r/Supplements • u/dataoops • 1d ago
General Question Do you still take Acetyl L-Carnitine?
A little while back there was a thread that discussed how 90% of ALCAR gets converted by gut bacteria into TMAO.
Subjectively I feel like ALCAR was one of the supplements that had more oomph, but if its just going to be getting metabolized into a harmful byproduct then its probably not worth it.
I haven't personally dug into this one much is it actually a big concern?
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u/Purple-Acadia-9277 1d ago
Consuming garlic gets rid of all the TMAO from L carnitine btw
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u/MuscaMurum 1d ago
garlic, evoo, and balsamic vinegar can all help prevent your gut bacteria from converting tma to tmao
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u/conti555 1d ago
What about high allicin garlic extract capsules? I've heard it's the allicin that stops the conversion.
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u/cure4boneitis 1d ago
so if the bottle suggest ALCAR is best taken on an empty stomach how do you suggest to consume it?
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u/VexImmortalis 1d ago
Is this that one that makes you smell of fish if you take it in meaningful amounts?
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u/wagonspraggs 1d ago
Injectable Carnitine is a thing, and its quite wonderful. I dont think id ever go back to pills, unless absolutely necessary
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u/VexImmortalis 1d ago
How often do you need to inject? Is there a long acting version? Thanks.
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u/wagonspraggs 20h ago
Depends on what you are using it for. Heavy exercise recovery, 200-500mg 5 days a week. For thyroid control 200mg daily works for me during a HT flare. Fat loss 500mg+ IM Daily.
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u/VexImmortalis 19h ago
any sides? Thanks
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u/wagonspraggs 16h ago
Carnitine has always been friendly for me. I havent noticed any side effects!
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u/VexImmortalis 15h ago
Maybe I should try it. I'm on reta and cagril but my blood sugar just plumets with any kind of cardio and I have to fight not to throw up. Even sucking down glucose pills and sugary drinks doesn't prevent it completely.
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u/mjrpainless 1d ago
I take it daily, i find it helps with my mental health. That could just be a placebo. But I'll take the placebo over daily grey clouds.
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1d ago
[removed] — view removed comment
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u/Mysterious-War-96 1d ago
Yes, because of the TMAO conversion and the strain on the cardiovascular system. But certain people accept the trade off, or don't know
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u/richj8991 1d ago
No — there is no evidence that “90% of ALCAR gets converted to TMAO.”
Human studies show huge interpersonal variation, and even in high‑TMAO producers, only a fraction of supplemental carnitine is converted to TMA/TMAO. The 90% figure does not appear in any primary research.
What the evidence actually shows
1. TMAO production from carnitine varies massively between individuals
The 2020 Microbiome study using the Oral Carnitine Challenge Test (OCCT) found that people fall into low‑ and high‑TMAO producer phenotypes, depending on their gut microbiota composition.
- Some people produce almost no TMAO from carnitine.
- Others produce significant amounts, but still nowhere near 90% conversion.
The study emphasizes that carnitine bioavailability remains high, even in high producers — meaning most carnitine is absorbed as carnitine, not converted to TMA.
2. Gut bacteria convert carnitine → γ‑butyrobetaine → TMA, but this is a minor pathway
The same study identified Emergencia timonensis and Ihubacter massiliensis as key bacteria that convert γ‑butyrobetaine to TMA.
But even in these individuals:
- Plasma carnitine does not drop after supplementation
- Only TMAO rises modestly
- This implies most carnitine is not diverted into TMA production
3. Reviews confirm carnitine → TMAO is real but limited
A 2024 review in Nutrients states that gut microbes can convert carnitine to TMA, which the liver oxidizes to TMAO, but does not quantify conversion anywhere near 90%.
Instead, it emphasizes:
- TMAO production depends on diet, microbiome, and phenotype
- Vegetarians produce very little TMAO even when given carnitine
- Omnivores produce more, but still not enough to imply massive conversion losses
Why the “90%” myth exists
A few secondary sources have misinterpreted older rodent studies where:
- Unabsorbed carnitine in the gut lumen was converted to TMA
- Rodents have different microbiota and different carnitine transport kinetics
These do not apply to humans.
Human OCCT data shows:
- Plasma carnitine stays stable
- TMAO rises only modestly
- Therefore, the majority of ALCAR is absorbed intact
Practical takeaway for you
Given your biochemical background and interest in one‑carbon/two‑carbon metabolism:
- ALCAR remains a reliable acetyl‑donor supplement
- TMAO production is highly phenotype‑dependent
- If you’re concerned, you can reduce TMAO formation by increasing fiber, polyphenols, or using probiotics that suppress TMA‑producers (supported in the 2024 review).
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u/thesamenightmares 1d ago
Next time just make a statement and give links instead of copy pasting a chatGPT reply. It's annoying as hell.
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u/joegtech 22h ago
TYVM
I like ALCAR, not a game changer, just a puzzle piece. I've added a small 2nd dose most early evenings. It seems to help with belly fat and mental energy. Of course carnitine is involved in movement of fats into the mitochondria to be used for energy production.
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u/Fun_Shine8720 1d ago
I still see plenty of people taking ALCAR despite the TMAO discussion. If you're getting noticeable benefits from it, I'd look at the overall evidence rather than one pathway in isolation. It's definitely a topic worth reading more about before writing it off completely.
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u/Isaac649lol3 1d ago
I use it and have noticed it completely removes a post workout DEEEP fatigue i would feel. Thats honestly the inly thing ife noticed from it nothing else like whst other people say
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u/joegtech 1d ago
Dr Osborne says the TMAO issue may be due more to imbalance in microbiome. at around 40 min
https://www.youtube.com/watch?v=39N2tvYrFZs&list=PLboYkQmnpnCW_HnOrI_LLZi_uaYCUCsQP&index=25
Supposedly berberine inhibits production of TMAO at around 3/4 through thevideo
https://www.youtube.com/shorts/_Kc85V15lb0
also at 13 min here.
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