CRT-E plays an essential role in the body for:

Producing energy from fat Ensuring athletic endurance Promoting recovery after exercise Providing the heart and immune cells with energy Preventing early onset of fatigue during exercise

L-CARNITINE is a natural nutrient also used to be known as vitamin BT. L-CARNITINE is a physiological substance, essential for energy production and for fat metabolism. (Natural Metabolite) L-CARNITINE can be synthesized in the human liver, but insufficient amounts may be produced in infants, in adolescents and in adults under certain physiological conditions

It is produced by the body In the liver and kidneys and stored in the skeletal muscles, heart, brain, and sperm. L-CARNITINE is an amino acid found in high levels in muscle tissue & is synthesized in the body from Lysine and Methionine.

Its main function:

Regulate the free fatty acid metabolism for production of energy. Facilitating the transport of FFA(free fatty acids) through inner mitochondrial membrane

L-CARNITINE USES The amount of L-CARNITINE made by the human body is generally not sufficient to meet bodily requirements, so we need to obtain some L-CARNITINE from our diet. Meat and dairy products like milk, cheese and yoghurt, are rich sources of L-Carnitine . One of the key uses of L-CARNITINE supplement is for fatty acid oxidation - helping users burn unwanted body fat & helps in lose weight. Other immense uses Of L-CARNITINE are as follows L-CARNITINE helps in slowing down the aging process

L-CARNITINE transfers long-chain fatty acids, triglycerides into mitochondria (a cell's energy powerhouse), where they may be oxidized to produce energy. L-CARNITINE is also great in dieting as it reduces feelings of hunger and weakness. L-CARNITINE is a very popular supplement that promotes growth and development. L-CARNITINE beneficially uses to avoid deficiency of protein or amino acids in the diet. L-CARNITINE supplementation appears promising as a treatment for intermittent claudicating. L-CARNITINE supplementation improves athletic performance in healthy people

In addition to helping those with Carnitine deficiencies, L-CARNITINE supplementation may benefit individuals in avoiding Heart Disease, Congestive Heart Failure (CHF), High Cholesterol & Intermittent Claudicating L-CARNITINE is used to prevent and treat this condition in patients with kidney disease on dialysis L-CARNITINE is used for fat-burning, increasing energy, and improving resistance to muscle fatigue. L-CARNITINEhas also been shown to help build muscle. L-CARNITINE Enhance cellular energy in the brain L-CARNITINE improves mental performance L-CARNITINE founds to decreases symptoms of depression & helps in preventing cataracts

There are at least two major functions of L-Carnitine-

All tissues except the brain use long-chain fatty acids for bioenergy production. In cardiac and skeletal muscle, a major contribution of bioenergy comes from the beta-oxidation of long-chain fatty acids. Long-chain fatty acids require L-CARNITINE to transport them across the inner membranes of the mitochondria, wherein their metabolism produces bioenergy . Following the delivery of long-chain fatty acids into other mitochondria, L-Carnitine, either by itself or esterified to an acyl group, recrosses the mitochondrial membrane to allow for continual use in this shuttle process.

Major functions of L-CarnitineAnother function of L-CARNITINE is to remove short-chain and medium-chain fatty acids from the mitochondria in order to maintain coenzyme A levels in these organelles. These fatty acids accumulate as a result of normal and abnormal metabolism. This mechanism prevents the build-up in the mitochondria of short-chain and medium-chain fatty acids that may interfere with the bioenergyproducing process vital to the normal function of the cell.

L-CARNITINE turns fat into energy

Fatty acid oxidation: Fatty acids are one of the primary energy sources for the body. oxidation is the process by which fatty acids are broken down for the ultimate production of energy. Although fatty acids need to enter the mitochondria (the 'furnace' of the cell) for -oxidation, they are unable to penetrate the inner mitochondrial membrane. L-CARNITINE is essential to transport long chain fatty acids across the mitochondrial membrane for subsequent fat breakdown and energy production. Free Co-Enzyme A (CoA) buffer: L-CARNITINE has been shown to buffer the bound CoA to free CoA ratio and removes toxic concentrations of acyl-CoA thereby helping to ensure that energy production can continue. Detoxification: Another important function of L-CARNITINE is the ability to shuttle short chain organic acids from inside the mitochondria to the cytosol. Due to its fundamental role in energy metabolism, L-CARNITINE is typically used to support all bodily functions that have a high energy demand.

PHARMACOLOGY
Carnitine, a branched non-essential amino acid, is synthesized from the essential amino acids lysine and methionine. Ascorbic acid, ferrous iron, pyroxidine and niacin are also necessary cofactors and deficiencies of any of these can lead to carnitine deficiency. Carnitine plays a critical role in energy balance across cell membranes and in energy metabolism of tissues that derive much of their energy from fatty acid oxidation such as cardiac and skeletal muscles.

Pharmacokinetics
L-carnitine is absorbed in the intestine by a combination of active transport and passive diffusion. Bioavailability following an oral dose of 2 gm b.i.d have varied substantially, with estimates as low as 16-18 percent and as high as 54-87 percent. Max plasma conc-80 mol/L Maximum blood concentration is reached approximately 3.3-3.5 hours after an oral dose and slowly decreases, with a half-life of about 15hours. Elimination of carnitine occurs primarily through the kidneys.

MOA
Carnitines primary mechanism of action is apparently attributable to its role as a cofactor in the transformation of free long-chain fatty acids in to acylcarnitines for subsequent transport into them into the mitochondrial matrix. Carnitine is involved in the metabolism of ketones for energy and the conversion of branched-chain amino acids valine, leucine, and isoleucine into energy.

Vitamin E
Vitamin E is a fat-soluble vitamin that acts as an antioxidant. Function Vitamin E is an antioxidant that protects body tissue from damage caused by unstable substances called free radicals. Free radicals can harm cells, tissues, and organs. They are believed to play a role in certain conditions associated with aging. Vitamin E is also important in the formation of red blood cells and helps the body to use vitamin K

Vitamin E Function
The main function of vitamin E is to maintain the integrity of the body's intracellular membrane by protecting its physical stability and providing a defense line against tissue damage caused by oxidation. Vitamin E is absorbed from the intestines, along with fat and bile salts, first into the lymph and then into the blood, which carries it to the liver to be used or stored. Vitamin E acts as a co-enzyme in cellular membranes and serves as a scavenger for free radicals that are destructive to the membrane and internal cellular components. Vitamin E is protective because it helps reduce oxidation of lipid membranes and the unsaturated fatty acids and prevents the breakdown of other nutrients by oxygen

Vitamin E and heart disease

Vitamin E helps protect against heart disease by limiting the oxidation of LDL-cholesterol. Vitamin E helps prevent oxidation of lipoproteins, particularly in smokers, and reduces the stickiness of platelets in the bloodstream. Vitamin E also keeps arteries flexible and elastic, allowing blood to flow freely. Vitamin E helps prevent arteries from clogging by blocking the conversion of cholesterol into the waxy fat deposits called plaque that stick to blood vessel walls. Vitamin E also thins the blood, allowing for blood to flow more easily through arteries even when plaque is present. Vitamin E also may help prevent the formation of blood clots, which could lead to a heart attack. Vitamin C and vitamin E, taken in combination, help to stabilise LDL cholesterol in the body. This may help to reduce the risk of atherosclerosis.

INDICATIONS AND USAGE

It is indicated for the treatment and management of: Cardiotoxicity etc. Cardiac indications: Dilated cardiomypathy, Chronic stable angina, Acute myocardial infarction, Diabetic cardiomyopathy Post hemodialysis complications: asthenia, cramps, cardiac dysfunction, anemia and hyperlipidemias. Primary and secondary carnitine deficiency: Acute and Chronic treatment of inborn errors of Metabolism, which results in secondary carnitine deficiency. Male Infertility -Carnitine levels in semen and sperm cell. Male Infertility: Asthenospermia, Oligospermia

Right Dosage
Dilated cardiomyopathy, Chronic stable angina, Diabetic cardiomyopathy, Chronic Fatigue Syndrome: 2-3 gm daily Acute myocardial infarction: 6 gm daily for the first 7 days followed by 2-3 gm daily as maintenance therapy Male Infertility: Asthenospermia, Oligospermia: 1-3 gm daily for 3-6 months Hemodialysis: 1-2 gm at the end of each dialysis

HIGHLIGHTS (USPs)
It is the natural regulator of fatty acid and glucose metabolism within the cell. Cardiac tissue concentration is 80 to 100 times higher than plasma. Protects the heart from the ischaemic and other cardiomyopathies. Oral L-carnitine is safe and moderately improves the duration of exercise and time to recovery of ST changes in patients with chronic stable angina. Post MI the parameters like QRS score, angina incidence, LV enlargement, and arrhythmias showed significant improvement with carnitine. L-carnitine attenuates progressive left ventricular dilatation after acute anterior MI. Carnitine supplementation increases walking distance in patients of Peripheral Vascular Disease. Dilated cardiomyopathy, which is common form of children CM, is significantly responsive to carnitine.