Acetyl-L-Carnitine (ALCAR) for ALS
Also known as: ALCAR, ALC, Levacecarnine
ALCAR supports mitochondrial energy production in ALS motor neurons facing bioenergetic crisis from Complex I dysfunction.
Mechanism of Action
ALCAR donates acetyl groups to the carnitine shuttle, facilitating fatty acid β-oxidation and acetyl-CoA production. It buffers CoA pools, supports mitochondrial membrane integrity, and enhances nerve growth factor receptor expression in motor neurons.
General mechanism: Acetylated amino acid derivative. Mitochondrial fatty acid transport, acetyl group donor for acetylcholine synthesis, neurotrophic factor enhancer.
Current Evidence
Small trials show trends toward functional stabilization. Combination with ALA studied. Phase II trials inconclusive at standard doses.
Clinical Status: Phase II pilot trials. Available as supplement.
Safety Profile
Very safe. GI effects possible. May increase seizure frequency in susceptible individuals. Fishy body odor at high doses.
Key Research Questions
- Can high-dose ALCAR improve motor neuron energy metabolism?
- Does ALCAR enhance neurotrophic signaling in ALS?