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Associate Professor, Residency Director, Department of Family Medicine, University of California, Irvine
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Associate Professor, Residency Director, Department of Family Medicine, University of California, Irvine
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CME Released: 4/14/2004; Reviewed and Renewed: 4/14/2005
Valid for credit through: 4/14/2006, 11:59 PM EST
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April 14, 2004 — Carnitine is more active than testosterone for improving symptoms of male aging such as sexual dysfunction, depressed mood, and fatigue, according to the results of a randomized study published in the April issue of Urology.
"Testosterone increases the tissue carnitine concentration," write G. Cavallini, from the Società Italiana di Studi di Medicina della Riproduzione in Bologna, Italy. "Propionyl-L-carnitine and acetyl-L-carnitine proved active for diseases typical of aging."
In this trial, 120 patients were randomized to receive testosterone undecanoate 160 mg/day, propionyl-L-carnitine 2 g/day plus acetyl-L-carnitine 2 g/day, or placebo for six months. Mean age was 66 years (range, 60-74 years).
Compared with baseline, testosterone and carnitines significantly improved the peak systolic velocity, end-diastolic velocity, and resistive index of cavernosal penile arteries, as well as nocturnal penile tumescence (NPT), International Index of Erectile Function score, Depression Melancholia Scale score, and fatigue scale score.
Compared with testosterone, carnitines were significantly more active in improving NPT and International Index of Erectile Function score. Testosterone, but not carnitines, significantly increased the prostate volume and free and total testosterone levels and significantly lowered serum luteinizing hormone. Prostate-specific antigen (PSA) and prolactin did not change significantly in any group.
No symptoms or physiological markers improved in the placebo group. Adverse effects were negligible in all groups.
Carnitines and testosterone were effective for as long as they were administered, with reversal to baseline values when treatment was stopped. Six months after testosterone suspension, prostate volume remained significantly greater than baseline.
"Testosterone and, especially, carnitines proved to be active drugs for the therapy of symptoms associated with male aging," the authors write. "At least one side effect of testosterone administration (i.e. prostate enlargement) will be avoided by carnitine administration."
Two of the authors are patent inventors for use of carnitines in treating symptoms of male aging.
Urology. 2004;63:641-646
