carnitine include L-acetyl carnitine and acetyl L-carnitine (LAC) and L-carnitine.

L-carnitine suppresses the production of tumour necrosis factor, which is responsible for wasting in HIV-positive people. Patients taking L-carnitine have reported reduced fatigue and greater energy^[1].

A six-month study of carnitine supplementation also significantly reduced the frequency of CD4 and CD8 T-cell death and produced higher CD4 cell counts^[2][3]. There is substantial evidence from an Italian research group that L-carnitine inhibits HIV-related cell death by targeting the immune system rather than the virus itself.

A deficiency in L-acetyl carnitine may also play a role in neuropathy related to HIV treatment^[4]. Taking L-acetyl carnitine supplements may reverse the nerve damage caused by HIV treatment, accompanied by an improvement of pain in most patients^[5]. Similar studies have also shown improvements in pain with L-acetyl carnitine treatment, with one showing sustained benefit after more than four years^[6][7][8]. Although the mechanism of L-acetyl carnitine’s action is unknown, it may counteract neuropathy by acting as an anti-oxidant, preventing the damage to mitochondria. Preliminary evidence suggests that carnitine may also be effective in treating other symptoms of mitochondrial toxicity, including elevated lactic acid levels^[9].

Side-effects of carnitine include mild gastrointestinal upset and diarrhoea.

Carnitine, L-carnitine and LAC come in various oral and intravenous formulations. L-carnitine is sold under the trade name Carnitor for the treatment of people with carnitine or vitamin B₇ deficiency.