Document Type : Review Article


Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch. Islamic Azad University, Tehran, Iran.


Colorectal cancer is the most common type of gastrointestinal cancer that results from abnormalities or changes in the genome and uncontrolled cell proliferation. Carnitine is a potent antioxidant that may result in an increase in cellular respiration, apoptosis, a reduction in proliferation and inflammation of tumor cells by various mechanisms. The present study was conducted to summarize the effects of carnitine on the treatment or prevention of colorectal cancer. The review was conducted with the following words "L-carnitine" in combination with colorectal cancer, neoplasm, colon, rectum, apoptosis, inflammation and precancerous lesions among animal and in vitro studies. From six interventional studies investigated in this article, one of them was performed on two groups of mice having precancerous lesions and macroscopic colonic tumors divided into AOM and APC groups and five other studies on adenocarcinoma cell lines of NCOL-1, Caco-2, HT-29, and SW480. One of them also was performed on DMH-induced colon carcinogenesis mouse model. These studies reported significant increment in the amount of the fatty acid transportation into the mitochondria; generation of mitochondrial superoxide anions (O2-), apoptosis and cell death in cells which were exposed by L-carnitine. An increment was also observed in pro-apoptotic proteins Caspase, Bak and Bax and reduction in anti-apoptotic proteins Bcl-Xl. In these studies, cellular inflammation which was associated with products of the cyclooxygenase enzyme pathway, and cancer cell proliferation was reduced as well and there was an increment in DNA fragmentation. The aberrant crypt foci development and pre-cancerous lesions were significantly inhibited by carnitine in the colons of the studied mice but did not exert protective effects on their intestinal tumors. L-carnitine may have potential anticancer effects and inhibits the progression of macroscopic and pre-cancerous tumors and prevents the growth and proliferation of cancerous cells.


  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer. 2015;136(5):E359-E86.
  2. WHO. Global health observatory. 2015. [Available from:].
  3. WHO. Noncommunicable disease (NCD) country profiles (Iran) 2014. [Available from:].
  4. Fateh S, AMINI M. An epidemiologic study of colorectal cancer in Arak during 1994-2004. Iranian Journal of Surgery. 2008;16(2):11- 7.
  5. Corman ML, Corman ML. Colon and Rectal Surgery. 2005.
  6. IARC. GLOBOCAN 2008: Cancer incidence and mortality worldwide. 2010. [Available from:].
  7. Fauci A. Harrison's gastroenterology and hepatology: McGraw-Hill Professional; 2010.
  8. WHO. Cancer Country Profiles (Iran) in 2014. 2016 [Available from:].
  9. Azizi F, Hatami H, Janghorbani M. Epidemiology and control of common diseases in Iran. Tehran: Eshtiagh Publications. 2000:602-16.
  10. WHO. Cancer 2018 [Available from:
  11. Jansman F, Postma M. Costs of chemotherapy in the treatment of colorectal cancer. The European Journal of Health Economics. 2006;7(2):145-6.
  12. Byford S, Torgerson DJ, Raftery J. Cost of illness studies. British Medical Journal. 2000;320(7245):1335.
  13. Cotran R, Kumar V, Collins T. Robinson pathologic basis of disease 6th Ed, Philadelphia. W. B Saunders company; 1999.
  14. Becker N. Epidemiology of colorectal cancer. Der Radiologe. 2003;43(2):98-104.
  15. Movahedi M, Bishop T, Barrett J. Association between alcohol, dietary factors and subsites of colorectal cancer: An ecological study. Yafteh. 2006;8(1):53-60.
  16. Han-Shiang C. Curative resection of colorectal adenocarcinoma: multivariate analysis of 5-year follow-up. World Journal of Surgery. 1999;23(12):1301-6.
  17. Tariq K, Ghias K, medicine. Colorectal cancer carcinogenesis: a review of mechanisms. Cancer Biology. 2016;13(1):120.
  18. Reuter SE, Evans AM. Carnitine and acylcarnitines. Clinical Pharmacokinetics. 2012;51(9):553-72.
  19. Dionne S, Elimrani I, Roy M-J, Qureshi IA, Sarma DR, Levy E, et al. Studies on the chemopreventive effect of carnitine on tumorigenesis in vivo, using two experimental murine models of colon cancer. Nutrition and Cancer Biology. 2012;64(8):1279-87.
  20. Penn D, Dolderer M, Schmidt-Sommerfeld E. Carnitine concentrations in the milk of different species and infant formulas. Neonatology. 1987;52(2):70-9.
  21. İzgüt-Uysal VN, Bülbül M, Tan R, Üstünel İ, Ağar A, Yargiçoğlu P. Effect of chronic stress and L-carnitine on rat stomach. The Journal of Physiological Sciences. 2007;57(3):187-92.
  22. Steiber A, Kerner J, Hoppel CL. Carnitine: a nutritional, biosynthetic, and functional perspective. Molecular Aspects of Medicine. 2004;25(5-6):455-73.
  23. Gülçin İ. Antioxidant and antiradical activities of L-carnitine. Life Sciences. 2006;78(8):803-11.
  24. Flanagan JL, Simmons PA, Vehige J, Willcox MD, Garrett Q. Role of carnitine in disease. Nutrition and Metabolism. 2010;7(1):30.
  25. Roy M-J, Dionne S, Marx G, Qureshi I, Sarma D, Levy E, et al. In vitro studies on the inhibition of colon cancer by butyrate and carnitine. Nutrition. 2009;25(11-12):1193-201.
  26. Wenzel U, Nickel A, Daniel H. Increased mitochondrial palmitoylcarnitine/carnitine countertransport by flavone causes oxidative stress and apoptosis in colon cancer cells. Cellular Molecular Life Sciences. 2005;62(24):3100-5.
  27. Wenzel U, Nickel A, Daniel H. Increased carnitine-dependent fatty acid uptake into mitochondria of human colon cancer cells induces apoptosis. The Journal of Nutrition. 2005;135(6):1510-4.
  28. Elimrani I, Dionne S, Saragosti D, Qureshi I, Levy E, Delvin E, et al. Acetylcarnitine potentiates the anticarcinogenic effects of butyrate on SW480 colon cancer cells. International Journal of Oncology. 2015;47(2):755-63.
  29. Roscilli G, Marra E, Mori F, Di Napoli A, Mancini R, Serlupi‐Crescenzi O, et al. Carnitines slow down tumor development of colon cancer in the DMH‐chemical carcinogenesis mouse model. Journal of Cellular Biochemistry. 2013;114(7):1665-73.
  30. Madiraju P, Pande SV, Prentki M, Madiraju SM. Mitochondrial acetylcarnitine provides acetyl groups for nuclear histone acetylation. Epigenetics. 2009;4(6):399-403.
  31. Calabrese, V., Stella, A. M. G., Calvani, M. & Butterfield, D. A. Acetylcarnitine and cellular stress response: roles in nutritional redox homeostasis and regulation of longevity genes. The Journal of Nutritional Biochemistry 17, 73-88 (2006).