Vitamin B11 (L-carnitine, levocarnitine, vitamin BT)

According to modern medical concepts, vitamin B11 does not exist! It has been reliably established that the substance known as “vitamin B11” is L-carnitine, which is normally produced by the tissues of our body in sufficient quantities. And since our body can independently provide itself with this substance, then there can be no talk of any vitamin nature of this compound! At the same time, levocarnitine is a very important and necessary substance. But let's talk about everything in order.

Synonyms of vitamin B11, which this substance had and has at different times: levocarnitine, L-carnitine, vitamin B.

History of the discovery of vitamin B11

V.S.
Gulevich At the beginning of the 20th century, carnitine was discovered by Russian biochemists. In 1905, Vladimir Sergeevich Gulevich, together with Robert Petrovich Krimberg, isolated a previously unknown nitrogenous compound from Liebig meat extract*. “Carnitine” gets its name from the Latin term “carnis” (that is, “meat”).

*Liebig meat extract in its rough sense is completely defatted boiled beef.

In a cycle of further independent research that lasted 2 years (1906-1908), R.P. Krimberg established its chemical structure as carnitine and proved its presence in the muscle tissues of vertebrates and humans. In 1927, its optical structure was characterized - it was found that the substance has two isomers (levorotatory and dextrorotatory forms or L-carnitine and D-carnitine).

G.S. Frenkel

The metabolic role and physiological function of carnitine became clear only in 1952 thanks to the work of the German entomologist Gottfried Samuel Frenkel and biochemist S. Friedman. Scientists studied the growth factors of the mealworm (Tenebrio molitor) and found that without carnitine, such worms could not grow, because without carnitine they could not use interstitial fat reserves. Thanks to this, carnitine got the name “vitamin B”, where “t” stands for Tenebrio molitor.

Further development of science made it possible to conduct more detailed studies, thanks to which we know everything about L-carnitine. Today, carnitine can be classified as a “quasi-vitamin,” that is, a conditionally essential nutrient.

What is breakfast?

The lack of a good definition of what breakfast is is one of the reasons why there has been little research in this area.
In Anglo-Saxon culture, breakfast is considered an essential part of life. However, most modern fad diets, particularly the Paleo diet, tend to follow the example of our ancestors, who lived thousands of years ago and led a nomadic lifestyle. But as applied to breakfast, this topic is rarely discussed. When I visited the Tanzanian Hadza tribe (the last true hunter-gatherers remaining in East Africa), I noticed that they do not have breakfast in their daily routine, although they go to bed and get up at approximately the same time. They don’t even have a special word in their language for morning meal. Usually, when men wake up, they go hunting on an empty stomach - later they can pick and eat some berries along the way. Women remain in or near the camp and may sometimes prepare simple food such as baobab porridge or eat stored honey, but usually not before 10 am. This means that during the day they do not eat anything for 14 or 15 hours, including sleep at night, which contrasts with the Western habit: our night fast lasts only 8-10 hours.

Physicochemical properties of vitamin B11

In its pure form it is a hygroscopic white crystalline powder.
When the temperature reaches +195 °C, the powder begins to melt. Has excellent solubility in water and alcohol. Thanks to this, carnitine is sold in a more stable powder form, and is taken in an easily digestible dissolved form. When talking about this compound, L-carnitine is most often mentioned. It is this form that is biologically active. The D-form of carnitine is not used for medicinal purposes, since it does not have a positive effect on the body and, moreover, is toxic. The D-form blocks receptors for L-carnitine and nullifies the physiological effect of this compound.

Despite its structural similarity to choline, no role in nerve impulse transmission has been found for carnitine.

What foods contain vitamin B11

Since the site of carnitine deposition is muscle tissue, this compound is present in the greatest quantities in food of animal origin.

The values ​​given in the table are approximate, since the carnitine content in meat varies depending on the conditions of keeping and nutrition of the animal. In this case, heat treatment leads to a decrease in the concentration of carnitine in food.

How to take levocarnitine

After L-carnitine enters the body, the compound penetrates into muscle cells within 3 hours, where it begins to fight fat deposits. Vitamin B11 works directly during intense exercise, as well as for a long time after training.

Divide the daily dose of the dietary supplement into 2-3 doses of 200 – 250 milligrams. The maximum amount of vitamin B11 (500 - 600 milligrams) on training days should enter the body at least 1 - 1.5 hours before going to the gym. The remaining dose should be divided into morning and afternoon doses. During rest periods (non-training days), levocarnitine should be taken in the morning and lunchtime, 30 to 60 minutes before the start of the meal. Only if this regimen is followed does the substance promote weight loss, otherwise the effect of the supplement is weakened by the food intake.

Let's consider when it is better to drink vitamin B11, depending on the form of release.

1. Beginner athletes are recommended to take tablets and capsules 2-3 times a day, 250–500 milligrams before physical activity, and professionals – 500–1500 milligrams at a time. The maximum duration of use of a weight loss supplement is 2 – 6 months.
2. The syrup should be taken 3 times a day, 5 milliliters, half an hour before physical activity (dosage for beginners). For experienced athletes, the single dose rate increases to 15 milliliters. The maximum duration of daily intake of liquid levocarnitine is 1.5 months. After this course, you need to take a 3-week break, then, if necessary, repeat the regimen.
3. If you purchase B11 in bulk form, before use, 2000 milligrams of powder must be dissolved in 500 milliliters of clean still water. If the amount of liquid is reduced, the drink will turn out cloying and unpleasant in taste. Drink the prepared solution on an empty stomach and immediately an hour before training. The course of taking the drug is 2–4 months. The maximum duration is half a year. Up to 6 courses can be completed in a year, with a minimum break between them of 2 weeks. Today, levocarnitine powder is available for sale in the flavors “Wild berries” and “Green Apple”.

If you missed taking L-carnitine before training, it is recommended to drink the vitamin in liquid form, which is quickly absorbed in the body and promotes a quick release of energy.

How does B11 work?

When taken orally, the vitamin is usually well absorbed. The maximum concentration of the beneficial compound in the body is observed three hours after administration, while the therapeutic concentration remains for 9 hours. In the case of intramuscular administration, the substance reaches the plasma after 3.5 - 4 hours, and when administered intravenously, the drug disappears from the blood after 3 hours. Taken L-carnitine quickly penetrates into the middle layer of the heart (myocardium) and liver, and more slowly into muscle tissue. The compound is excreted by the kidneys as acyl esters.

Daily requirement for vitamin B11

The recommended daily requirement for carnitine is fixed at the federal level by special methodological recommendations developed on the basis of the Research Institute of Nutrition of the Russian Academy of Medical Sciences. This once again proves the importance of this connection.

It is believed that due to interstitial synthesis, the human body is able to independently provide itself with carnitine. Its production is carried out in the liver and kidneys with the participation of ascorbic acid, nicotinic acid, pyridoxine, folic acid, cyanocobalamin, iron, lysine, methionine and a number of special enzymes. Carnitine is deposited in muscle and liver tissue, providing its physiological effect.

It should be noted that, for example, in the USA, daily consumption of carnitine is not standardized, since it is not an essential nutrient.

Breakfast cereals

Despite obvious flaws in design and a steady increase in the number of randomized controlled trials with contrary results, the belief that skipping meals is harmful has been around for decades and is still one of the eight principles of healthy eating in the UK National Health Service guidelines, as well as in current USDA and Australian Dietary Guidelines.
Thriving food conglomerates have huge marketing budgets and great influence over government officials; it allows food corporations to influence public policy—so much so that long-debunked principles find their way into government-sanctioned guidelines. When you think about how much money a multibillion-dollar industry would lose if, for example, people stopped eating breakfast cereal, it's easy to see why myths about breakfast are so common and persistent.

So what good do we get from skipping breakfast? A number of positive effects likely stem from the fact that we fast for longer periods of time as a result. There is now growing evidence that limiting the window during which we eat and extending the window during which we don't eat may help lower insulin levels and help some people lose weight. Some of these recent, seemingly counterintuitive discoveries can be understood when considered in the context of the GI microbiome. This community of 100 trillion microbes, found primarily in the large intestine, behaves like an additional organ of the body, influencing our health and metabolism. Many microbes have circadian rhythms similar to ours, and microorganisms differ greatly in composition and function when they are hungry versus when they are fed.

Although the discipline is relatively new, some evidence suggests that microbial communities suffer from long periods of fasting, but short periods of fasting—such as skipping breakfast—may benefit them. After 4-6 hours without food, certain types of microbes begin to multiply and feed on carbohydrates from the layer of mucus lining the intestines, essentially cleaning it out, resulting in a more efficient and healthier intestinal barrier. It's possible that microbial communities, like ourselves, also need to relax and rest as part of their circadian rhythm, which is why rest is important for our gut health.

L-carnitine - why the body needs it

How L-carnitine works
Carnitine plays a key role in the oxidation of fats and converting them into energy, which is stored in cells in the form of ATP (adenosine triphosphate). This entire process occurs in mitochondria, cellular organelles that are sometimes called “energy stations” because of their ability to convert various chemical substrates into energy.

So carnitine acts as a conductor of fats. Without its help, fats cannot get inside the mitochondria. Even if a mass of fat accumulates around the organelle, it will in no way be able to “digest” it.

Carnitine regulates the amount of coenzyme A. The latter, in turn, takes part in the metabolism of fats, the breakdown of certain amino acids, detoxification of the body and the excretion of organic acids and xenobiotics, and, most importantly, in the tricarboxylic acid cycle (Krebs cycle), which is a key stage almost all metabolic processes, including cellular respiration.

A number of experiments have proven that carnitine has a neuroprotective effect, that is, it prevents damage to nerve fibers. It is assumed that this effect is associated with the normalization of metabolism in the neuron and providing it with a sufficient amount of energy.

Sources, role and symptoms of hypovitaminosis

B vitamins include: B1, B2, B3, B5, B6, B7, B9, B12. Previously, these included compounds B4 (choline), B8 (inositol). Levocarnitine has also been mistakenly called vitamin B11.

Vitamin B1 - thiamine

Takes part in the metabolism of carbohydrates and a number of amino acids, is important for the nervous, cardiovascular systems, and liver cells. Vitamin B1 is not synthesized in the body; it requires regular intake from food to meet its needs. They are rich in wheat sprouts, rye bread, various seeds and nuts, brown rice, legumes, and sea buckthorn berries. Animal sources include pork, chicken, salmon, and eggs.

Symptoms of vitamin B1 deficiency develop during fasting, unbalanced diet and manifest themselves in the form of severe neurological disorders (beriberi disease):

• pain in the calf muscles;
• decreased deep and cutaneous sensitivity of the legs and feet;
• paresthesia in the legs (tingling, goosebumps);
• sleep disturbances, emotional instability;
• decreased memory and mental performance.

In patients with anorexia and alcoholism, symptoms of B1 deficiency (acute Gaye-Wernicke encephalopathy, Korsakoff syndrome) can develop acutely. The clinic shows severe motor disturbances, visual disturbances, confusion, and psychotic symptoms. Without emergency help, a person can die within a few days.

Vitamin B2 - riboflavin

This is a source for creating enzymes that participate in the synthesis of vitamin B6 derivatives, reactions with acids, break down foreign and dangerous compounds, and are responsible for the state of hemoglobin in the body.

So it is necessary for:

1. maintaining healthy skin, hair nails;
2. formation of red blood cells and antibody proteins;
3. regulation of reproductive function.

The main sources of B2 are food of animal origin - kidneys, liver, eggs. It is found in smaller quantities in porcini mushrooms and champignons, broccoli, almonds and cottage cheese.

Anorexia, vegetarianism, inflammatory diseases of the gastrointestinal tract, alcoholism, taking sulfur preparations or tranquilizers can provoke hypovitaminosis B2.

Its clinical manifestations are as follows:

• angular stomatitis (“jams”, ulcers in the corners of the mouth);
• dryness and cracks in the mucous membranes of the lips;
• glossitis (swelling, redness of the tongue);
• conjunctivitis or keratitis (red eyes, photophobia, decreased vision);
• dermatitis on the skin of the face (eyelids, nasolabial folds, ears, nose);
• weakness, fatigue, drowsiness;
• muscle pain and muscle weakness;
• anemia.

B3 - niacin

Other well-known names for the vitamin include nicotinic acid and vitamin PP. The substance takes part in cell division, protein synthesis, hormones, cellular respiration and many other processes. With the participation of this vitamin, steroid hormones and fatty acids are formed. In addition, B3 has a vasodilating effect, heals wounds, and reduces the concentration of cholesterol in the blood (primarily “dangerous” fractions).

The source of the vitamin is the essential amino acid tryptophan. Rich foods include: liver, tuna, turkey, brewer's yeast. You can also get B3 by adding whole grains to your diet: oats, rye, barley, wheat germ, peanuts.

Heat treatment reduces the vitamin content in food, and love for refined carbohydrates increases the need for it.

The unusual name “vitamin PP” is an abbreviation of two English words “preventive pellagra”, which means “preventing pellagra”. Signs of deficiency are described as a disease of the “three Ds”: diarrhea, dermatitis, dementia. They occur with prolonged hypovitaminosis. Clinical manifestations are more extensive and include:

• dermatitis, increased skin sensitivity to sunlight, baldness;
• walking impairment, neuritis, paralysis of limbs;
• weakness and fatigue, headaches;
• from the psyche: asthenia, sleep disturbances, aggression, dementia;
• heart damage - dilated cardiomyopathy.

Vitamin B5 - pantothenic acid

The biologically active substance is involved in the metabolism of proteins, fats and carbohydrates. It stimulates the adrenal cortex to increase the secretion of corticosteroids. The vitamin is involved in the synthesis of antibodies, normalizes lipid metabolism, and restores the integrity of the skin and mucous membranes.

A smaller part of B5 enters the body with food: egg yolk, yeast, milk, carrots, caviar, green salads. The main amount of the vitamin is synthesized by intestinal flora. This fact explains the occurrence of its deficiency against the background of long-term use of antibacterial or synthetic sulfonamide drugs and malabsorption syndrome. in which the absorption of substances is impaired.

Hypovitaminosis manifests itself in the form of metabolic disorders, damage to the digestive tract, skin and nail diseases, and weakened immunity.

Patients usually complain of:

• fatigue, headaches;
• deterioration of skin condition;
• low mood;
• muscle pain;
• numbness and pain in the feet;
• nausea, digestive disorders;
• frequent viral infections.

Vitamin B6 – pyridoxine

Participates in the formation of red blood cells and the hemoglobin they contain. Being a coenzyme of proteins that process amino acids (primarily in the nervous system) it helps cells properly utilize and consume glucose, preventing sudden surges in blood sugar. The effect on the body is to maintain physical and mental performance, ensuring trophic innervation of the nervous system.

Therefore, deficiency primarily manifests itself in the form of symptoms such as:

• depression, lethargy;
• decreased resistance to any load;
• numbness, paresthesia in the arms and legs;
• joint pain, arthritis;
• muscle weakness;
• “jams” in the corners of the mouth, hair loss.

Hypovitaminosis occurs against the background of an unbalanced diet (diet, alcoholism), taking the B6 antagonist drug ftivazid. An increase in the need for B6 is possible during antibiotic treatment, smoking, and hormonal contraceptive therapy.

Pyridoxine is found in green plants, nuts, tomatoes, strawberries, lemons, oranges, and legumes. Animal sources include eggs, liver, fish.

Hypervitaminosis occurs due to the consumption of large doses of B6 and is characterized by a decrease in protein concentration in tissues: weakness, confusion, convulsions. Scientists have proven that an overdose of this vitamin increases the risk of developing lung cancer in men.

Vitamin B7 - Biotin

Regulates all types of metabolism, participates in the synthesis of the structural protein collagen, and the transfer of carbon dioxide molecules. Contained in egg yolks, beef liver, bananas, brown rice, citrus fruits, apples, parsley. Most of the vitamin is synthesized by intestinal flora.

Biotin deficiency develops against the background of strict diets, taking antibiotics, using preservatives E221-E228, and alcoholism.

Signs of deficiency will be:

• anemia;
• dryness, flaking of the skin;
• dermatitis in the corners of the mouth;
• anorexia, nausea;
• weakness, apathy, increased drowsiness;
• high levels of fat and glucose in the blood.

Hereditary diseases associated with impaired vitamin metabolism are also possible. They manifest in the neonatal period or in older children. Among the alarming symptoms are seizures, delayed physical and mental development.

Vitamin B9 - folic acid

Responsible for cell growth and maintaining DNA integrity. The vitamin has an effect on the development of the nervous system and is involved in hematopoiesis. Folic acid enters the body with food and is synthesized by bacteria in the intestines. Sources of B9 - spinach, asparagus, broccoli, pork and chicken liver, legumes.

Vitamin deficiency is most dangerous during pregnancy, as there is a risk of miscarriage and deformities in the fetus. The risk group includes:

1. women with folate metabolism disorders, when B9 is less absorbed by the body;
2. pregnant women receiving treatment with valproic acid (anticonvulsant) drugs.

But hypovitaminosis is dangerous not only for special categories of people. An increased need for B9 occurs during therapy with anti-malaria drugs and cytostatics (Fansidar, Methotrexate).

You can suspect a vitamin deficiency if you have the following symptoms:

• infertility in men and women;
• early miscarriages;
• fetal development abnormalities;
• decreased mental performance;
• megaloblastic anemia (by blood test).

Substance B10 or para-aminobenzoic acid is a fragment of vitamin B9; its properties have not been fully studied, and there are no clinical studies on the need for prophylactic use.

Vitamin B12 - cyanocobalamin

It is absorbed and works only when taken with animal food or as part of medications in the small intestine. Cyanocobalamin is also produced by bacteria in the large intestine, but the body cannot absorb it.

The substance participates in the oxidation reactions of proteins and fats. Food sources of cyanocobalamin are pork, beef liver, herring, mackerel, eggs, cheese, cottage cheese.

A complete rejection of animal products that contain the vitamin leads vegans to the development of megaloblastic anemia. The following also suffer from vitamin deficiency:

1. patients with diseases of the ileum, helminthiases (absorption is impaired);
2. persons with Castle factor deficiency (produced in the stomach and activates B12).

Hypovitaminosis is associated not only with pathologies of hematopoiesis, but also with the destruction of the myelin sheaths of nerve fibers, and depressive syndrome in the elderly.

Vitamin B11 for athletes

During the experiments, all the beneficial properties that athletes attribute to L-carnitine were not clearly proven. Some studies proved its benefits, others refuted it. Studies of the effect of additional doses of carnitine continue. The most popular “sports” properties of vitamin B11 include:

• fat burning, “drying”;
• increase in the amount of pure muscle mass without fat accumulation;
• increased physical performance, ability to perform longer physical activities;
• improvement of mood and cognitive functions of the brain (memory, attention, assimilation of information, etc.);
• strengthening the body’s ability to withstand adverse environmental factors and increasing resistance to stress;
• removing toxins and cleansing the body;
• reducing the concentration of cholesterol in the blood, reducing the risk of developing atherosclerosis, heart attack or stroke;
• antioxidant effect;
• protects nerve tissue from damage;
• increases tissue resistance to hypoxia;
• prevents bone destruction;
• acceleration of tissue regeneration and restoration.

Vitamin B11 for weight loss

On numerous women's forums you can find advice on using carnitine for weight loss. Based on reviews from women, we can conclude that carnitine really helps to lose excess weight.

However, experimentally, a zero effect was shown from taking carnitine (at a dosage of 4000 mg per day) in combination with regular cardiac exercise (running 4 times a week for 30 minutes). Either the dose was wrong, or the loads were insufficient, but there was no effect from this combination.

It is important to understand that a person does not lose weight when he takes carnitine or other dietary supplements. A person loses weight only when more kilocalories have been spent in 24 hours than were eaten in the same day.

Use of vitamin B11 in medicine

L-carnitine is used in cases where it is necessary to speed up metabolic processes in the body. Usually it is not the only treatment, but is used in conjunction with other drugs.

Carnitine, indications for use.

1. Laboratory established secondary carnitine deficiency (observed in diseases such as Marfan syndrome, Chernogubov-Ehlers-Danlos syndrome, Beals syndrome, muscular dystrophies, hemodialysis).
2. To increase physical endurance and reduce fatigue under high loads, including in elderly people and athletes.
3. Abnormally high acidity of the blood (eg, propionic acidemia).
4. In the complex treatment of chronic inflammatory diseases of the stomach and pancreas, which occur with reduced secretory function.
5. The recovery period after suffering severe infectious and inflammatory diseases or surgical interventions.
6. Anorexia nervosa syndrome.
7. Delayed growth and development in children and adolescents under 16 years of age (levocarnitine preparations are prescribed even to newborns and infants, including premature infants).
8. Mild thyrotoxicosis.
9. Some dermatological diseases (psoriasis, focal scleroderma, seborrheic dermatitis, discoid lupus erythematosus and others).
10. Neurological manifestations in vascular, toxic and traumatic brain lesions.

Harm and side effects of carnitine

We can say with complete confidence that carnitine is not harmful and completely safe. This statement can be confirmed by several theses:

1. Levocarnitine is a natural compound that is produced by cells and performs a number of vital functions.
2. Levocarnitine is used in newborns (including premature babies), and a positive effect on the growth and development of the child is observed.
3. When taking carnitine 100 times more than the recommended daily dosage, no toxic effects were observed.

At the same time, we should not forget the famous catchphrase of the ancient Greek physician Hippocrates: “Everything is good in moderation. Avoid extremes if you want to maintain balance." It is the extreme, namely excessive consumption of carnitine, that can cause side effects (although they are extremely rare).

1. Insomnia due to increased energy release. Therefore, it is not recommended to take carnitine in the afternoon and especially in the evening.
2. Individual intolerance to increased doses of carnitine may be accompanied by abdominal pain, digestive disorders, headaches and stool disorders.
3. In patients on hemodialysis, taking carnitine can trigger the development of myasthenia gravis (muscle weakness).
4. In studies conducted in 2013, it was shown that L-carnitine is metabolized by intestinal microflora to trimethylamine-N-oxide, which can provoke the development of heart and vascular diseases, in particular atherosclerosis (the study was carried out on mice).

Does breakfast “kick start” your metabolism?

Some beliefs about breakfast are so widely held that most people never think to question them. For example, the fact that breakfast somehow “starts” our metabolism in the morning, allowing us to more efficiently digest food throughout the day. And also the fact that if you skip breakfast, you will get hungry, then overeat and, as a result, gain weight. Despite the lack of evidence, these ideas are presented as scientific facts.

In Britain, for example, they were included in National Health Service guidelines developed by civil servants from the Public Health Service, a committee of specialist scientists who receive data from the food industry. Similar statements are found in the US Department of Agriculture's recommendations for Americans and in the Australian government's current healthy eating guidelines. The same statements about the need for breakfast can be found in the recommendations of health authorities in other countries, as well as in the press and the Internet around the world. But what if we were misled? What if this is just another nutrition myth?

In 2021, a systematic review and meta-analysis of studies looking at the effects of skipping breakfast was finally published in the British Medical Journal. The review authors reviewed 52 studies and rejected most of them because they were poorly designed and lacked proper randomization (in other words, the results of the studies could not possibly be objective), and four because they were conducted in low-income countries. Of the remaining 11 randomized clinical trials that qualified, the majority were conducted in the US and UK and only one in Japan.

The studies varied in both length (from one day to six weeks) and quality. Seven of the studies tracked participants' changes in weight as well as variations in their energy intake, which was determined by measuring their metabolic rate. The conclusion of this meta-analysis was the same as previous reviews based on less information: there is no evidence that skipping breakfast makes you gain weight or lower your basal metabolic rate. In fact, evidence shows that the opposite is true: skipping breakfast may be a successful strategy for weight loss. Why were nutritionists of the past so wrong and why didn’t they point out the lack of quality data sooner?

There may be several reasons, and they all relate to traditional beliefs about nutrition and food.

Vitamin B11 preparations:

1. Elkar – powder and solution for oral administration, injections.
2. Carnitene - drinking solution and injections.

Other levocarnitine preparations (tablets, capsules, drinking solutions) are mostly classified as dietary supplements and are more often used in sports medicine.

Lack of vitamin B11 in the body

Such conditions are extremely rare. At the same time, it is quite difficult to identify an isolated carnitine deficiency in the body, since the symptoms of such a deficiency are nonspecific:

1. Weakness and fatigue.
2. Weakness of the heart.
3. A decrease in muscle mass and a simultaneous increase in fat mass.
4. Muscle pain.
5. Low blood sugar (glucose) levels.
6. Confusion, deterioration of cognitive functions (memory, speech, attention).

Signs of levocarnitine deficiency

It is difficult to recognize a lack of levocarnitine in the initial stages, since the symptoms are similar to many other diseases.

Vitamin B11 deficiency can manifest itself :

• a person feels weak throughout the body;
• rapid weight gain occurs;
• performance decreases, lethargy and fatigue appear;
• muscle pain appears.

A symptom of a lack of levocarnitine.
If the doctor has confirmed a lack of levocarnitine in the body, then in some cases the following symptoms may appear:

• muscle tissue dystrophy;
• kidney encephalopathy;
• angina pectoris;
• changes in blood composition;
• obesity;
• slower development of children;
• decreased sperm activity.

B11 deficiency often occurs in children under 10 years of age and in older people.