l-Carnitine is the form most commonly used. As the d form is not biologically active, there is concern that it might interfere with the use of the l isomer by competitive inhibition and thus cause l-carnitine deficiency (Tsoko et al 1995).
Clinical note — Acetyl-L-carnitine shows promise as a strong therapeutic agent
Acetyl-l-carnitine, an ester form of l-carnitine, has also been researched for its use in the treatment of Alzheimer's disease (Brooks et al 1998, Pettegrew et al 1995, Sano et al 1992, Thai et al 1996), depression in the elderly (Garzya 1990), diabetic neuropathy (De Grandis & Minardi 2002), peripheral neuropathy (Onofrj et al 1995), prevention of neuropathy in chemotherapy (Bianchi et al 2005; Maestri et al 2005), fatigue in multiple sclerosis (Tomassini et al 2004), Peyronie's disease (Biagiotti & Cavallini 2001), degenerative cerebellar ataxia (Sorbi et al 2000) and cognitive disturbances in chronic alcoholics (Tempesta et al 1990).
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