The combination of apremilast with biologics is safe and associated with reductions in the mean Psoriasis Area and Severity Index (PASI) score in patients with psoriasis who have recently shown biologic fatigue, according to study results published in the Journal of Dermatology.

The study was a retrospective analysis of efficacy and safety results of a combination psoriasis treatment regimen consisting of apremilast and biologics (n=14). Patients included in the analysis were initially treated with 1 biologic, but after the efficacy of the biologic(s) declined, apremilast was added to the existing treatment program. Biologics included infliximab, adalimumab, secukinumab, ixekizumab, and ustekinumab.

Changes in the PASI score, as well as achievement of 75% and 50% reductions in PASI Score (PASI-75 and PASI-50, respectively), were assessed at weeks 0, 12, and 24 after the apremilast addition.

A total of 11 patients achieved a 90% improvement in PASI score after biologic therapy, with the lowest PASI scores ranging from 0 to 3.8 (mean, 1.30.3). Prior to biologic treatment, PASI scores in the overall cohort ranged from 5.9 to 39.0 (mean, 19.52.7). The mean PASI score before the addition of apremilast to biologic therapy was 3.20.4. The addition of apremilast to the existing biologic treatment protocol decreased the mean PASI score to 1.60.3 at 24-week follow-up. Approximately 50% of patients had achieved PASI-50, whereas only 29% achieved PASI-75 at 24 weeks.

There were 4 patients who developed diarrhea during the 24 weeks and 1 patient reported both diarrhea and nausea. In 2 patients, weight loss >5% of body weight occurred. Adverse events were not severe enough to cause any patient to discontinue the combination treatment.

Study limitations were the small number of patients, the inclusion of only patients with biologic fatigue, and its retrospective nature.

Based on their findings, the investigators concluded that apremilast could be safely combined with a biologic in psoriatic patients who are not responding adequately to a biologic alone.

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Reference

Takamura S, Sugai S, Taguchi R, Teraki Y. Combination therapy of apremilast and biologics in patients with psoriasis showing biologic fatigue [published online December 22, 2019]. J Dermatol. doi:10.1111/1346-8138.15193

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Addition of Apremilast to Biologic Therapy Is Successful for Treating Psoriasis in Biologic Fatigue - Dermatology Advisor

Now that the long-anticipated trade of Mookie Betts and David Price to the Los Angeles Dodgers is finally over, Boston Red Sox fans can settle in and get ready for the 2020 season knowing where things stand. Well, sort of. The roster tweaking probably isnt finished, and theres also the matter of hiring a new manager.

One difference afforded, literally, by the Betts/Price trade is that Red Sox Baseball Chief Chaim Bloom has fiscal breathing room in which to operate. Look for him to acquire at least one more player, if not two or three, on the cheap in the coming days or weeks and still have change left over to accommodate in-season trades.

Start by re-signing Brock Holt. Now. (Well come back to Brockstar in a jif.)

By shedding Betts $27 million salary and half of Prices $32 million, as reported by the Boston Globes Peter Abraham, $43 million gets whacked from the teams taxable payroll for 2020. That takes it down to about $189 million, safely satisfying ownerships goal (i.e., mandate) of getting below the $208 million threshold to reset the teams competitive balance tax rate at zero with almost $20 million of wiggle room.

With Price now out of Dennis Eckersleys hair and gone from the starting rotation (and headed to the land of sun and sand, where yuck has no place in the vocabulary of the beautiful people), Bloom once again needs a fifth starter. The Sox went through a similar deal earlier this offseason when Rick Porcello exited via free agency, soon followed by the free-agent signing of left-hander Martin Perez, formerly of the Minnesota Twins. Now Bloom gets to do the same drill all over again. Fun. Just like in the army.

Prices departure leaves Chris Sale, Eduardo Rodriguez, Nathan Eovaldi, and Perez as the four starters, with no apparent in-house candidate primed and prepared for promotion to the No. 5 spot. Ryan Weber? I like him, but nah. Hector Velazquez? Not this time: wouldnt be prudent.

One possibility down the (short) road is 21-year-old right-hander Brusdar Graterol, acquired from the Twins as part of ruby Tuesdays three-team Betts/Price deal. Graterol is an intriguing option with a 100-plus MPH sinker to go with a slider and changeup, although he likely needs two or three months of fine-tuning at Pawtucket to be fully MLB-ready, either as a starter or reliever.

One interesting angle about Graterol that awaits a Fort Myers eye test is just how big a guy he is. The Twins 2019 40-man roster at both MLB.com and Baseball-Reference.com have the 6-1 righty pegged at 265 pounds; the Red Sox 2020 40-man roster at ESPN.com says he weighs . . . 180. We can only assume either that Graterol has found a weight-loss program soon to be the envy of keto dieters across America, or whoever typed in his Red Sox roster data needs remedial Typing 101. In any event, Boston-area tailors should be fighting among themselves to get his cell number.

OK, where does that leave the Sox? Although Chaim hasnt asked me (yet) for my two cents, Im going to suggest moves to plug holes and get a complete 26-man roster in place for Opening Day. I base these signings on a quick check of the MLB.com list of remaining unsigned 2019-2020 free agents. (Youre welcome to look for yourself and see if you can do better.). Here goes:

1. Sign the Brockstar. Immediately. Its a no-brainer. Holt is 32 and should have at least two good seasons left as a super-utility guy, good for something in the range of .270/.330/.380. He can start some at second base, maybe to platoon there with Jose Peraza (with Michael Chavis also in the mix); give Rafael Devers an occasional rest at third base; and take the burden of being the fourth outfielder off of J.D. Martinezs iffy back.

The clubhouse needs Holt, the greater Boston community wants him, the fans love him, and hes good with media. His return would help offset the loss of Betts in terms of fan favorites. The expansion to a 26-man roster makes this work and you can still go with eight relievers. Next . .

2. Sign righty free-agent starters Clay Buchholz and Andrew Cashner. Both of them. On the really cheap, maybe minor-league deals. This is not about favoritism and teary Red Sox reunions its strictly gap-plugging business. Look again at that remaining free-agent listand you tell me which other starter you would sign instead.

Let Bucky and Andy battle it out for the fifth spot. Theres a chance Cashner has worked out the pitching bugs that apparently bit him while making his dismal 2019 mid-season transition from Baltimores badlands to Bostons 24-hour sauna. Hes a decent bet for a 2020 rebound.

3. Sign reliever Sam Dyson, most recently of the Twins. Hes probably not a closer candidate the Sox should be OK there with Brandon Workman. Maybe Dysons not quite good enough to push Matt Barnes out of the primary eighth-inning setup role, but he could bolster the bullpen nicely as a middle/seventh-inning reliever.

Before going from the San Francisco Giants to the Twins late in 2019, Dyson posted a 2.47 ERA, 0.902 WHIP and dazzling 6.71 SO/W ratio in 51 innings of relief for the Giants. In 2018, Dysons respective numbers were 2.69/1.081/2.80 in 70.1 innings. Hes a workhorse, and any reliever who can put together two or more consecutive decent years is worth a look.

Thats it. Bloom should be able to do all that without committing more than about $10 million of 2020 payroll, leaving $8-10 million for an in-season move or two (if needed). Dont rule out another spring trade, either. Opening Day is almost two months away thats plenty of time.

More:
Expect more Boston Red Sox moves, starting by signing Brock Holt - BoSox Injection

Annabel Wright was 15 when she killed herself last spring. She loved horse riding and dogs, and was the only daughter of Helen and Simon Wright. She had also just been prescribed a course of Roaccutane, a potent medication used to clear nodular, cystic acne that has an unconfirmed link to depression.

While the cause of Annabels death is yet to be confirmed, her parents blame the drug. At the end of 2019, the Guardian reported that ten out 12 deaths connected to Roaccutane were by suicide the highest since records began in 1983.

The safety of Roaccutane, a brand name for the drug isotretinoin, has been debated in the House of Commons four times in the past decade, with the last government-funded review taking place in 2014. The Medicines and Health products Regulatory Agency (MHRA) concluded that the data was insufficient in establishing a link between Roaccutane and depression, but that an association could also not be ruled out. Instead, they insisted that the current warnings on Roaccutanes product information, added in 1998, should be emphasised.

But for 27-year-old Bethany Simpson, the written warnings didnt make clear the long-term impact Roaccutane would have on her mental health. She was 15 when her dermatologist prescribed her the medication. I still have issues now, she tells me over the phone. Im pretty convinced [Roaccutane] was a definite cause.

Half way through the six-month course, Simpsons mood began to dip significantly, leading to arguments with those closest to her. I remember being like, I cant understand why I feel like this because especially towards the end [of the prescription], my skin started to clear up and I was like, I should feel way happier but I definitely didnt.

Simpson also felt that her depression wasnt being taken seriously by the medical staff who prescribed Roaccutane. There was never a full check-in, she says. [The nurse] said, Hows your mood? and I said, Fine. And that was the end of that, really.

Roaccutane, a medication used to clear nodular, cystic acne. Photo via Wikimedia Commons.

Roche, the pharmaceutical company that manufacturers Roaccutane, says that it takes the safety of all its medications seriously. A spokesperson told me: It is vital that patients are fully informed as to what to expect when they take it and that they are monitored closely to ensure they get the ongoing care they need.

In the 2014 review, before any data on the psychiatric effects of Roaccutane is discussed, the MHRA takes care to explore the pre-existing link between acne and depression. Its a double-edged sword: while this defence cant account for patients like Simpson, whose depression persisted after her skin healed, the anxiety and lack of self-esteem felt by acne sufferers is worth acknowledging.

I was first prescribed Roaccutane for my acne at 15, and then again at 22. For me, the meteoritic rise of skincare as a fashionable hobby exaggerated my poor mental health. In the past decade, skincare has exploded into the mainstream, gobbling up nearly 60 percent of the global cosmetic market growth, with the industry projected to reach 134 billion by 2025. Reddits r/SkincareAddiction gets more than 1,000 posts a day. During my second course of Roaccutane medication, I remember watching girls no older than 13, with glassy, prepubescent complexions queue to buy 50 jars of face mask at my local Urban Outfitters.

This shame felt by many acne sufferers is only intensified by the current trend for skincare as fashion. Although Annabel Wrights acne was classified as non-severe, her dermatologist suggested Roaccutane as the best method to prohibit any scarring. And to Annabel, her mother told Channel 4 in October, that was everything.

So, why is Roaccutane, a drug with climbing suicide rates, still taken by 30,000 people every year? In comparison, weight-loss wonder drug Acomplia was pulled from the UK market in 2008 after being linked to five suicides in a trial of 36,000 patients. Unlike the MHRAs 2014 review of Roaccutane, there was no mention of the pre-existing relationship between obesity and depression in the European Medicines Agencys official press release.

Glen Hamilton, 40, who was prescribed Roaccutane in 2007, points out that there are not many alternative acne treatment options. There werent any other drugs being suggested as a solution, he tells me. [My dermatologist] did say to me that he would take it himself, but that he was a risk taker. And thats the way it was positioned to me.

The reality is that the social stigma surrounding acne runs deep. Just like Hamiltons dermatologist, society tells us that clear skin is always worth the risk.

Hamilton made the decision to stop taking the medication just six weeks into the course, but within those six weeks already so much had changed. I just remember I left my job, I struggled to work and I just felt incredibly down. Like the world was going to end.

Dr. Jibu Varghese, a consultant dermatologist in the south west of England, says that the percentage of patients who experience such side effects are significantly low. Despite Roaccutanes product information instructing patients to alert their doctor to any previous cases of mental illness, Dr. Varghese tells me this is not a contraindication for a Roaccutane prescription. Ive got a patient who had postnatal depression, he says, now shes completed her course safely.

But for many, opening up about mental health is still a challenge. David Kochanowicz, 20, says that the lack of emphasis professionals placed on Roaccutane's potential mental health side effects made him believe the depression he was experiencing was a separate issue.

Kochanowicz says: The only side effects they talked about were cosmetic, so dry lips, skin, pregnancy in women and what not. Mental illness wasnt really something that was raised.

Like many other Roaccutane patients, Kochanowiczs experience of the medication hinged on his ability to fill in the gaps of NHS support. Due to the long wait list to see a therapist, he relied heavily on the helpline provided by mental health charity Campaign Against Living Miserably.

A new inquiry into Roaccutanes safety will be conducted by the Isotretinoin Expert Working Group, with the first meeting set to be as early as possible in 2020. Rather than an outright ban of the drug, Hamilton believes that closer psychiatric monitoring, more comprehensive warnings and a better support system for patients is needed.

That would be the most sensible route, he concludes, just being aware it can have really serious side effects in terms of mental health and then giving channels to communicate and get support if they need it. Its that life changing stuff.

Go here to see the original:
The Acne Miracle Drug with Links to Ten Suicides - VICE UK

Created for Greatist by the experts at Healthline. Read more

Whether you live at the gym or on a YouTube fitness channel, youve probably heard abs are made in the kitchen at some point. The trope may be overused, but its also very true. If you want a bod like Gal Gadots or Kumail Nanjianis (like, WHAT?), youll need to be as dedicated to your diet as you are to your squats. Enter: the cutting diet.

The objective of a cutting diet is to cut body fat while maintaining your musculature. The technique is popular with bodybuilders and fitness enthusiasts who are looking to get as lean as possible without losing muscle mass.

FYI:

Cutting isnt a long-term lifestyle. Its a phase that typically lasts 24 months. Its usually timed around a bodybuilding competition, an athletic event, or any occasion where you want your physique to be *chefs kiss.*

The diet tends to be low in calories, with most of the calories coming from carbs and protein, and it always involves weightlifting. Weightlifting is key: It helps prevent muscle loss when you begin to cut calories.

Bottom line:

Cutting is a low calorie, high protein, temporary diet phase that also includes weightlifting. The goal of cutting is to get as lean as possible without losing muscle mass.

Is the term macros unfamiliar? Dont worry you already know what they are!

Macronutrients aka macros include protein, fat, and carbohydrates. A cutting diet often involves getting a certain amount of calories from fat versus carbs, which is where counting macros comes into play.

To determine your ideal macronutrient breakdown, you must first figure out your caloric needs.

Fat loss occurs when you consistently eat fewer calories than you burn. But a cutting diet isnt just about reducing your caloric intake. The source of your calories matters too.

The number of calories you should consume each day depends on your height, weight, lifestyle, gender, and activity level. Its also important to keep in mind that while a larger calorie deficit could help you lose weight faster, research shows that dropping weight too quickly could result in muscle loss.

A slow, even rate of weight loss often works best for cutting. Studies have found that losing 1 pound (or 0.5 to 1 percent of your body weight) per week may be most effective.

Since youre consuming fewer calories and exercising routinely while cutting, your protein needs will increase. Luckily, studies have found that a high protein diet can reduce appetite, boost metabolism, and even help preserve lean muscle mass.

Pro tip:

To help ensure that youre shedding pounds, not muscles, aim for 0.70.9 grams of protein per pound of body weight (or 1.62 grams per kilogram). Translation: Someone who weighs 155 pounds (or 70 kilograms) should eat 110140 grams of protein a day.

Too much fat will obviously hinder your ability to lose weight. But not consuming enough can impact your bodys ability to produce hormones like testosterone and IGF-1, which help preserve muscle mass.

Pro tip:

Experts recommend 1520% of your calories come from fat while cutting. One gram of fat contains 9 calories, so a person on a 2,000-calorie regimen should aim to consume 3367 grams of fat each day.

If your workouts tend to be intense, stay on the lower end of the fat range this will allow you to get more of your calories from carbs.

Love em or hate em, carbs may help preserve muscle mass while cutting. This is because your body actually prefers to use carbs, not protein, for energy. Also, carbs help fuel your performance. (Hello, carbo-loading.)

Pro tip:

To determine your carb intake, subtract the calories that should come from protein and fat from your overall calorie count. The remaining calories should come from carbs. Divide that number by 4 (because carbs provide 4 calories per gram) to figure out how many carbs you should eat each day.

For example: If the 155-pound (or 70-kilogram) person mentioned above is on a 2,000-calorie cutting diet, they should eat 110 grams of protein and 60 grams of fat. The remaining 1,020 calories can come from carbs (about 255 grams of carbs, to be specific).

Bottom line:

Your caloric and macro needs depend on your height, weight, gender, and activity level. Accurate calculation is crucial to a successful cutting diet, so break out that calculator.

There are pros and cons to cheat meals and refeed days, which are totally optional. If you incorporate either into your diet, be sure to plan them carefully.

Cheat meals, which are occasional deviations from your plan, are meant to ease the strictness of cutting. (After all, you still have a life outside the gym and the kitchen.) But if you have difficulty with moderation, these special meals may sabotage your weight loss efforts or promote unhealthy eating habits.

Refeed days, on the other hand, are meant to boost your carb intake (usually once or twice a week). This increase in carbs can help restore your bodys glucose stores, improve performance, and balance your hormones.

Weight gain is possible after cheat meals or refeeding, but dont sweat it too much. The extra pounds tend to be water weight thats lost after a few days of cutting.

Cutting is just one element of a bodybuilders in-season eating plan. Before they start cutting fat, they go through a bulking phase that can last for months (or even years whoa).

During the bulking phase, bodybuilders follow a high calorie, protein-rich diet and an intense weightlifting regimen to build as much muscle as possible. Once they reach their muscle mass goal, they often transition to the cutting phase. This can last from 12 to 26 weeks.

Competitive bodybuilders are judged purely on their physical appearance, but there are a few health benefits associated with the lifestyle.

For one thing, they often practice resistance and aerobic training, which can help reduce the risk of dying from cancer, heart disease, kidney disease, and other critical illnesses.

They also tend to consume lots of nutrient-dense foods from all different food groups, which may also help reduce the risk of chronic disease.

Calculating macros for bodybuilding requires a little more precision than, say, calculating macros for regular weight loss. The first step: Find out your maintenance calories.

The simplest way to determine your maintenance calories is to:

If, by the end of the week, your weight has stayed the same, the number of calories youve consumed per day is your maintenance calories (its helping you maintain your weight, not gain or lose).

During the bulking phase, you should aim to increase your maintenance calories by at least 15 percent. This means that if your maintenance number is 3,000 calories a day, you should try to consume 3,450 calories a day.

As you gain weight, continue to evaluate and increase your caloric intake (preferably on a monthly basis).

Once youve met your muscle mass goal and your weight is stable, the next step is to reduce your calorie intake by 15 percent of the amount youve been eating while your weight has been stable.

You should also continue to adjust your calories as you lose weight, like you did in the bulking phase.

During both phases, try not to lose or gain more than 0.5 to 1 percent of your body weight each week. Itll help ensure you dont gain too much body fat or lose too much muscle.

Time for more math!

Now that youve calculated your calories, you need to determine your macronutrient ratio. (If you need a refresher, macros are your protein, carb, and fat intake.) Luckily, your macronutrient ratio wont change based on the phase youre in.

The following ratios are general guidelines for a bodybuilders needs, but its best to consult a registered dietitian to ensure your goals (and nutritional needs) are being met:

For the general population, the Acceptable Macronutrient Distribution Range (AMDR) according to the Institute of Medicine suggests:

Heres a breakdown of the macro ratios for both bulking and cutting if your maintenance calorie total is 3,000:

The carb and fat ratios are a bit flexible if these exact numbers dont fit into your lifestyle.

What you eat and dont eat is just as important as your training. Consuming the right foods in the right amounts will give your muscles what they need to recover and grow stronger post-workout.

Similarly, consuming the wrong foods (or not eating enough of the correct ones) will negatively affect your results.

FYI: You dont need to change the kinds of foods you eat depending on whether youre bulking or cutting, but the amounts will vary.

The following foods are great for both phases:

while its best to limit or avoid the following foods:

Certain foods can slow digestion or upset your stomach if you eat them before a workout. Try to avoid the following foods before hitting the gym:

The makeup of your meals can stay the same during each phase, but portions will obviously change depending on whether youre bulking or cutting.

If the thought of eating chicken and broccoli for months on end makes you want to throw a barbell out a window, take a moment. Counting macros doesnt have to involve eating bland, boring food.

In fact, bodybuilders should focus on eating a variety of foods and food groups throughout the day to ensure their nutritional needs are being met.

Bottom line:

Make sure every meal and snack contains 2030 grams of protein to support muscle-building.

Heres some #inspo for your meals:

Eating the right foods, watching your macros, and working out consistently are most important to a successful cutting diet, but the following tips will help support your weight loss:

The goal of cutting is to maximize fat loss without losing muscle mass. Its a phase meant to last only a few months, typically before an occasion when you want to look lean and mean. You should also follow an exercise regimen that emphasizes weightlifting.

The diet is based on reducing calorie intake and following certain macronutrient ratios, which depend on your weight and lifestyle. If youre an athlete or bodybuilder, consider talking to a trainer or medical professional to see if cutting is the right weight loss method for you.

Go here to see the original:
Cut Mass, Not Muscle: The Basics of a Cutting Diet - Greatist

stockvisual - Getty Images According to a new study published in the journal Obesity, those who were most successful at losing weightand keeping it offhad a more positive outlook.

It should go without saying that no runner needs to lose weight, and runners indeed come in all shapes and sizes (see: Allie Kieffer advocating for body-positivity in the running community and social media movements like Dorothy Beals #IHaveaRunnersBody). But the reality is that many people get into running to lose weight, which is a challenging process, and those who are successful face an even harder road ahead: keeping the pounds off.

While theres no single strategy that works best for everyone, new research highlights certain tactics that many weight loss maintainers have in common, providing at least a roadmap for the maintenance journey.

Published in the journal Obesity, the study surveyed almost 5,000 members of WWformerly known as Weight Watcherswho lost an average of 50 pounds and didnt regain the weight for at least three years. Researchers looked at 54 behaviors related to weight management, encompassing strategies related to goal-setting, attitudes, food tracking, and type of food consumed.

In terms of habits around food, the most prevalent behaviors of the weight loss maintainers were keeping healthy, lower-calorie food accessible, setting daily consumption goals, recording actual food consumed, and continuing to measure or weigh foods.

Also important for those who kept the weight off for years is an emphasis on outlook. These participants focus on remaining positive and often think about past successes, said lead study author Suzanne Phelan, Ph.D., a kinesiology and public health professor at California Polytechnic State University.

Focus on building these skills first, she told Runners World. The more these skills are practiced, the more they become habitual.

And while there are often unhealthy temptations and distractions all around us, putting consistent habits in place can counteract this environment, Phelan added.

Video: 7 incredible results you'll get from walking 30 minutes a day (Courtesy: Prevention)

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What the weight loss maintainers did not do was beat themselves up for regaining a few pounds or feel negative about themselves or the behaviors that had led to being overweight or obese.

Practicing self-kindness and mindfulness are connected to being self-aware, and to understanding that eating and activity are part of a process, Phelan said. There will be days of excess eating and low activity. How people respond to these days makes a difference.

Preventing weight regain isnt important just for a sense of emotional wellbeing. Recent studies have highlighted the health hazards of yo-yo dieting, since the weight thats regained is often fat, which raises heart disease risk and increases systemic inflammationa potential cause for many health issues, such as high blood pressure and high cholesterol.

For those who are on a weight loss track right now, it may be helpful to look past that goal weight moment and think about implementing strategies that will boost maintenance efforts, too. Above all, obsessing over every single calorie or every single pound can quickly result in an unhealthy mindset so focusing on awareness, positivity, and healthy habits is key.

Slideshow: These 40 fit celebrities over 40 will inspire you to hit the gym (Provided by Prevention)

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Yep, It's TrueStaying Positive Can Actually Help You Maintain Weight Loss - msnNOW

Created for Greatist by the experts at Healthline. Read more

Last week your trainer hyped it as a workout recovery supplement. Then yesterday your co-worker raved about its fat-torching prowess. Rumor has it L-carnitine is a fat-burning, brain-boosting, performance-enhancing machine of a supplement.

But is it all its cracked up to be? Here are the details on L-carnitine.

If the name has you craving some juicy carne, youre actually on the right track. L-carnitine is an amino acid derivative found in meat and animal products. Lucky for the vegans in the house, our bodies can also make it.

Whether you know it or not, youre already familiar with L-carnitine. Your body relies on it every day. Its responsible for fast-tracking fatty acids to your mitochondria, which burn the fat into energy. L-carnitine is basically the low-key conveyor belt sending your fat to the incinerator.

Some signs youre deficient include:

These symptoms are similar to those of many other conditions, so talk to your healthcare provider before you jump on the supplement train.

There are several types of carnitine. L-carnitine kinda steals the spotlight since its the one in red meat and most supplements.

Meet the others:

Bottom line:

ALC and L-carnitine are probably your best bets for a general supplement. But its also important to take a look at the different types in relation to your #goals.

Almost all the L-carnitine in your body is stored in your muscles. The rest is chillin in your liver and bloodstream.

Right now your L-carnitine stores are busy keeping your mitochondria, aka your cells engines, fueled up. And since amino acids play a lot of roles, L-carnitine also picks up toxins and dumps them outside the cell walls. What a gem.

Bottom line:

L-carnitine lives in your muscles, where it shovels fatty acids into cells so they can be burned for energy. Your body makes L-carnitine, but you can boost your level through food or supplements.

Popping L-carnitine might sound like a pretty convenient way drop a little weight. But lets keep it 100: Sure, L-carnitine is responsible for shoveling fatty acids into the furnace, but thats just a teeny, tiny part of the metabolic process.

Despite claims from supplement companies, there just isnt much medical evidence of L-carnitines weight loss superpowers.

Heres what we know:

If youre generally healthy, you probably already produce enough L-carnitine. But your biological clock wreaks havoc on more than baby-making and crows feet. Age can cut into your L-carnitine stores (so can diabetes and genetic conditions).

Studies on animals have suggested that L-carnitine can boost function in aging brains and possibly protect brain cells from damage.

Unfortunately, there isnt much research yet on whether taking L-carnitine boosts brain power in younger, healthier people.

Lets start with the good news: A 2013 review found that L-carnitine helped heart attack patients recover quickly. Since all the carnitines prefer to do their work inside muscle tissue, it makes sense that their presence is good for the heart.

But that same year, a study in mice found that L-carnitine in red meat might increase levels of trimethylamine-N-oxide (TMAO), which could cause clogged arteries.

What gives? A 2004 review of older medical research suggested that L-carnitine does the most for people whove already had a heart attack. The jurys still out on exactly how it could help or harm healthy hearts.

Some research says L-carnitine supports workout #goals in the long term. Typically, L-carnitine is a slow burn. Dont expect it to kick in overnight like caffeine or creatine. Stick with it and you might be running harder, better, faster, stronger in a few months.

On the flip side, a small study of professional athletes found that those who received 3 to 4 grams of L-carnitine immediately before a workout had better endurance.

Heres how L-carnitine might improve your workouts over the long haul:

Living with type 2 diabetes takes a whole lotta discipline. But theres evidence that taking L-carnitine might alleviate some symptoms and risks.

Some research suggests acetyl-L-carnitine (ALC) dials down nerve pain and weakness caused by type 2 diabetes. A 2005 study suggested L-carnitine supplements could also lower blood sugar.

There isnt much new research on links between type 2 diabetes and L-carnitine (weight loss studies get all the love, amiright?). But the bottom line is that if youre dosing properly and checking with your doctor, L-carnitine is way more likely to help than to hurt.

L-carnitine is technically FDA-approved for just one use: treating carnitine deficiency. But doses of less than 3 grams a day seem safe for pretty much anyone. Taking too much (2 to 3 grams, depending on your body) can cause mild side effects, including:

And, as we mentioned, a 2013 study in mice found that L-carnitine in red meat might contribute to clogged arteries, although more research is needed.

tl;dr

More medical studies are needed, but up to 2 grams a day seems safe for most people. One animal study suggested that L-carnitine supplements could raise your risk of blocked arteries.

Theres no one size fits most answer for whether or not you should add a bottle of L-carnitine to your medicine cabinet.

Technically, your body can whip up L-carnitine without help, thank you very much. The main things to consider are your diet and whether your body is healthy enough to create what it needs.

The folks most likely to benefit from supplementation:

If you still wanna give L-carnitine a whirl, remember to research the specific carnitine type thats right for your goals. Chatting with your doctor isnt a bad idea either.

Most people supplement with 500 to 2,000 milligrams of L-carnitine per day. Two grams (2,000 milligrams) seems to be the sweet spot for long-term effectiveness without health risks.

Pill-popping isnt the only way to give yourself a little L-carnitine love. You can find it in foods, liquids, powders, and even injections.

While the best way to score nutrients is through diet and a healthy lifestyle, supplements can help. If youre concerned about mixing meds, its always a good idea to check with your doctor.

Your body absorbs L-carnitine from food sources more quickly than from supplements. Sneak in some L-carnitine with a 3-ounce serving (about the size of your palm) of these meats:

Meat is your best bet, but other animal products deliver itty-bitty doses of L-carnitine too:

Mix a concentrated liquid supplement into your morning glass of water or OJ if youre not a fan of swallowing pills. Bonus: You can try ALL the flavors! Start slow, with a 1,000-milligram dose per day.

Cost is the main drawback to liquid supplements. Youll get more bang for your buck with powder or pill forms.

Powdered L-carnitine supplements work well for those who already whip up a protein shake or smoothie in the morning. Add a scoop (1,000 milligrams) along with your collagen or protein powder.

Theres not much difference in cost between powder and pills, so pick whatever strikes your fancy.

Injections and IV doses of L-carnitine are best left up to the pros. In a 2014 study of people who had an L-carnitine deficiency, switching from pills to IV therapy had a positive effect on cholesterol levels.

If you think your body is L-carnitine deficient, its best to talk to your healthcare provider about treatment options and sources.

Most medical research on humans taking L-carnitine has involved pills, so sticking to this supplement form gives you the highest chance of getting good results. Vegetarian capsules are available, so its a #win for those who prefer their L-carnitine without the carne.

L-carnitine is known as a fat-burner because thats what it does on the cellular level. Studies on leveraging that for weight loss have been mixed.

Of all the different carnitine types, L-carnitine and acetyl-L-carnitine show the most promise. Theres evidence that these forms are good for your brain and heart and even for disease prevention.

Supplements are a good idea for people with naturally low L-carnitine levels: older adults, vegans, and vegetarians. But its best to chat with your doctor before taking any new supplement.

Read more:
Whats L-Carnitine, and Does It Live Up to the Hype? - Greatist