Is Levocarnitine Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Levocarnitine? Is Levocarnitine safe for nursing mother and child? Does Levocarnitine extracts into breast milk? Does Levocarnitine has any long term or short term side effects on infants? Can Levocarnitine influence milk supply or can Levocarnitine decrease milk supply in lactating mothers?

Amino acid that is present in many foods, among them the milk. Indication is the treatment of Primary Deficiency of Carnitine, or, Secondary Deficiency due to Hemolysis, Myocardiopathy and other diseases. Only Levocarnitine is effective as a supplement, with the consumption of D-carnitine regarded as a risk for deficiency. Normal levels in the milk are not modified by the consumption of supplements of Carnitine. Mean concentration level within the first month is about 10 to 12 mg/L, with lower levels in the next following months. The supplementation with Carnitine of the milk for premature infants does not improve their weight increment, with no proof of a beneficial effect.

Levocarnitine and acetyl-l-carnitine (acetlycarnitine) are normal components of human milk that are required for fat metabolism. The body can use only levocarnitine, and dextrocarnitine can be an antagonist of levocarnitine. Acetyl-l-carnitine, and propionyl-l-carnitine can be converted to levocarnitine by the body. The bioavailability of levocarnitine is less than 20%, but acetylcarnitine and propionlycarnitine may be higher. These substances have no specific lactation-related uses. Within the normal range of dietary intake, excretion of levocarnitine into breastmilk is relatively constant. Women with carnitine deficiency appear to secrete insufficient amounts of carnitine into their breastmilk for their breastfed infants, who may require levocarnitine supplementation.[1] Preterm infants are often deficient in levocarnitine and require supplementation.[2] No data exist on the safety and efficacy levocarnitine supplementation in nursing mothers or infants without carnitine deficiency. Levocarnitine and its derivatives are generally well tolerated in adults with occasional gastrointestinal upset and restlessness. A fishy odor to the breath, sweat and urine has been reported. Although data are very limited, poor bioavailability might limit absorption by the breastfed infant. It appears unlikely that maternal levocarnitine supplements during nursing would be harmful to the infant, but until more data are available, it is probably best to avoid levocarnitine supplementation unless it is prescribed by a healthcare professional. Pasteurization (method not stated) had little effect on the concentration of endogenous carnitine in one study. Pasteurization followed by refrigeration at 5 degrees C for 48 hours reduced the carnitine concentration by about 13%.[3]