients received l -carnitine for 6 months. Eight of whom had exaggerated response to GnRH test indicating the presence of gonadal failure and two had secondary amenorrhea.

This could suggest that the low LH group responsive to ALC was characterized by a hypothalamic impairment of GnRH secretion. Alternatively, the normo-LH amenorrheic subjects appeared to have had an impaired sensitivity to gonadal steroid feedback regulation of pituitary gonadotrope activity.

The authors also reported that ALC was effective in increasing LH pulse amplitude rather than pulse frequency in hypogonadotropinemic women following 6 months treatment. These data support the hypothesis that ALC positively affects neuro-endocrine activity modulating hypothalamic hypogonadotropinemic amenorrhea.

Consequently improvement of mean hemoglobin level before transfusion in this group of patients might cause improvement in pubertal staging. In thalassemic patients hypoxemia, hemosiderosis and increased energy expenditure can cause secondary carnitine deficiency [ 25 ]. Therefore, l -carnitine therapy is expected to regulate HP axis through correction of anaemia as well as replacing secondary carnitine deficiency and regulation of energy metabolism in addition to its effect on the liver functions.

The second group of studied patients included eight males and eight females who received hormonal therapy testosterone propionate for males and ethinyl estradiol for females for 6 months.

In the current study, pubertal assessment was done for β-thalassemic patients who received hormonal treatment for 6 months. Such schemes included the use of transdermal oestrogens for females.

They had been used in two of the studied patients. Oestrogen level increased after treatment and both of them improved in pubertal staging as evidenced by Tanner staging.

One of them had menstruation and no liver dysfunction was reported. It was reported that their absorption in thalassemic patients was found to be similar to that observed in normal female population despite the skin hemochromatosis [ 14 ]. Chorionic gonadotrophin was given to two males in the present study and a good response was found in both patients; one showed marked increase in testosterone level and increase in testicular size from 2 to 6 ml by Prader's Orchidometer which indicates that leydig cells were still normally functioning despite gonadal hemochromatosis observed in those patients.

So the previous findings illustrated that the clinical pubertal response Tanner staging in male and female β-thalassemic patients was found to be improved after both hormonal and l -carnitine treatment.

However, these findings showed no significant difference between both groups. Delayed puberty in β-thalassemia major is either due to failure of gonads or failure of the whole HP axis. l -carnitine as well as hormonal replacement therapy had a similar positive effect on puberty in the thalassaemic patients.

Continuous schemes of hormonal replacement therapy with both oral and transdermal oestrogens for females, or testosterone and HCG for males are effective therapies in pubertal thalassemics in addition to their positive effect on bones. l -carnitine also had a positive effect in decreasing transfusion requirements in the studied β-thalassaemic patients.

In addition, l -carnitine has the advantages of being orally administered, safe, inexpensive, easily available drug in treatment of transfusion dependent thalassemic patients.

We recommend: regular follow up of thalassemic patients for early detection of endocrine complications in order to improve their quality of life. Careful follow up of thalassemic girls who have already had menarche is essential since they are vulnerable to develop secondary amenorrhea even if they have intensive transfusion and chelation therapy.

Routine l -carnitine treatment in all thalassaemic patients is necessary to avoid occurance of delayed puberty in addition to the benefit of decreasing transfusion requirement in these patients. Continuous schemes of sex hormone replacement therapy in pre-adolescent β-thalassemic patients are important to improve pubertal growth and to avoid the occurrence of osteoporosis as it improves bone density.

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Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Patients and Methods. Journal Article. Assessment of Puberty in Relation to l -carnitine and Hormonal Replacement Therapy in β-thalassemic Patients.

Amal El Beshlawy , Amal El Beshlawy. a Department of Pediatrics, Cairo University, Ain Shams University and National Research Centre, Cairo, Egypt. Oxford Academic. Galila Mohtar. Esmat Abd El Ghafar. b Department of Clinical pathology, National Research Centre, Cairo, Egypt.

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Abstract Objective: To investigate puberty in a group of thalassemic patients with delayed or arrested pubertal development and to compare the effects of hormonal and l -carnitine therapy on puberty in those patients. puberty , l -carnitine , hormonal therapy , β-thalassemic.

T able 1 Descriptive statistics of demographic data of patients with β-thalassemia major. All patients.

Ginseng root extract, the content L-carnitine and hormonal balance L-farnitine store can't be seen by a younger hormonaal. Come back L-carnitine and hormonal balance you're older. L-carnitine, sometimes known as levocarnitine, is best known for its ability to help your body transform fats L-carnltine usable energy. It's involved in the energy production process, making sure your cells' engines mitochondria burn those fats efficiently. While your body can create L-carnitine on its own, some may need an extra boost, especially if you follow a vegan diet or face genetic challenges in producing enough. That's where supplements come in! Pair this with its versatility, and you have one of the most underrated vitamins out there.

L-carnitine and hormonal balance -

Forgot Password. Send Log in. Log in Forgot your password? L-Carnitine and Women's Health Tori Hudson, ND. Send to Close share. Explanations for this can include: An increase in luteal phase progesterone. The free radical scavenging effect of L-carnitine and subsequent effects on the endometrial blood flow ultimately supporting healthy endometrial receptivity in the peri-implantation phase.

Cell Biol Toxicol ; Pillich R et al. Exp Cell Res ; Montgomery SA et al. Int Clin Psychopharmacol. Malaguarnera M et al. Metab Brain Dis. Pettegrew JW et al. Neurobiol Aging. Vivoli E et al. It can help increase the egg follicle production and maturation.

The improvement in energy production and the protective effects L-Carnitine has as an antioxidant can improve the quality of these eggs. The higher the quality of the egg and its DNA, the greater likelihood of a successful conception and pregnancy.

The second supplement analyzed in the review was Acetyl-L-Carnitine, a form of L-Carnitine that can cross the blood brain barrier. This means that it is made available to the nerve cells in the brain and its glands. How Does Acetyl-L-Carnitine help with Infertility? Acetyl-L-Carnitine, once in the nerve cells, functions similar as L-Carnitine to help support energy production in the glands of the brain, such as the Pituitary and Hypothalamus glands.

When menstrual cycles are irregular, the secretion of two important hormones Luteinizing Hormone LH and Follicle Stimulating Hormone FSH becomes irregular as well.

For example, when cycles are irregular after the discontinuation of the birth control pill or with polycystic ovarian syndrome PCOS , the normal secretion rhythm of these two hormones from the Pituitary gland becomes altered.

The use of Acetyl-L-Carnitine helps to improve the production of both of the hormones LH and FSH. It can also help to reduce the secretion of the hormone prolactin, which inhibits the secretion of FSH and LH. The result of an increase in FSH and LH secretion and reduced prolactin secretion leads to a downstream increase in levels of estrogen and progesterone.

This can help support better follicle production, ovulation, and growth of the uterine lining to support implantation. The study of the influence of a high-altitude environment on serum sex hormones may require in-depth research on the molecular mechanism. Hypoxic conditions will cause blood to redistribute to important organs, such as the brain and heart, resulting in reduced blood flow in the testicles.

In addition, sperm production consumes a large amount of oxygen. However, the high-altitude hypoxic environment cannot meet the oxygen demands of spermatogenesis. These low-pressure and low-oxygen conditions will damage sperm quality.

The hypoxia pathway is also highly related to the pathological mechanism of male infertility caused by varicocele. The excess production of ROS is one of the main molecular causes that contributes to varicocele-related male infertility, in which MIRHG and MLLT4-AS1 hypoxia-related lncRNAs also showed significant positive correlations with ROS and negative correlations with sperm count and motility [ 48 ].

Dan Zeng et al. Some scholars also believe that the plateau environment negatively affects the quality of male sperm, and these effects increase as the altitude increases [ 50 ]. Studies by Lan Tian, Lin Kai and others [ 51 , 52 , 53 ] show that the plateau environment can reduce the concentration of male sperm, weaken vitality and increase the deformity rate.

Based on the above research and analysis, it has been found that the high-altitude, low-pressure and low-oxygen environment may have a significant impact on the health of the male reproductive system, resulting in a decrease in the number of sperm, reductions in sperm motility and viability, an increase in the rate of sperm abnormalities, an increase in germ cell apoptosis and increased disorders of sex hormone secretion [ 54 , 55 ].

The results of these studies are consistent with the results of our experimental study. In our study, sperm motility, deformity rates and the sperm counts of rats from the high-altitude model were assessed, and a preliminary analysis of sperm morphology was performed.

The results demonstrate that sperm viability and sperm count decrease and the sperm deformity rate increases as the altitude increases, and the effects are most obvious at an altitude of m. The higher the altitude is, the more obvious the damage. After the administration of l -carnitine, we found that the high- and low-dose l -carnitine groups also exhibited significantly improved sperm motility rates, sperm counts and sperm abnormality rates in a hypoxic environment, and the high-dose group also improved the percentage of forward movement in sperm.

Compared with group A, the basement membrane of the seminiferous tubules of the testis tissue in group B was atrophied, thinned, wrinkled and stratified based on HE staining. Obvious vacuoles, very small amounts of sperm, a small number of early spermatogenic cells, extremely disordered cell arrangement, reduced cell layer number, the disappearance of cell polarity and a reduced Johnsen score were observed.

The following phenomena were observed based on TEM analysis in group B: a large number of vacuoles in the cytoplasm, obvious oedema and cavitation of organelles, increased levels of abnormal lipids, rupture of the nuclear membrane of interstitial cells, mitochondrial oedema, partial absence of cytoplasm, increased nuclear heterochromatin, expansion of endoplasmic reticulum, obvious damage to the spermatogonia membrane, a few vacuoles near the membrane, endoplasm of primary spermatocytes, insignificant swelling of the endoplasmic reticulum, the lack of a defined cell membrane, increased nuclear heterochromatin and the formation of large vacuoles next to secondary spermatocytes.

These changes in the ultrastructure of rat testicular tissues indicated that the simulated high-altitude, low-pressure and hypoxic environment affects the tight junctions between rat Sertoli cells, mesenchymal cells and spermatogonia. These effects lead to obvious cell damage, further affecting the spermatogenic function of the rat testis.

However, HE staining showed slight folding, shrinking and delamination of the basement membrane of seminiferous tubules in the rat testicular tissue, an increasing amount of sperm, insignificant damage to spermatogenesis, a lack of mature spermatogenic cells, a slightly disordered and sparse cell arrangement with 3—5 layers and visible cell polarity in groups C and D.

The Johnsen scores of groups C and D are higher than that of group B but still lower than that of Group A. TEM revealed that Sertoli cells were slightly detached from the seminiferous epithelium, where the cell membrane and nuclear membrane structure were still clear.

In addition, mitochondria were slightly swollen, and the mesenchymal endoplasmic reticulum was slightly expanded. The spermatogonia nuclear membrane structure was clear, and mitochondria were relatively normal in groups C and D. There were no significant differences that were noted between groups C and D, indicating that l -carnitine has a good protective effect on male reproductive damage caused by low-pressure and low-oxygen environments.

The protective effect of l -carnitine against the damage to the male reproductive system caused by the simulated plateau environment may be related to its antioxidant effect. Some studies have shown that mitochondrial oxidative phosphorylation is an important system involved in energy production in various cells to maintain cell energy and integrity.

In this system, l -carnitine is essential for the uptake of fatty acids into mitochondria. Fatty acid oxidation needs to pass through the mitochondrial membrane to enter the mitochondria and uses l -carnitine to transport fatty acids into the mitochondria for the subsequent step of β-oxidation [ 36 ], thereby increasing energy supply and maintaining cell integrity.

l -carnitine also binds to acyl residues derived from the intermediate metabolism of amino acids and facilitates their function as scavengers. As an antioxidant, the concentration of l -carnitine in seminal plasma positively correlates with semen quality. l -Carnitine can prevent oxidative stress by regulating cellular respiration, nitric oxide levels and the activity of enzymes involved in antioxidative damage [ 56 ].

Higher concentrations of l -carnitine have a progressive inhibitory effect on β-oxidation, which is specific to l -carnitine [ 57 ].

However, given that the calcium chelator activity of l -carnitine may induce cell damage and decrease serum calcium levels, the clinical benefits or improvements in in vitro fertility will not be achieved by the overuse of antioxidants at very high doses.

Researchers [ 58 , 59 ] have also confirmed that l -carnitine can regulate the metabolism of cellular fat, sugar and protein, reduce excessive ROS generation, remove excess ROS and maintain the normal physiological function of sperm. Chavoshi Nezhad N et al.

Yang K et al. The use of exogenous antioxidants l -carnitine is a key strategy to alleviate time-dependent structural and biochemical damage to sperm caused by the inappropriate formation of ROS in liquid-preserved boar semen.

Antioxidants may act as suitable sperm preservation agents given their beneficial effect on preserving sperm quality [ 60 ].

Under normal conditions, active antioxidant enzymes can effectively eliminate ROS, maintain the balance of the oxidation-antioxidant system and promote the development and differentiation of germ cells. However, abnormalities may cause spermatogenesis disorders [ 61 ].

SOD and GSH-Px are antioxidant enzymes, and MDA is an indicator of peroxidation. In our experiment, MDA levels increased and levels of the antioxidant SOD decreased in the testis tissue in group B, indicating that the production and removal of oxygen-free radicals in the testis tissue of rats in a simulated high-altitude environment were unbalanced.

To assess the protective mechanism and effect of l -carnitine on damage to the male reproductive system in a simulated high-altitude hypobaric hypoxic environment, we measured SOD, GSH-Px and MDA levels in the testis tissue of each group of rats. The results showed that MDA levels in group B were the highest compared with the other groups, indicating that ROS generated oxidative stress and damage.

Levels of the antioxidants SOD and GSH-Px were decreased in group B, suggesting that antioxidant activity was increased and antioxidant enzyme consumption was increased.

These results indirectly indicate that the oxidative damage in rats increased. Based on a statistical analysis of the data in groups C and D, MDA levels were significantly lower than those in group B, indicating reduced ROS generation.

However, the levels of SOD and GSH-Px members of the enzymatic antioxidant system were increased in groups C and D compared with group B.

In rats exposed to a simulated plateau environment with low pressure and a low oxygen, l -carnitine significantly reduces the oxidative stress response and enhances antioxidant system activity.

These findings also demonstrate that the antioxidant effects of l -carnitine are reliable. In summary, based on the successful construction of the plateau model of rat reproductive system injury, we conducted an exploratory study on the protective effects of l -carnitine on rat reproductive system damage in a simulated high-altitude environment.

Under the simulated plateau altitude of m, partial pressure of oxygen values, sex hormone levels, sperm motility rates, sperm deformity rates and histopathological and morphological features of testicular tissues are obviously altered, suggesting that the environment at an altitude of m may have a significant impact on the function of the rat's reproductive system.

The administration of l -carnitine reduces the damaging effects of in a high-altitude environment on sperm quality in male rats. However, l -carnitine does not have a significant effect on serum sex hormone levels.

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With the research behind L-carnitine and hormonal balance treatments continually evolving, balancce importance of adjusting znd plans balane take in to account newly published Protein for improved focus and concentration becomes very important. Dealing with Infertility, L-carnitine and hormonal balance baalance is unexplained or the result of a specific condition, can be L-carhitine as Ans success rates of currently available Mindfulness meditation techniques continue to remain relatively low. And perhaps the answer to continue supporting an improvement in fertility success rates will require a healthy integrative approach to support these treatments. A recently published review looked at all of the available studies to date on the use of two important supplements to support female fertility, and the results have important implications on how to help improve treatment strategies. What Supplements are good for Fertility? The first supplement analyzed was L-Carnitine. While this supplement has been used by some for quite some time, we now better understand how it can work, and who might benefit from using it. Salvatore L-carnitone, Rosaria M. Old studies in animals and unblinded ba,ance L-carnitine and hormonal balance hormonl few Bapance patients suggested BCAAs for endurance l -carnitine is a periferal antagonist horonal thyroid L-carnitine and hormonal balance action gormonal least in some tissues. This conclusion was substantiated by our recent observation that carnitine inhibits thyroid hormpnal entry into the nucleus of hepatocytes, neurons, and fibroblasts. We also evaluated changes on nine thyroid hormone-sensitive biochemical parameters and on vertebral and hip mineral density bone mineral density. Fifty women under a fixed TSH-suppressive dose of l -T 4 for all 6 months were randomly allocated to five groups of 10 subjects each. Symptoms and biochemical parameters worsened in group 0. In group A, symptoms and biochemical parameters worsened during the first bimester, returned to baseline or increased minimally during the second bimester except osteocalcin and urinary OH-prolineand worsened again in the third bimester.

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