Acetyl L-Carnitine (ALCAR) for chronic hoof pain

The many faces of ALCAR – part 1

Previously, we talked about supercharging your jiaogulan by adding AAKG. But what if your horse is still footsore? Try acetyl l-carnitine (ALCAR)

In 2007, Jones et al, published a study, which describes the changes that occur within the digital nerve for horses with laminitis. The study also described how the number of nerve fibers was reduced, along with an increase in the markers for nerve damage (1). The changes were consistent with neuropathic pain that is found in other disease states. For horses that experienced extended periods of time that the horse experienced hoof pain, the nerve change still existed, even after the hoof was healed. The pain signals emanated from the damaged nerve and not from the hoof (2).

In cases like these, jiaogulan can help, but not completely restore the horse to comfort.  This is where Acetyl L-Carnitine (ALCAR) may be helpful. Studies have shown that ALCAR affects neuropathic pain in the following ways:

Changes to the nerve

  • Increases nerve function by increasing conduction velocity
  • Reduces the rate of nerve fiber loss (3)
  • Promotes nerve regeneration
  • Changes to the receptors located on the nerves (4, 5)
  • Is neuroprotective from further damage (6)

Offers pain relief via

  • Modulating the receptors on the nerve itself
  • Modulating receptors at the level of the dorsal root ganglion
  • Activating receptors in the brain which reduces the sensation of pain

These results are not immediate, but occur over a period of time (5, 7).

Take Home Message:

When your horse is experiencing hoof pain, acetyl l-carnitine may help preserve the nerves from damage, help restore the receptors on the nerve, and help to relief current neuropathic pain.

It’s important to start early and continue with use, as these are long-term effects, not short term effects.


  1. Jones E, Viñuela-Fernandez I, Eager RA, Delaney A, Anderson H, Patel A, et al. Neuropathic changes in equine laminitis pain. Pain. 2007;132(3):321-31.
  2. Driessen B, Bauquier SH, Zarucco L. Neuropathic pain management in chronic laminitis. Vet Clin North Am Equine Pract. 2010;26(2):315-37.
  3. Kopsky DJ, Hesselink JM. Nerve regeneration in neuropathic pain. Pain Med. 2010;11(10):1576.
  4. Formaggio F, Rimondini R, Delprete C, Scalia L, Merlo Pich E, Liguori R, et al. L-Acetylcarnitine causes analgesia in mice modeling Fabry disease by up-regulating type-2 metabotropic glutamate receptors. Mol Pain. 2022;18:17448069221087033.
  5. Sarzi-Puttini P, Giorgi V, Di Lascio S, Fornasari D. Acetyl-L-carnitine in chronic pain: A narrative review. Pharmacol Res. 2021;173:105874.
  6. Tomassoni D, Di Cesare Mannelli L, Bramanti V, Ghelardini C, Amenta F, Pacini A. Treatment with acetyl-L-carnitine exerts a neuroprotective effect in the sciatic nerve following loose ligation: a functional and microanatomical study. Neural Regen Res. 2018;13(4):692-8.
  7. Chiechio S, Copani A, Gereau RW, Nicoletti F. Acetyl-L-carnitine in neuropathic pain: experimental data. CNS Drugs. 2007;21 Suppl 1:31-8; discussion 45-6.


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