Do you include this essential nutrient when fueling your mitochondria?
Wahls Team - September 6, 2022

Most people with neurological, psychological, cardiac, or ocular problems will benefit from a tune-up of their mitochondria.

Are you filled with energy and vitality? Or are you exhausted before noon? You may be due for a mitochondrial tune-up.

The mitochondria generate adenosine triphosphate (ATP) which our cells use the drive the chemistry of life. If your mitochondria are inefficient or strained, your cells struggle to do the chemistry of life. This shows up in our lives most commonly as neurological and psychiatric symptoms, cardiac symptoms, and/or visual symptoms.

As the mitochondrial strain continues, the symptoms become more severe, and diagnoses begin to appear:

  • Migraines
  • Chronic headache
  • Anxiety/Depression
  • Learning disability/Behavioral disorders
  • Autism spectrum disorders
  • Multiple Sclerosis
  • Cognitive decline
  • Alzheimer’s
  • Parkinson’s
  • Macular degeneration
  • Retinitis pigmentosa
  • Heart failure

Medications are added…More symptoms appear…More diagnoses.…More medications.

Rarely does the medical team consider supporting the mitochondria—that is unfortunate.

Bruce Ames, a nutritional biochemist, identified mitochondrial strain as a key driver of accelerated aging, neurodegeneration, heart failure and ocular disease.1-3

If the cells do not have sufficient nutrition to properly conduct the chemistry of life, the cells will prioritize the most immediate needs for survival at the expense of long-term health. Consider this a biological triage of the various vitamins, minerals and essential nutrients to ensure short-term survival…but at the expense of long-term health.

The result is accelerated aging, neurodegeneration, ocular disease, and cardiovascular disease.3  Dr. Ames advocated for intensive nutritional support to improve mitochondrial health. The key nutrients that Dr. Ames recommended for mitochondrial support included carnitine, lipoic acid, B vitamins, magnesium, zinc and vitamin K2, and vitamin D.3,4

He was notably supportive of adding supplemental carnitine to delay mitochondrial aging.4

Carnitine is an essential nutrient to support mitochondrial generation of ATP via the Krebs cycle. Tissues with the highest energy requirements—the brain, eyes, and heart, have the most mitochondria per cell. They are also the most vulnerable to mitochondrial strain if nutrition is marginal.

Those with chronic diseases are more likely to have insufficiencies in minerals, vitamins, antioxidants, and protein than healthy individuals.

Carnitine has been shown to reduce symptoms in the setting of diabetic neuropathy,5,6, cardiovascular disease,7 ocular diseases,8,9,and depression.10

Because mitochondrial dysfunction is a factor for neuroinflammation and neurodegeneration supplemental carnitine has been proposed as a part of a neuroprotection supplement plan for persons with Alzheimer’s, Parkinson’s, multiple sclerosis, ALS, and other neurodegenerative disorders. 5,11-13

Healthy aging requires excellent nutrition, regular exercise, both physical and mental, sleep, and social contact. Cutting out added sugar and processed foods are important steps to improving nutrition.  Eating more non-starchy vegetables and having sufficient protein.

Carnitine-rich foods include meat and especially organ meats.

People with neurological, psychological, cardiovascular, and ocular symptoms or disease states likely have some level of mitochondrial dysfunction and higher nutritional requirements than healthy individuals.

Repairing damaged tissues requires more nutrition.

Our diets need to be even better than the diet for healthy people.

To resuscitate my mitochondria, I have added more carnitine. I often recommend this to my patients with complex neurological, psychological, cardiovascular or ocular issues.

I also recommend additional carnitine for anyone over the age of 60 who is focused on healthy aging. Muscle loss (sarcopenia) increases as we age.

As we lose muscle mass, there is also less carnitine and increasing mitochondrial dysfunction. This combination worsens as we age.

Muscle loss increases the person’s frailty and risk of falling. In time muscle loss increases the risk of loss of independence. For healthy aging over the age of 65, it is particularly beneficial to strength train, and supplement with carnitine to slow the age-related loss of muscle. 14,15

I am over 65. I jog, swim and strength train each week. I have a great diet filled with plenty of vegetables from my garden. I eat meat, including liver.

I am at risk of losing muscle. I am doing all I can to keep my muscles conditioned and ideally continue to build muscle.  To achieve that goal, in addition to strength training, I also take carnitine twice a day.

My goal is to live to 120, still doing research, teaching, gardening, and foraging with young people.

How are you taking care of yourself so you can be thriving at 120?

The Wahls Protocol® line of supplements carries the Complete Carnitine formula that you can shop here. 

Always work with your care team when adding trying or adding a new diet or supplement regimen.


  1. Ames BN. Delaying the mitochondrial decay of aging-a metabolic tune-up. Alzheimer Dis Assoc Disord.2003;17 Suppl 2:S54-57.
  2. Ames BN. Delaying the mitochondrial decay of aging. _Ann N Y Acad Sci._2004;1019:406-411.>
  3. Ames BN. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. _Proc Natl Acad Sci U S A._2006;103(47):17589-17594.
  4. Ames BN, Liu J. Delaying the mitochondrial decay of aging with acetylcarnitine.Ann N Y Acad Sci. 2004;1033:108-116.
  5. Sergi G, Pizzato S, Piovesan F, Trevisan C, Veronese N, Manzato E. Effects of acetyl-L-carnitine in diabetic neuropathy and other geriatric disorders. Aging Clin Exp Res. 2018;30(2):133-138.
  6. Bene J, Hadzsiev K, Melegh B. Role of carnitine and its derivatives in the development and management of type 2 diabetes.Nutr Diabetes. 2018;8(1):8.
  7. Ferrari R, Merli E, Cicchitelli G, Mele D, Fucili A, Ceconi C. Therapeutic effects of L-carnitine and propionyl-L-carnitine on cardiovascular diseases: a review. Ann N Y Acad Sci. 2004;1033:79-91.
  8. Chao de la Barca JM, Rondet-Courbis B, Ferre M, et al. A Plasma Metabolomic Profiling of Exudati2020;9(3).
  9. Moos WH, Faller DV, Glavas IP, et al. Treatment and prevention of pathological mitochondrial dysfunction in retinal degeneration and in photoreceptor injury. _Biochem Pharmacol._2022;203:115168.
  10. Veronese N, Stubbs B, Solmi M, Ajnakina O, Carvalho AF, Maggi S. Acetyl-L-Carnitine Supplementation and the Treatment of Depressive Symptoms: A Systematic Review and Meta-Analysis._Psychosom Med._2018;80(2):154-159.
  11. Kepka A, Ochocinska A, Borzym-Kluczyk M, et al. Preventive Role of L-Carnitine and Balanced Diet in Alzheimer’s Disease. Nutrients. 2020;12(7).
  12. Kidd PM. Neurodegeneration from mitochondrial insufficiency: nutrients, stem cells, growth factors, and prospects for brain rebuilding using integrative management.Altern Med Rev. 2005;10(4):268-293.
  13. Traina G. The neurobiology of acetyl-L-carnitine. _Front Biosci (Landmark Ed)._2016;21(7):1314-1329.
  14. Crentsil V. Mechanistic contribution of carnitine deficiency to geriatric frailty._Ageing Res Rev._2010;9(3):265-268.
  15. ###### Par A, Hegyi JP, Vancsa S, Par G. Sarcopenia – 2021: Pathophysiology, diagnosis, therapy. _Orv Hetil._2021;162(1):3-12.