Acetyl-L-Carnitine (ALCAR) Review – Uses, Benefits, Effects

Acetyl-L-Carnitine or ALCAR is a potent nootropic known for its effects on memory, cognition as well as several other neuroprotective effects. While the research speaks volumes of the nootropic, the anecdotal evidence seems a bit subtle. Read on to make an unbiased decision for yourself.

Each nootropic that is introduced in the market time-to-time has just one purpose: to disrupt the market by enhancing the cognitive performance of individuals. 

While the mechanism of action of nootropics largely remains the same which is usually upregulating the levels of neurotransmitters, the question that eventually matters is which nootropic is best at doing so. 

The potency and efficiency of nootropic depend on the constituents that it is made up of. Perhaps the ingredients can make or break a nootropic in the market and in the eyes of customers. 

In this long series of nootropics that we are covering, we have talked enough about cholinergic nootropics. And, by this time I am sure that you will be crystal clear and well aware of the benefits of choline inside the body, particularly brain health.

Cholinergic nootropics differ usually in their makeup which changes its potency and efficacy but the effects remain the same. One such cholinergic nootropic that we are talking about today is Acetyl-L-Carnitine (ACLAR). 

While as complicated as the name sounds, I will make sure to break down everything related to this compound in this Acetyl-L-Carnitine (ALCAR) Review.

What is Acetyl-L-Carnitine (ALCAR)? 

Acetyl-L-Carnitine (ALCAR), an amino acid, is sometimes referred to as Acetyl Levocarnitine in academic settings. It is an acetylated derivative of L-Carnitine and is synthesized in smaller quantities in our brain, liver, and kidneys. 

Acetyl-L-Carnitine (ALCAR) Review
Figure 1: Acetyl-L-Carnitine

Chemically this compound is L-Carnitine with an added acetyl group. L-Carnitine is a derivative of lysine, an amino acid (1). This acetyl group allows this compound to easily cross over the blood-brain barrier, a membrane that separates our brain’s blood vessels from the neurons and other parts of our brain.

Our bodies produce their own L-Carnitine and we also synthesize some from the lysine found in animal products. L-Carnitine is easily convertible into Acetyl-L-Carnitine by the activity of an enzyme called acetyltransferases. 

Even though an actual deficiency in carnitine is rare, supplementation has been found to produce a wide variety of benefits for the body and brain.

There are three versions of L-Carnitine that people will supplement with for different purposes:

  1. Acetyl-L-Carnitine (ALCAR): Brain health and function (nootropic benefits)
  2. L-Carnitine L-Tartrate (LCLT): Exercise performance and physical power
  3. Glycine Propionyl L-Carnitine (GPLC): Blood flow and alleviation of intermittent claudication

In animal studies, Acetyl-L-Carnitine has been shown to be the most bioavailable of these carnitine supplements.

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How Does ALCAR Work?

Choline and Acetylcholine

Many of the memory and learning benefits attributed to ALCAR are believed to be due to an improved cholinergic function.

In a study on mice fed ALCAR daily, it was found that these mice were able to learn more new tasks when compared to placebo mice (2). The researchers hypothesize that this was because of the cholinergic activities of this supplement. They found that synaptic high-affinity choline uptake (HACU), acetylcholine (ACh) synthesis, and ACh release were all increased with supplementation.

ACh is a neurotransmitter critical for learning, memory, focus, arousal, and sleep. It is believed that the rate-limiting step in the production of ACh is HACU. By increasing HACU and ACh synthesis and release, users can experience a noticeable boost in their cognitive function.

Another animal study found that rats who were given ALCAR daily led to less degeneration in both the number and size of cholinergic cells in the basal forebrain (3). 

Supports Brain and Neurotransmitter Metabolism

ALCAR has been shown to increase energy in the brain and also boost neurotransmitter metabolism.

The mitochondria of our cells are known as our cell powerhouses. In essence, the mitochondria are in charge of producing energy for the cells throughout the body.

The amino acid L-Carnitine is important for the metabolism and health of our mitochondria. When these energy producers are functioning well, they contribute to healthy cognitive functions. As we age their function can decrease, leading to age-related cognitive decline.

In a study on mice, long-term ALCAR supplementation was found to increase the levels of serotonin in the cortex and noradrenaline in the hippocampus (4).

Low serotonin levels are linked to depression, and this neurotransmitter is known to play important roles in mood, sleep, memory, appetite, and more.

Noradrenaline, also known as norepinephrine, is critical for our ability to focus, memory, creativity, and alertness.

Indirect Antioxidant and Neuronal Protection

ALCAR has shown effectiveness in boosting antioxidant activity in the brain, protecting brain cells, and preventing mitochondrial damage.

In one study, this compound was found to prolong the activities of certain antioxidant enzymes intrinsic to the human brain, including Superoxide Dismutase (5). This is thought to be one of the ways by which it prevents mitochondrial damage.

Benefits of ALCAR

Acetyl-L-Carnitine exerts the majority of its effects on brain function and health.

The main benefits of ALCAR include:

  • Increases focus
  • Helps relieve depression
  • Acts as a stimulant, reducing mental fatigue
  • Boosts brain health
  • Promotes memory and learning
  • Improves insulin sensitivity
  • Enhances capillary (blood vessel) health

Enhancing Memory

In animal studies, Acetyl-L-Carnitine has been found to both improve learning in older mice and mitigate the risk of developing age-related cognitive decline when fed to young mice daily at low doses (6).

In the elderly population, this nootropic has been found to improve memory in those with memory impairments and Alzheimer’s disease (7,8,9). 

Combating Depression

In a double-blind randomized study, Acetyl-L-Carnitine was compared to Amisulpride in treating dysthymia, which is a subtle form but is categorized as chronic depression (10). In comparison to Amisulpride, a common prescription for dysthymia, ALCAR was found to be just as effective at alleviating symptoms all while being better tolerated, with a greater safety profile.

A meta-analysis found that preliminary controlled trials of ALCAR support the antidepressant effects of this compound, particularly in the elderly population. (11)

Improving Focus

Two studies in children have found improvement in ADHD symptoms with the treatment of carnitine (12,13). 

In one of the studies, boys with both ADHD and fragile X syndrome were treated with either ALCAR or placebo for one full year. In comparison to the placebo group, ALCAR significantly improved both social behavior and hyperactivity (13).

In another study on adults with chronic fatigue syndrome, daily supplementation with 2 g/day ALCAR led to improvements not only in mental fatigue but also in attention and concentration (14).

Alleviating Fatigue

Chronic fatigue is becoming increasingly common in Western countries. As we push ourselves to mental and physical extremes daily, fatigue is all too common. Chronic fatigue is especially more prevalent in the elderly population.

Multiple studies have found that supplementation with this compound can help reduce chronic fatigue. 

One study on elderly patients aged 71-88 with chronic fatigue found that daily supplementation with ALCAR led to improved mental and physical fatigue when compared to placebo. Cognitive status and physical ability were also positively impacted.

Another study looked at the impact of supplementation for six months with 2 g/day ALCAR plus 2 g/day Propionyl-L-Carnitine on fatigue, sexual dysfunction, and fatigue that is associated with male aging (15). This study found benefits for not only fatigue but depression and sexual dysfunction as well.

Neuroprotection

Every day as we get older, the function of our brains tends to decline. This can be due to the consumption of alcohol, pollution, or even simply the aging process. Much of the damage that occurs to our brains and nerves as we grow older is from reactive oxygen species.

Studies have found that this nootropic protects neurons from oxidative damage, and can even help the brain flush out toxins. It has also been shown to restore synaptic transmission, also known as neurotransmission. 

Several meta-analyses have shown that ALCAR supplementation led to pain relief and optimal neuronal health.   

Delays Age-Related Cognitive Decline

Over 20% of adults 60 and older suffer from a mental or neurological disorder, with this number continuing to increase into older age (9).

Many studies have confirmed that supplementing with ALCAR may lead to improvements in the decline of cognitive abilities that come with age.

In one study on those over 65 with mild mental impairment, it was found that 2 grams of this nootropic daily for three months led to improvements in memory, attention, verbal fluency, and behavior. 

Manage Alzheimer’s Disease

Multiple human studies have found supplementation with this compound to lead to improvements in symptoms associated with Alzheimer’s disease and dementia of the Alzheimer’s type. 

In one 24-week double-blind, placebo-controlled study, both short-term memory and reaction time showed a trend towards improvement in the treatment group compared with placebo, although the differences between the groups did not reach statistical significance (7)

In another study of one year, patients with Alzheimer’s disease were either treated with a placebo or ALCAR. While both groups showed deterioration over the year, this deterioration was slower for 13 of 14 measured outcomes for the treatment group. These differences did reach statistical significance for focus, memory, critical abilities, and logical intelligence.

Other Minor Benefits 

Although insufficient evidence exists, ALCAR supplementation may also manage and possibly treat patients with fibromyalgia. One of the trials showed that it was effective in alleviating the symptoms associated such as depression and pain. 

Not only this, but small clinical trials also found that ALCAR supplementation looked to be effective in treating hepatic encephalopathy which is brain damage caused by liver dysfunction. 

Recommended Dosage and Half-life 

ALCAR is generally taken daily in quantities between 250 and 2,000 mg/day. 

If you are a healthy adult looking to add this supplement to your nootropic stack for its memory, brain function, and energy effects, the dosage normally starts at 500 mg/day.

Some users report the benefits all day long when taken in the morning time, while others prefer the feeling when they split their doses. With a half-life of around 4.2 hours for 500 mg, you may find heightened benefits splitting into two. This half-life is highly variable, so experiment to see what is best for you.

If you will be using this drug for certain conditions, you may need more. For example, the dosage for chronic fatigue is generally around 2 grams daily. 

How to Take ALCAR Supplement? 

The best time to take this supplement is early in the day. Avoid taking it late in the day as this can lead to trouble sleeping. with or without food. 

If you experience any digestive upset or pain when taking it without food, you will want to take it with breakfast and/or lunch.

Side Effects and Interactions 

This supplement is very well tolerated and considered safe when taken within the standard dosage.

The most common side effects are nausea and head pain. It is not uncommon for users to report headaches, and in rare cases, migraines, when taking this supplement. Other side effects include:

  • Trouble sleeping
  • Digestive upset
  • Diarrhea
  • High blood pressure

This supplement has been linked to psychosis in people with bipolar disorder and higher triglycerides and lower blood sugar in those with diabetes. 

There are some other conditions and medications that can be affected by using this supplement as well so it’s better to talk to your physician before using this supplement. 

User Reviews and Experiences 

Let’s dig into some of the anecdotal experiences shared by people on Reddit and see if the nootropic is any good. 

Kujoh says, 

“Just as another anecdote, in my long time of experimenting with various nootropics, alcar is the only thing I’ve actually found helpful more than short term and the only noot I’ve continued to take long term.”

Another user said, 

“I find I get a physical energy boost for a few hours after taking it, I use it in the late afternoon as a caffeine alternative because it doesn’t affect my sleep.”

One of the users shared a detailed experience saying, 

“….I notice a strong increase in general mood and focus, decrease in apathetic feelings about everything, higher overall energy and fewer barriers to action when completing tasks.”

Another user said, 

“Hey, I’m glad you also enjoy alcar. I’ve been taking it for about 8 months daily with no negative side effects. I’ve been taking it 3 times daily, but it’s been so long that I forget what it’s like to not take it, to be honest. Studies prove that it is relatively safe compared to a lot of other nootropics out there that lack empirical data!”

While these are just a few reviews, what I have noticed from reading the experiences is that the effects of ALCAR are subtle and mostly behind the scenes. It might actually take long enough before you start seeing the benefits. 

ALCAR Stacks

Acetyl-L-Carnitine and Choline Stack

Taking choline with this supplement is a good idea when it comes to reducing side effects and boosting your production of ACh, and thus your memory, learning, and cognitive benefits.

CDP-Choline (Citicoline) by Double Wood Supplements 
Figure 2: Combining CDP-Choline with ALCAR could have increase the effectiveness of ALCAR

ALCAR is known to boost the production of high-affinity choline uptake, and this choline is in turn used to synthesize the ACh. Without sufficient choline stores in your body, this nootropic could lose its effectiveness and cause headaches and fatigue.

To get the most out of your choline and Acetyl-L-Carnitine stack, we recommend either Alpha GPC choline or CDP-Choline (also known as Citicoline), two highly bioavailable choline supplements that are able to cross over the blood-brain barrier efficiently. 

Acetyl-L-Carnitine and Piracetam Stack

This supplement is especially powerful in a nootropic stack with members of the racetam family. The effects of both nootropics are reported to be amplified when combined.

While the most common addition to a racetam stack is a highly bioavailable form of choline (such as Alpha GPC and CDP-Choline), ALCAR has demonstrated efficiency at boosting the benefits of the racetams through cholinergic function outside of providing a choline source.

But why do these two nootropics stack so well together?

Racetams are known to increase the levels of ACh, often through increased synthesis.

Just as choline is needed for the synthesis of ACh, so is acetate. Acetate formed in your body after taking ALCAR can combine with choline to produce ACh.

Piracetam is one of the oldest and most popular nootropics and is a member of the racetam family. Its benefits range from improved learning and memory to stimulation and protection against age-related cognitive decline. 

As you may have noticed, these benefits are very similar to those experienced when supplementing with ALCAR.

If you do pair Piracetam and ALCAR, it is also a good idea to add in a supplemental choline source.

Where To Buy ALCAR Supplement? 

ALCAR is one of the few nootropic supplements that is readily available at drug stores across the United States, however, it is still better to purchase this supplement online. The major advantage of buying online you will find better prices and user reviews specific to the supplement you purchase.

This supplement comes in both powder and capsule form so depending on the preferred form of intake, you can buy the supplement. 

ALCAR vs Other Compounds 

ALCAR vs L-Carnitine 

While both of the compounds are easily interconvertible and offer similar benefits, there are some differences that one may need to consider. 

ALCAR is more pronounced for its nootropic effects, such as enhanced cognition, improved memory, and optimal mental health. 

On the other hand, L-Carnitine, according to research, has more dominant effects on weight loss. It enhances one’s physical performance as well as improves cardiovascular health and mitigate any risk of developing heart complications. 

Is ALCAR Legit? 

Largely yes! 

ALCAR is well-backed by scientific research and works in a very natural way. It is definitely going to offer long-term benefits such as delaying the age-related cognitive decline as well as offering neuroprotective effects. 

However, if you are looking for immediate effects, I highly doubt if ALCAR is for you. Maybe try out other better alternatives available in the market for short-term results. 

FAQs about ALCAR 

What does ALCAR do in the body?

ALCAR has numerous effects on brain and muscle metabolism, protects against neurotoxic insults, and may be an effective treatment for certain forms of depression. 

Does ALCAR increase dopamine?

ALCAR doesn’t affect dopamine release much. 

How does Acetyl-L-carnitine make you feel?

Taking acetyl-L-carnitine by mouth might improve memory and mental function in older people with some memory loss.

Does ALCAR affect sleep? 

Increasing acetyl-l-carnitine may decrease inflammation. This brings the benefits straight to the brain and potentially improves the quality and length of sleep. 

Does ALCAR raise blood pressure?

Six-month oral ALC supplementation did not affect blood pressure, lipid and glycemic control, insulin sensitivity and kidney function in hypertensive normoalbuminuric and microalbuminuric T2D patients on background statin therapy. 

Does Acetyl-L-carnitine help neuropathy?

In a few clinical trials, people who had diabetic neuropathy had reduced pain, improvements in other sensory problems, and improvements in nerve function tests.

1)https://pubchem.ncbi.nlm.nih.gov/compound/Acetyl-L-carnitine
2)https://www.ncbi.nlm.nih.gov/pubmed/11592123
3)https://www.scirp.org/journal/PaperInformation.aspx?paperID=17717
4)https://www.ncbi.nlm.nih.gov/pubmed/22549035
5)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384514/
6)https://www.ncbi.nlm.nih.gov/pubmed/11592123
7)https://www.ncbi.nlm.nih.gov/pubmed/2178869
8)https://www.ncbi.nlm.nih.gov/pubmed/1944900
9)https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
10)https://www.ncbi.nlm.nih.gov/pubmed/16316746
11)https://www.ncbi.nlm.nih.gov/pubmed/18491985
12)https://www.ncbi.nlm.nih.gov/pubmed/12213433
13)https://www.ncbi.nlm.nih.gov/pubmed/18286595
14)https://www.ncbi.nlm.nih.gov/pubmed/15039515
15)https://www.ncbi.nlm.nih.gov/pubmed/15072869

Kartik Kumar Rathi

Kartik is a Doctor in training currently in his second year of medical school with the ultimate goal of becoming a successful cardiologist, he currently contributes to health blogs, research papers and also founded a social health startup to help educate others.

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