Carnitine for the Treatment of Hyperthyroidism
Carnitine and Thyroid Hormone, A Potential Treatment for Obesity
By Stephen L. DeFelice, M.D.
In 1965, I was training to become a clinical pharmacologist at St.
Vincent's Hospital and Medical Center in New York City. One day, my
colleague and physician friend, Dr. Sheldon Gilgore, visited my research
unit and told me about some European clinical studies which reported
that carnitine is effective in the treatment of hyperthyroidism or an
overactive thyroid gland. He came to me because I was also trained as an
endocrinologist and had much experience in treating patients with
I reviewed the data and found that the studies were poorly
conducted and would not be accepted by quality medical journals. I did,
however, notice that, though the studies were not well controlled,
certain clinical effects occurred which probably didn't happen by chance
Since carnitine is an exceptionally safe natural substance, I
decided that it was reasonable to test this substance in a few
Three female patients with classic hyperthyroidism were selected.
All had the common manifestations of tremors, weight loss, nervousness,
insomnia, heat intolerance, excessive sweating and emotional
I treated them with carnitine, and within a ten-day period all
three were virtually without signs and symptoms. (1) Then came the
The assumption was that carnitine was blocking the production of
thyroid hormone by the thyroid gland. Not so. Thyroid function tests
still showed hyperactivity continuing to produce excessive amounts of
thyroid hormone. I then postulated that carnitine must have-somehow,
some way-blocked thyroid hormone activity peripherally.
Dr. Gilgore and I then decided to take the next step. We gave two
groups of normal volunteers high doses of thyroid hormone together
either with carnitine or placebo. The results supported our belief that
carnitine blocks thyroid hormone peripherally. (2)
As with the adriamycin-carnitine story, very little interest was
shown in these studies. There were scattered reports in the scientific
literature dealing with the carnitine-thyroid hormone connection, but
not until the year 2002-thirty-seven years later-was a well-controlled
clinical study published which confirmed that indeed carnitine does
block thyroid hormone activity. (3)
There are a number of hyperthyroid patients in whom this property
of carnitine could be particularly useful such as in pregnancy and
patients that are difficult to control including thyroid storm.
In the aforementioned second clinical study that Dr. Gilgore and I
conducted, we stumbled upon an unexpected finding. It is well known that
excessive thyroid hormone, be it produced by the thyroid gland or given
as a pill, causes weight loss. Much to our surprise, though carnitine
blocked thyroid hormone activity on many clinical parameters, it failed
to do so in the case of weight loss. The weight loss was equally as
great in the thyroid hormone-treated group as it was in the thyroid
This raises the intriguing possibility that the combination of
carnitine and thyroid hormone may be a means to clinically treat certain
types of obesity where the weight loss effect of excessive thyroid
hormone is maintained while its side effects are negated.
There are some legitimate concerns that must be considered and
evaluated. For example, thyroid hormone increases calcium excretion
which may lead to osteoporosis. (4) It has been shown, however, that, in
patients given exogenous thyroid hormone, carnitine has a beneficial
effect on bone mineralization. (3) This study also supports the weight
With the obesity epidemic in the United States coupled with the
reality that exercise and diet have failed to stem this epidemic, it is
past time that this promising treatment be clinically evaluated
Contrary to what you may hear or read, American medicine is, by
far, the best in the world. But like many things in life, it can be
greatly improved upon.
Educating physicians about non-FDA approved therapies is extremely
risky. Our system is based on strong patents that are needed to justify
the extremely high costs and risks involved in obtaining FDA approval
for an NDA or New Drug Application, which legally permits pharmaceutical
companies to spend many millions of dollars to educate physicians about
the clinical benefits and risks of an approved product.
The costs to obtain an NDA are generally prohibitive for non-
patented products, and it is very difficult to obtain strong patents for
most natural substances which are our greatest potential weapons
against disease. The large investment required to obtain FDA approval
for the carnitine -- thyroid combination will not happen simply because
both are generic natural substances.
My personal experience with carnitine, magnesium and other natural
substances is the reason that I proposed the Nutraceutical Research and
Education Act or NREA. The latter is designed to encourage companies to
sponsor clinical research on the specific dietary supplements and foods
and legally make medical-health claims based on the results of the
clinical studies at much reduced costs.
Congressman Frank Pallone (D-NJ) introduced the NREA in Congress in
1999. There was virtually no support from any dietary supplement or
food company or their associated organizations. Evidently, they prefer
to make marketing medical-health claims on their specific products that
they sell that are not based on the results of clinical studies on their
1. DeFelice SL, Gilgore SG 1996 The antagonistic effect of carnitine in hyperthyroidism. Preliminary report. J New Drugs 6:351-353
2. Gilgore SG, DeFelice SL 1966 Evaluation of carnitine an antagonist
of thyroid hormone. Clinical pharmacology report. J New Drugs 6:349-350
3. Benvenga S, et al. 2001 Usefulness of l-carnitine, a naturally
occurring peripheral antagonist of thyroid hormone action, in iatrogenic
hyperthyroidism: A randomized, double-blind, placebo-controlled
clinical trial. Journal of Clinical Endocrinology & Metabolism
4. Rivlin, R.S. Medical Intelligence. Therapy of Obesity in Hormones.
NEJM 292:26-29, 1975.