Decreased Carnitine is Associated with Low Testosterone in Hemodialysis Patients

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Nelson Vergel

Evidence for a positive association between serum carnitine and free testosterone levels in uremic men with hemodialysisSakai K,et alJournalRejuvenation Res. 2013 Jun;16(3):200-5. doi: 10.1089/rej.2012.1399.

BACKGROUND AND AIMS: Low free testosterone levels are associated with sexual dysfunction and an increased risk of cardiovascular disease in male hemodialysis patients. Carnitine deficiency is frequently observed in hemodialysis patients as well. However, the relationship between carnitine and testosterone levels remains unknown. In this study, we examined whether carnitine deficiency was independently associated with low free testosterone levels in male hemodialysis patients.
METHODS: Nineteen male hemodialysis patients underwent determinations of blood chemistries, including serum levels of free testosterone, carnitine, and pentosidine, one of the well-characterized advanced glycation end products.
RESULTS: Mean free testosterone levels in hemodialysis patients were significantly lower than those in healthy controls (4.67±2.69 vs. 9.50±3.67 pg/mL, p<0.001). Univariate analysis revealed that carnitine (p=0.023), pentosidine (inversely, p=0.027), blood glucose (inversely, p=0.032), creatinine (p=0.026) levels, and statin use (inversely, p=0.034) were correlated with free testosterone values. Multiple stepwise regression analysis revealed that carnitine (p=0.001) and statin use (inversely, p=0.002) were the independent determinants of age-adjusted free testosterone levels in hemodialysis patients (r² =0.612).
CONCLUSIONS: The present study gives the first evidence that decreased carnitine levels were independently associated with low free testosterone values in male hemodialysis patients. Our study suggests that decreased carnitine levels may be a novel therapeutic target for uremic men with hemodialysis.
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Defy Medical TRT clinic doctor

Dave Barry

"Our study suggests that decreased carnitine levels may be a novel therapeutic target for uremic men with hemodialysis."The problem that I am seeing with more and more research is that they make a recommendation (or suggestion) based upon serum levels. At first look, it seems appropriate and is a potential resolution to the problem. However, often the serum levels are within the recommended range. Therefore, it opens another door to the discussion. What's going on at the cellular-level that is not allowing the drug/nutrient, in question to be absorbed?

Nelson Vergel

Good point, Dave. I have used this test (Spectracell Nutritional Status Test) in the past that actually uses one's lymphocyte (immune cells) by adding different amounts of vitamins/aminoacids,etc to them, challenging them with mitogenic compounds (compounds that activate cell division) and then measuring DNA synthesis.


"SpectraCell's patented, chemically-defined control media contains the minimal amount of each essential micronutrient that is needed to support optimal lymphocyte growth or mitogenic response. The functional intracellular status of micronutrients involved in cell metabolism is evaluated by manipulation of the individual micronutrients in the media followed by mitogenic stimulation and measurement of DNA synthesis.

The same technology also provides a total antioxidant function test (SPECTROX) which assesses the ability of cells to resist damage caused by free radicals and other forms of oxidative stress. Due to the considerable number of cellular antioxidants with extensive interactions, redundancies, repair and recharging capabilities, measuring total function is the most accurate and clinically useful way to assess your patients' capacity to resist oxidative damage.

Since lymphocytes are produced in the bone marrow and stored in the peripheral locations for long periods of time (the average life span of a lymphocyte is approximately four to six months), SpectraCell's measurements provide a powerful portrait of each patients' long-term nutrient status. This is analogous to the use of a glycosylated hemoglobin test to evaluate blood glucose levels over a one to three month period.

Interpreting Test Results

SpectraCell provides easy-to-read test reports for the clinician and the patient. We've incorporated numerical and graphic representations for each result, and we offer repletion suggestions based on each patient's deficiencies. We've included easy-to-understand supplement information that explains the role of each nutrient found deficient, deficiency symptoms, how to obtain that nutrient in food and toxicity and RDI standards for adults."


Dave Barry


The information you presented seems much more useful than simply knowing the serum levels. Billions of dollars are wasted on in-adequate health-care yearly so it would be great to be able to acquire truly useful information so that health-care professionals could develop effective, pin-point protocols. I will check into this more as I think it would be helpful with my particular health conditions.
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