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ALCAR a Mitochondria Empowering Antiaging Nootropic for Biohacking Hepatic Encephalopathy

alcar mitochondria hepatic encephalopathy carnitine antiaging fatigue cofactor

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#1 jroseland

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Posted 01 February 2017 - 03:36 PM

Why start hacking your Mitochondria with ALCAR…

Carnitine (It’s name when found in nature), L-Carnitine or ALCAR (the supplement name) is also an anti-aging agent. L-Carnitine has several positive effects on the mind; faster learning, improved memory (spatial, verbal), verbal critical abilities, and constructional thinking.

This article is mostly going to focus on decoding what the human studies are saying about Carnitine and how this squares up with the anecdotal experiences of the Biohacking community.
Acetyl L-Carnitine (ALCAR)

This is the form of this amino acid which is most demonstrated as a Nootropic. Since the readers of this website are mostly concerned with Nootropics effects; increasing focus, improving memory and fighting cognitive decline, this article will focus mostly on ALCAR.
As a Nootropic, it’s not a one man band, it needs to be stacked with Racetams or Ampakinic smart drugs to reach true cognitive enhancement (more on these cofactors below) and there’s a good case that these smart drugs also require ALCAR to reach their maximum potential.
ALCAR is able to cross the blood brain barrier, whereas L-Carnitine does not.
While there is clear scientific evidence of ALCAR as a neuroprotective agent that helps the elderly improve brain power, there is not as much data backing its effect in the minds of young healthy people, a single unpublished study (ACETYL-L-CARNITINE AND ITS EFFECTS ON MEMORY AND COGNITION) said it improved cognitive abilities of college students.

Googling ALCAR, you will come across a lot of discussion on bodybuilding forums and speculation on it’s effects on exercise. There’s some studies that demonstrated increases in power output but were done with other forms of carnitine. I couldn’t find any decent studies showing a clear effect on exercise or muscle gain from ALCAR itself, so this article will focus on the Nootropic effects.

Mechanism of Action

As a Nootropic, the primary benefit that ALCAR offers is in the Acetylcholine (ACh) system.

Acetylcholine a neurotransmitter of many talents, it’s functions include:

  • It delivers instructions to cardiac muscle fibers.
  • It’s release in the hippocampus is essential to learning and formation of new memories.
  • Levels of ACh in cortex are linked to responsiveness to audio and visual stimuli.

In addition to its protective effect it boosts superoxide dismutase activity in the mind.

L-Carnitine also improves the health of heart and blood vessels. Since the brain depends completely on the cardiovascular system to deliver blood, oxygen and essential nootropics, a healthy cardio system directly affects brain power.L-Carnitine exerts a substantial antioxidant effect as well, protecting against oxidative stress. An italian study, L-acetylcarnitine in depressed elderly subjects. A cross-over study vs placebo, showed it was highly effective in decreasing A paper in the American Journal of Clinical Nutrition (Volume 86) demonstrated that L-Carnitine boosts neurotransmitter function in the elderly. A study by Bossoni & Carpi, demonstrated that acetyl-L-carnitine supplementation memory processes and learning ability.

A Mitochondria Hack

Carnitine increases the quantity and quality of the Mitochondria along with greasing the microscopic mechanism of fuel transport that our individual cells need to thrive.
From a University of Naples study:
“…ALCAR supplementation partly reduces the leptin resistance… and improves ATP production in skeletal muscle mitochondria through an increase in mitochondrial protein content.”
In none scientific terms, it helps transport fat into individual cells that need it for power.
It’s antioxidant mechanism may be something of boozing biohack, according to a 2011 University of Nebraska study on the human brain and alcohol:
“Mitochondrial membrane protein damage and decreased membrane potential after ethanol exposure indicated mitochondrial injury. These changes were prevented by [carnitine]. Our findings suggest the counteracting mechanisms of oxidants and antioxidants during alcohol-induced oxidative stress at the [blood brain barrier].”
Lack of energy to zealously take on life is such a common symptom, that the voracious consumer has near limitless stimulant options to spike energy. Since ALCAR so profoundly affects energy generation at such a foundational level it’s a favorite of more holistic biohackers.


It’s profound effect on the Mitochondria, makes it an antiaging agent worthy of the attention of anyone who takes hacking their longevity seriously.
It’s an efficacious solution for maintaining vitality for those in the 3 figure age range according to a double blind, placebo controlled 6 month clinical trial of 66 centenarians. The dosage of L-Carnitine in the trial was 2 grams, from the abstract:
“Centenarians are characterized by weakness, decreasing mental health, impaired mobility, and poor endurance. L-Carnitine is an important contributor to cellular energy metabolism… Our study indicates that oral administration of [L-carnitine]… facilitates an increased capacity for physical and cognitive activity by reducing fatigue and improving cognitive functions.”
From a 2011 study out of the Institute of Biomembranes and Bioenergetics in Italy:
“A significant age-related change occurred in 31 proteins involved in several metabolisms. ALCAR supplementation altered the levels of 26 proteins. In particular, ALCAR reversed the age-related alterations of 10 mitochondrial proteins relative to mitochondrial cristae morphology…”
An Italian study, demonstrated that 8 months of supplementation protected rats from age-related deterioration, in a spatial learning challenge.
Furthermore, the chemical process of lipid peroxidation is a driver of memory degradation as brains age, ALCAR reduces this process.

An Anti-Fatigue Agent

At least 7 high quality human clinical trials, totaling over 420 human subjects, demonstrate that at doses between 1–2 grams daily it has a significant effect on fatigue, specifically in the elderly. The evidence of it fighting fatigue in younger people is thinner. 
A 24 week Dutch study dosed 90 human subjects suffering from chronic fatigue with 2 grams of daily. From the abstract:
“Acetylcarnitine and propionylcarnitine showed beneficial effect on fatigue and attention concentration… Acetylcarnitine had main effect on mental fatigue and propionylcarnitine on general fatigue.”
An Italian study of 96 elderly persons reached the conclusion:
“There are few effective treatment options for patients with chronic fatigue syndrome… Our data show that administering [ALCAR] may reduce both physical and mental fatigue in elderly and improves both the cognitive status and physical functions.”

Mood Adjustments

Feeling blue? ALCAR is supposed to be an effective modulator of mood stability, especially combined with other Nootropics that focus on optimizing mitochondrial energy. A 2013 paper stated about a stack of ALCAR and CoQ10:
“[mitochondrial modulators] treatment targets mitochondrial dysfunction, oxidative stress, altered brain energy metabolism and the dysregulation of multiple mitochondrial genes in patients with bipolar disorder… Convergent data implicate mitochondrial dysfunction as an important component of the pathophysiology of bipolar disorder.”
One Bulletproof biohacker remarked:
“…I began taking acetyl l carnitine. I have found that I have a better mood and degree of mental clarity.”

Along with 5-HTP it might be something of a partying lifehack for those who dabble with Ecstasy and Molly. Several rat studies strongly suggested that ALCAR with ALA almost completely blocked MDMA-induced serotonin depletion. Good news for those who have a multi day electronica festival coming up and are going to party so hard they make out with a tree.

Hepatic Encephalopathy

There’s a 100% scientific consensus about Carnitine’s transformational effects this devastating fatigue condition. Hepatic Encephalopathy is a downstream effect of liver failure, which can ultimately lead to death, but most people who suffer with it simply have to deal daily with:

  • Lowered level of consciousness
  • Negative personality changes
  • Extreme lethargy

In it’s early stages, it’s symptoms include:

  • Forgetfulness and irritability
  • Inverted sleep-wake pattern (staying up all night and sleeping during the daylight hours — basically vampire life)
  • Cognitive decline

An University of Catania study of 121 patients with hepatic encephalopathyfound that 2 grams of daily supplementation made a marked difference:
“Acetyl-L-carnitine (ALC) offers neuroprotective benefits and improves mitochondrial energetics and function… Patients with [hepatic encephalopathy] treated with [carnitine] showed a decrease in the severity of both mental and physical fatigue and an increase in physical activity.”
Another double blind, placebo controlled Italian study of 125 patients suffering stated:
“The benefits of [carnitine] in comparison with placebo are demonstrated in greater reductions in serum ammonia levels, as well as in improvements of neuropsychological functioning.”
Researching hepatic encephalopathy, I felt like I was hearing about one of those fear mongering medical conditions that big pharma invents just to scare people into buying their drugs…
Early symptoms include forgetfulness and irritability and it may lead to death…
Couple this with the fact that it’s very difficult to detect clinical in it’s early stages and you seemingly have a condition perfect for marketing drugs.
I guess the good news in the face of this uncertain yet potentially deadly condition, is that L-Carnitine does treat it, as demonstrated by at least four high quality studies, totaling 373 human subjects and it’s also a pretty a cheap fix, with 100 grams running around $20.

ADHD in Children

In a double-blind, placebo-controlled dutch study of 24 boys (ages 6–13), it improved behavioral metric significantly. From the abstract: 
“Compared to baseline, the carnitine treatment caused in the responsive patients a decrease of 20–65%… as assessed by the Child Behavior Checklist total problem rating scale. Treatment with carnitine significantly decreased the attention problems and aggressive behavior in boys with ADHD.”

Weight Loss?

It has actually been somewhat deceptively marketed as weight loss supplement, it doesn’t actually do anything that directly caused weight loss, however since it reduces fatigue which leads to a more active lifestyle.

Food Sources

In the human diet L-Carnitine shows up mostly in red meat and dairy products. Carnitine per 100 grams of food: Milk, Pork (27.7 mg), Ground Beef (94 mg), Bacon (23.3 mg), Tempeh (19.5 mg), Cod Fish (5.6 mg), Avocados (2 mg)

In mammals Carnitine is biosynthesized in the kidneys and liver.

Supplemental Sources
Powdered ALCAR 6 month supply $25

So why consider supplementation when you can get it naturally via a diet high in quality red meats? The food sources only actually contain L-Carnitine, not ALCAR and it’s hard to say how much actually gets converted into ALCAR, which can cross the blood-brain barrier and have the Nootropic effect desired.
You would have to eat a lot of premium red steak to get the mitochondria empowering Nootropic effects ALCAR.
The powder taste is not great, but nowhere near as bad as some smart drugs. It’s taste is described optimistically as…
“…vaguely pleasant, if you’re into things like salt & vinegar chips or sour patch kids.” 
And less positively as tasting like a rotten batch of lemons.
It’s smell is frequently described as fishy.

Recommended Daily

For cognitive improvement, the unpublished study suggested health people take up to a gram daily (two 500 Milligram doses). Generally, 20–200 Milligrams per day for those on an omnivorous diet, vegans and vegetarians may take as little as 1 Milligram per day. Elderly people dosing for memory empairment are given up to 1.5 Grams per day. Those recovering from heart attack may take up to 2–6 grams daily.


ALCAR, Piracetam and a choline source are a favorite of holistic biohackers but there’s a protocol that should be followed.
Start taking Piracetam on it’s own at the recommended dosage 3–4 grams and begin pushing the dosage up to the point that you either start getting Piracetam headaches or the Piracetam starts to lose it’s effect.
Then add a Choline source, at a 1:4 ratio (1 gram Alpha GPC : 4 grams Piracetam). They should potentiate the Piracetam and get rid of the headaches, you could even experiment with pushing the dosage up.
Then add ALCAR at a dosage starting at 500 milligrams daily and push the ALCAR dosage up by 100 milligrams daily, some biohackers take up to 1 gram of ALCAR daily in this three part stack.
Following this process, over approximately 3–4 weeks, you’ll optimize your stack for your individual brain chemistry.
Speaking hyperbolically about a stack of ALCAR, Choline and Aniracetam one biohacker reported:
“I do feel like I’m on a whole new level, a god among men… Seriously it’s like a mild cocaine high that lasts all day, without the intense energy that makes people uncomfortable or the come down.”
Since ALCAR has such an effect on the ACh system, it’s a really good idea to supplement ACh precursors. Choline also optimizes deposition of carnitine in muscles.
CoQ10, some recent papers have suggested that ALCAR with Coenzyme Q10 have a profound effect on everything from mood stability to bipolar disorder, especially when combined with…
Alpha-Lipoic Acid, stacking ALCAR with this antioxidizing amino is favorite of cognitive enhancement dragon chasers, the two have also been the subject of several studies.
Caffeine, which boosts carnitine production.

Side Effects

Those dosing L-Carnitine take pretty high levels safely. WebMD advices that possible side effects include nausea, vomiting, stomach upset, heartburn, and diarrhea. Those who have history of seizures should not take L-Carnitine.
The following drugs have moderate interactions with L-Carnitine; Acenocoumarol (Sintrom), Thyroid hormone, and Warfarin (Coumadin).


Edited by jroseland, 01 February 2017 - 03:39 PM.

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#2 PeaceAndProsperity

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Posted 01 February 2017 - 10:34 PM

Whether it's pro-aging or anti-aging is not completely certain. There's some talk that it may speed up accumulation of mitochondrial dna mutations. Besides that, it does benefit the elderly in some areas such as cardiac health and weight loss.

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#3 BieraK

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Posted 14 February 2018 - 12:27 AM

Whether it's pro-aging or anti-aging is not completely certain. There's some talk that it may speed up accumulation of mitochondrial dna mutations. Besides that, it does benefit the elderly in some areas such as cardiac health and weight loss.


A possible explanation behind this is the increased ATP and general antioxidant effect on mitochondria, for which damaged and mutated mitochondria are not eliminated because the body can not detect them as inefficient, ALCAR and other antioxidants mask the problem.
If this is true, the best way to solve it is to alternate periods of antioxidants with periods of stress and autophagy, for example the Fasting mimicking diet developed by Valter Longo.

I remember a time when my party nights while drinking alcohol where highly prevented in side effects only through the consumption of Quercetin and ALCAR, personally if I do not have antioxidants at hand I prefer not to drink alcohol.

Also tagged with one or more of these keywords: alcar, mitochondria, hepatic encephalopathy, carnitine, antiaging, fatigue, cofactor

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