Journal of Literature Pharmacy Sciences

L-Karnitinin Beslenme ve Sağlık Açısından Değerlendirmesi
L-Carnitine, Evaluation in Terms of Nutrition and Healthy
Filiz YANGILARa
aErzincan Binali Yıldırım Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Erzincan, TÜRKİYE
J Lit Pharm Sci. 2021;10(1):1-11
doi: 10.5336/pharmsci.2020-75885
Article Language: TR
Full Text
ÖZET
 Kas dokusu ve miyokardda yüksek konsantrasyonda bulunan karnitin (trimetilamino-β-hidroksibutirat), vücudumuzun doğal bir bileşiği olup uzun zincirli yağ asitlerinin iç mitokondriyal membrandan geçişini sağlamada etkili olmaktadır. Elzem bir besin bileşeni olan karnitin, hücre ve dokularda, açil-L-karnitinin hem serbest karnitin hem de açilkarnitin formu olarak bulunur. Karnitinin uzun zincirli yağ asitleri üzerindeki etkisiyle vücutta fazla miktarda bulunan yağ kütlesinden enerji karşılanarak, yağ dokusundan kilo kaybı sağlanmış olur. Aynı zamanda karnitin, sinir sisteminde de antioksidan ve nörotrofik etki göstermektedir. İlaç olarak kullanıldığında, aşırı dozlarda risk düzeyi yüksek olup istenmeyen etkilere neden olabilmektedir. Aslında insan vücudu ihtiyacı olan miktarda karnitini sentezleyebilme özelliğine sahiptir. Fakat bazı organizmalarda sentez miktarı ya da kullanılabilecek oranda karnitinin dokulara transferi yeterli olamayabilir. Karnitinin %75'i ekzojen olarak besinlerden sağlanırken, %25'i endojen olarak böbrek, karaciğer ve beyinde sentezlenmektedir. L-karnitin içeriği, çeşitli gıda ürünleri arasında farklılık göstermektedir ve bitkisel ürünlerden daha çok hayvansal ürünler L-karnitin içeriğine sahiptir. Özellikle kırmızı et ve süt ürünleri, L-karnitin açısından en zengin gıda kaynaklarını oluşturmaktadır. Bu derlemede L-karnitin metabolizması, biyoaktif özellikleri, gıda işleme yöntemlerinin L-karnitin üzerine etkileri ile L-karnitinin beslenme ve sağlık üzerine etkileri vurgulanmıştır.

Anahtar Kelimeler: L-karnitin; biyoyararlılık; beslenme; sağlık
ABSTRACT
 Carnitine (trimethylamino-β-hydroxybutyrate), which is found in high concentrations in muscle tissue and myocardium is a natural compound of our body and an effective compound in providing the transfer of long-chain fatty acids through the inner mitochondrial membrane. It is also an essential nutritional component in cells and tissues, found present as both free carnitine and acylcarnitine form of acyl-L-carnitine. Carnitine effect on long-chain fatty acids and weight loss is provided through the fat tissue. Therefore, the energy is met from the excess fat mass in the body. At the same time, carnitine also shows antioxidant and neurotrophic effects in the nervous system. When it is used drug, which is at high risk in excessive doses, it can cause undesirable effects. In fact, the human body has the ability to synthesize the amount of carnitine it needs. However, the amount of synthesis or the transfer of usable amount of carnitine to the tissues may not be sufficient in some organisms. Although 75% of carnitine is obtained from foods as exogenously, 25% is as endogenously synthesized in kidney, liver and brain. L-carnitine content shows difference between various food products and animal products which are contains a much larger amount of L-carnitine than plant products. Especially the red meat and dairy products is the richest food sources for L-carnitine. In this review, L-carnitine metabolism, bioactive properties, effects of food processing on L-carnitine with their effects of L-carnitine on nutrition and health are highlighted.

Keywords: L-carnitine; biological availability; nutrition; health
REFERENCES:
  1. Anonim 2021a. [Link]  (Erişim tarihi: 20.04.2021).
  2. Kris-Etherton PM, Harris WS, Appel LJ; American Heart Association. Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002;19;106(21):2747-57. Erratum in: Circulation. 2003;28;107(3):512. [Crossref] [PubMed] 
  3. Möller NP, Scholz-Ahrens KE, Roos N, Schrezenmeir J. Bioactive peptides and proteins from foods: indication for health effects. Eur J Nutr. 2008;47(4):171-82. [Crossref] [PubMed] 
  4. Gür F, Güzel M, Öncül N, Yıldırım Z, Yıldırım M. Süt serum proteinleri ve türevlerinin biyolojik ve fizyolojik aktiviteleri. [Biological and physiological activities of whey proteins and their derivatives]. Akademik Gıda. 2010;8(1):23-31. [Link] 
  5. Şimşek A, Kılıç B. Et kaynaklı biyoaktif peptitler ve fonksiyonel özellikleri. [Meat-derived bioactive peptides and their functional properties]. Gıda. 2016;41(4):267-74. [Crossref] 
  6. Kurt Ö, El SN. Biyoaktif bir gıda bileşeni L-karnitin: beslenme ve sağlık açısından önemi ve biyoyararlılığı. [L-carnitine as a bioactive compound: importance of in nutrition and health, bioavailability]. TÜBAV Bilim Dergisi. 2011;4(2):97-102. [Link] 
  7. Medeiros F, Casanova Mde A, Fraulob JC, Trindade M. How can diet influence the risk of stroke? Int J Hypertens. 2012;2012:763507. [Crossref] [PubMed] [PMC] 
  8. Seline KG, Johein H. The determination of L-carnitine in several food samples. Food Chemistry. 2007;105(2):793-804. [Crossref] 
  9. Kaneko T, Yoshida R. On the absolute configuration of L-carnitine (vitamin BT). Bulletin of the Chemical Society of Japan. 1962;35(7):1153-5. [Crossref] 
  10. Taşbozan O, Gökçe MA. L-karnitin ve akuakültürde kullanımı. [L-carnitine and its use in aquaculture]. Turkish Journal of Aquatic Life. 2007;(5-8):694-703. [Link] 
  11. Bruzell E, Granum B, Husøy T, Rohloff J, Wicklund T, Steffensen IL, et al. Risk assessment of "other substances"-L-carnitine and L-carnitineL-tartrate. Opinion of the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food and Cosmetics of the Norwegian Scientific Committee for Food Safety. Oslo, Norway: VKM Report; 2015. [Link] 
  12. Koyuncu O, Urfalı S, Polat S, Hakimoğlu S, Özbakış Akkurt Ç. Oral L-karnitin kullanan hastada tedavi yaklaşımımız. [Our treatment approach in patients with side effects of L-carnitine]. MKÜ Tıp Dergisi. 2019;10(38):105-7. [Link] 
  13. Demirci N. Egzersiz esnasında enerji tüketiminde leptin mi karnitin mi daha etkilidir? [Are leptin or carnitine more effective in consuming energy during doing exercise?]. Gümüşhane University Journal of Health Sciences. 2013;2(3):396-410. [Link] 
  14. Bizzi A, Cini M, Garattini S, Mingardi G, Licini L, Mecca G. L-carnitine addition to haemodialysis fluid prevents plasma-carnitine deficiency during dialysis. Lancet. 1979;21;1(8121):882. [PubMed] 
  15. Koşan C, Sever L, Çalışkan S, Kavunoğlu G, Sever A, Arısoy N. Kronik periton diyalizi tedavisi gören çocuklarda plazma karnitin düzeyleri. [Plasma carnitine levels in pediatric hemodialysis patients]. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2002;ll(l):27-31. [Link] 
  16. Marín VB, Azocar M, Molina M, Guerrero JL, Ratner R, Cano F. Total carnitine and acylated carnitine ratio: relationship of free carnitine with lipid parameters in pediatric dialysis patients. Adv Perit Dial. 2006;22:130-5. [PubMed] 
  17. Gülçin I. Antioxidant and antiradical activities of L-carnitine. Life Sci. 2006;78(8):803-11. [Crossref] [PubMed] 
  18. Anonim 2021b. [Link]  (Erişim tarihi: 20.04.2021).
  19. Madiraju P, Pande SV, Prentki M, Madiraju SR. Mitochondrial acetylcarnitine provides acetyl groups for nuclear histone acetylation. Epigenetics. 2009;4(6):399-403. [Crossref] [PubMed] 
  20. Li K, Sun Q. Simultaneous determination of free and total carnitine in human serum by HPLC with UV detection. J Chromatogr Sci. 2010;48(5):371-4. [Crossref] [PubMed] 
  21. Evangeliou A, Vlassopoulos D. Carnitine metabolism and deficit--when supplementation is necessary? Curr Pharm Biotechnol. 2003;4(3):211-9. [Crossref] [PubMed] 
  22. Kalaiselvi T, Panneerselvam C. Effect of L-carnitine on the status of lipid peroxidation and antioxidants in aging rats. J Nutr Biochem. 1998;9(10):575-81. [Crossref] 
  23. Mohammadi M, Hajhossein Talasaz A, Alidoosti M. Preventive effect of L-carnitine and its derivatives on endothelial dysfunction and platelet aggregation. Clin Nutr ESPEN. 2016;15:1-10. [Crossref] [PubMed] 
  24. Atabilen B, Yıldıran H. Hemodiyaliz hastalarında karnitin kullanımı. [The use of carnitine in hemodialysis patients]. Turk Neph Dial Transpl. 2017;26(3):246-53. [Link] 
  25. Krajcovicová-Kudlácková M, Simoncic R, Béderová A, Babinská K, Béder I. Correlation of carnitine levels to methionine and lysine intake. Physiol Res. 2000;49(3):399-402. [PubMed] 
  26. Tao RC, Yoshimura NN. Carnitine metabolism and its application in parenteral nutrition. JPEN J Parenter Enteral Nutr. 1980;4(5):469-86. [Crossref] [PubMed] 
  27. Fritz IB, Yue KT. Long-chain carnitine acyltransferase and the role of acylcarnitine derivatives in the catalytic increase of fatty acid oxidation induced by carnitine. J Lipid Res. 1963;4:279-88. [Crossref] [PubMed] 
  28. Wanner C, Wieland H, Wäckerle B, Boeckle H, Schollmeyer P, Hörl WH. Ketogenic and antiketogenic effects of L-carnitine in hemodialysis patients. Kidney Int Suppl. 1989;27:S264-8. [PubMed] 
  29. Bremer J. The role of carnitine in intracellular metabolism. J Clin Chem Clin Biochem. 1990;28(5):297-301. [PubMed] 
  30. Özdemir S, Aydın A. Karnitin ve karaciğer hastalıklarının tedavisindeki yeri. [Carnitine and its role in treatment of liver diseases]. Nobel Med. 2013;9(3):5-8. [Link] 
  31. Jeukendrup AE, Randell R. Fat burners: nutrition supplements that increase fat metabolism. Obes Rev. 2011;12(10):841-51. [Crossref]  [PubMed] 
  32. Torgutalp ŞŞ, Köse B. Dönmez G. Zayıflama ürünleri gerçekten etkili mi? [Do slimming pills really work?]. Turkiye Klinikleri J Sports Med-Special Topics. 2016;2(3):66-72. [Link] 
  33. Möder M, Kießling A, Löster H. Current methods for determination of L-carnitine and acylcarnitines. Monatshefte für Chemie/Chemical Monthly. 2005;136(8):1279-91. [Crossref] 
  34. Vitali G, Parente R, Melotti C. Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res. 1995;21(4):157-9. [PubMed] 
  35. Demarquoy J, Georges B, Rigault C, Royer MC, Clairet A, Soty M, et al. Radioisotopic determination of L-carnitine content in foods commonly eaten in Western countries. Food Chemistry. 2004;86(1):137-42. [Crossref] 
  36. Campoy C, Bayés R, Peinado JM, Rivero M, López C, Molina-Font JA. Evaluation of carnitine nutritional status in full-term newborn infants. Early Hum Dev. 1998;53Suppl:S149-64. [Crossref] [PubMed] 
  37. Tornberg E. Effects of heat on meat proteins - implications on structure and quality of meat products. Meat Sci. 2005;70(3):493-508. [Crossref] [PubMed] 
  38. Engel AG, Rebouche CJ. Carnitine metabolism and inborn errors. J Inherit Metab Dis. 1984;7 Suppl1:38-43. [Crossref] [PubMed] 
  39. Yavuz H, Kurtoğlu F. Biyokimyasal özellikleri ile L-karnitin. [L-carnitine and biochemical characteristics]. J Fac Vet Med Istanbul Univ. 2012;38(2):207-18. [Link] 
  40. Harmeyer J. The physiological role of L-carnitine. Lohmann Information. 2002;27:15-21. [Link] 
  41. Deniz G. Karnitin: sentez, metabolizma, fonksiyon ve iskemik kalpte terapötik önemi. [Carnitine: synthesis, metabolism, function and therapeutic importance in the ischemic heart]. T Klin J Med Sci. 1999;19:55-62. [Link] 
  42. Jones LL, McDonald DA, Borum PR. Acylcarnitines: role in brain. Prog Lipid Res. 2010;49(1):61-75. [Crossref] [PubMed] 
  43. Yılmaz G, İbiş S. L-karnitinin sportif performansa etkileri. [Effects of L-carnitine on sports performance]. Spor ve Tıp. 2006:103-5. [Link] 
  44. Kendler BS. Carnitine: an overview of its role in preventive medicine. Prev Med. 1986;15(4):373-90. [Crossref] [PubMed] 
  45. Monograph. L-carnitine. Altern Med Rev. 2005;10(1):42-50. [PubMed] 
  46. Lombard KA, Olson AL, Nelson SE, Rebouche CJ. Carnitine status of lactoovovegetarians and strict vegetarian adults and children. Am J Clin Nutr. 1989;50(2):301-6. [Crossref] [PubMed] 
  47. Vaz FM, Wanders RJ. Carnitine biosynthesis in mammals. Biochem J. 2002;1;361(Pt 3):417-29. [Crossref] [PubMed] [PMC] 
  48. Penn D, Dolderer M, Schmidt-Sommerfeld E. Carnitine concentrations in the milk of different species and infant formulas. Biol Neonate. 1987;52(2):70-9. [Crossref] [PubMed] 
  49. Alhomida AS. Total, free, short-chain and long-chain acyl carnitine levels in Arabian camel milk (Camelus dromedarius). Ann Nutr Metab. 1996;40(4):221-6. [Crossref] [PubMed] 
  50. Woollard DC, Indyk HE, Woollard GA. Carnitine in milk: a survey of content, distribution and temporal variation. Food Chemistry. 1999;66(1):121-7. [Crossref] 
  51. Pons R, Carrozzo R, Tein I, Walker WF, Addonizio LJ, Rhead W, et al. Deficient muscle carnitine transport in primary carnitine deficiency. Pediatr Res. 1997;42(5):583-7. [Crossref] [PubMed] 
  52. Evans AM, Fornasini G. Pharmacokinetics of L-carnitine. Clin Pharmacokinet. 2003;42(11):941-67. [Crossref] [PubMed] 
  53. Pooyandjoo M, Nouhi M, Shab-Bidar S, Djafarian K, Olyaeemanesh A. The effect of (L-) carnitine on weight loss in adults: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2016;17(10):970-6. [Crossref] [PubMed] 
  54. Fielding R, Riede L, Lugo JP, Bellamine A. l-carnitine supplementation in recovery after exercise. Nutrients. 2018;10(3):349. Erratum in: Nutrients. 2018;10(5). [Crossref] [PubMed] [PMC] 
  55. Karlic H, Lohninger A. Supplementation of L-carnitine in athletes: does it make sense? Nutrition. 2004;20(7-8):709-15. [Crossref] [PubMed] 
  56. Ford MA. The formulation of sports drinks. In: Ashurst PR, ed. Production and Packaging of Non-Carbonated Fruit Juices and Fruit Beverages. 2nd ed. Gorthersburg, Maryland: An Apsen Publication; 1999. p.311-29. [Crossref] 
  57. Koozehchian MS, Daneshfar A, Fallah E, Agha-Alinejad H, Samadi M, Kaviani M, et al. Effects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power, and exercise-induced oxidative stress in resistance-trained males. J Exerc Nutrition Biochem. 2018;22(4):7-19. [Crossref] [PubMed] [PMC] 
  58. Bayram HM, Öztürkcan SA. Sporcularda ergojenik destekler [Ergogenic supplements in athletes]. Turkiye Klinikleri J Health Sci. 2020;5(3):641-52. [Crossref] 
  59. Gıda Gündemi [İnternet]. Copyright © 2021 [Erişim tarihi: 20.4.2021]. Sporcu içecekleri. Erişim linki: [Link] 
  60. Anonim. 2020b. Resmî Gazete. (16.08.2013 Sayı: 28737) Tebliğ no: 49. Türk Gıda Kodeksi Takviye Edici Gıdalar Tebliği (Tebliği no: 49); 2013. [Link] 
  61. Harnack LJ, Rydell SA, Stang J. Prevalence of use of herbal products by adults in the Minneapolis/St Paul, Minn, metropolitan area. Mayo Clin Proc. 2001;76(7):688-94. [Crossref] [PubMed] 
  62. Atalay D, Erge HS. Gıda takviyeleri ve sağlık üzerine etkileri. [Dietary supplements and their effects on health]. Food and Health. 2018;4(2): 98-111. [Crossref] 
  63. Resmî Gazete. (02.07.2019 Sayı: 30819) Türk Gıda Kodeksi Bebek Formülleri ve Devam Formülleri Tebliği (Tebliğ no: 14); 2019. [Link] 
  64. Serban MC, Sahebkar A, Mikhailidis DP, Toth PP, Jones SR, Muntner P, et al. Impact of L-carnitine on plasma lipoprotein(a) concentrations: A systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2016;6:19188. [Crossref] [PubMed] [PMC] 
  65. Gonwa TA, Wadei HM. Kidney disease in the setting of liver failure: core curriculum 2013. Am J Kidney Dis. 2013;62(6):1198-212. [Crossref] [PubMed] 
  66. Malaguarnera M. Acetyl-L-carnitine in hepatic encephalopathy. Metab Brain Dis. 2013;28(2):193-9. [Crossref] [PubMed] 
  67. Abbasnezhad A, Choghakhori R, Kashkooli S, Alipour M, Asbaghi O, Mohammadi R. Effect of L-carnitine on liver enzymes and biochemical factors in hepatic encephalopathy: a systematic review and meta-analysis. J Gastroenterol Hepatol. 2019;34(12):2062-70. [Crossref] [PubMed] 
  68. Shang R, Sun Z, Li H. Effective dosing of L-carnitine in the secondary prevention of cardiovascular disease: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2014;21;14:88. [Crossref] [PubMed] [PMC] 
  69. Kriston L, von Wolff A, Westphal A, Hölzel LP, Härter M. Efficacy and acceptability of acute treatments for persistent depressive disorder: a network meta-analysis. Depress Anxiety. 2014;31(8):621-30. [Crossref] [PubMed] 
  70. Martí-Carvajal AJ, Gluud C, Arevalo-Rodriguez I, Martí-Amarista CE. Acetyl-L-carnitine for patients with hepatic encephalopathy. Cochrane Database Syst Rev. 2019;5;1(1):CD011451. [Crossref] [PubMed] [PMC] 
  71. Georgala S, Schulpis KH, Georgala C, Michas T. L-carnitine supplementation in patients with cystic acne on isotretinoin therapy. J Eur Acad Dermatol Venereol. 1999;13(3):205-9. [Crossref] [PubMed] 
  72. Malaguarnera M, Gargante MP, Russo C, Antic T, Vacante M, Malaguarnera M, et al. L-carnitine supplementation to diet: a new tool in treatment of nonalcoholic steatohepatitis--a randomized and controlled clinical trial. Am J Gastroenterol. 2010;105(6):1338-45. [Crossref] [PubMed] 
  73. Lim CY, Jun DW, Jang SS, Cho WK, Chae JD, Jun JH. Effects of carnitine on peripheral blood mitochondrial DNA copy number and liver function in non-alcoholic fatty liver disease. Korean J Gastroenterol. 2010;55(6):384-9. [Crossref] [PubMed] 
  74. Malaguarnera M, Vacante M, Giordano M, Motta M, Bertino G, Pennisi M, et al. L-carnitine supplementation improves hematological pattern in patients affected by HCV treated with Peg interferon-α 2b plus ribavirin. World J Gastroenterol. 2011;21;17(39):4414-20. [Crossref] [PubMed] [PMC] 
  75. Pirmadah F, Ramezani-Jolfaie N, Mohammadi M, Talenezhad N, Clark CCT, Salehi-Abargouei A. Does L-carnitine supplementation affect serum levels of enzymes mainly produced by liver? A systematic review and meta-analysis of randomized controlled clinical trials. Eur J Nutr. 2020;59(5):1767-83. [Crossref]  [PubMed] 
  76. Derosa G, Maffioli P, Ferrari I, D'Angelo A, Fogari E, Palumbo I, et al. Comparison between orlistat plus L-carnitine and orlistat alone on inflammation parameters in obese diabetic patients. Fundam Clin Pharmacol. 2011;25(5):642-51. [Crossref] [PubMed] 
  77. Samimi M, Jamilian M, Ebrahimi FA, Rahimi M, Tajbakhsh B, Asemi Z. Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf). 2016;84(6):851-7. [Crossref] [PubMed] 
  78. Ahmadi S, Dehghan Banadaki S, Mozaffari-Khosravi H. Effects of oral L-carnitine supplementation on leptin and adiponectin levels and body weight of hemodialysis patients: a randomized clinical trial. Iran J Kidney Dis. 2016;10(3):144-50. [PubMed] 
  79. Mohammadi H, Djalali M, Daneshpazhooh M, Honarvar NM, Chams-Davatchi C, Sepandar F, et al. Effects of L-carnitine supplementation on biomarkers of oxidative stress, antioxidant capacity and lipid profile, in patients with pemphigus vulgaris: a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr. 2017;23. [Crossref] [PubMed] 
  80. Talenezhad N, Mohammadi M, Ramezani-Jolfaie N, Mozaffari-Khosravi H, Salehi-Abargouei A. Effects of L-carnitine supplementation on weight loss and body composition: a systematic review and meta-analysis of 37 randomized controlled clinical trials with dose-response analysis. Clin Nutr ESPEN. 2020;37:9-23. [Crossref] [PubMed] 
  81. Tekin T, Ayaz A. L-karnitin depresyon üzerinde etkili midir? [Is L-carnitine effective on depression?]. SDU Journal of Health Science Institute. 2020;11(1):100-6. [Link] 
  82. Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G. Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Urology. 2004;63(4):641-6. [Crossref] [PubMed] 
  83. Cruciani RA, Dvorkin E, Homel P, Culliney B, Malamud S, Shaiova L, et al. L-carnitine supplementation for the treatment of fatigue and depressed mood in cancer patients with carnitine deficiency: a preliminary analysis. Ann N Y Acad Sci. 2004;1033:168-76. [Crossref] [PubMed] 
  84. Jamilian H, Jamilian M, Samimi M, Afshar Ebrahimi F, Rahimi M, Bahmani F, et al. Oral carnitine supplementation influences mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Gynecol Endocrinol. 2017;33(6):442-7. [Crossref] [PubMed] 
  85. Zanardi R, Smeraldi E. A double-blind, randomised, controlled clinical trial of acetyl-L-carnitine vs. amisulpride in the treatment of dysthymia. Eur Neuropsychopharmacol. 2006;16(4):281-7. [Crossref] [PubMed] 
  86. Martinotti G, Andreoli S, Reina D, Di Nicola M, Ortolani I, Tedeschi D, et al. Acetyl-L-carnitine in the treatment of anhedonia, melancholic and negative symptoms in alcohol dependent subjects. Prog Neuropsychopharmacol Biol Psychiatry. 2011;1;35(4):953-8. [Crossref] [PubMed] 
  87. Ruggenenti P, Cattaneo D, Loriga G, Ledda F, Motterlini N, Gherardi G, et al. Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy. Hypertension. 2009;54(3):567-74. [Crossref] [PubMed] 
  88. Hatanaka Y, Higuchi T, Akiya Y, Horikami T, Tei R, Furukawa T, et al. Prevalence of carnitine deficiency and decreased carnitine levels in patients on hemodialysis. Blood Purif. 2019;47 Suppl 2:38-44. [Crossref] [PubMed] 
  89. Van Oudheusden LJ, Scholte HR. Efficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorder. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2002;67(1):33-8. [Link] 
  90. Tashiro K, Kaida Y, Yamagishi SI, Tanaka H, Yokoro M, Yano J, et al. L-carnitine supplementation improves self-rating depression scale scores in uremic male patients undergoing hemodialysis. Lett Drug Des Discov. 2017;14(6):737-42. [PubMed] [PMC] 
  91. Miwa T, Hanai T, Morino K, Katsumura N, Shimizu M. Effect of l-carnitine supplementation on muscle cramps induced by stroke: A case report. Nutrition. 2020;71:110638. [Crossref] [PubMed] 
  92. Gürses VV, Baydil B, Akgül MŞ, Ceylan B. Akut aerobik egzersiz öncesi L-karnitin alınımının kan yağları üzerine etkisi. [The effect of l-carnitine intake before acute aerobic exercise on blood lipids]. International Journal of Cultural and Social Studies. 2018;4(1):70-6. [Link] 
  93. Lee BJ, Lin JS, Lin YC, Lin PT. Antiinflammatory effects of L-carnitine supplementation (1000 mg/d) in coronary artery disease patients. Nutrition. 2015;31(3):475-9. [Crossref] [PubMed] 
  94. Yildirim S, Yildirim A, Dane S, Aliyev E, Yigitoglu R. Dose-dependent protective effect of L-carnitine on oxidative stress in the livers of hyperthyroid rats. Eurasian J Med. 2013;45(1):1-6. [PubMed] [PMC] 

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E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com