Propionyl-L-Carnitine benefit
July 1 2017

Claudication, exercise performance, physical activity improvement
Vasc Med. 2013. A systematic review and meta-analysis of propionyl-L-carnitine effects on exercise performance in patients with claudication. Propionyl-L-carnitine (PLC) may improve exercise performance in patients with peripheral artery disease, but results from clinical trials have been inconsistent. The safety and efficacy of PLC for treatment of claudication was evaluated by a systematic review and meta-analysis of clinical trials for which data were available through September 2010. Oral PLC is associated with a statistically significant increase in peak walking distance in patients with claudication, which may be clinically relevant.

Propionyl-L-carnitine and claudication 
Levo Propionyl-carnitine improves the effectiveness of supervised physical training on the absolute claudication distance in patients with intermittent claudication.
Angiology. 2008. Angiology Care Unit of University Hospital of Padua, Italy.
The mechanisms by which supervised physical training improves walking ability in patients with intermittent claudication are microcirculatory, rheological, and metabolic. The main mechanism of levo propionyl carnitine is metabolic; it increases the walking ability in claudicants, providing an additional energy to the ischemic muscle by an anaplerotic activity. Therefore, the current study was carried out to ascertain whether the combined treatment has a synergistic effect. The results confirm the effectiveness of supervised physical training in patients with intermittent claudication, and we recommend the use of propionyl carnitine during the exercise training program, at least in patients with severe claudication. Finally, underlining the similar mechanisms of physical training and LPC treatment, the study suggests that a cycle of propionyl l carnitine infusions could be advised in patients with severe claudication who cannot be included, for various reasons, in an exercise rehabilitation program.

Sexual dysfunction treatment
This brain enhancer may also have a positive influence on sexual performance.

Erectile dysfunction or impotence 
Effect of propionyl-L-carnitine, L-arginine and nicotinic acid on the efficacy of vardenafil in the treatment of erectile dysfunction in diabetes.
Curr Med Res Opin. 2009; Gentile V, Antonini G, Antonella Bertozzi M, Rizzo C, Ashraf Virmani M, Koverech A. Dipartimento di Urologia U Bracci, Sapienza University of Rome, Italy.
The association of diabetes-related vascular damage and the role of metabolic factors in erectile dysfunction are well known in the literature. The compounds propionyl-L-carnitine (PLC), L-Arginine amino acid (L-Arg) and nicotinic acid have numerous metabolic actions which have been reported to improve endothelial function. This study investigated the administration of the combination of these three compounds alone and in association with an inhibitor of 5-phosphodiesterase (5PDE), vardenafil, on endothelial function in diabetic patients with erectile dysfunction. A total of 40 patients aged between 50 and 60 years with insulin-dependent diabetes (IDDM) for 3-4 years were selected from 509 patients presenting with erectile dysfunction. The patients were randomly subdivided into four groups of ten to be treated for 12 weeks. Group A was administered one sachet each day of test formulation containing PLC, L-Arg and nicotinic acid (Ezerex); group B with one 20 mg capsule of vardenafil (Levitra) twice a week; group C was treated with one sachet each day of the test formulation plus vardenafil 20 mg twice a week. Group D was administered placebo capsules twice weekly. Endothelial function was evaluated by examining flow-mediated dilation (FMD) and erectile function was estimated with the International Index of Erectile Function (IIEF5) questionnaire in all subjects. At the end of treatment group A showed an increment of 2 points in the IIEF5; group B showed an increment of 4 points; group C, the group which was administered all the treatments, showed an increment of 5 points, and group D, treated with placebo, showed no increment in the IIEF5. Although there was a small number of subjects in this study the data suggest that the test formulation may improve the endothelial situation in diabetes. The test formulation together with vardenafil was better than the 5PDE inhibitor alone, but further studies are needed to confirm these findings.

Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes
Curr Med Research Opin. 2004.
Patients with medically documented erectile dysfunction of organic or mixed etiology and diabetes (type 1 and 2) were randomised to receive oral propionyl-L-carnitine (2 g/day) plus sildenafil (50 mg twice weekly) (20 patients, Group 1) or sildenafil alone (20 patients, Group 2), in a double-blind, fixed-dose study. All patients had been previously treated unsuccessfully with a minimum of eight administrations of sildenafil. Salvage therapy with propionyl-L-carnitine plus sildenafil was more effective in erectile dysfunction than sildenafil in the treatment of erectile dysfunction in patients with diabetes refractory to sildenafil monotherapy.

Carnitines versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging.
Urology. 2004.
A total of 120 patients were randomized into three groups. Group 1 was given testosterone undecanoate 160 mg/day, the second group was given propionyl-L-carnitine 2 grams per day plus acetyllcarnitine 2 g/day. The third group was given a placebo (starch).  Testosterone and carnitines significantly improved the peak systolic velocity, end-diastolic velocity, resistive index, nocturnal penile tumescence, International Index of Erectile Function score, Depression Melancholia Scale score, and fatigue scale score. Carnitines proved significantly more active than testosterone in improving nocturnal penile tumescence and International Index of Erectile Function score. Testosterone significantly increased the prostate volume and free and total testosterone levels and significantly lowered serum luteinizing hormone; carnitines did not. No drug significantly modified prostate-specific antigen or prolactin. Carnitines and testosterone proved effective for as long as they were administered.

Heart disease and blood flow
Propionyl-L-Carnitine Improves Postischemic Blood Flow Recovery and Arteriogenetic Revascularization and Reduces Endothelial NADPH-Oxidase 4-Mediated Superoxide Production.
Arterioscler Thromb Vasc Biol. 2010. Stasi MA, Scioli MG, Arcuri G, Lombardo K, Marcellini M, Riccioni T, De Falco S, Pisano C, Spagnoli LG, Borsini F. General Pharmacology and Oncology Department Sigma-Tau, Pomezia, Rome, Italy; Anatomic Pathology, Tor Vergata University, Rome, Italy; Experimental Medicine and Biochemical Sciences, Tor Vergata University of Rome, Italy; Institute of Genetics and Biophysics, CNR, Napoli, Italy.
The beneficial effect of the natural compound propionyl-L-carnitine (PLC) on intermittent claudication in patients with peripheral arterial disease is attributed to its anaplerotic function in ischemic tissues, but inadequate information is available concerning action on the vasculature. We investigated the effects of PLC in rabbit hind limb collateral vessels after femoral artery excision, mouse dorsal air pouch, chicken chorioallantoic membrane, and vascular cells by angiographic, Doppler flow, and histomorphometrical and biomolecular analyses. PLC injection accelerated hind limb blood flow recovery after 4 days and increased angiographic quadriceps collateral vascularization after 7 days Histomorphometry confirmed the increased vascular area, with unchanged intramuscular capillary density. PLC-induced dilatative adaptation, and growth was found associated with increased inducible nitric oxide synthase and reduced arterial vascular endothelial growth factor and intracellular adhesion molecule-1 expression. PLC also increased vascularization in air pouch and chorioallantoic membrane, particularly in large vessels. PLC increased endothelial and human umbilical vascular endothelial cell proliferation and rapidly reduced inducible nitric oxide synthase and NADPH-oxidase 4-mediated reactive oxygen species production in human umbilical vascular endothelial cells; NADPH-oxidase 4 also regulated NF-kappaB-independent intracellular adhesion molecule-1 expression. Our results provided strong evidence that PLC improves postischemic flow recovery and revascularization and reduces endothelial NADPH-oxidase-related superoxide production. We recommend that Propionyl-L-Carnitine should be included among therapeutic interventions that target endothelial function.

Absorption
Comparison of pharmacokinetics of L-carnitine, acetyl-L-carnitine and propionyl-L-carnitine after single oral administration of L-carnitine in healthy volunteers.
Clin Invest Medicine. 2009; The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China.
To investigate the pharmacokinetics of L-carnitine and its analogues, acetyl-L-carnitine and propionyl-L-carnitine in healthy volunteers after single L-carnitine administration. Liquid L-carnitine (2.0 g) was administered orally as a single dose in 12 healthy subjects. L-carnitine has a greater maximum plasma concentration than acetyl-L-carnitine and propionyl-L-carnitine. L-carnitine also has a longer half-life than ALC and propionyl-L-carnitine. These data may have important implications in the designing of dosing regimens for L-carnitine or its analogues, such as ALC or propionyl-L-carnitine.

Emails
Q. I have read a study of using Propionyl L-Carnitine and Acetyl-L-Carnitine coupled with Viagra to combat erectile dysfunction in diabetics. However, has any study results revealed that this treatment is effective with those who suffer high blood pressure and are taking high blood pressure meds. I specifically take Lisinopril, Valsartan, and hydrochlorothiazide.
   A. We are not aware of any studies that have evaluated the combination of acetyl carnitine or other carnitine supplements in the treatment of erectile dysfunction in combination with prescription medications for blood pressure or other purposes. If one is already taking prescription medications and wants to begin taking supplements, it is wise to begin with low dosages.

I read that GPLC, glycine propionyl-l-carnitine can increase nitric oxide. Is this true? Do you think this product could be useful to help with erectile dysfunction? Are there side effects to this product?
   A. I have not studied this nutrient in enough detail to know for sure.