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Evidence-Based Supplement Research
Evidence-Based Supplement Research

Modulatory effects of l-carnitine plus l-acetyl-carnitine on neuroendocrine control of hypothalamic functions in functional hypothalamic amenorrhea (FHA).

  • 2017-06-02
  • Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 33(12)
    • Alessandro D Genazzani
    • Giulia Despini
    • Adam Czyzyk
    • Agnieszka Podfigurna
    • Tommaso Simoncini
    • Blazej Meczekalski

Study Design

Type
Clinical Trial
Sample size
n = 27
Population
patients (n = 27) with FHA
Methods
combined integrative treatment for 12 weeks of LAC (250 mg/die) and l-carnitine (500 mg/die)
Duration
12 weeks
Functional hypothalamic amenorrhea (FHA) is a relatively frequent disease due to the combination of metabolic, physical, or psychological stressors. It is characterized by the low endogenous GnRH-induced gonadotropin secretion, thus triggering the ovarian blockade and a hypoestrogenic condition. Up to now various therapeutical strategies have been proposed, both using hormonal treatment as well as neuroactive compounds. Since carnitine, namely l-acetyl-carnitine (LAC), has been demonstrated to be effective in the modulation of the central hypothalamic control of GnRH secretion, we aimed to evaluate whether a combined integrative treatment for 12 weeks of LAC (250 mg/die) and l-carnitine (500 mg/die) was effective in improving the endocrine and metabolic pathways in a group of patients (n = 27) with FHA. After the treatment, interval mean LH plasma levels increased while those of cortisol and amylase decreased significantly. When patients were subdivided according to baseline LH levels, only hypo-LH patients showed the significant increase of LH plasma levels and the significant decrease of both cortisol and amylase plasma levels. The increased 17OHP/cortisol ratio, as index of the adrenal activity, demonstrated the reduced stress-induced adrenal activity. In conclusion, our data sustain the hypothesis that the integrative administration of LAC plus l-carnitine reduced both the metabolic and the neuroendocrine impairment of patients with FHA.

Research Insights

  • The increased 17OHP/cortisol ratio, as index of the adrenal activity, demonstrated the reduced stress-induced adrenal activity.

    Effect
    Beneficial
    Effect size
    Small
    Dose
    500 mg/die
  • After the treatment, interval mean LH plasma levels increased...

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    500 mg/day
  • ...those of cortisol and amylase decreased significantly.

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    500 mg/day
  • ...those of cortisol and amylase decreased significantly...the increased 17OHP/cortisol ratio, as index of the adrenal activity, demonstrated the reduced stress-induced adrenal activity.

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    500 mg/day
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