Acetylcarnitine (Montiff) Each bottle, 90 capsules. Each capsule, 500 mg of acetyl-L-carnitine, a form of the amino acid, carnitine. (Technically, it is a "quaternary ammonium compound".) This form of acetylcarnitine has been studied by Mike Youle and his group in London. They found that 3000 mg per day (6 capsules) was beneficial for managing neuropathy arising from use of nukes (like AZT). Anecdotally, some have reported relief at lower doses, so you could try 3 capsules a day to begin with to see if that helps.

Several reports indicate that systemic carnitine deficiency could occur in AIDS, and that primary and secondary carnitine deficiency leads to critical metabolic dysfunction. In a 1993 Italian study of 28 PWHIV, 6 grams of carnitine was administered for just two weeks. Immune responsiveness was greatly enhanced as well as significant reductions in beta-2 microglobulin, a disease progression marker.

Most importantly, tumor necrosis factor levels were normalized in the two study participants who had abnormally high levels, while triglycerides levels were reduced on average approximately 35% (triglyceride levels are a secondary marker for high inflammatory immune messenger [cytokine] levels in the body like TNF and others).

Increased tumor necrosis factor (TNF) levels have been strongly associated with opportunistic infections. This can greatly foster disease progression through increased HIV replication and loss of T-cells through the mechanism of early cell death (apoptosis) since TNF signals the body to produce large quantities of free radicals which hyperactivate immune cells (see antioxidant, NAC and vitamin E sections).

Several recent reports have implicated L-carnitine deficiency to AZT-related muscle wasting (myopathy) and the authors suggest that carnitine supplementation may prevent the development of myopathy when used together with AZT. This may be accomplished by reducing AZT’s toxicity to cellular mitochondria (the energy producing factories of the cell)—a cellular target particularly sensitive to AZT’s destructive effects.

The acetylcarnitine form has been used as a “smart drug” to enhance memory and other cognitive functions. A small study in 2000 showed some benefit for this form of carntine in offsetting “nuke” neuropathy.

Please note: over-the-counter L-carnitine is expensive but there is a pharmaceutical (prescribed) form of L-carnitine which medical insurance plans (including state-run medicaids) will pay for, so you should get your doctor to write a prescription for the following: Carnitor Tablets, Sigma Tau, 330 mg., 3 tablets, 3 times per day.

If your doctor wants to see the original research on L-carnitine in HIV/AIDS before writing a prescription, see L-Carnitine information sheet on this website.

Several European studies have found it useful in improving memory retention and recall in Alzheimer's patients. Acetylcarnitine has been used for years as a "smart drug" and reportedly increases mental functions in healthy individuals. Test tube studies of this form showed that it improves the ability of immune cells to proliferate and also stopped the cells from producing TNF.

This was bolstered by regular carnitine studies in humans that showed a high dose of 6 g/day over two weeks normalized high TNF (and reduced triglyceride) levels. There are also several laboratory studies which revealed dramatic reductions in CD4 cell apoptosis (premature cell suicide). Apoptosis may contribute to the substantial loss of uninfected T-cells.

Store unopened container at room temperature. Do not store at extreme temperatures. Once opened, reseal container and store in a cool, dry place (not refrigerator). Suggested use is 1-2 capsules per day on an empty stomach or as directed by your healthcare provider. (Up to 6 capsules a day if you are living with neuropathy.)

Some PWHIV are using 500 mg per day in an attempt to offset cellular mitochondrial damage caused by nukes like AZT (see above). Other PWHIV take larger doses (1–2 grams per day) in an attempt to modulate a dysfunctional immune response (see above).